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A federal appeals court on Wednesday struck down a central provision of the Affordable Care Act, ruling that the requirement that people have health insurance was unconstitutional. But the appeals panel did not invalidate the rest of the law, instead sending the case back to a federal district judge in Texas to “conduct a more searching inquiry” into which of the law’s many parts could survive without the mandate. (Goodnough, 12/18)

The 2-1 ruling handed down by a panel of the 5th U.S. Circuit Court of Appeals in New Orleans means the ultimate fate of the rest of the Affordable Care Act including such popular provisions as protections for those with pre-existing conditions, Medicaid expansion and the ability for children under the age of 26 to remain on their parents' insurance remains unclear. The panel agreed with Texas-based U.S. District Judge Reed O’Connor’s 2018 finding that the law’s insurance requirement, the so-called “individual mandate,” was rendered unconstitutional when Congress, in 2017, reduced a tax on people without insurance to zero. (Santana, Sherman and Alonso-Zaldivar, 12/18)

The appeals court said the 2017 change meant there was no longer a valid basis for upholding the mandate. “There is no other constitutional provision that justifies this exercise of congressional power,” Judge Jennifer Elrod, a George W. Bush appointee, wrote in the majority opinion, which was joined by Judge Kurt Engelhardt, a Trump appointee. (Kendall and Armour, 12/18)

The court, however, avoided answering the key question of whether the rest of the law can remain in place or must be struck down, instead sending the case back to a district court judge for further analysis. That means the fate of the signature domestic achievement of Democratic former President Barack Obama remains in limbo. Writing for the majority, Judge Jennifer Walker Elrod said that Texas-based U.S. District Court Judge Reed O'Connor must "employ a finer-toothed comb" to determine if the entire law must be struck down. (Hurley, 12/18)

In 2012, Chief Justice John Roberts forged a compromise with the four liberal Supreme Court justices to uphold Obamacare by calling it a tax. But 5th Circuit Judge Jennifer Walker Elrod, writing for the majority, said the individual mandate could no longer be justified after a Republican-controlled Congress in 2017 got rid of the financial penalty that once came with it. (Sledge, 12/18)

Dissenting Judge Carolyn Dineen King said her colleagues were prolonging “uncertainty over the future of the healthcare sector.” King said she would have found the mandate constitutional, although unenforceable, and left the rest of the law alone. (Mears and Phillips, 12/18)

The 5th Circuit decision almost certainly will bring the health-care law before the Supreme Court for a third time, and California Attorney General Xavier Becerra, leading a coalition of his Democratic counterparts fighting to preserve the law, said Wednesday night that he was prepared to ask the high court to take the case before the lower court rules again. But by sending a thorny legal question back to the Texas jurist who already has held the law unconstitutional, the judges may effectively slow the progress of the case, so that the high court does not take it during its current term and decide it before the November elections. (Goldstein, 12/18)

"The best way to get certainty is to go to the Supreme Court," said Becerra, who is leading a coalition of Democratic attorneys general in defending the law. "We will move swiftly to challenge this decision and seek certification because this could mean the difference between life and death for so many Americans and their families," he added. (Hellmann, 12/18)

Kaiser Health News: Federal Appeals Court Strikes Down Portion Of Obamacare

Hanging in the balance is not only health coverage for the roughly 20 million Americans directly served by the ACA, but also hundreds of millions more whose health care and coverage have been affected by the thousands of changes enacted in the law. Those include provisions as wide-ranging as changes in Medicare drug copayments, requirements for calorie counts on menus, a pathway for approval of generic copies of expensive biologic drugs and, perhaps most important politically, protections for people with preexisting conditions. (Rovner, 12/18)

Invalidating the law in only the 18 states in the lawsuit would throw the nation's health care system into chaos and deepen the inequality of access to health care that already exists. Also, several provisions -- such as making it easier to obtain lower-cost versions of certain complex drugs, changing Medicare payment rates or increasing certain taxes on wealthier Americans -- would be difficult to divide up by state. The court acknowledged that when the lower court reviews its opinion it might once again hold that the entire law must fall. But the judges urged limits, writing: "It is no small thing for unelected, life-tenured judges to declare duly enacted legislation passed by the elected representatives of the American people unconstitutional." (Berman, Biskupic, Luhby and De Vogue, 12/18)

The 5th US Circuit Court of Appeals has found the Affordable Care Act's individual mandate unconstitutional, but did not invalidate the entire law. Read the opinion here. (12/18)

Several leading Democrats criticized the appeals court ruling Wednesday evening, saying that it would create continued uncertainty in the healthcare system. “Tonight’s ruling is a chilling threat to the 130 million Americans with preexisting conditions and every other family who depends on the lifesaving protections of the Affordable Care Act,” House Speaker Nancy Pelosi (D-San Francisco) said in a statement. “This ruling should not stop families from continuing to sign up for the quality, affordable coverage they need in states where the enrollment period is still open.” (Levey and Savage, 12/18)

Democratic lawmakers on Wednesday also blasted Trump and Republicans over the ruling. “Today’s ruling is the result of the Trump Administration and congressional Republicans attempting to make dangerous health policy using the courts since they failed to succeed in Congress,” Ways and Means Committee Chairman Richard Neal said in a statement. (Lovelace and Higgins, 12/18)

Many legal scholars, including Obamacare opponents, have sharply criticized the latest GOP-led lawsuit as baseless. They argue courts typically avoid striking entire laws if they can stand without provisions found invalid, and Congress's decision to zero out just the mandate penalty in 2017 is proof lawmakers meant for the rest of the ACA to stand. The Republican chairman of the Senate health committee, Lamar Alexander of Tennessee, drove home that point Wednesday, describing the Justice Department's argument as "far-fetched." "I am not aware of a single senator who said they were voting to repeal Obamacare when they voted to eliminate the individual mandate penalty," said Alexander, a moderate who is retiring next year. (Demko, 12/18)

Health scholars who support Obamacare say the writing is on the wall for the next ruling from O’Connor, a former prosecutor and aide to Republican senators who was appointed to the bench by former President George W. Bush. “He’s going to say very substantial parts of the Affordable Care Act are invalid,” said Nicholas Bagley, a professor at University of Michigan Law School. “He’s already made that determination, so there’s really no uncertainty about what Judge O’Connor will say.” (Wheeler, Tozzi and Calkins, 12/18)

Hospital, insurer and patient advocacy groups, along with Democratic lawmakers, lamented that the 5th Circuit was unwilling to determine whether entire ACA could stand without the individual mandate, noting that not doing so creates drives further chaos in the healthcare system and is harmful to Americans. "Sending the decision back to the federal district court that invalidated the entire law puts health coverage— and peace of mind — for millions of Americans at risk," Rick Pollack, president and CEO of the American Hospital Association said in a statement. (Livingston, 12/18)

President Donald Trump said a U.S. appeals court ruling on Wednesday that a component of the Obamacare law is unconstitutional would not change the current U.S. healthcare system. "This decision will not alter the current healthcare system. My Administration continues to work to provide access to high-quality healthcare at a price you can afford, while strongly protecting those with pre-existing conditions," Trump said in a statement after the court ruled that Obamacare's individual mandate that directed Americans to obtain health insurance was unlawful. (Hurley, 12/18)

President Donald Trump hailed the ruling as "a win for all Americans." In a statement, the White House called it "a positive step toward moving away from Obamacare, which has failed the American people for too long." (Wolf, 12/18)

Starting in 2017, the Republicans’ failed effort to repeal and replace large portions of the health law was deeply unpopular and became a central campaign theme of the 2018 election, in which Democrats won a House majority. Democrats cast themselves as the protectors of Obamacare’s most popular provisions, especially its protections for Americans with pre-existing health conditions. While most Democrats would have favored a court ruling that upheld Obamacare, a reprise of those politics could have given them a lift in an election year. Voters tend to trust Democrats more than Republicans on health care, but much of the debate during the primary season has focused on ambitious new expansions of government coverage. Those proposals do not enjoy the widespread support attached to the preservation of Obamacare’s core consumer protections. (Sanger-Katz, 12/19)

ObamaCare was thrust back into the 2020 spotlight on Wednesday after a federal appeals court ruling added new uncertainty over the law's future. In a 2-1 ruling, the 5th Circuit Court of Appeals found the individual mandate unconstitutional, but avoided ruling on the entire law, instead sending the case back down to the district court level. (Hellmann, 12/19)

Just seven Democrats will take the stage for the sixth and final round of presidential debates in 2019. That's down from 20 candidates six months ago. The field may be winnowing, but the primary contest remains deeply unsettled. The tug-of-war between the progressive and moderate wings of the party is deadlocked. There are essentially four front-runners, each with his or her own glaring flaws. ... It was a litmus issue for ambitious Democrats a year ago. But now, only one of the seven Democrats on the debate stage is promising to fight for Medicare for All immediately after taking office. That would be the bill's author, Bernie Sanders, who is nothing if not consistent. (Peoples, 12/19)

As Mr. Buttigieg surpassed Ms. Warren in polls in Iowa, the two have also been at odds over their health-care plans. The mayor has aired ads knocking Medicare for All and said Ms. Warren was being evasive on how much her health-care plan would cost. The Massachusetts senator is now emphasizing that her single-payer plan gives Americans a choice, in the form of a transition period during which people could opt into a government-run program before private insurance is eliminated. (Parti, 12/18)

Readers wanted to know what was important to independents, defined for the purpose of this study as people who leaned neither Democratic nor Republican (leaners were included in our previous article). Impeachment was the highest priority for them among topics we asked about, which included those related to health care, abortion, taxes, foreign policy, immigration and the environment. (Vavreck, Sides and Tausanovitch, 12/19)

President Donald Trump has promised that the plan his administration rolled out Wednesday to bring in cheaper prescription drugs from Canada will immediately lower medication costs. Experts say the plan won’t work — and many write it off as a political stunt. Under the proposal, importers would need the cooperation of the Canadian government and the drug industry, both of which oppose it. Importers would have to take many expensive and complicated steps to prove to the FDA that importation wouldn’t harm Americans, and to weave through complex regulations and the intricacies of the U.S. health delivery system. (Karlin-Smith and Owermohle, 12/18)

Between the lines: Canada doesn't have nearly enough drugs to meet American demand, and even if it did, it doesn't want to send them to us at the expense of its own market. (Owens, 12/19)

Furthermore, the importation pathway available to states wouldn't include products like insulin or other complex and expensive biotech drugs. Azar acknowledged that limitation but argued that if the importation program were successful, Congress might consider changing the law to allow the importation of the biologic drugs, which require more careful handling in transport, such as cold storage, because they are produced from living organisms or parts of them. (Siddons, 12/18)

Kaiser Health News: Border Fight: Trump’s Plan To Import Cheaper Drugs From Canada Faces Hurdles

Nancy LeaMond, executive vice president of AARP, welcomed the administration’s move. “The ability to import lower-priced medicines would help states manage their ever-tightening budgets, save taxpayers’ money, and lower drug costs for its citizens,” she said in a statement. Yet critics say the administration’s plan ― offered in a 169-page proposed rule seeking comments from states, drugmakers and other stakeholders ― has more to do with President Donald Trump seeking to shore up reelection chances for 2020 than bringing dramatic changes to how people afford drugs. (Galewitz, 12/18)

President Trump’s plan to let states and drug wholesalers import medicines from Canada doesn’t apply to every single drug in the same way — and early indications suggest some drug makers have far more to lose than others. On Wednesday, the Trump administration began a long, regulatory march toward eventually allowing states to import drugs from Canada. While the implementation of that policy is likely to take months, if not years, four states have already passed laws directing their state administrations to submit importation plans to HHS for eventual approval. (Florko, 12/19)

The guidelines rolled out by Azar on Wednesday include a pathway for state governments to import Canadian drugs to be used by those receiving state-funded health care, such as Medicaid recipients and inmates in Florida’s prisons. Additionally, Azar said the federal government will also offer guidelines for American drug manufacturers to also import from Canada, eventually allowing American consumers to get cheaper drugs at local hospitals and pharmacies. Drugs that must be injected, like insulin, as well as controlled substances such as opioid painkillers, are excluded from Florida’s importation proposal. (Mahoney and Koh, 12/18)

Senate Finance Committee Chairman Chuck Grassley (Iowa) on Wednesday accused Senate Majority Leader Mitch McConnell (Ky.) of blocking progress on his bill to lower drug prices, escalating tensions between two powerful GOP senators. Asked why more Republican senators have not signed on to his bill to lower drug prices, Grassley told reporters, “Because McConnell’s asked them not to.” (Sullivan, 12/18)

The remarks are especially surprising from Grassley, one of the Senate’s highest-ranking Republicans. He told reporters at a briefing that his package has not gotten more Republican support “because McConnell has asked them not to [support it].” Visibly exasperated, Grassley even accused McConnell of opposing the Trump administration — although he insisted he is “not frustrated.” “The president wants it,” Grassley said, his voice rising. “Senate majority leaders, historically, if you’ve got the president of the same party, they tend to be spokesmen for the administration, not against the administration.” (Florko, 12/18)

Experts have known for years that some of these transplants wouldn’t provide full immune protection over the course of a SCID [severe combined immunodeficiency] patient’s entire life. They say clinicians should have avoided the word “cure.” But even scientific papers that hinted at such complications called the treatment “curative.” Just this year, an Immune Deficiency Foundation employee was given the unenviable task of sifting through the organization’s thousands of pages of online material, scrubbing out every “cure” that popped up. It was only there a handful of times — sometimes in quotes from clinicians, Boyle said — but it was there and it needed to be removed. (Boodman, 12/19)

CVS Health and Rite Aid joined other pharmacy chains Monday in a lawsuit accusing three drugmakers of squeezing out generic competitors to protect their sales of a diabetes medication, resulting in $2.8 billion in excessive spending. The lawsuit details a series of events that allegedly impeded competitors via notorious "patent games" that policymakers aim to ban. The pharmacy chains allege Assertio Therapeutics paid Lupin Pharmaceuticals to delay its generic version of Glumetza, the extended-release iteration of a drug that has been used to treat Type 2 diabetes since 2002. While Lupin's generic could have entered the market in 2009, the companies settled a related patent lawsuit and kept the competition at bay until 2016. (Kacik, 12/18)

The first public meeting of a working group on insulin accessibility showed little progress Wednesday as Minnesota lawmakers remained at odds over how to operate and pay for an emergency program to help diabetics secure the lifesaving drug. Republicans and Democrats, who have been meeting over the past two months, both want patients who are having a crisis to immediately get insulin they can afford. They also want to connect people with long-term health care coverage to prevent future emergencies for those dealing with the skyrocketing cost of insulin. (Van Berkel, 12/18)

Congress started the year with heady talk of bipartisan action to lower drug prices and protect patients from surprise medical bills. It ended the year with a massive government funding deal that did little to address those issues but did cut taxes on the health care industry by $373 billion. The result is a year-end government funding package that was a win for the health care industry and highlighted just how hard it is for lawmakers to overcome powerful industry groups. (Sullivan, 12/19)

While insurers and medical device manufacturers are heading into the holidays with a windfall from Congress, consumers lost big as lawmakers failed to protect them from surprise medical bills and high drug prices. Lawmakers gave a major handout to the industry when it repealed three Affordable Care Act taxes: a 40% excise tax on employer-provided health plans that exceed certain thresholds; a health insurance tax; and a 2.3% excise tax on medical devices. (Cohrs, 12/18)

[NPR's] health reporting team took a look at what is in the package and picked out notable highlights, including some surprising policy reverses for Congress. The budget provides SAMHSA with $19 million for the Suicide Prevention Lifeline — this includes an increase of $7 million over last year. The additional funding is a "significant improvement," notes Lauren McGrath, the vice president of public policy at Centerstone, a behavioral health care provider working in several states. Calls to the Lifeline are answered by a patchwork of about 165 local call centers that receive only about $1,500 to 2,000 per year of federal money. Most of the federal funds support the Lifeline's national infrastructure. The additional funding "will provide much needed resources to improve consumer access to the National Suicide Lifeline," McGrath wrote in an email. (12/18)

Doctors and advocates are hopeful that new funding for federal agencies to study gun violence will prove to be the first step in preventing mass shootings, suicides and other firearm deaths. For the first time in 23 years, a government spending bill will set aside funds — in this case, $25 million — for the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH) to collect data on what the American Medical Association has called a public health crisis. (Hellmann, 12/18)

President Donald Trump’s expansion of a program aimed at steering more veterans to private health care is getting an $8.9 billion boost as part of the massive government spending bill approved by the House, setting up a potential battle over the direction of the Veterans Affairs Department. The deal provides $81 billion for VA medical care to treat 9.3 million veterans, including the $8.9 billion for private care under a law passed last year expanding the Veterans Choice program. Another $11.3 billion is on tap for private care in 2021. (Yen, 12/18)

Judging by the marketing, it would seem that the teachers of New Jersey have collectively thrown out their backs, pulled a muscle or pinched a nerve while engaged in rigorous educating. Last fall, when teachers at about a dozen New Jersey schools returned from break, employees from Thompson Healthcare & Sports Medicine welcomed them with bagels and orange juice. The clinic’s owner also created an empathetic YouTube video titled “We Understand Painful Conditions Suffered By Teachers.” (Allen, 12/19)

Kaiser Health News: ‘An Arm And A Leg’: Reporter Says ‘Shame’ Spurred Hospital To Cancel Debt For Thousands

Multiple journalists have spotlighted huge medical bills that have left patients swimming in medical debt. After those stories were made public, in many cases health providers waived the bill or canceled the debt. Sadly, there are a lot of crazy-high medical bill stories out there — and not nearly enough journalists to go around. But in Memphis, Tenn., one journalist’s reporting produced a scaled-up response. (Weissmann, 12/19)

E-cigarette makers face an existential threat. By May, they must submit applications to the U.S. Food and Drug Administration proving that their products provide a net benefit to public health. If a company fails to make its case, the FDA has the power to order its products off the market. The agency will judge that benefit with a two-part test: Are e-cigarettes effective in getting smokers to quit? (Kirkham, 12/18)

As the FDA pressures e-cigarette firms to stamp out youth vaping, the agency faces criticism itself for failing to rein in the fast-growing industry after years of bureaucratic delays dating back to the Obama administration. Despite recent tough talk, the FDA has yet to pass any new industry-wide restrictions after two years of rapid growth in teenage vaping tied to the popularity of e-cigarettes made by Juul Labs Inc. (12/18)

Worldwide, the number of men using traditional tobacco products has finally started to decline, health officials said Thursday. Four out of five tobacco users globally are men, so declines among males "mark a turning point in the fight against tobacco,” Dr. Tedros Adhanom Ghebreyesus, head of the World Health Organization, said in a statement. (Stobbe, 12/18)

The New York City chief medical examiner on Wednesday ruled that the October death of a teenage boy was caused by complications from a lung injury related to use of an e-cigarette or vaping product. The Bronx teenager, Denis Byrne Jr., was 17 years old, the chief medical examiner said. The manner of death is considered an accident. It was the state’s first reported vaping-related death. The teenager’s family hadn’t responded to requests for comment. (West, 12/18)

There's no way to sugarcoat this news: Nearly half of American adults will be obese within a decade and one-quarter will be severely so, a new report predicts. It corrects for a weakness in previous estimates that may have made the problem seem not as big as it really is. Those estimates often relied on national health surveys and people tend to understate their weight in those. (12/18)

"Given how notoriously difficult obesity is to treat once it's established, you can see that we're in an untenable situation," said Aviva Must, chair of Tufts University's Public Health and Community Medicine, who was not involved in the study. "The societal cost is high," she said, "both in terms of obesity-related health consequences and healthcare expenditures which could bring us to our knees." (LaMotte, 12/18)

Eating ultraprocessed foods may increase your risk for Type 2 diabetes. Ultraprocessed foods — including chips, instant noodles, breakfast cereals, chicken nuggets and other industrially processed ready-to-eat or microwaveable fare — are designed for tastiness and long shelf-life. They typically contain emulsifiers, thickening agents, food coloring and other additives of no nutritive value. In previous studies, they have been linked to an increased risk for cancer, depression and cardiovascular disease. (Bakalar, 12/18)

The New Year is right around the corner, and if you are looking to makeover your diet there are some simple suggestions to help you eat healthier in 2020. I'm not talking about a major food overhaul, but month-by-month "mini-resolutions" that will give you a complete nutritional upgrade by next December. (Drayer, 12/19)

Heidi Boucher loaded two big straw baskets into her Toyota Highlander. She always kept them packed, ready for death. Inside were a pair of leather work gloves and a hammer, a bunch of bed pads, a few adult diapers (dead bodies sometimes leak), Q-tips for cleaning ears, noses and mouths and for applying lipstick, cotton balls, disinfectant spray, a plastic zip bag of safety pins to help drape silk and other fabrics around a gurney or casket, a small screwdriver to tightly close a casket, latex gloves, a hairbrush and oils infused with rose, lavender and rosemary. (Jones, 12/19)

A prominent pediatrician on Long Island lost his medical license after allegations emerged that he had sexually abused girls in his care for decades. But he never spent a day in court. The doctor, Stuart Copperman, was never charged with a crime by local authorities. According to the Nassau County district attorney’s office, not one victim came forward within the statute of limitations for the crime. (Rabin, 12/18)

As the Trump administration eyes easing organ transplant restrictions, new research shows advances in hepatitis C treatments could create a whole new group of donors. When comparing heart transplant patients' survival rates, researchers found no significant differences between patients who received organs from hepatitis C-positive donors and uninfected donors. The study published Wednesday in JAMA Cardiology reviewed 80 heart transplant patients' results. (Johnson, 12/18)

The number of people waiting for a life-saving organ transplant has long exceeded the supply of donors, though the gap has narrowed as organ donations have risen over the past decade. But some researchers and transplant experts disagree about what is driving the increase — a critical piece of information if health regulators are going to succeed at meeting the demand for organs. Researchers from the University of Miami’s Miller School of Medicine found that an increase in organ donations over the past decade was “mostly caused by the opioid crisis,” though the study has drawn criticism from organ transplant experts who say the researchers used overly broad terms to define drug-related deaths in search of a predetermined conclusion. (Conarck, 12/19)

Roughly 300,000 people in the United States have suffered spinal cord injuries, life-changing events with far reaching-effects. But, as William Brangham reports, new research out of the University of Louisville is giving dozens of paralyzed people the prospect of regaining some of what they have lost. (Brangham, 1218)

"I don't think as a kid I ever saw a minority physician," says Russell J. Ledet. Ledet is a second-year medical student in the M.D./MBA program at Tulane University School of Medicine, and African American. Last weekend he organized a trip to Whitney Plantation, now a museum, in Edgard, La., for fellow members of the Tulane chapter of the Student National Medical Association, a student-run organization that supports black medical students. (Vaughn, 12/19)

Jay Van Bavel, a social neuroscientist at New York University, is vowing not to work during the Christmas holidays. A few years ago, Dr. Van Bavel had agreed to conduct peer review on a couple of manuscripts before the end of the semester. But he got really busy and ended up having to do one on Christmas Day and another on New Year’s Eve, while his family was visiting. (Chawla, 12/18)

Beware of dog, especially the cute puppies in pet store windows, U.S. health officials warn. A bacteria resistant to common antibiotics has sickened 30 people this year, sending four of them to hospitals, and puppies are the likely culprit, according to an advisory issued late Tuesday by the Centers for Disease Control and Prevention. (12/18)

Recognizing a lack of mental health resources catered to Muslims in a state with a fairly large Muslim population, Sumaya, 26, and her sister Fadumo Hassan founded Open Minds Initiative earlier this fall. The Minnesota-based organization provides a crisis hotline that they hope will help address the stigma surrounding seeking help for mental health issues in the Muslim community. (Ibrahim, 12/19)

American Indians in Minnesota have the highest opioid overdose death rate of American Indians anywhere in the country. In a search for solutions, White Earth officials and university researchers have collaborated on what they are calling a groundbreaking review of opioid overdose deaths that looks deep into the medical histories and the personal lives of a handful of people who died as a result of opioid overdose on the White Earth Reservation. (Gunderson, 12/18)

Kaiser Health News: Parenting Your Aging Parents When They Don’t Want Help

David Solie’s 89-year-old mother, Carol, was unyielding. “No, I will not move,” she told her son every time he suggested that she leave her home and relocate to a senior living residence. And it didn’t stop there. Although Carol suffered from coronary artery disease, severe osteoporosis, spinal compression fractures and unsteady balance, she didn’t want assistance. When Solie brought in aides to help after a bad fall and subsequent surgery, his mother fired them in a matter of days. (Graham, 12/19)

Every time she got out of jail, Jamie Cline started hustling again for heroin, driven by an addiction she didn’t understand. “You want to get clean so bad. You know something’s killing you and you can’t stop,” said the 33-year-old who used heroin for 10 years. This spring was different. While in a jail work-release program, she took a medication called buprenorphine. (12/18)

John Kapoor should serve 15 years in prison for leading a racketeering conspiracy that helped fuel the national opioid crisis with bribes to boost prescriptions of a highly addictive painkiller, federal prosecutors said. Four other former executives at Insys Therapeutics Inc., who were convicted at trial along with Kapoor, the former chief executive officer, deserve prison terms ranging from six to 11 years, the U.S. said in a court filing on Wednesday. Kapoor, 76, was the first CEO convicted in a federal opioid trial. (Lawrence, 12/18)

The ACLU of Tennessee filed a lawsuit against a Nashville suburb Wednesday to stop a zoning ordinance that effectively bans surgical abortions within the city’s borders, an antiabortion tactic that is putting town councils on the front lines of one of the most polarizing issues in American life. The suit, joined by the national ACLU and filed on behalf of the nonprofit national women’s clinic Carafem, calls the Mount Juliet City Commission’s zoning ordinance “unconstitutional.” The ordinance is part of “the state’s relentless attack on abortion rights, enacting a multitude of restrictions designed to shutter clinics that have provided safe and affordable abortion care and impose unconscionable obstacles,” the lawsuit states. (Wax-Thibodeaux and Cha, 12/18)

A lawsuit has been filed against Mt. Juliet by the ACLU, ACLU of Tennessee and a law firm over the city's zoning ordinance aimed at restricting surgical abortion clinics. The lawsuit is on behalf of carafem, a national abortion provider that opened a clinic in Mt. Juliet on Crossings Circle near Providence Marketplace on March 1. (Humbles, 12/18)

A federal lawsuit filed Wednesday by the Cook County public guardian alleged that children as young as 7 were sexually abused, while others were injected with sedatives to control them and physically attacked, at a Chicago psychiatric hospital. Child welfare officials, meanwhile, allegedly worked with the hospital to cover up the abuse. Charles Golbert, the Cook County public guardian, filed the lawsuit on behalf of seven children who are in the care of the Illinois Department of Children and Family Services and who had been involuntarily admitted to Chicago Lakeshore Hospital in 2017 and 2018. (Eldeib, 12/18)

Children as young as 7 were subject to or witnessed sexual abuse by staff and peers, according to the lawsuit. When children reported the abuse, they were further victimized, the complaint said. One was allegedly given a powerful sedative when it wasn't necessary. “Instead of being placed in a safe environment where they could focus on their treatment, each plaintiff found himself or herself in a hospital of horrors where they were subjected to sexual, physical and emotional abuse and otherwise not properly supervised or monitored,” the lawsuit said. (12/18)

Gov. Gavin Newsom has long touted a single-payer health system, and campaigned on it during his successful gubernatorial run. On Tuesday, he announced a step toward exploring a single-payer financing model and other policies that could get Californians closer to universal health coverage. (Ho, 12/18)

U.S. health officials have confirmed that three children recently hospitalized with measles in Colorado traveled from New Zealand to Los Angeles International Airport before arriving in Denver. The Denver Post reported Tuesday that the Centers for Disease Control and Prevention has issued warnings at airports in Denver and Los Angeles involving the same airline passengers. (12/18)

As of November, Texas distributed more than $4.2 billion in federal money to an average of 1.5 million people — about $261 per person. The rule that passed this month won’t affect Texans in the short term, but a second rule coming down the pipeline could kick at least 125,000 Texans off SNAP. The most recent rule change, which goes into effect in April 2020, is estimated to cut benefits for a roughly 700,000 Americans. (Fernández, 12/18)

Washington Gov. Jay Inslee said Wednesday he wants to spend more than $300 million from the state’s emergency budget reserve to add 2,100 shelter beds and provide other help to combat homelessness. In unveiling his supplemental spending plan in Olympia, Washington for the state’s current $52.4 billion two-year budget, Inslee said Washington must do more to find housing for people. (12/18)

A man, who by at least one city official’s account was homeless, was found dead outside Los Angeles City Hall on Wednesday. The Los Angeles Police Department received a call about a deceased man and responded at 7:40 a.m. to 200 N. Main St. in Los Angeles, said LAPD Officer Lizeth Lomeli. She had no other information about the man. However, Los Angeles City Atty. Mike Feuer told reporters at an unrelated event Wednesday morning that the man was homeless. (Smith, 12/18)

Temple University has reached a definitive agreement to sell Fox Chase Cancer Center, an affiliated bone marrow transplant program, and its share of Health Partners Plans to Thomas Jefferson University, the two organizations said Wednesday. The deal is being announced after nearly a year of exclusive negotiations. Still, Temple and Jefferson, among the largest nonprofits in Philadelphia, did not disclose the price. (Brubaker, 12/18)

The Cleveland Clinic will offer fully paid parental leave to eligible employees starting in April.In an announcement of the new policy, Clinic President and CEO Dr. Tom Mihaljevic said, “Paid family leave offers economic security and peace of mind to families during one of life’s most significant events. And it has a positive effect on the health and well-being of both the mother and the newborn.” (Christ, 12/18)

Jane Garcia started as an intern at La Clínica de La Raza in the late 1970s, attracted by its mission to provide health care to all — especially immigrants, regardless of their legal status or ability to pay. Forty years later, Garcia, 66, is the chief executive officer of the organization, which now operates more than 30 clinics in Alameda, Contra Costa and Solano counties and serves about 90,000 patients a year. About 65% of its patients are Latino, many of whom are immigrants. (Ibarra, 12/18)

The health care sector produces 10% of all greenhouse gas emissions in the U.S. Hospitals are 36% of that. And operating rooms are their hot spots for emissions, waste and energy use.But this OR, inside a renovation at Boston Medical Center (BMC), is about as climate friendly as they come. BMC says the renovation has helped it draw 70% less energy from the grid, starting in 2012. (Bebinger, 12/19)

For the second time in four months, Truman Medical Centers has suffered a data breach, this one involving more than 114,000 patients. The Kansas City safety net hospital informed the Department of Health and Human Services’ Office for Civil Rights that the cause of the breach was a laptop theft on Dec. 5. Leslie Carto, a spokeswoman for the hospital, said the work-issued laptop was stolen from an employee’s vehicle. (Margolies, 12/18)

Campbell County Health's (CCH) Chief Operating Officer (COO) Colleen Heeter has been selected by the system's Board of Trustees as the next CEO. Heeter will replace outgoing CEO Andy Fitzgerald. Heeter started her current position this past February after moving to Gillette in 2018 to be interim director of the Powder River Surgery Center. (Wheeler, 12/18)

Wednesday marked the grand opening of Our Lady of Lourdes' $9 million free-standing emergency room just north of Interstate 10 in Scott. Staff and executives from Our Lady of Lourdes, representatives from the Roman Catholic Diocese of Lafayette, representatives from local health care organizations and state and local leaders were on hand for the blessing and ribbon cutting for the emergency room, which is located in the Destination Pointe development. (Boudreaux, 12/18)

State environmental officials say a warehouse operated by a medical sterilizing company in Covington, a suburb of Atlanta, is releasing high levels of the toxic gas ethylene oxide. The state’s Environment Protection Division (EPD) has charged the company, BD — which also runs a sterilizing plant in Covington — with a violation for operating the warehouse, which is a global distribution center, without an air quality permit. (Goodman and Miller, 12/18)

It’s the gait of a man who over the past eight years had 19 surgeries on his legs, which included the amputation of his toes on both feet due to complications with Type 2 diabetes. But finding ways to be mobile was only one of Walker’s recent obstacles in life. The surgeries kept him from working for extended periods of time, and without a steady income, Walker, along with his mother, Suzette Solis, and his great aunt, Carol Moreno-Solis, became homeless. Sleeping in makeshift rooms at the homes of relatives in Bay Point and Concord was the norm for the trio for several years. (Phillips, 12/18)

Sometimes, a baby may be born prematurely or with a health condition that requires admission to the NICU, and the baby’s stay may range from a few days to as long as six months. With extended lengths of stay, it is natural for a strong bond to form among the nurses, doctors and others on the medical team and the families, sometimes becoming close friends, according to Kirsten Riney, vice president of patient services. (12/18)

A new government board started setting up ways to distribute medical marijuana oil in Georgia on Wednesday, an effort to provide access to the drug to patients who are already allowed to use it. The Georgia Access to Medical Cannabis Commission, during its first meeting Wednesday, began exploring how to manufacture or import the oil for use by the state’s nearly 14,000 registered patients. (Niesse, 12/18)

The city council voted 7-3 Tuesday night to allow cannabis-related businesses to come to the city. Aldermen made the decision quickly with almost no debate on the issue. Fairview Heights joins five other Metro East communities that will allow cannabis sales next year when recreational marijuana use for adults is legal. (Schmid, 12/18)

Infants are often assumed to be immune to measles through maternal antibodies transferred during pregnancy and, in many countries, receive their first measles-containing vaccine at 12 to 15 months. Immunity may wane before this time in measles-eliminated settings, placing infants at risk for measles and complications. We investigated humoral immunity to measles in infants <12 months of age in Ontario, Canada. (Science et al, 12/1)

A strong primary care system can help prevent illness, manage patient care across multiple providers, and reduce health care costs. Essential to such a system is effective communication. To address patients’ needs, primary care physicians often must communicate and exchange information with specialists, hospitals and other care settings, social service providers — and, of course, the patients themselves. (Doty, Tikkanen, Shah and Schneider, 12/10)

In this large observational prospective study, a higher proportion of UPF in the diet was associated with a higher risk of T2D. Even though these results need to be confirmed in other populations and settings, they provide evidence to support efforts by public health authorities to recommend limiting UPF consumption. (Srour et al, 12/16)

Poor sleep may increase the risk for cardiovascular disease, new research suggests. Researchers assigned “sleep scores” on a scale of zero to five to 385,292 British men and women, giving one point for having each of five indicators of healthy sleep: being an early bird, sleeping seven to eight hours a night, having no insomnia, not snoring and not being sleepy during the day. The scores depended on self-reports of sleep behavior. (Bakalar, 12/18)

This month’s Democratic presidential debate will likely see a continued focus on the single-payer health care proposal endorsed by Sens. Bernie Sanders of Vermont and Elizabeth Warren of Massachusetts. But for all the general discussion — and pointed controversy — over single payer at prior debates, many unanswered questions remain. (Chris Jacobs, 12/19)

Just a few months shy of the 10-year anniversary of the Affordable Care Act, or Obamacare, as it has been widely known, the future of America’s general health never has looked more bleak. One reason is that millennials, members of a generation defined as those born between 1981 and 1996, are sicker than the generation before them, both physically and mentally. This phenomenon came to light as the result of a Deseret News report by Lois Collins. It was based on a new study by Moody Analytics for Blue Cross Blue Shield titled, “The Economic Consequences of Millennial Health,” and on interviews with health care professionals. (12/18)

With most purchases, whether it’s groceries, a new car or a house, the price is clear up front. Not so for medical services, which can produce massive, mysterious bills to insurers and patients long after a hospital visit. An ongoing series by National Public Radio and Kaiser Health News has documented bills of $142,000 for a young girl’s snake-bite treatment, $94,000 as part of a woman’s spinal surgery and $48,000 for allergy testing, to note just a few examples. Such insane bills often remain stubbornly unexplained by the hospitals and insurers involved; all are wildly out of whack with expected costs. (12/17)

Earlier this month, the Trump administration approved a new rule for SNAP that will cut an estimated 700,000 unemployed people from the program. The administration argues that cutting people who are out of work off of SNAP will nudge them into the workforce and onto a path of independence. Democrats have roundly decried the decision, which Rep. Marcia Fudge (D-Ohio) described as “the latest act of cartoonish villainy by the Trump administration." However, it is too easy to simply attribute this latest decision to the cruel excesses of our current president and his staff. (Maggie Dickinson and Megan A. Carney, 12/18)

When even the left-leaning Washington Post calls a Democratic talking point a lie, you know it must be a doozy. And thanks to fact-checker Glenn Kessler, we now know that Speaker of the House Nancy Pelosi has repeatedly and knowingly lied about the rates of child gun death to push an agenda. Consider this tweet from the California Democrat: “100 people die every day from gun violence — 47 of them children & teenagers.” Pelosi asked, “How many more must perish before [Mitch McConnell] will take action?” She has repeated the same or similar forms of this statistic, that 47 children and teenagers die every day from gun violence, in press releases, speeches on the House Floor, and comments to reporters. (Brad Polumbo, 12/17)

Last month, the Food and Drug Administration took the unusual step of admitting it had made a mistake 25 years ago when it granted orphan drug status to an opioid addiction treatment called buprenorphine (Subutex).The original orphan drug application was based on the claim by Indivior, the maker of Subutex, that the company was not likely to make a profit from marketing the drug. At the time, opioid addiction was not the widespread scourge it is today.In its reversal, something I had called for in STAT earlier in the year, the FDA said its original decision was incorrect because the manufacturer has made billions of dollars from the drug. (Diane Dormande, 12/19)

House lawmakers just passed Speaker Nancy Pelosi's Lower Drug Costs Now Act (H.R. 3). The bill, which now heads to the Senate, imposes strict price controls, taxes, and regulations on biopharmaceutical companies. The nonpartisan Congressional Budget Office expects the measure to reduce the industry's revenues by $1 trillion over the coming decade. Many H.R. 3 proponents acknowledge this government price-setting will choke off private-sector research funding. But they believe the National Institutes of Health — the federal agency that funds most basic scientific research — could fill the gap left by private researchers.  It can't. (Sandip Shah, 12/17)

A recent OPB report about Oregon’s foster care system shed light on the extraordinary actions of child welfare officials within the Oregon Department of Human Services. The state agency not only sent hundreds of children in our foster care system to out-of-state facilities run by a private, for-profit company, but it also ceded any responsibility for them as well. Oregon child welfare officials’ lack of oversight, lack of scrutiny, and lack of even basic tracking of the children placed in those facilities and their well-being are astonishing. (Jake Cornett, 12/18)