KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Kaiser Health News Original Stories

Medicaid Is Balm And Benefit For Victims Of Gun Violence

Young men injured by gunshot wounds often lacked insurance and went for years without proper follow-up care. The health law’s Medicaid expansion, in doubt since the election, changed that in many of the states with the most gun violence. (Sarah Varney, 12/2)

Political Cartoon: 'Pig Skin?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Pig Skin?'" by Lee Judge, The Kansas City Star.

Here's today's health policy haiku:


Testing ideas
To change health system payments ...
Such work now at risk.

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Summaries Of The News:

Capitol Hill Watch

Senate Republicans Reluctant To Tinker With Medicare, Despite House GOP's Eagerness

Meanwhile, House Speaker Paul Ryan dismisses Democrats' attacks over his vision for overhauling the program as "MediScare politics."

Politico: GOP's Medicare Plans Run Into Wall In The Senate
The GOP’s dream of privatizing parts of Medicare is running up against resistance among Senate Republicans. Interviews with more than a dozen GOP lawmakers reveal they’re not planning to pursue big changes to the popular health care program for seniors — at least not in the first year of the Trump administration. That hesitation starts with the chairman who would lead any overhaul in the Senate. (Haberkorn and Cancryn, 12/2)

The Associated Press: Senate GOP Shies From Fight Over Medicare
Congressional Democrats are warning that Speaker Paul Ryan and President-elect Donald Trump are gunning for Medicare — and they are rubbing their hands in glee at the prospect of an epic political battle over the government's flagship health program that covers 57 million Americans. It turns out that Republicans, especially in the Senate, are not spoiling for a fight. (Taylor, 12/2)

Reuters: Senator Warns Against Simultaneous Overhaul Of Medicare And Obamacare
A senior U.S. Senate Republican warned his party on Thursday against simultaneously overhauling Medicare and the Obamacare health insurance program, saying this would be "biting off more than you can chew." The cautionary comments from Senator Lamar Alexander came after House Speaker Paul Ryan, long an advocate of privatize Medicare, said Republican lawmakers would be discussing reforms of the health insurance program for the elderly with President-elect Donald Trump's administration. (Cornwell, 12/1)

The Hill: Ryan Defends Medicare Plan Amid Dem Attacks
Speaker Paul Ryan (R-Wis.) on Thursday defended his plan for overhauling Medicare amid escalating attacks from Democrats. Ryan dismissed the criticism, calling it “the latest wave of Democratic talking points to try and play ‘Mediscare' politics, which is what they typically do every other Tuesday. ”The Speaker has long called for transitioning Medicare to a “premium support” system, where seniors would get a set amount of money from the government to help them buy health coverage from a private insurance company or from traditional Medicare. (Sullivan, 12/1)

The Associated Press: Key House Chairman: GOP Will Change Medicare, To 'Save' It
The chairman of a key House committee is pledging that congressional Republicans will change Medicare in order to save it. GOP Rep. Kevin Brady of Texas, head of the Ways and Means Committee, insisted Thursday that Republicans won't be deterred by the politics, even though Donald Trump won election as president on promises to protect the popular health care program for older Americans, and Democrats are already warning of a "war on seniors." (Werner, 12/2)

McClatchy: Trump's Team Wants To Privatize These 4 Government Programs 
Donald Trump was not the kind of presidential candidate who lays out the finer details of his policies on the campaign trail. Now, as the president-elect assembles his government, the people he is choosing to run it provide a clearer picture of the policies his administration will pursue. Among them are a lot of plans to privatize government programs, including Medicare, services provided by the Veterans Affairs department, college loans and infrastructure projects. (Bergengruen, 12/1)

Health News Florida: Deadline Looming For Medicare Annual Election Period 
There's less than a week left in the Annual Election Period for Floridians enrolled in Medicare to change their plans. Oct. 15 to Dec. 7 is when Medicare enrollees can change their Medicare plans and prescription drug coverage for the following year to better meet their health and financial needs. (Miller, 12/1)

In other news from Capitol Hill —

The Hill: Walden To Head Powerful Energy And Commerce Committee 
Republicans have elected Rep. Greg Walden (R-Ore.) the next chairman of the powerful House Energy and Commerce Committee. Walden defeated Reps. John Shimkus (R-Ill.) and Joe Barton (R-Texas), the former committee chairman, in the race for the gavel. Current chairman Fred Upton (R-Mich.), is stepping down from the position due to term limits. (Henry and Wong, 12/1)

Health Law Issues And Implementation

The Five Major Hurdles Republicans Have To Overcome To Dismantle Health Law

Bloomberg offers a look at the problems facing congressional Republicans, including the fact that even after six years of ardently trying to come up with a replacement plan there has yet to be one that the party has gotten behind. Meanwhile, amid fears of a mass exodus of insurers from the marketplace, Republicans have begun talks with the companies to figure out what can be done to keep them.

Bloomberg: GOP’s Delayed-Repeal Obamacare Strategy Faces Major Obstacles
Republicans are coalescing around a plan to quickly pass next year a delayed repeal of Obamacare to give them two or three years to craft an alternative. But that plan, designed to create a “cliff” that according to lawmakers and aides would push Congress to get its act together, comes with significant perils. “We’re going to begin immediately to repeal Obamacare and reconciliation is the only way to do it. And I believe we will have 51 Republican senators or 52 to vote for that,” Senator Lamar Alexander of Tennessee, who chairs the health committee, told reporters Thursday. (Kapur, 12/1)

Politico Pro: Collins Won't Rule Out A Vote To Repeal Obamacare 
Sen. Susan Collins won’t rule out voting for Obamacare repeal next year. The Maine Republican voted against the GOP’s most significant Obamacare repeal measure late last year. But she told POLITICO on Thursday that no one should assume she would do it again if a similar bill comes to a vote next year. (Haberkorn, 12/1)

The Hill: GOP In Talks About Helping Insurers After ObamaCare Repeal
Congressional Republicans are talking to health insurers about ways to prevent a collapse of the insurance market once they pass an ObamaCare repeal bill. Republicans are planning to pass repeal legislation as soon as January, but plan to delay it from taking effect for a few years to avoid immediate disruption in people’s coverage. The delay would also buy them time to come up with a replacement. (Sullivan, 12/1)

Bloomberg: Trump’s Health-Care Reform Uncertainty Could See Jobs Shrink
Six years after the biggest overhaul of U.S. health care in half a century, the industry is bracing for more change under President-elect Donald Trump, who wants to tear it apart. As many as 200,000 jobs may be lost in the health-care sector over the next year and employers will slow investment as they wait to see Trump’s clear plan for reform, according to Chris Rupkey, chief financial economist for Bank of Tokyo-Mitsubishi UFJ Ltd. in New York. Goldman Sachs Group Inc. economist Alec Phillips, in a report last week, forecast “somewhat depressed” job growth in the sector, based on other tumultuous periods. (Matthews, 12/2)

The Fiscal Times: 5 Health Care Trends That Could Affect You In 2017
The American health care system faces massive uncertainty heading into 2017. Three years after the rollout of the Obamacare exchanges, more Americans have insurance than ever before, but they’re also having more trouble affording it. The promise of health care reform was a key part of the platform that got Donald Trump elected, but while changes are almost certainly coming, just what they’ll be and how they’ll affect you is still unclear — and likely will be for months if not years. (Braverman, 12/1)

Kaiser Health News: HSA Balances Climb But Benefits Reward Wealthier Consumers Most
President-elect Donald Trump has proposed expanding health savings accounts as an alternative to the health law. More than 20 million people now have high-deductible health plans that can link to the tax-advantaged accounts, and the average account balance grew by more than a third last year to more than $1,800, according to a new analysis. But consumer advocates warn that health savings accounts would do little to help lower income people who would lose their health insurance if the health law is repealed. (Andrews, 12/2)

And in news from the states —

The CT Mirror: With Obamacare’s Future Uncertain, CT Exchange Contemplates Strategies 
One person likened it to looking at a “foggy crystal ball.” Another spoke of changing a tire on a car that’s still moving. The topic: Figuring out a future strategy for the state’s Obamacare exchange at a time when the president-elect and the Republican majority in Congress are plotting the demise of the law it was charged with implementing. President-elect Donald J. Trump and GOP leaders have talked of replacing the health law, but it’s not yet clear what that replacement would look like. (Levin Becker, 12/1)

Sacramento Bee: ‘Code Blue!’ UC Davis Med Students Call Trump A ‘Medical Emergency’
Calling it a “code blue” medical emergency, more than 100 UC Davis medical students held a rally on the Sacramento campus Thursday night to speak out about their fears for health care under incoming president Donald Trump... Organized over Thanksgiving break, the rally included about a dozen speakers, mostly medical students, who described their concerns as future doctors and as Muslims, minorities, gays, immigrants and victims of sexual assault. (Buck, 12/1)


While ACA Was Never Boon Pharma Hoped For, Industry Now On Tenterhooks Over TrumpCare

It's unclear what any replacement proposals hold in store for pharmaceutical companies, but it seems like it might be a mixed bag. Meanwhile, some leaders in the industry think their colleagues' relief at a Trump administration instead of a Clinton administration is premature.

Stat: Drug Makers Are Getting Ready To Shape Trumpcare
The upcoming fight over repealing and replacing the Affordable Care Act promises to shake up hospitals and insurers, but drug makers also stand to gain — or lose — a lot. On the upside, congressional Republicans have already signaled that they plan to roll back billions of dollars in fees the law imposed on the industry. But drug makers also risk losing millions of new customers who became insured under the health care law. And if President-elect Donald Trump and Congress decide they need to cover the full cost of whatever they propose to replace the law, they might turn to drug companies to pay up. (Scott, 12/2)

Bloomberg: Trump May Be More ‘Vicious’ On Drug Prices, Pharma CEO Says 
Donald Trump’s victory in the presidential race, often cited as a boon to free-market health care, doesn’t mean drugmakers are free of scrutiny over prices, an industry leader said. U.S. pharmaceutical shares rose after the defeat of Democratic candidate Hillary Clinton, who had vowed to go after companies’ “gouging.” Yet if more pricing scandals emerge like the one that beset Mylan NV’s EpiPen, President-elect Trump could be more “vicious” than Clinton, Allergan Plc Chief Executive Officer Brent Saunders said Thursday. (Hopkins and Tracer, 12/1)

Bloomberg: Pharma CEOs In Shouting Match Over Prices: ‘It’s Ridiculous’ 
Regeneron Pharmaceuticals Inc. Chief Executive Officer Leonard Schleifer jumped into the drug pricing debate Thursday at a health-care conference, accusing fellow drug company executives he shared a stage with of raising prices to cover up a lack of innovation. ... Ian Read, who leads drugmaker giant Pfizer Inc., countered with an oft-cited statistic that drug costs as a percentage of health-care expenses haven’t changed in two decades, regardless of price increases. Schleifer’s response: “You’re not entitled to a fraction of the GDP.” The shouting match was a rare occurrence in an industry that’s been trying to show a united front to defend itself from attacks coming from the outside -- politicians, patients and health benefits managers. In the past 18 months, companies like Mylan NV, the maker of allergy shot EpiPen, and Valeant Pharmaceuticals International Inc. have emerged as the faces of the public’s outrage over drug costs. (Hopkins and Bloomfield, 12/1)

In other pharmaceutical news —

Stat: Mylan CEO Accepts Responsibility For EpiPen Price Hikes
In a rare appearance since the EpiPen controversy flared this summer, Mylan Pharmaceuticals CEO Heather Bresch accepted “full responsibility” Thursday for the price hikes that caused national outrage. ... Mylan increased the price of an EpiPen two-pack nearly 550 percent to $608 over the past decade. But, Bresch reiterated remarks she made about the price of EpiPen at a congressional hearing in September, citing a lack of transparency in the pharmaceutical pricing system for the controversy surrounding the product. She justified the price increases by pointing to investments made to improve the device and patient access. (Silverman, 12/1)

Administration News

Visionary Policy Wonk Or Day-To-Day Boss: What Will Price's HHS Role Look Like?

Politico talks to former Democratic Senate Majority Leader Tom Daschle about what kind of HHS secretary Rep. Tom Price will turn out to be. Meanwhile, Price's stock portfolio includes investments in pharmaceutical, medical device, and health insurance companies, which could raise conflicts of interest questions.

Politico: Does Trump Need A Health Care Czar?
Rep. Tom Price, President-elect Donald Trump's pick to run HHS, is facing an early test: How to repeal and replace Obamacare when congressional Republicans and Trump aren't necessarily on the same page. "It's going to be very difficult," former Democratic Senate Majority Leader Tom Daschle told POLITICO's "Pulse Check" podcast. For instance, Trump's pledge to keep Obamacare's consumer protections raises complicated questions around how to pay for those provisions — "and that's just for starters." (Diamond, 12/1)

Stat: Rep. Tom Price Investments Raise Conflict Of Interest Questions
The public spotlight may be on President-elect Donald Trump’s conflicts of interests, but his nominee to be secretary of health and human services, Rep. Tom Price, could have conflicts of his own. Price’s wealth pales in comparison with Trump’s. The orthopedic surgeon, first elected to Congress from Georgia in 2004, is ranked as only the 50th richest member of Congress by the Capitol Hill publication Roll Call. But his stock portfolio includes investments in pharmaceutical, medical device, and health insurance companies, the heart of the industries he would be overseeing as secretary. (Kaplan, 12/2)

The Washington Post: Trump To GOP: Here’s How To Defend My Cabinet Picks
President-elect Donald Trump’s transition team has provided detailed instructions to congressional Republicans on how to defend his Cabinet picks, including directions to portray his attorney general nominee, Sen. Jeff Sessions (R-Ala.), as a strong defender of civil rights and to play up South Carolina Gov. Nikki Haley’s Indian heritage as evidence of Trump’s purported commitment to a diverse administration. ... [The memo says] "Congressman Price, a renowned physician, has earned a reputation for being a tireless problem solver and the go-to expert on quality health care policy, making him the perfect choice to serve in President-elect Trump’s cabinet as Secretary of Health and Human Services." (Snell and Viebeck, 12/1)

In other news about the incoming administration —

Politico: Veterans Groups Fear Trump Will 'Burn Down' VA
Donald Trump won the White House pledging to use his business acumen to overhaul the Department of Veterans Affairs, the poster child for government mismanagement — even if he has to "pick up the phone and fix it myself." But Trump’s leading candidates to run the troubled Cabinet department strike fear in many veteran's advocates, current and former agency officials and members of Congress, who worry that the new administration will aim to gut the VA and privatize many of its services. (Bender, 12/2)


Anthem Deal Would Result In $3B Being Passed On To Employers, Company's Expert Testifies

Economist Mark Israel defended the Anthem-Cigna merger and said the Justice Department’s expert erred in ignoring savings from reduced medical costs estimated in his analysis of the deal's impact. Meanwhile, Anthem could face a $3 billion penalty from Blue Cross Blue Shield Association if it acquires Cigna and the Aetna-Humana trial is set to start on Monday.

Politico Pro: Anthem's Economics Expert Makes Case For Cigna Deal 
Anthem’s $54 billion acquisition of Cigna would create $3 billion in annual savings in the national accounts market. Nearly all of that money would be passed on to customers through cheaper rates, economist Mark Israel testified Thursday at the antitrust trial challenging the deal. Compass Lexecon’s Israel is arguably Anthem’s most important witness. He's providing expert validation to the insurer’s key arguments for why the deal won’t hurt competition in the market for large employers, which is the focus of the first phase of the trial. (Demko, 12/1)

Bloomberg: Anthem’s Cigna Takeover May Draw $3 Billion Blue Cross Fine 
Anthem Inc. could face a penalty of about $3 billion from the national Blue Cross Blue Shield Association if it fails to derive the bulk of its nationwide revenue from Blue-branded products after acquiring Cigna Corp., according to testimony from an Anthem executive during a U.S. antitrust trial in Washington. Twenty-three percent of Cigna’s domestic revenue would need to be rebranded to comply with rules of the BCBS association, said Steve Schlegel, Anthem’s vice president for corporate development, under questioning Wednesday by a Justice Department lawyer. (Harris, 11/30)

The CT Mirror: Aetna-Humana Antitrust Trial To Have A Different Twist 
As the first part of the antitrust trial on a proposed merger of health insurers Anthem and Cigna is wrapping up, a similar challenge to Aetna’s plan to merge with Humana is about to begin. While both are the result of lawsuits to block the mergers filed by the U.S. Justice Department on the same day in July, the trials will be much different. (Radelat, 12/2)

And in other news from the health industry —

The Wall Street Journal: Zenefits Must Charge For Software In Washington State
Washington’s insurance regulator said Thursday that Zenefits can no longer offer its human resources software for free in the state, another setback for the embattled health-benefits brokerage that has sought to move past regulatory violations. The order from Washington Insurance Commissioner Mike Kreidler strikes at the heart of Zenefits’s business model, which offers free human-resources software to small businesses so that it can collect commissions when the companies use Zenefits to sign up for health benefits. (Winkler, 12/1)

Women’s Health

Opponents Say Texas' Fetal Remains Rule 'Designed To Shame' Women Seeking Abortions

The state finalized the rule -- which requires aborted fetal remains be buried or cremated -- this week. Media outlets report on other news on abortion out of Arkansas, Ohio and Maryland.

The New York Times: Texas Again Places Obstacles In Front Of Those Seeking Abortions
Despite losing a milestone abortion case at the United States Supreme Court this past summer, Texas threw down another stumbling block this week. It will require facilities that provide abortions to pay for the cremation or burial of fetal remains, rather than dispose of them as biological medical waste. It is the latest attempt by abortion opponents to make it more burdensome for women to get abortions — by creating new rules and laws that make it more difficult for providers to stay in business. (Alvarez, 12/1)

Texas Tribune: Funeral Directors Anxious Over Texas Fetal Remains Rules
With Texas set to implement rules requiring the burial or cremation of fetal remains, it's not just health care providers who are anxious about the recently adopted requirements. Funeral directors in the state are joining the chorus of medical professionals and reproductive rights activists who have raised concerns about the rules. Though it hasn't taken a formal position on the requirements, the Texas Funeral Directors Association says it’s concerned about how they’ll affect the families they serve and the costs associated with compliance. (Ura, 12/2)

The Associated Press: Trump Win Buoys Push For New Abortion Limits In Arkansas
Buoyed by Republicans' expanded majorities in the Legislature and Donald Trump's presidential victory, abortion opponents in Arkansas are pushing for bans on a commonly used second trimester procedure, terminating a pregnancy based on the fetus' sex and other restrictions next year. A Republican lawmaker plans to file legislation next week to prohibit dilation and evacuation, or "D&E," a second trimester procedure that abortion supporters say is the safest and most common. (12/1)

The Associated Press: Ohio Pulls License Of 1 Of State's Last Few Abortion Clinics
Ohio has revoked the operating license of one of the state's few remaining abortion clinics on the grounds that it failed to obtain a required transfer agreement with a nearby hospital for emergencies. Women's Med Center of Dayton has 15 days to appeal the order, which was signed Wednesday by Rick Hodges, the director of the Department of Health. The clinic said it will do so. (12/1)

The Associated Press: Maryland’s Democrats Vow Planned Parenthood Fight
Although President-elect Donald Trump has vowed to defund Planned Parenthood as long as it provides abortions, several of Maryland’s Democratic lawmakers said that despite their party’s minority status in Congress, they will fight every effort to do so. “This will be an ongoing battle,” Chris Van Hollen, a Democratic congressman who was elected to the Senate last month, said in an interview with Capital News Service. “It’s unfortunate that in the 21st century we’re still having to wage this battle, but we will fight tooth and nail to prevent Donald Trump and the Republicans from turning back the clock on women’s rights.” (Haq and Tonic, 12/1)

And birth control takes center stage post-election —

Stat: Birth Control Becomes A Rallying Cry Against Trump's HHS Pick
Reproductive rights activists opposed to Donald Trump’s nominee for health secretary have hit upon a potent rallying cry: The cost of birth control. The campaign stems from a remark made back in 2012 by Georgia congressman Tom Price, who this week was tapped to run Trump’s Department of Heath and Human Services. Back then, Price had joined other Republicans in a fierce fight to block an Obamacare mandate that insurers give women free access to contraception. (Robbins, 12/2)

Chicago Tribune: IUD Appointments Up 82% After Trump’s Win, Planned Parenthood Of Illinois Reports 
Protests and social media diatribes aren't the only ways anxious Illinoisans are responding to an impending Donald Trump presidency. At least one organization has seen more Illinois women seeking birth control since Trump's election. Planned Parenthood of Illinois said it saw an 82 percent increase in the number of women making appointments online for intrauterine devices last month after the election compared with the previous November — an increase of about 200 appointments. After the election, appointments made online for all kinds of birth control services spiked 40 percent over the same time last year, said Julie Lynn, manager of external affairs for Planned Parenthood of Illinois, which operates 16 centers. The organization's contact center also has been fielding thousands of additional calls, she said. (Schencker, 12/1)

Public Health And Education

Parents' Struggles With Opioids Take Wrenching Toll On Children

Other developments in the nation's drug crisis include $1 billion in federal funding to the states, the difficulties law enforcement faces in the fentanyl battle and the debate over family notifications of overdoses.

Boston Globe: Opioids’ Hold On Parents Takes Toll On Kids
More than half of drug arrests in the city involve out-of-state residents, Cuddy said. The department does not have statistics on how often children witness drug use.In Lawrence, overdose deaths climbed from six in 2012 to 25 in 2015, according to state statistics. The 2015 number could increase as the medical examiner confirms additional cases. (Allen, 12/1)

New Hampshire Public Radio: Opioid Recovery Advocates Hopeful About $1 Billion Federal Spending Bill
The Senate is scheduled to take up a bill next week that would send $1 billion to states battling the opioid addiction crisis. The federal dollars would be divvied up among states based on per-capita drug overdoses. By that measure, New Hampshire ranks third nationally. The funding would help strengthen the state's growing but still inadequate network of services, including prevention, early detox, long-term housing and mental health treatment, says Tym Rourke, Chair of the Governor's Commission on Substance Abuse. (Rodolico, 12/1)

New Hampshire Public Radio: Health Care Reform Bill Includes $1B For N.H., Other States Battling Heroin Crisis
Lawmakers in the U.S. House have overwhelmingly passed a wide-ranging health care reform bill that sets aside $1 billion to be split among states like New Hampshire battling the heroin and opioid addiction crisis. The bipartisan legislation sailed through on a 392-26 vote Wednesday, and includes everything from an overhaul of how new drugs are approved to nearly $5 billion for medical research. (Ganley and Brindley, 12/1)

Kaiser Health News: Delivered ‘Like A Pizza’: Why Killer Drug Fentanyl Is So Hard To Stop
The Obama administration agreed that the increasing supply of fentanyl on the street is a major challenge and said agencies are doing a lot. But reducing the supply is complicated. ... “Synthetic drugs are a real winner because they are easy to make, and they’re cheap to produce,” said Kara McDonald, director of policy, planning and coordination at the international narcotics and law enforcement bureau of the U.S. Department of State.“They’re not dependent on a season or the weather like a plant-based drug,” McDonald said. “And with the distribution system — through mail order — they can be delivered directly to the door in some cases. Like a pizza. (Bebinger, 12/2)

And from the states —

Georgia Health News: Fulton Co. Ranks High In Opioid Deaths, HIV Rate
Fulton County’s rate of opioid overdose deaths was more than double the national average in 2014, newly released figures show.Fulton CountyAnd the county — which contains most of the city of Atlanta as well as some of Georgia’s most affluent suburbs — had a higher rate of HIV diagnoses than all but one of 28 large cities studied, according to statistics released this week by the Big Cities Health Coalition project. (Miller, 12/1)

Magnetic Stimulation Creates 'Frankenstein Effect' For Memories Thought Lost To Void

New research shows that working memory -- the ability to retain a new piece of information even when our attention is temporarily directed elsewhere -- may not be as volatile as once thought. Also in public health news: labeling on homeopathic treatments, life in an Alzheimer's ward, a 'tidal wave' of hepatitis C, and more.

NPR: Magnetic Pulse Jump-Starts Short-Term Recall In Memory Study
Forget where you just left your car keys? A magnetic pulse might help you remember. Some dormant memories can be revived by delivering a pulse of magnetic energy to the right brain cells, researchers report Thursday in the journal Science. The finding is part of a study that suggests the brain's "working memory" system is far less volatile than scientists once thought. (Hamilton, 12/1)

NPR: Time For Homeopathic Remedies To Prove That They Work?
Homeopathy has been around since the 1700s, but despite having devoted followers, there is no scientific evidence that it works. Soon, packages for homeopathic products might say just that. On Nov. 15, the Federal Trade Commission released an enforcement policy statement about labeling for over-the-counter homeopathic products. Homeopathic treatments have increasingly been marketed in drug store and supermarket aisles, alongside Food and Drug Administration-approved over-the-counter medications like Tylenol and Mucinex. (Ross, 12/2)

NPR: Photographer Reveals Life Inside An Alzheimer's Ward
Inside the walls of a geriatric hospital in France, time stands still. Light falls across two stockinged feet on a bed. The fading floral pattern on a swath of wallpaper is interrupted by an unused corkboard. And between these scenes of stillness, residents approach a pair of locked doors with modest curiosity, expectation and even anger. Swedish photographer Maja Daniels says those doors, which were locked to prevent the residents from wandering, were crucial early in the project. (Rizzo, 12/1)

Richmond Times Dispatch: 'Tidal Wave Of Hep. C Coming,' Health Commissioner Warns 
As the state lingers in the grip of its ongoing opioid epidemic, Virginia’s top health official is warning that the state soon may also be dealing with skyrocketing rates of hepatitis C and HIV. During a Virginia Board of Health meeting Thursday, the state health commissioner, Dr. Marissa Levine, said that as opioid use continues, the two deadly infections “will rear their ugly heads.” (Demeria, 12/1)

Health News Florida: Despite Skeptics, Alternative Doctors ‘Detoxifying’ Blood With UV Rays 
A blood treatment that was popular 75 years ago but faded away when antibiotics came along may be making a comeback with the increasing popularity of “integrative medicine.” Historically called “ultraviolet blood irradiation” (UBI), the treatment appeals to alternative practitioners, especially those who give regular IV treatments for energy boosts and “detoxification.” (Gentry, 12/1)

The Associated Press: Public Housing Smoking Ban Sparks Mixed Reviews In NYC
Elba Acosta was distressed to learn that her morning habit of coffee and a smoke inside her New York City Housing Authority apartment will be banned under new federal rules prohibiting smoking in public housing. “I have my black coffee and a cigarette at home,” Acosta, 67, said Thursday outside the Chelsea-Elliot Houses. “I mean, that’s my freedom. You do whatever you want to do because it’s your body. The government has no business in your personal choice.” (Matthews, 12/1)


Companies Managing Iowa's Medicaid Program Continue To Lose Money

In other Medicaid news, some Minnesota residents on public health programs will have to switch to a new plan because an insurer and the state were unable to agree on a new contract. News outlets also report on developments the dire outlook for expansion in Virginia and how gunshot victims get help from the state-federal health insurance program.

Des Moines Register: Medicaid Management Firms Continue To Lose Millions
The three for-profit companies managing Iowa’s Medicaid program continue to lose tens of millions of dollars on the project, a report released Wednesday shows. The companies, Amerigroup, AmeriHealth Caritas and UnitedHealthcare, reported losses ranging from 18 percent to 25 percent for the three months ending in September. The firms took over management of Iowa’s $4 billion Medicaid program last year in a controversial shift ordered by Gov. Terry Branstad. (Leys, 11/30)

Pioneer Press: Thousands On Medicaid, MinnesotaCare To Switch Plans As Medica Drops Contract 
More than 300,000 Minnesotans on public health programs could have to switch to a new plan next year after insurer Medica couldn’t agree on a new contract with the state of Minnesota. The move is fallout from last year, when Minnesota for the first time issued contracts to manage Medicaid and MinnesotaCare plans based on competitive bidding. Medica was among the carriers submitting winning bids — bids far below what the state paid in previous years. As a result of the low bids, officials forecast savings to taxpayers of about $450 million in the first year alone. (Montgomery, 12/1)

Richmond Times Dispatch: Saslaw Says Coal Jobs Are Not Coming Back; Stanley Says Medicaid Expansion Is Dead 
Coal jobs are not coming back to Southwest Virginia, according to a Democratic legislative leader — and the prospects of Medicaid expansion in Virginia are similarly dire, a Republican leader said Thursday. But lawmakers from both parties say they recognize the need for economic development in some of the state’s most depressed regions and the importance of working to fill any coverage gap that could open if the Trump administration succeeds in repealing the Affordable Care Act. (Nolan, 12/1)

Kaiser Health News: Medicaid Is Balm And Benefit For Victims Of Gun Violence
Kenneth Berry can feel the bullets in his body move. One jiggles down his leg toward his ankle; another presses on his sciatic nerve; a third has migrated to his hip. The three bullets have been inside Berry, 41, for more than two decades, pumped into him when he was a teenager near St. Louis. Now, after years without health coverage, besieged by untreated nerve pain and hunched over a cane, he finally has the golden ticket to get the medical procedures that will bring relief: a Medicaid card. (Varney, 12/2)

State Watch

State Highlights: Ga. Autism Advocates Push To Increase Age Cap For Kids' Insurance; Mass. Health Data Agency Cuts 65 Jobs

Outlets report on health news from Georgia, Massachusetts, Oregon, Maryland, Pennsylvania, Minnesota, California, Florida, Virginia and Missouri.

Boston Globe: State Health Data Agency Is Cutting 65 Jobs
The public agency responsible for analyzing data about the Massachusetts health care market is eliminating dozens of jobs to contend with $45 million in planned budget cuts. The Center for Health Information and Analysis, or CHIA, will reduce spending over five years, part of a political compromise struck earlier this year to avoid a ballot question about hospital payments. The deal allowed the state to take money from CHIA to help fund community hospitals. (Dayal McCluskey, 12/2)

The Bend Bulletin: Hospital Smoking Bans Yield Fewer Fires
Over the past two decades, U.S. hospitals have been moving steadily toward establishing smoke-free campuses in a bid to promote healthier lifestyles among their patients and their staff. But the movement has had a secondary benefit — a reduction in the number of hospital fires. According to a new report issued by the National Fire Protection Association, smoking materials accounted for an average of 50 fires per year in hospitals and hospices from 2009 to 2013. That’s down from 100 fires per year from 2006 to 2010, and 3,800 fires per year from 1980 to 1984, when nearly half of smoking-related fires occurred in patient rooms. (Hawryluk, 12/1)

The Baltimore Sun: Maryland Hospitals Spend $1.6 Billion On Community Services 
Maryland's hospitals in the past year provided nearly $1.6 billion in services other than the medical care traditionally offered in emergency rooms, operating rooms, or hospital beds, according to the Maryland Hospital Association. The hospital association said its members spent 10 percent of their operating expenses on non-traditional services, or community benefits, such as chronic disease management programs, free health education and other public health programs. (McDaniels, 12/1)

The Philadelphia Inquirer: St. Christopher's Hospital For Children Again Faulted For Care After Third Surprise Inspection
For the third time this year, surprise inspections by state investigators have revealed serious shortcomings in patient care at St. Christopher's Hospital for Children. After the latest site inspection, in mid-October, investigators said the North Philadelphia hospital did not do enough to determine why four patients who underwent surgery suffered some kind of treatment-related harm during their stay. One of the patients died, though the cause of death was not revealed in the inspection report. (Avril and Purcell, 12/1)

Boston Globe: Galvin Files Fraud Charges Against Investment Adviser 
Secretary of State William F. Galvin on Thursday filed civil fraud charges against an investment adviser with Boston-based LPL Financial for allegedly selling costly variable annuities to retirees and health care workers, reaping $1.8 million in commissions. The adviser, Roger S. Zullo, allegedly sold unsuitable annuity investments to at least 11 clients, generating large payouts for himself and the brokerage firm. (Healy, 12/1)

Boston Globe: Caregiver Respite Program Launches In Reading 
Reading Trust Fund Commissioners recently announced the launch of a new Caregiver Respite Program, which provides care for Reading residents by certified home health aides through Hallmark Health VNA and Hospice for up to three hours per month. The new initiative is part of the Reading Response Program. (Buote, 12/1)

The Baltimore Sun: Area Public Health Experts Make Case For Federal Health Programs 
With a host of federal health programs on the line with the incoming Trump administration, some public health experts in the Baltimore region are both bracing for big changes and offering their take on how to better spend taxpayer funds to improve outcomes for millions of Americans. ...A panel of policy experts largely supportive of the health programs gathered this week at the Johns Hopkins Bloomberg School of Public Health and said large groups of people could be affected in the new year as GOP lawmakers in charge of the Congress and the White House make use a budgetary process to alter programs. (Cohn, 12/1)

The Star Tribune: With Greater Outreach, Hennepin County Aims To Curb HIV Cases 
Hennepin County officials unveiled a plan Thursday to reduce the spread of HIV, starting with outreach to residents who have the infection but are not receiving treatment. Last year, 168 county residents were diagnosed with the virus that causes AIDS — a number that has been fairly constant for nearly two decades. (Howatt, 12/1)

Los Angeles Times: California Health Officials Report First Death Of Flu Season
California health officials on Thursday confirmed the state’s first death of this year’s influenza season and reminded everyone to get a flu shot before more people get sick. “As this unfortunate case illustrates, the flu can be deadly and causes thousands of fatalities each year in the United States,” said Karen Smith, director of the California Department of Public Health. “Fortunately, people can get vaccinated to help keep them from getting sick and spreading the flu to others.” (Karlamangla, 12/1)

Minnesota Public Radio: Hennepin Co. Seeking HIV-Infected People In Need Of Care 
Hoping to curb the spread of the virus that causes AIDS, Hennepin County officials Thursday launched a new effort to contact some 2,000 county residents who are HIV-positive but who've dropped out of care or never received it. Early and sustained medical treatment is now considered the key to stopping the spread of HIV because drugs have proven so effective. (Benson, 12/1)

Health News Florida: Court Rejects $18.5M Award In Smoker’s Death 
A South Florida appeals court Wednesday said an $18.5 million damages award against R.J. Reynolds Tobacco Company was excessive in a lawsuit filed by the daughter of a woman who died of lung cancer. A panel of the 4th District Court of Appeal ordered that a circuit judge consider reducing the amount or hold a new trial on damages. The Palm Beach County case was filed against the tobacco company by Gwendolyn Odom, whose mother, Juanita Thurston, died of lung cancer in 1993 after smoking cigarettes. (12/1)

California Healthline: California Has High Aspirations For Lowering HIV Infections
Zero. That’s the number of new HIV infections California officials are aiming for under a comprehensive initiative released this fall. The “Getting to Zero” plan, intended to guide the state’s AIDS policy from 2017 to 2021, is designed to boost surveillance, increase access to care and eliminate disparities in treatment. (Korry, 12/2)

The Star Tribune: PTSD Is Added To Minnesota's Medical Pot Program As Qualifying Condition 
Post-traumatic stress disorder, or PTSD, is being added to the list of conditions covered by Minnesota’s medical cannabis program, effective next August. The expansion, announced Thursday by Health Commissioner Dr. Ed Ehlinger, adds an option for the estimated 8 percent of Minnesotans who, at some point in their lives, will suffer PTSD, a condition that can cause people to relive the emotion of traumatic experiences through panic attacks, nightmares and severe anxiety. (Olson, 12/1)

Kansas City Star: Petition Seeking Vote To Decriminalize Pot In KC Has Enough Signatures 
A petition initiative seeking a vote to decriminalize marijuana possession in Kansas City has enough signatures to qualify for an election ballot.City Clerk Marilyn Sanders said Thursday that election authorities had counted more than 2,000 valid signatures of registered voters, more than the 1,708 required to place a citizen-led initiative on a Kansas City ballot. (Horsley, 12/1)

Health Policy Research

Research Roundup: Dementia Care; Asthma In Schools; Paid Family Leave

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

JAMA Internal Medicine: Effect Of The Goals Of Care Intervention For Advanced Dementia
Can a decision aid intervention about goals of care improve communication, decision-making, and palliative care for patients with advanced dementia? ... In this randomized trial of 302 nursing home residents with advanced dementia, family decision makers reported better end-of-life communication with clinicians. Clinicians were more likely to address palliative care in treatment plans, use Medical Orders for Scope of Treatment, and less likely to send patients to the hospital. (Hanson et al., 11/28)

JAMA Pediatrics: Association Between Allergen Exposure In Inner-City Schools And Asthma Morbidity Among Students
In this cohort study evaluating students with asthma, higher mouse allergen exposure at school was significantly associated with both increased asthma symptoms and lower lung function, independent of allergic sensitization and allergen exposure in the home. ... The school environment is an important contributor to childhood asthma morbidity, and future school-based environmental interventions may benefit all children with asthma. (Sheehan et al., 11/21)

Health Care Cost Institute: 2015 Health Care Cost And Utilization Report
The report covers the health care cost and utilization trends for Americans younger than age 65 and covered by employer-sponsored insurance (ESI) for the years 2012 through 2015. ... In 2015, spending per capita for the ESI population grew by 4.6% over the previous year, to $5,141 per person .... This growth was faster than previous years’ growth: 3.0% growth in 2013 and 2.6% growth in 2014. ... In every year studied, the biggest driver of per capita spending growth was increasing prices. However, in some years increases in the utilization of services also played a role in spending growth. (11/22)

Health Affairs: Paid Family And Medical Leave
Most people at some point in their lives need to take time away from work to deal with a serious personal or family illness or to care for a new child. In contrast to almost every other developed nation in the world, the United States has no federal law that guarantees paid family or medical leave, whether that leave is to care for a new child or a seriously ill family member, or to address one's own serious health condition. ... President-elect Donald Trump during the campaign surprised many in the Republican Party by proposing a modest paid maternity leave policy. Republicans in Congress might oppose guaranteed paid leave in any form or promote their own reform. (Findlay, 11/21)

The Kaiser Family Foundation/American Institutes for Research: Payment And Delivery System Reform In Medicare: A Primer On Medical Homes, Accountable Care Organizations, And Bundled Payments
Policymakers, health care providers, and policy analysts continue to call for “delivery system reform”—changes to the way health care is provided and paid for in the United States—to address concerns about rising costs, quality of care, and inefficient spending. The Affordable Care Act (ACA) established several initiatives to identify and test new health care payment models that focus on these issues. Many of these ACA programs apply specifically to Medicare, the social insurance program that provides coverage to 57 million Americans age 65 and older and younger adults with permanent disabilities. This Primer describes the framework and concepts of three payment models that CMS is currently testing and implementing within traditional Medicare—medical homes, ACOs, and bundled payments. (Baseman et al., 11/17)

Editorials And Opinions

Perspectives On GOP Plans For Medicare And Advice About Replacing Obamacare

Opinion writers contemplate what the Trump administration's pick to lead the Department of Health and Human Services portends in terms of health policy changes and offer cautions.

The Washington Post: Will Republicans Gut Medicare? Trump Promised Over And Over He Wouldn’t. Here’s The Video.
Donald Trump’s choice of GOP Rep. Tom Price as secretary of health and human services is being widely interpreted as a sign that he is likely to proceed with plans to repeal the Affordable Care Act and convert Medicare into a “premium support” scheme along the lines that Paul Ryan has long championed. Trump did repeatedly promise to repeal Obamacare. But Medicare is a different matter. Trump promised countless times not to cut Medicare and repeatedly suggested he would leave the program as it is. (Greg Sargent, 12/1)

The New York Times: What Republicans Should Know About The A.C.A.
As President-elect Donald Trump and Republicans in Congress decide the future of the Affordable Care Act, they ought to pay close attention to a survey published on Thursday that shows that a large majority of the country supports the law’s most important provisions. Republican lawmakers and candidates have portrayed the 2010 law as an unmitigated disaster that must be repealed. (Vikas Bajaj, 12/1)

Sacramento Bee: Trump Starts To Reveal Obamacare Plans 
After campaigning on a platform long on platitudes and short on specifics, President-elect Donald Trump this week started to reveal what he has in store for the nation’s health care system – and many Californians aren’t going to like what they hear. Trump, who promised to replace Obamacare with “something terrific,” chose Rep. Tom Price, a tea party Republican from suburban Atlanta and one of Obamacare’s fiercest critics, as his nominee to lead the Department of Health and Human Services. (Sal Rosselli, 12/1)

The New York Times: Seduced And Betrayed By Donald Trump
Yes, the white working class is about to be betrayed. The evidence of that coming betrayal is obvious in the choice of an array of pro-corporate, anti-labor figures for key positions. In particular, the most important story of the week — seriously, people, stop focusing on Trump Twitter — was the selection of Tom Price, an ardent opponent of Obamacare and advocate of Medicare privatization, as secretary of health and human services. This choice probably means that the Affordable Care Act is doomed — and Mr. Trump’s most enthusiastic supporters will be among the biggest losers. (Paul Krugman, 12/2)

Arizona Republic: Obamacare Is A Bad Deal For Arizona Millennials
Why aren’t Arizona’s Millennials signing up for the Affordable Care Act? That’s what the Obama administration is wondering now that open enrollment is underway in Arizona and across the nation. My generation is the key to the Affordable Care Act’s success, and yet so far we’ve steered clear for three straight years. (David Barnes, 12/1)

Viewpoints: Congress Should Engage Now In Fighting Opioid Addiction; New HIV Prevention Methods For Women

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

The Wall Street Journal: Congress Can Fight Opioid Addiction On Its Way Out
Much attention and speculation surrounds the incoming Trump administration and the new Congress, but it’s important to remember that the current Congress still has work to do. Before the new Congress is sworn in on Jan. 3, more than 2,500 people will die from an opioid overdose. More than half of these preventable deaths will be due to prescription opioids such as morphine or oxycodone. Nearly 40,000 others will visit the emergency room due to misusing prescription opioids. (Newt Gingrich and Patrick Kennedy, 12/1)

Stat: New Methods Needed For HIV Prevention In Women
Leading research and advocacy organizations are sounding alarms on stagnating and even rising infection rates in settings where adolescent girls and young women bear the greatest burden of new infections. But new prevention methods on the horizon, called multipurpose prevention technologies (MPTs), offer protection against HIV as well as an opportunity to simultaneously engage in family planning and reduce other sexual and reproductive health risks with discreet tools that are user-controlled. (Bethany Young Holt, 12/1)

Milwaukee Journal Sentinel: Partnerships In Health Care Could Help Heal Rural, Urban Discontent
Deficiencies in affordable housing, education and employment, as well as access to health care and its excessive cost, are critical factors driving unrest, preventable illness and premature death. But partnerships have the potential to coordinate Wisconsin’s intrinsic academic and community resources to address these deficiencies. But promoting health for everyone requires more than sufficient health care resources. (Richard Rieselbach, Byron Crouse, Cynthia Haq, Tom Jackson, Greg Nycz and Patrick Remington, 12/1)

The New England Journal Of Medicine: Clarifying Stem-Cell Therapy’s Benefits And Risks
The current excitement over the potential for stem-cell therapy to improve patient outcomes or even cure diseases is understandable. We at the Food and Drug Administration (FDA) share this excitement. However, to ensure that this emerging field fulfills its promise to patients, we must first understand its risks and benefits and develop therapeutic approaches based on sound science. Without a commitment to the principles of adequate evidence generation that have led to so much medical progress, we may never see stem-cell therapy reach its full potential. (Peter W. Marks, Celia M. Witten and Robert M. Califf, 11/30)

The Washington Post: Feds Pay Steep Price For Long-Term Care Company Errors
John Hancock got it wrong, and now federal employees and retirees are paying the price. A very high price. Their cost for coverage in the Federal Long Term Care Insurance Program (FLTCIP) skyrocketed this year by an average of 83 percent, with some taking a 126 percent hit. The reasons for the huge increases? The John Hancock Life and Health Insurance Co. made one error after another in its calculations. (Joe Davidson, 12/1)

The Fiscal Times: Here Are 3 Things We Need To Do As Another Alzheimer’s Drug Fails 
Since the early 2000’s, Alzheimer’s drugs have faced a failure rate of over 99 percent. Even so, Solanezumab demonstrated the best of science, as Lilly’s researchers worked tirelessly for years with the goal of improving patients’ lives and our understanding of dementia’s underlying causes. Alas, failure was the outcome once again, but these ongoing efforts emphasize the need for a breakthrough – despite the odds – to address the severe social and economic consequences of Alzheimer’s. (Michael Hodin, 12/1)

Chicago Tribune: Group Homes Mess Shows What Happens When Politics Trump People
Finally, the state cracked down on a shoddy group home operator serving adults with disabilities. The Illinois Department of Human Services has yanked the license of Disability Services of Illinois following a Tribune investigation into health and safety violations — some resulting in deaths — at group homes statewide. (12/1)

Los Angeles Times: End The Outdated, Unscientific Restrictions On Gay Blood Donors
More than 30 years ago, as the AIDS epidemic exploded, the nation’s blood banks banned donations from men who had sex with other men. The logic was sound at the time. Tests of the era couldn’t adequately detect HIV, the virus that causes AIDS. As a result, thousands of people unwittingly contracted HIV from tainted blood during transfusions. Banning donations from gay men was a drastic step, but necessary to protect the nation’s blood supply. (12/1)

Louisville Courier-Journal: A Case For A Marijuana Middle Ground
As of last week, voters in California and seven other states have passed ballot initiatives to allow for-profit companies to produce, distribute and sell non-medical marijuana. With more than 65 million people living in states that have passed marijuana legalization, and a Gallup poll showing that 60% of the country supports legalizing marijuana use, national legalization may seem inevitable. (Beau Kilmer, 12/1)