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Morning Briefing

Summaries of health policy coverage from major news organizations

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Friday, Aug 18 2017

吃瓜不打烊 Original Stories 4

  • Podcast: 'What The Health?' Why Is It So Difficult To Control Drug Prices?
  • Medicare Unveils 鈥楽keletal鈥 Site For Hospice Comparison Shopping
  • Opioid Crisis Strains Foster Care System; Programs Aim To Keep Kids With Mom
  • Gun Sellers Join Forces To Curb Suicide-By-Firearm, Rampant In Rural Areas

Capitol Watch 2

  • Congressional Clock Is Ticking On Efforts To Shore Up Obamacare Insurance Markets
  • House Democrats Push Pharmaceutical Companies To Explain High Costs Of MS Drugs

Health Law 1

  • Former HHS Sec. Sebelius Says Trump Administration Still 'Working To Engineer' ACA's Failure

Marketplace 1

  • Trump's Mar-A-Lago Club Loses Fundraising Galas Of Cleveland Clinic And American Cancer Society

Public Health 3

  • Post-Surgical Patients Are Rarely The Ones Who Start Long-Term Opioid Use
  • 'DNA Surgery': Scientists Try Gene Editing In Human Embryos
  • Guns Account For Higher Suicides Rates In Rural Areas Over Urban Ones, Study Finds

Veterans' Health Care 1

  • Trump Signs Law To Aid WWII Vets Exposed To Mustard Gas

State Watch 3

  • Large Mass. Health Care System Drops Out Of Networks Being Planned For Medicaid
  • Colorado Hospital President Resigns After Managing Transition To New Owner
  • State Highlights: Conn. Medical Society Gets Impatient, Starts Own Health Information Exchange; Mo. Families Struggle With Home-Care Cuts

Health Policy Research 1

  • Research Roundup: Labor Force Participation After The ACA; Childhood Firearm Injuries

Editorials And Opinions 2

  • Perspectives On Health Reform: Trump Should Help The Health Law; GOP Isn't Living Up To Its Obamacare Promises
  • Viewpoints: Californians Need Safe Water; A Simple Way To Save People From Overdosing

From 吃瓜不打烊 - Latest Stories:

吃瓜不打烊 Original Stories

Podcast: 'What The Health?' Why Is It So Difficult To Control Drug Prices?

In this episode of 鈥淲hat the Health?鈥 Mary Agnes Carey of Kaiser Health News, Sarah Karlin-Smith of Politico, Margot Sanger-Katz of The New York Times and Julie Appleby of Kaiser Health News discuss the recent extension of cost-sharing subsidies for millions of low-income beneficiaries on the Affordable Care Act鈥檚 marketplaces and the state of play on Capitol Hill and in the states concerning initiatives to lower prescription drug costs. ( 8/17 )

Medicare Unveils 鈥楽keletal鈥 Site For Hospice Comparison Shopping

This is the first federal website designed to help families choose a hospice, but experts aren鈥檛 impressed. ( Melissa Bailey , 8/18 )

Opioid Crisis Strains Foster Care System; Programs Aim To Keep Kids With Mom

One Kentucky program is eyed by other jurisdictions as a way to get addicted parents into recovery and help them care for their children at home. ( Shefali Luthra , 8/18 )

Gun Sellers Join Forces To Curb Suicide-By-Firearm, Rampant In Rural Areas

New research suggests that efforts to address climbing rates of rural suicide must focus on safe access to firearms. State-based coalitions are attempting just that. ( Shefali Luthra , 8/17 )

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Summaries Of The News:

Capitol Watch

Congressional Clock Is Ticking On Efforts To Shore Up Obamacare Insurance Markets

Though some senators say they are cautiously optimistic, it is not yet clear if lawmakers will be able to reach agreement before a self-imposed mid-September deadline. Meanwhile, the outcome of the trial of Sen. Robert Menendez (D-N.J.) could have a serious impact on the Senate's balance of power and the outcome of major legislative battles, such as efforts to either repeal and replace the Affordable Care Act, or to fix it. News outlets also report on specific health policy positions of various senators and KHN's weekly "What The Health?" podcast reports on all the Capitol Hill health-policy goings on.

The leaders of a key Senate committee say they are cautiously optimistic about reaching a deal to shore up the Affordable Care Act鈥檚 individual marketplaces, but even with a bipartisan effort, it is far from certain whether they can push out an agreement in time. The Senate Health, Education, Labor and Pensions Committee leaders of both parties have set a self-imposed mid-September deadline for a bipartisan agreement. To keep lingering animosity from the Obamacare repeal fight from seeping into negotiations, Chairman Lamar Alexander has made clear that what he鈥檚 seeking is far from comprehensive. (Reid, 8/18)

If Mr. Menendez, a Democrat, is convicted and then expelled from the United States Senate by early January, his replacement would be picked by Gov. Chris Christie, the Republican governor of New Jersey and an ally of President Trump. That scenario 鈥 where Mr. Menendez鈥檚 interim replacement would more than likely be a Republican 鈥 would have immediate and far-reaching implications: The Republicans would be gifted a crucial extra vote just as the party remains a single vote shy in the Senate of advancing its bill to dismantle President Obama鈥檚 signature health care law. (Goldmacher, 8/17)

Sen. Joni Ernst says she wants the federal government to continue making payments for Obamacare subsidies to health insurance companies. President Trump has repeatedly threatened to stop making "cost-sharing reduction" payments. That uncertainty has led the only health insurance company left on Iowa鈥檚 exchange to propose a nearly 57 percent rate hike for 2018. (Sostaric, 8/17)

Sen. Ron Johnson (R-Wis.) wants information about why members of Congress and their staff receive an employer contribution toward their health coverage, which critics have dubbed an ObamaCare "congressional exemption." Johnson's request asks the Office of Personnel Management to preserve records related to the "exemption." (Roubein, 8/17)

Mary Agnes Carey of Kaiser Health News, Sarah Karlin-Smith of Politico, Margot Sanger-Katz of The New York Times and Julie Appleby of Kaiser Health News discuss the recent extension of cost-sharing subsidies for millions of low-income beneficiaries on the Affordable Care Act鈥檚 marketplaces 鈥 as well as the state of play on Capitol Hill and in the states concerning efforts to lower prescription drug costs. (8/17)

House Democrats Push Pharmaceutical Companies To Explain High Costs Of MS Drugs

Two Democratic lawmakers, Rep. Elijah Cummings of Maryland and Rep. Peter Welch of Vermont, are pressing Bayer, Biogen, EMD Serono, Novartis, Sanofi, Teva, and Roche Pharmaceuticals for an explanation of the pricing strategies and whether companies were increasing prices as part of a coordinated effort.

U.S. House Democrats said on Thursday they were launching an investigation into why prices for Multiple Sclerosis (MS) treatments have nearly quintupled since 2004, and they sent letters requesting information from seven drugmakers. (Erman, 8/17)

Two Democratic lawmakers are pressing major pharmaceutical companies to explain their pricing strategies for multiple sclerosis drugs. Reps. Elijah Cummings of Maryland and Peter Welch of Vermont wrote to Bayer, Biogen, EMD Serono, Novartis, Sanofi, Teva, and Roche Pharmaceuticals to request documents that reference pricing strategies. They also asked for information about corporate profits, expenses, patient assistance programs, and drug distribution systems. (Mershon, 8/17)

Health Law

Former HHS Sec. Sebelius Says Trump Administration Still 'Working To Engineer' ACA's Failure

In other news, Rhode Island regulators have approved health insurance premium rates for 2018.

President Donald Trump and Republican congressional leaders came up short in their initial efforts to repeal the Affordable Care Act, but former Health and Human Services Secretary Kathleen Sebelius says they鈥檙e still working to engineer its failure. In a recent interview, Sebelius, who spearheaded implementation of the ACA, said she knows that the law isn鈥檛 perfect. But she said it would be working better if Republicans would stop undermining it. (McLean, 8/17)

Rhode Island officials have approved health insurance premium rates for 2018, giving the OK to increases ranging from 5 percent to 12.1 percent. Marie Ganim, the state health insurance commissioner, said Thursday that approved rates were in some cases lower than the insurance companies had requested. She says that will save consumers nearly $17 million. (8/18)

Marketplace

Trump's Mar-A-Lago Club Loses Fundraising Galas Of Cleveland Clinic And American Cancer Society

Both organizations announce that they will move fundraising events in Florida following events since the Charlottesville violence. The Cleveland Clinic's decision is a reversal after organization leaders resisted earlier calls to pull its annual gala from Donald Trump's resort.

The Cleveland Clinic and the American Cancer Society said they will not hold annual fundraising galas at President Trump鈥檚 Mar-a-Lago resort in Florida amid intense criticism over the president鈥檚 reluctance to denounce white nationalist groups. The announcements come as businesses have faced increasing pressure to distance themselves from Trump, who has been sharply criticized for his equivocal response to the deadly violence in Charlottesville, Va. The clinic鈥檚 decision, which was announced Thursday, was a reversal from聽its prior commitment聽to keep the event. (Ross, 8/17)

A leading U.S. hospital pulled its annual fundraiser from Donald Trump鈥檚 Mar-a-Lago resort on Thursday, reversing course after initially resisting pressure from health professionals and others over the president鈥檚 support for repealing the Affordable Care Act and cutting federal budget dollars to medical research. (Carr Smyth, 8/17)

The Cleveland Clinic will聽no longer hold its annual fundraising gala at President Trump鈥檚 Mar-a-Lago club in Florida. "After careful consideration, Cleveland Clinic has decided that it will not hold a Florida fundraiser at Mar-a-Lago in 2018," the hospital system said in a statement, according to Cleveland.com. "We thank the staff of Mar-a-Lago for their service over the years." (Lorenz, 8/17)

Public Health

Post-Surgical Patients Are Rarely The Ones Who Start Long-Term Opioid Use

Its more common for those who receive their first prescription for back pain or 鈥渙ther ill-defined conditions鈥 to go on to use painkillers for six months or more, according to new research. In other news related to the national epidemic, the Cherokee Nation asks a judge to allow its lawsuit against opioid distributors and retailers to be heard in the tribe's own court. And KHN reports that the public health crisis is taking a toll on the nation's foster care system.

Don鈥檛 blame the nation鈥檚 surgeons for an opiate-abuse crisis that now claims 142 lives daily in the United States. New research suggests that patients leaving the hospital after surgeries or inpatient procedures are rarely the ones whose long-term opioid use started with a doctor鈥檚 prescription. Instead, the patients who most frequently go on to use opioid medications for six months or more got their first prescription for some sort of back pain, or for pain described in medical code as 鈥渙ther ill-defined conditions,鈥 according to a research letter published Wednesday in the journal JAMA Surgery. (Healy, 8/17)

The Cherokee Nation is urging a federal judge to allow a tribal lawsuit against distributors and retailers of opioid medications to be litigated in the tribe鈥檚 own court. Cherokee Nation Attorney General Todd Hembree has filed written arguments with U.S. District Judge Terence Kern in a lawsuit that alleges the companies have contributed to 鈥渁n epidemic of prescription opioid abuse鈥 among the tribe鈥檚 citizens. The lawsuit alleges that six distribution and pharmaceutical companies have created conditions in which 鈥渧ast amounts of opioids have flowed freely from manufacturers to abusers and drug dealers鈥 within the tribe鈥檚 territory. (8/18)

Data from the U.S. Department of Health and Human Services show that from October 2012 to September 2015, as addiction surged, the number of kids entering the foster system rose 8 percent. In recent years, experts suggest, the number has continued to climb, though data aren鈥檛 yet available to track that increase. Even before this epidemic, social systems struggled to meet demand. Now, the swell of kids needing care is putting new pressure on a network already stretched to capacity 鈥 both financially and in its ability to find homes and families that can take in displaced children. (Luthra, 8/18)

And in news from Indiana, New Hampshire, California and Missouri聽鈥

A hospital in a rural eastern Indiana county hit hard by opioid abuse is planning to start a drug detoxification unit emphasizing treatment for those diagnosed with HIV. Fayette Regional Hospital in Connersville says the 46-bed unit will provide treatment for about a week for patients with severe intoxication or withdrawal problems and mental health disorders. The unit is meant to stabilize the patient before moving to another treatment program. (8/18)

The Office of the Chief Medical Examiner is projecting at least 466 people will die from drug overdoses by year鈥檚 end 鈥 not quite as many as last year鈥檚 record of 486, but close. Chief Forensic Investigator Kim Fallon says officials make those projections using a formula that accounts for both confirmed and pending cases, as well as the months left in a given year. (McDermott, 8/17)

Emergency room visits stemming from opioid use increased by 141% in Orange County from 2005 to 2015, with large numbers of patients coming from Huntington Beach, Costa Mesa, Anaheim and Santa Ana, according to a study released this week by the Orange County Health Care Agency. More recently, between 2011 and 2015, 7,457 Orange County residents went to an emergency room for treatment of opioid addiction or overdose, according to the report. (Fry, 8/17)

From March 2013 to August 2015, central Missouri physician Justin LaMonda gave a patient a long list of drugs she didn鈥檛 need 鈥 including painkillers, anti-depressants, anti-anxiety medications and sedatives 鈥 without keeping records. ...Those were the findings of the Missouri State Board of Registration for the Healing Arts in an order handed down earlier this month that suspended LaMonda鈥檚 medical license for three years. (Marso, 8/17)

An Oak Park doctor is heading to prison after admitting she peddled more than $2 million in pain pills on the street聽so that she and her cohorts could make money, including two other doctors. Jennifer Franklin, 40, of Harrison Township, pleaded guilty Wednesday in U.S. District Court to writing prescriptions for oxycodone without any medical reason, admitting she made $200,000 in聽the scheme. She also聽acknowledged that the street value of the addictive painkiller聽she prescribed totaled more than $2 million. (Baldas, 8/17)

'DNA Surgery': Scientists Try Gene Editing In Human Embryos

NPR goes inside the lab that is working on embryonic research. In other public health news today are developments related to HIV, tuberculosis, Alzheimer's, maternal mortality and nicotine addiction.

Human eggs are the key starting point for the groundbreaking experiments underway in this lab. It's run by Shoukhrat Mitalipov, a biologist who's been on the cutting edge of embryonic genetic research for decades. Mitalipov and his international team electrified the world this summer when the group announced it had successfully 鈥 and seemingly safely 鈥 figured out how to efficiently edit the DNA in human embryos. (Stein, 8/18)

Kyle, a 29-year-old Sydneysider, never knew a time when HIV wasn鈥檛 a persistent and pernicious threat 鈥 until he began popping a pill to prevent it. The blue, oval-shaped antiviral tablet, known as Truvada, that Kyle takes daily is the subject of a study in Australia鈥檚 New South Wales state that, in less than a year, has helped drive new cases of the AIDS-causing human immunodeficiency virus among gay and bisexual men to the lowest since 1985. ...Thirty-six years after a rare lung infection in聽gay men in Los Angeles聽heralded the start of the AIDS epidemic in North America, the deadly disease is firmly in retreat globally. For the first time, more than half of all people living with HIV are on virus-suppressing treatment that staves off symptoms and prevents transmission. (Gale, 8/17)

These minty bacteria are genetically engineered relatives of Mycobacterium tuberculosis, the bacterium that kills 1.5 million people each year. Thankfully this strain 鈥 Mycobacterium smegmatis 鈥斅爄s harmless. But it鈥檚 a close enough cousin that scientists can use it as a proxy for the real thing. And though a mint-scented bacterium might seem like a silly achievement, it鈥檚 part of a serious strategy by a team of Harvard scientists to speed up discovery of a better tuberculosis vaccine. Their goal: to modify the germ so that it can be safely given to people to test a vaccine 鈥 and if the vaccine doesn鈥檛 work, that the participants can be cured. (Wosen, 8/18)

It鈥檚 neuroscience鈥檚 oldest and most acrimonious debate. On one side, scientists who aver that blasting away toxic plaques called amyloid is the best path toward treating Alzheimer鈥檚 disease. On the other, frustrated skeptics ready to ditch the amyloid hypothesis once and for all. But a parade of failed clinical trials has seeded a growing middle ground of agnostics and stoked a bevy of new research efforts, as 鈥渢he field in general 鈥 and our pharma colleagues 鈥 are recognizing that they need to think beyond amyloid,鈥 said Dr. David Knopman, a neurologist at the Mayo Clinic. (Garde, 8/18)

Safe Start, funded by the pharmaceutical giant Merck, is a small but innovative example of efforts to reverse a disturbing trend: While deaths as a complication of pregnancy have been falling around the globe, including in many poor countries, the U.S. maternal mortality rate has doubled since the 1990s. And Philadelphia鈥檚 rate is even higher than the national average. (McCullough, 8/17)

Nicotine replacement therapy products, which have been sold over the counter at drugstores since 1996, are effective only when paired with counseling, according to a UCSF study released Thursday. Without that, relying on such products can actually make it harder to kick tobacco, the study found. (Johnson, 8/17)

Guns Account For Higher Suicides Rates In Rural Areas Over Urban Ones, Study Finds

Suicides-by-firearm are 66 percent higher in thinly populated counties than in urban counties. There is little regional disparity in non-firearm suicide rates. In related news, experts target teens in suicide prevention efforts while the California prison system reports an increase in suicide attempts among women inmates.

Suicide rates are higher in rural counties, according to a new study, and the reason is firearm use by men. The report, in the American Journal of Public Health, used data on 6,196 suicides of Maryland residents over age 15. They found that the rate of firearm suicides was 66 percent higher in the most thinly populated counties than in metropolitan areas with populations greater than a million. Non-firearm suicide rates in rural and urban counties were roughly the same. (Bakalar, 8/17)

John Yule, 53, manages Wildlife Sport Outfitters, a hunting and fishing supplies store on the edge of Manchester, N.H., and is 鈥渄eeply involved in the Second Amendment community.鈥 But six years ago, while listening to a public radio story, Yule heard about a way he could tackle a familiar problem 鈥 the high rates of suicide in rural areas like some nearby in his state ... Now he鈥檚 part of a team of people on the front lines, trying a simple but radical approach to curb rates of suicide, the nation鈥檚 10th-leading cause of death. (Luthra, 8/17)

There are evidence-based ways to prevent suicide. The World Health Organization has a guide for how media professionals should talk about the subject. They should avoid sensationalizing it or normalizing it. They should be careful not to repeat accounts of suicide or to provide explicit descriptions as to how suicide might be attempted or completed. They should word headlines carefully, and avoid video or photos of suicides or the victims. (Carroll, 8/17)

Recent studies from Centers for Disease Control and Prevention (CDC) found that from 1999 to 2014, the overall U.S. suicide rate increased by 24 percent. ... And according to聽the CDC, suicide rates among 15- to 19-year-old girls doubled between 2007 and 2015, reaching a 40-year high. (Nibokun, 8/17)

California鈥檚 corrections department鈥檚 failure to prepare when it moved hundreds of high-security female inmates from a Central Valley prison to one in inland Southern California may have contributed to a recent spike in suicide attempts by women prisoners, according to a new state audit.聽Between 2013 and 2016, women made up 4 percent of the state鈥檚 prison population but accounted for 11 percent of the system鈥檚 suicides, according to the audit. (Ashton, 8/17)

Veterans' Health Care

Trump Signs Law To Aid WWII Vets Exposed To Mustard Gas

The legislation was advanced through Congress by Sen. Claire McCaskill (D-Mo.) and requires the Department of Veterans Affairs to reconsider denied disability benefits for those who claimed the testing caused health problems.

World War II veterans exposed to mustard gas by the military will find it easier to receive help under legislation President Donald Trump has signed into law. The St. Louis Post-Dispatch reports that Trump on Wednesday signed the legislation that Democratic Sen. Claire McCaskill, of Missouri, pushed through Congress. It requires the Veterans Affairs Department to reconsider disability benefits denied to those who claimed the testing caused health problems. (8/18)

The VA reassigned the head of the agency鈥檚 national health enrollment office in Atlanta and another employee pending the outcome of an investigation into racially charged messages that included mention of sending people to 鈥渢he ovens.鈥 The move comes after a report by the Atlanta Journal-Constitution and Channel 2 Action News this week about the messages between HEC Director Angel Lawrence and program analyst Nathan Jaco. (Schrade, 8/17)

State Watch

Large Mass. Health Care System Drops Out Of Networks Being Planned For Medicaid

UMass Memorial Health Care said it will continue to care for MassHealth patients but it won't join in the accountable care organizations being formed as the state revamps Medicaid. Meanwhile, a California health care system is moving some of its Medicaid patients to clinics instead, and Utah formally submits a request to the federal government for a limited Medicaid expansion for some homeless people.

Central Massachusetts鈥 largest health care provider has dropped out of a program to redesign the way the state pays for and manages health care for poorer residents, saying the financial risks are too great. The move makes UMass Memorial Health Care the state鈥檚 only large network of doctors and hospitals that will not participate in the restructuring of the Massachusetts Medicaid program, called MassHealth. (Dayal McCluskey, 8/17)

In Sacramento and Placer counties, roughly 10,000 adult Medi-Cal enrollees with Anthem Blue Cross are learning this summer that Sutter鈥檚 primary-care doctors will no longer see them. Instead, those patients are being shifted to primary-care doctors at community health centers such as Sacramento鈥檚 WellSpace Health or Auburn鈥檚 Chapa-De Indian Health, said Dr. Ken Ashley, the medical director for primary care at Sutter Medical Group. He said the change in providers will allow the patients to access more services. (Anderson, 8/17)

Utah asked the Trump administration this week to approve a limited Medicaid plan to help the homeless and those in need of mental health and drug addiction treatment. The plan is part of a state strategy to curb violence and drug trafficking in a Salt Lake City neighborhood near an overcrowded homeless shelter, but it鈥檚 a very limited alternative to expanding Utah鈥檚 Medicaid plans as offered under President Barack Obama鈥檚 health care law. (8/18)

Colorado Hospital President Resigns After Managing Transition To New Owner

News outlets look at hospital news across the country, including an analysis of how Tianqiao Chen's purchase of a large stake in Community Health Systems could affect that large chain.

The president and CEO of Longmont United Hospital is resigning, having completed a two-year management transition following the hospital鈥檚 purchase by Centura Health. Mitchell Carson, president and CEO of Longmont United, said in the news release that he had committed to leading the hospital through that changeover聽after Centura Health bought it in 2015. (Antonacci, 8/17)

Tianqiao Chen's聽22.1% stake聽in Community Health Systems could give him enough influence to encourage hospital sales at lower prices than what CHS has been demanding to accelerate CHS's divestiture strategy.聽Chen, through his Singapore-based Shanda Group affiliates, roared back on the public scene less than a week ago by buying 9.8 million more shares of CHS to raise his equity stake from 13.7% to 22.1%. (Barkholz, 8/17)

The U.S Department of Health and Human Services announced this week it is awarding nearly $4.8 million to 72 health centers across Texas to promote access to care, address disparity and maintain quality of care. Recipients included at least 10 centers or agencies in the Houston area. "Americans deserve a healthcare system that's affordable, accessible, of the highest 聽quality, with ample choices, driven by world-leading innovations, and responsive to the needs of the individual patients," said HHS Sec. Dr. Tom Price in a statement from the agency. (Deam, 8/17)

Federal officials say 29 health centers in Tennessee are receiving a total of more than $2 million to further improve quality, efficiency and effectiveness. The centers are chosen based on high levels of performance in categories including improving quality of care, increasing access to care, enhancing delivery of high-value health care, addressing health disparities and achieving patient-centered medical home recognition. (8/18)

Orlando Health is revamping its pediatric neurology and neurosurgery programs at its Winnie Palmer and Arnold Palmer hospitals in downtown Orlando, aiming to offer state-of-the-art procedures, such as fetal surgery. (Miller, 8/17)

State Highlights: Conn. Medical Society Gets Impatient, Starts Own Health Information Exchange; Mo. Families Struggle With Home-Care Cuts

Media outlets report on news from Connecticut, Missouri, Ohio, Massachusetts, Pennsylvania, Illinois, Texas, California, New Mexico, Oregon and Tennessee.

Frustrated that after 10 years of effort the state of Connecticut has yet to launch a functioning health information exchange (HIE) allowing physicians, hospitals and other health care providers to share patient medical records, the Connecticut Medical Society is offering one of its own. Available to all clinicians in the state and called CTHealthLink, it is based on a system currently used in Kansas. (Werth, 8/18)

Lawmakers approved a one-time funding fix aimed at avoiding cuts to the in-home care program in May, but it was vetoed by Gov. Eric Greitens. The bill passed the House with 83 votes 鈥 26 votes shy of a two-thirds majority needed to override a veto. Without the $35 million funding fix, the $27 billion state budget approved by lawmakers and signed by Greitens changes eligibility requirements for Missourians to qualify for in-home and nursing care services through Medicaid. Essentially, people are now required to display more severe disabilities to get state-funded care, a change that could eventually affect more than 8,000 Missourians. (Hancock and Montgomery, 8/18)

The Ohio Ballot Board approved language Thursday afternoon for how a prescription drug proposal will be presented on the Nov. 7 ballot, with no conflict between the sides lined up for and against Issue 2. Issue 2, if passed, would require Ohio to obtain the same discounts on prescription drugs as the prices obtained by the U.S. Veterans Administration - affecting an estimated 4 million Ohioans who get drugs in a range of state programs, such as Medicaid and state employee and retiree health care. (Hancock, 8/17)

Key members of the state鈥檚 alcohol industry are tempering expectations that a task force reviewing Massachusetts鈥 booze laws will deliver sweeping reforms to how beer, wine, and spirits are sold and distributed in Massachusetts, saying it鈥檚 more likely to result in modest tweaks. ... The list includes a number of highly controversial policy questions that have long divided businesses, health advocates, and policy makers. (Adams, 8/17)

Gov. Tom Wolf will nominate his insurance commissioner, Teresa Miller, to lead Pennsylvania鈥檚 Department of Human Services while he waits to see whether lawmakers will approve its merger with the Department of Health. Wolf made the announcement in an email to employees Thursday, and said the change in duties takes effect Monday. Wolf鈥檚 current human services secretary, Ted Dallas, is on medical leave. Wolf鈥檚 office says Dallas will take an advisory role to the governor when he returns to work. (8/18)

Former New York Mayor Michael Bloomberg is throwing his support behind a Chicago-area sweetened beverage tax by financing an ad campaign backing the levy. Bloomberg's charity announced Thursday that $2 million will be spent on television, radio and digital ads. The ads will contend the tax could help fight "the epidemic of childhood obesity and diabetes" and support Cook County hospitals and health programs. (8/18)

The number of medical residents and fellows providing care in Travis County clinics and hospitals is up by 30 percent since 2012, according to a report released this week by the University of Texas鈥 Dell Medical School. ... In 2016, there were 287 residents working in county clinics and hospitals, up from 218 in 2012, the community benefit report says.聽 (Goldenstein, 8/17)

Springfield Township is offering its residents a chance to get training so they would be ready to take care of neighbors and victims through the Community Emergency Response Team program. The training program trains volunteers to organize themselves and others at the disaster site, to provide immediate assistance to victims, and to collect disaster information to support responder efforts when help arrives. (Key, 8/17)

A federal judge has given the go-ahead to a lawsuit filed by the parents of an autistic teenager who was shot multiple times with a Taser after he stopped to tie his shoe on the lawn of a Missouri Highway Patrol trooper.聽U.S. District Judge Fernando Gaitan this week denied dismissal motions filed by the five law enforcement officials named as defendants in the case by the parents of Christopher Kramer. (Margolies, 8/17)

There is a strong link between education and student health, and Ohio is one of the least healthy states in the nation, representatives of the Health Policy Institute of Ohio told the Task Force on Education and Poverty, a panel designed to recommend ways to close a persistent achievement gap involving students in poverty. ... Neither state nor federal law requires schools to provide comprehensive health services to all students. (Siegel, 8/17)

In recent years, apparent double-suicides and murder-suicides have been capturing worldwide attention amid an emotional right-to-die debate 鈥 couples from Florida to聽Paris聽reportedly聽ending their lives together. Assisted suicide has summoned up deep religious and ethical concerns among critics. In the United States, the subject was widely debated in 2014, when a 29-year-old聽woman who had a fatal brain tumor聽moved from California to Oregon, where she could legally seek medical aid to end her life. California聽has since enacted its聽End of Life Option Act, joining a small number of states where it is legal. (Bever, 8/17)

The owner of a string of Houston home health care clinics was sentenced to 40 years in federal prison Thursday for a brazen scheme involving more than $17 million in fraudulent Medicaid and Medicare billing. "I'm not here to pass the buck," Godwin Oriakhi, who ran the five clinics, told U.S. District Judge Sim Lake before sentencing. "I never set out in any way to defraud the government." Defense lawyer Sean Ryan Buckley said prior to sentencing that Oriakhi did not live an opulent life but got caught up trying to pay expenses for his business. (Banks, 8/17)

Mitalipov and his international team electrified the world this summer when the group announced it had successfully 鈥 and seemingly safely 鈥 figured out how to efficiently edit the DNA in human embryos. For the first time, they said, they had corrected a mutation that causes a potentially fatal heart condition. (Stein, 8/18)

Missouri will use two of its 34 vials of the sedative pentobarbital on Tuesday when it executes Marcellus Williams, who was convicted in the 1998 killing of Felicia Gayle, a former St. Louis Post-Dispatch reporter. The state has enough pentobarbital for 17 executions, Williams鈥 included, according to a document obtained by St. Louis Public Radio. (Hunzinger, 8/18)

An Alhambra couple has filed a federal discrimination lawsuit against a former employer, alleging the company refused to provide spousal health insurance coverage because of their sexual orientation and rescinded previous coverage, leaving them with tens of thousands of dollars in medical bills. Judith Dominguez, 59, began working as a loan originator for Colorado-based Cherry Creek Mortgage at a branch office in Diamond Bar in 2016 and enrolled herself and her wife, Patricia Martinez, 55, in the UnitedHealthcare plan offered by the company. The couple had been covered for most of the year when, in November, Dominguez submitted her annual re-enrollment 鈥渆mployee + spouse鈥 forms. (Branson-Potts, 8/17)

Farmington officials say a resident of the northwestern New Mexico city has died of the West Nile virus, making him the first human fatality of the mosquito-borne disease in the state this year. Officials say it鈥檚 not known how the 61-year-old man contracted the virus and the city says it has an aggressive mosquito control program that includes treatment of standing water and weekly spraying at night. (8/18)

A Tennessee sheriff and judge violated the constitutional rights of jail inmates by promising to reduce their sentences if they underwent birth control procedures, an ex-inmate says in a federal lawsuit. Christel Ward was among the misdemeanor-level White County Jail inmates who took the deal, according to the lawsuit. She said Thursday that she still has the unwanted birth control device in her arm that authorities injected in her. 鈥淚 want this out of my arm, and I鈥檓 still not allowed to get it out until I pay,鈥 Ward said at a news conference. 鈥淚 can鈥檛 come up with $250 to get this out.鈥 (Mattise, 8/18)

Health Policy Research

Research Roundup: Labor Force Participation After The ACA; Childhood Firearm Injuries

Each week, KHN compiles a selection of recently released health policy studies and briefs.

In 2011 the Centers for Medicare and Medicaid Services (CMS) implemented a competitive bidding program to reduce spending on durable medical equipment and similar items. Previously, CMS had used prices in an administrative fee schedule to reimburse for these items. ... Our results suggest that the initial years of the program produced prices comparable to those obtained, on average, by large commercial insurers鈥攕ophisticated purchasers that presumably were able to negotiate prices with suppliers of durable medical equipment and similar items. (Newman, Barrette and McGraves-Lloyd, 8/1)

Women, the elderly, and minorities have been underrepresented in clinical trials. Risks and benefits of medical therapies, however, can vary based on these patient characteristics. ... Although the 2014 FDA Action Plan4 calls for examination of results by age, race and/or ethnicity, and sex, such analyses infrequently occur鈥攆ewer than 20% of all studies for original PMAs approved in 2015. (Dhruva et al., 7/24)

In a neuroimaging study, depression was not associated with a reduced neural impact of reward prediction errors in a nonlearning context. Depression also was not associated with a reduced emotional impact of reward prediction errors in a laboratory behavioral study and in a smartphone study with 1833 participants. Meaning: In moderate major depression, impacts of reward prediction errors that are linked to dopamine, known to be attenuated in a learning context, are intact in nonlearning tasks. (Rutledge et al., 7/5)

Our findings indicate that the majority of the increase in health insurance coverage since 2013 is due to the ACA. ... While labor market outcomes in the aggregate were not significantly affected, our results indicate that labor force participation reductions in areas with higher potential exchange enrollment were offset by increases in labor force participation in areas with higher potential Medicaid enrollment. (Duggan, Goda and Jackson, 7/1)

Fatal injuries were examined by using data from the National Vital Statistics System and nonfatal injuries by using data from the National Electronic Injury Surveillance System. ... Firearm-related deaths are the third leading cause of death overall among US children aged 1 to 17 years, surpassing the number of deaths from pediatric congenital anomalies, heart disease, influenza and/or pneumonia, chronic lower respiratory disease, and cerebrovascular causes. (Fowler et al., 7/1)

Editorials And Opinions

Perspectives On Health Reform: Trump Should Help The Health Law; GOP Isn't Living Up To Its Obamacare Promises

Opinion writers offer their thoughts on the issues facing the health law.

Yet the administration has stoked more uncertainty than it has allayed, leaving the health system in peril. The White House has been deciding month-to-month whether to keep important subsidy payments flowing to insurance companies 鈥 payments that were simply assumed during the Obama administration. Without these payments, insurers would have to jack up premiums or leave Obamacare markets next year. The CBO estimated Tuesday that average premiums would jump by 20 percent next year if the Trump administration pulled them. Moreover, because of how the payments interact with other elements of the health-care system, the government would end up losing money 鈥 $194 billion over a decade. (8/17)

Democrat obstruction is devastating for ordinary, hard-working Texans, making it difficult for government to function. However, after seven years of promises, I find it amazing and deeply disappointing that congressional Republicans are unable to govern in spite of holding both chambers of Congress. (Don Kirchoff, 8/17)

House and Senate GOP health-care plans, like Obamacare itself, have squawked loudly about subsidizing demand but said little about the supply of doctors, nurses and drugs. That is economic malpractice. It is also so 20th-century. ... An aging population is pushing up demand, and without more supply, prices will catapult higher. Doctors are aging, too: More than 30 percent are 60 or older. Forecasts project a physician shortage ranging from 46,000 to 90,000 by 2025, especially among specialists. Already, one quarter of the federal budget goes to Medicare and Medicaid. Taxpayers will find themselves frustrated with packed waiting rooms and higher taxes. So what can Washington do to help spark a supply-side shock in health care? (Todd G. Buchholz, 8/17)

Like repeal and replace, Medicare for All is catchy. It鈥檚 simple. It makes the incredibly complex problem of providing universal health insurance sound easy 鈥 Medicare for all! Like repeal and replace on the right, single-payer health care is also popular with the Democratic base and quickly getting more popular with time. ... But the fine print on Medicare for All is much more complex. For one thing, there is almost no fine print on congressional proposals to extend Medicare to the entire population. (Patricia Murphy, 8/17)

Those predisposed to like the Affordable Care Act are pointing to the dwindling number of counties in which no insurer is willing to sell insurance. The fear of numerous "bare counties" appears to have gone away. Their celebration is understandable: those predisposed to dislike the Affordable Care Act had cited the number of bare counties as evidence of Obamacare's implosion. But the argument over bare counties is only part of the story. ... Another sensible measure of ACA success is the affordability of the policies being sold. (Seth Chandler, 8/17)

ACA marketplaces may never work well in rural areas. Indeed some of the very same counties lack Medicare Advantage plans, and for some of the same reasons. These areas have too few people for real competition among insurers or among providers. These gaps are not a huge problem in Medicare. Why is that? Because Medicare has a powerful alternative to Medicare Advantage. It鈥檚 called traditional Medicare, but it might as well be labeled the public option. ... So here鈥檚 the irony: Trump Country really needs a way to bypass the ACA marketplaces entirely. So Democrats鈥 favorite policy option 鈥 the public option 鈥 would be most valuable in precisely the deep-red areas that went most fervently for Republicans and for the President. (Harold Pollack, 8/15)

Viewpoints: Californians Need Safe Water; A Simple Way To Save People From Overdosing

A selection of opinions on health care from around the country.

California鈥檚 wet winter eased the immediate water shortages that affected most of the state, giving lawmakers and water agencies a bit of a breather as they craft new policies and design new infrastructure to weather the next big drought (which, for all we know, may already be underway). But neither the rainfall nor the new projects and policies will help hundreds of thousands of Californians whose local water supply is contaminated. (8/18)

A vast majority of opioid deaths are preventable if the person overdosing is given naloxone, a safe, easy-to-use and relatively inexpensive drug that has successfully reversed tens of thousands of overdoses over the years. But this medicine is often not on hand when and where it is needed. Making it more readily available could save many lives. (Megan McLemore and Corey Davis, 8/18)

鈥淚鈥檓 detoxing.鈥 This is the sort of news that delights the families of patients who are addicted to heroin. The promise of a seven-day detox solution is seductive. But detoxification is actually extremely dangerous. Nearly every addict who successfully completes a week-long detox program without further treatment relapses, and in a world with increasingly powerful synthetic drugs on the market, the risk of overdosing and dying during a relapse has become ever more threatening. (Michael Stein, 8/17)

[O]verwhelming majorities in both chambers of the Legislature passed a bill [in June] called 鈥淟avern鈥檚 Law.鈥 Under it, cancer patients alleging malpractice would have twice as long to bring action: two and a half years. Critically, the clock would start running from the time they became aware of the misdiagnosis. By way of compromise, the legislators elected not to cover all instances of medical malpractice, just cancer cases (though that is a potentially large number). Now the question is whether Gov. Andrew Cuomo will sign the bill when it is formally sent to him. (8/18)

The Doublespeak Award was established in 1974 and is given by the National Council of Teachers of English. The ironic, annual tribute recognizes individuals and entities using language that is, among other things, deceptive, evasive and confusing. ... Iowans should nominate Gov. Kim Reynolds for her misleading rhetoric on the Medicaid privatization experiment implemented by her former boss. Her statements deserve recognition. After handing over management of the $4 billion Medicaid program to three for-profit companies last year, Iowans have filed hundreds of complaints, including many about losing access to care. Health providers have closed their doors. Iowans with disabilities have filed a federal lawsuit against Reynolds, accusing the state of depriving thousands the right to live safely outside institutions. Yet the new governor continues to insist privatization is a great thing. (8/17)

The inherent goodness of people was made clear this week when a pair of readers offered to pay for a 75-year-old Encino man鈥檚 prescription meds after the drug maker imposed a $1,100 deductible to be eligible for financial assistance. Meanwhile, the warped priorities of our for-profit healthcare industry once again tumbled into the open as the drug company in question, Eli Lilly & Co., responded to this demonstration of humanitarian fellowship with a shrug of its corporate shoulders. (David Lazarus, 8/18)

Several of these shortcomings affect a chronically underserved population: infants and children. While there has been tremendous progress in recent years toward preventing mother-to-child transmission of HIV, the report shows that global access to antiretroviral therapy (ART) for women with HIV who are pregnant or breastfeeding is plateauing at around 75 percent. That鈥檚 well below the level needed to eliminate infections before and soon after birth. A substantial number of children infected with HIV as infants are not brought for treatment until they reach adolescence, at which point many already suffer from HIV-related health problems. These include infectious diseases such as tuberculosis and malaria, which take advantage of weakened immune systems. (Charles Lyons, 8/16)

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