KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Podcast: 'What The Health?' No Vacation For Insurers

In this episode of “What the Health?” Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Sarah Kliff of, and Margot Sanger-Katz of The New York Times discuss the state of the individual health insurance markets in the wake of the failure (for now) of Congress’s efforts to repeal and replace the Affordable Care Act. (8/10)

Summaries Of The News:

Administration News

Trump Declares Opioid Crisis A National Emergency. So What Does That Mean?

President Donald Trump hasn't yet spelled out what the declaration will entail, but it could allow the government to negotiate lower prices for naloxone, open up additional funding to states and provide technical assistance and manpower to places where local and state resources have been overwhelmed. Some experts say it is a mostly symbolic move, though.

The Associated Press: Trump To Declare Opioid Crisis A 'National Emergency'
"The opioid crisis is an emergency. And I am saying officially right now: It is an emergency, it's a national emergency. We're going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis," Trump told reporters during a brief question-and-answer session ahead of a security briefing Thursday at his golf course in Bedminster, New Jersey. (Covin and Lemire, 8/10)

The Wall Street Journal: Trump Declares Opioid Epidemic A National Emergency
Declaring an emergency under the Public Health Service Act, or the Stafford Act, would “empower your cabinet to take bold steps and would force Congress to focus on funding and empowering the executive branch even further to deal with this loss of life,” [the national commission] said. The Stafford Act was designed to organize federal assistance to natural disasters. Jessica Nickel, president of the Addiction Policy Forum, who testified before the opioid commission, applauded the announcement. “This declaration can help communities with flexibility and resources to help implement a comprehensive response to the opioid epidemic,” she said. (Radnofsky and Campo-Flores, 8/10)

Politico: Trump Says He Will Declare Opioid Crisis A ‘National Emergency’
Trump was briefed on the epidemic Tuesday by HHS Secretary Tom Price, who told reporters at the time that the administration believed the crisis could be effectively addressed without the declaration of an emergency. Trump vowed his administration would beat the epidemic by beefing up law enforcement and strengthening security on the southern border to stop illegal drugs from entering the country. (Ehley, 8/10)

Stat: Trump, Reversing Course, To Declare National Emergency Over Opioids
The declaration could help the government negotiate lower prices for naloxone, the overdose reversal medication, but many experts and advocates have said that it would likely be more of a symbolic step and public education tool. Under laws that outline national emergencies, the government can open up additional funding to states and provide technical assistance and manpower to places where local and state resources have been overwhelmed. But major initiatives to expand treatment options, promote more research, and boost funding would still require congressional action or initiatives from federal agencies. (Joseph, 8/10)

The Washington Post: Trump Says Opioid Crisis Is A National Emergency, Pledges More Money And Attention
Last week, the President’s Commission on Combating Drug Addiction and the Opioid Crisis, which is led by New Jersey Gov. Chris Christie (R), issued a preliminary report that described the overdose death toll as “September 11th every three weeks” and urged the president to declare a national emergency. On Tuesday, Trump received an extended briefing on the subject in Bedminster. White House aides said Trump was still reviewing the report and was not yet ready to announce which of its recommendations he would embrace. (Achenbach, Wagner and Bernstein, 8/10)

Modern Healthcare: Declaring Opioid Crisis A National Emergency Opens Up Resources For Providers 
The declaration of emergency would exempt providers from complying with certain requirements that often prevent them from getting paid. For example, HHS could temporarily lift Medicaid rules that limit how long patients can receive mental health or substance use disorder treatment in residential facilities with more than 16 beds. Currently the program covers the costs for up to 15 days. "Waiving that requirement would allow many, many more facilities to be able to accept patients, and maybe reduce waiting lists and get people the kind of help that they need when they need it," said Tom Coderre, a senior adviser with the Altarum Institute and a former chief of staff and senior adviser to the Assistant Secretary at the U.S. Substance Abuse and Mental Health Services Administration during the Obama administration. (Johnson, 8/10)

Nashville Tennessean: Tennesseans Praise President Donald Trump For Declaring Opioid Crisis A 'National Emergency'
From the governor and lawmakers to law enforcement and community health groups, Tennesseans across the state praised President Donald Trump's efforts to address the opioid crisis after Trump announced plans Thursday to declare a national emergency to address the issue. Trump said he is "drawing documents now" to officially label the crisis a national emergency. A formal declaration of a public health emergency would give the federal government additional powers to waive health regulations, pay for treatment programs and make overdose-reversing drugs more widely available. (Buie, Nelson and Fletcher, 8/10)

Health Law

Americans: Stop Trying To Undermine The Health Law And Start Fixing It

Just 3 in 10 want President Donald Trump and congressional Republicans to continue their drive to repeal and replace the statute, while nearly 8 in 10 say Trump should be trying to make the health law work according to a new poll.

The Associated Press: Poll: Most Say Time To End Effort To Repeal Obama Health Law
Message to President Donald Trump and congressional Republicans: It's time to make the Obama health care law more effective. Stop trying to scuttle it. That's the resounding word from a national poll released Friday by the nonpartisan Kaiser Family Foundation. The survey was taken following last month's Senate derailment of the GOP drive to supplant much of President Barack Obama's statute with a diminished federal role in health care. (Fram, 8/11)

Kaiser Health News: Americans Eager For Leaders To Cooperate To Make Health Law Work
Move on. That’s what most people say Congress and the Trump administration should do after the Senate failed to approve legislation in July to  revamp the Affordable Care Act, according to a survey this month. Nearly 8 in 10 Americans say President Donald Trump should be trying to make the health law work, according to poll conducted by the Kaiser Family Foundation. This includes large majorities of Democrats (95 percent) as well as half of Republicans (52 percent) and President Trump’s supporters (51 percent). (Galewitz, 8/11)

The Hill: Poll: 78 Percent Say Trump Should Try To Make ObamaCare Work 
Eight in ten Americans say President Trump and his administration should do what they can to make ObamaCare work, according to a new poll released Friday. That includes 95 percent of Democrats, 80 percent of independents and even a majority of Republicans at 52 percent, according to the Kaiser Family Foundation Poll. (Hellmann, 8/11)

Meanwhile —

The Associated Press: Swing-District House GOP Feel The Heat On Health Care
Republican Rep. David Young angered conservatives in Iowa when he initially opposed a House Republican health care bill then weeks later backed it. Independents were frustrated with the two-term congressman's embrace of a partisan approach to repealing and replacing Barack Obama's Affordable Care Act. And now the Democrats are coming. (8/11)

WABE: Health Care Divides Raucous Town Hall Hosted By GOP Rep. Collins
Georgia’s 9th Congressional District includes more than a dozen counties in the northeast part of the state, and it’s the country’s third most conservative, but a town hall hosted by its representative Wednesday showed sharp divisions. Republican Rep. Doug Collins answered questions from a crowd of more than 250 at the Gainesville city courthouse, at times talking over liberal protesters and his GOP supporters who yelled at them to “shut up.” (Kauffman, 8/10)

Escalating Discord Between Trump, McConnell Puts Shockingly Public Spotlight On Party's Problems

President Donald Trump unleashed another wave of criticism toward Senate Majority Leader Mitch McConnell (R-Ky.), highlight the growing distance between the president and Congress.

Politico: Trump To GOP: Get Obamacare Repeal Bill Done
President Donald Trump renewed his call for Senate Republicans to take another crack at dismantling Obamacare, saying Thursday it’s a “disgrace” that they failed to pass a repeal bill. “They lost by one vote,” Trump said from his Bedminster, New Jersey, golf course. “For a thing like that to happen is a disgrace.” (Cancryn, 8/10)

The Washington Post: Trump Attacks On McConnell Bring Rebukes From Fellow Republicans
President Trump aimed a fresh barrage of criticism at Senate Majority Leader Mitch McConnell on Thursday, escalating an extraordinary fight with a key Republican leader that could undermine the party’s ability to regroup and pass shared legislative priorities this fall. ... Trump associates said the attacks, which began Wednesday night and resumed Thursday, were intended to shore up Trump’s outside-the-Beltway populist credentials and would resonate with core supporters frustrated by a lack of progress in Washington. But the tweets were quickly met with public and private defenses of McConnell — and rebukes of Trump. Sen. Orrin G. Hatch (R-Utah), tweeted: “@SenateMajLdr has been the best leader we’ve had in my time in the Senate, through very tough challenges. I fully support him.” (Wagner, O'Keefe and Kane, 8/10)

The New York Times: Trump’s Twitter Fury At McConnell Risks Alienating A Key Ally
By preventing President Barack Obama from filling a Supreme Court vacancy, Senator Mitch McConnell secured Donald J. Trump the signature accomplishment of his young presidency: the confirmation of Justice Neil M. Gorsuch. But any gratitude President Trump felt for Mr. McConnell’s first-of-its-kind maneuver appears to be exhausted as the president, upset at the failed health care repeal, has turned his Twitter fire and fury on Mr. McConnell, the one person he may most need to execute a stalled Republican legislative agenda. (Hulse, 8/10)

Bloomberg: McConnell Given Daunting To-Do List To Regain Trump Favor 
President Donald Trump laid out a path for Senate Majority Leader Mitch McConnell to get back in his good graces: replace Obamacare, overhaul the U.S. tax code and find a way to pay for big infrastructure improvements. Yet clearing Trump’s agenda anytime soon is close to impossible in the narrowly controlled Republican Senate that already has a packed agenda of must-pass legislation. (Litvan, 8/11)

Early Look At Premiums For Marketplace Plans Show Wide Variability

The price changes in 21 cities range from an increase of 49 percent to a decrease of 5 percent. Elsewhere, news outlets examine insurance companies' efforts to get lawmakers to drop the health law's tax on plans, some health organizations propose fixes for the law, Oscar's plans for Tennessee, Ambetter's decision to stay in the New Hampshire marketplace and other topics.

Modern Healthcare: Early 2018 Marketplace Rates Vary Widely Across States 
Health insurers selling individual plans next year on the federally operated marketplace,, have until Wednesday to finalize their rates. But early filings provide a good look at how the ACA marketplace is shaping up for 2018. Changes in benchmark silver plan premiums for 2018 range from an increase of 49% to a decrease of 5% from 2017 across 21 major U.S. cities where state regulators have published detailed information about insurers' preliminary rate requests, according to a Kaiser Family Foundation analysis released Thursday. In about half of those cities, premiums would go up less than 15%. In two cities, premiums would either decrease or stay the same. (Livingston, 8/10)

The Fiscal Times: Taxpayers Will Pay The Price For Uncertainty Over Obamacare In 2018
With the open enrollment period approaching for Obamacare insurance plans sold through state exchanges, Kaiser Foundation experts were able to analyze the proposals for 2018 submitted by insurance companies to 20 states and the District of Columbia — the only places where enough information is made public to allow an assessment of what health care costs would look like for an average policyholder under the insurers’ requested rate structures. ...Because the majority of Americans obtain health insurance through an employer-sponsored plan or from federal programs like Medicare and Medicaid, the impact of the premium increases of exchange-based policies will mean little to a large element of the population. (Garver, 8/10)

Bloomberg: Health Insurers Face Long Odds To Win Reprieve Of Obamacare Tax 
Health insurers won a victory in 2015 when a tax that was part of the Affordable Care Act was suspended. Now as they fight to repeal or delay the tax again before it comes back into effect, the odds don’t seem to be in their favor. Insurers, businesses and conservative groups are scrambling for ways to at least delay the health-insurance tax, or HIT, following the collapse of health-care legislation in July. They seemed poised for victory just a few months ago, when the health-insurance fee, and most of the other levies enacted to help fund Obamacare, were targeted in repeal bills passed by House Republicans and considered by Senate Republicans. (Brody, 8/11)

The Hill: Health Groups Recommend Fixes To ObamaCare
A group of 14 health organizations is asking Congress to "strengthen" ObamaCare instead of repealing it. In a letter to Senate Majority Leader Mitch McConnell (R-Ky.) led by the American Heart Association, the organizations recommend five ways to stabilize the individual insurance market and bring down premiums and other costs. (Hellmann, 8/10)

Nashville Tennessean: Don't Understand Health Care? You're Not Alone. It's The Industry's Fault — Not Yours
There's a growing but small subset of companies geared toward translating and opening up the health care system to people who come from all walks of life and income and education. The proliferation of high deducible health plans, or consumer directed health plans, combined with the necessity of capping the rise of health care spending means the industry will have to change how it thinks about its processes, overhead and interactions with people. (Fletcher, 8/11)

Nashville Tennessean: Why Would Oscar Health Partner With Humana?
Oscar Health, the New York-based insurance startup that recently announced plans to sell individual plans in Nashville next year, sees an additional business opportunity in Middle Tennessee. The company has also announced a partnership with Humana to offer plans in Nashville’s small group market, creating an unusual partnership between what would otherwise be two competing insurers. The announcement demonstrates just how uncertain the health insurance market is right now — much of the traditional business models are changing, and new alliances and partnerships are being formed. (Tolbert, 8/10)

New Hampshire Union Leader: NH Healthy Families To Keep Ambetter Plan On Obamacare Exchange 
Gov. Chris Sununu has been pushing the three remaining health insurance companies on the Obamacare exchange in New Hampshire to indicate their intentions for 2018, and one of the three has confirmed that it will offer policies on when open enrollment begins in November. NH Healthy Families announced on Thursday its decision to continue offering its health insurance marketplace product, Ambetter, in New Hampshire for 2018. (Solomon, 8/10)

Capitol Hill Watch

'I Have No Illusions' Medicare-For-All, Single-Payer Bill Will Pass, Sanders Says

But Sen. Bernie Sanders is looking to start a conversation about why America has the problem it does with its current health care system.

USA Today: Bernie Sanders Seeks 'Citizen Co-Sponsors' For Single-Payer Health Care Bill
Sen. Bernie Sanders is seeking "citizen co-sponsors" for a “Medicare-for-all” health care bill he plans to introduce in a few weeks. While pledging to fight GOP efforts to repeal Obamacare, the Vermont independent told supporters in a Wednesday email that the ultimate goal is a single-payer system, a federally administered program that would eliminate the role of private insurers in basic health care coverage. (Gaudiano, 8/9)


Republican Candidates For Colo. Governor Say Medicaid Costs Are Unsustainable

Three candidates seek to make Medicaid's budget a key campaign issue. In other Medicaid news, talks between Iowa officials and the managed care companies there appear to have bogged down but no one is talking about what the problem is, and two insurance companies have filed suit in Mississippi over how the state awarded the managed care contract.

Denver Post: Is Medicaid Gobbling Up Colorado’s Budget? 
Among Republican candidates to be Colorado’s next governor, a common argument has emerged: Medicaid spending in Colorado, driven upward by the Affordable Care Act, is unsustainable. Victor Mitchell talks about it in a campaign video. Doug Robinson references the concern on his website. George Brauchler spoke of it at the Western Conservative Summit last month .... Is Medicaid really eating the rest of the state budget alive? And could the state move large sums of money to other priorities by slashing Medicaid spending? The answers are complicated — some yes and some no. (Ingold, 8/11)

Des Moines Register: Iowa's High-Stakes Medicaid Payment Talks Have Bogged Down, But It's Not Clear Why
State administrators aren't telling the public or legislators why negotiations over hundreds of millions of dollars in Medicaid spending are dragging on for weeks after the talks were supposed to conclude. The administrators also won’t estimate how much more money the cash-strapped state might have to shell out to private Medicaid management companies as a result of those talks. (Leys, 8/10)

Jackson (Miss.) Clarion-Ledger: Lawsuit: Medicaid Signed Billion Dollar Contract Despite Protests
Mississippi's Medicaid delivery program is now the subject of a legal battle between several parties. The day after two companies protested the billion-dollar managed care award on June 29, Medicaid signed contracts with three other companies with the highest scores in evaluation. The award drew skepticism from some lawmakers who question whether officials discriminated against Mississippi True, a hospital-backed, nonprofit Provider Sponsored Health Plan that responded to the state's request for proposals. (Wolfe, 8/10)

Women’s Health

As Much Of The Country Sees Insurance Gains Under ACA, Texan Women Are Left Behind

The Commonwealth Fund's 2016 Biennial Health Insurance Survey reported solid progress for women across the country since the law was enacted, but in Texas the gains for women have been minimal. Meanwhile, state lawmakers are inching toward passing legislation that will require women to buy separate insurance for abortions.

Houston Chronicle: Health Insurance Gains Elude Many Texas Women
One in four Texas women remain uninsured - nearly five times the rate of uninsured women in New York and almost 1½ times higher than those in California. The Commonwealth findings show they also lag far behind in affording treatment and are struggling with medical debt. ... Overall, Texas continues to lead the nation in the number of uninsured, with an estimated 4.5 million people without coverage. One of the biggest changes under the current law is that insurers can no longer charge women higher premiums or deny them outright simply based on gender, researchers found. (Deam, 8/10)

Houston Chronicle: Texas Will Join Eight Other States If It Bans Abortion Coverage In Health Plans
Texas is on the verge of following just a handful of states that have gone as far as banning insurance coverage of abortions, not just people who have coverage through the health exchanges through the Affordable Care Act, but also for all private insurance plans. For some groups opposed to abortion rights, the fact Texas hasn't already joined other states, including most of the South, in restricting abortion coverage in health plans through the Obamacare exchanges has been a source of frustration. (Wallace, 8/10)

In other women's health news —

Public Health And Education

The Cost Of Treating An Opioid Overdose: $92,400

Researchers said the cost highlights a troubling trend: that overdose patients are arriving in worse shape, requiring longer stays and a higher level of treatment. In other news on the opioid crisis: a vaccine for addiction, treatment deserts, sober homes, safe injection centers and more.

Stat: The Cost Of Treating Opioid Overdose Victims Is Skyrocketing
The cost of treating opioid overdose victims in hospital intensive care units jumped 58 percent in a seven-year span, according to a new study that concludes increasingly sick patients are placing a greater strain on an overmatched health care system. Between 2009 and 2015, the average cost of care per opioid admission increased from $58,500 to $92,400 in the 162 academic hospitals included in the study, which was led by Beth Israel Deaconess Medical Center in Boston. That rapid escalation far outpaced the overall medical inflation rate in the U.S., which was about 19 percent during the period covered by the study. (Ross, 8/11)

NPR: A 'Vaccine For Addiction' Would Be Complicated. No Guarantees
It's always appealing to think that there could be an easy technical fix for a complicated and serious problem. For example, wouldn't it be great to have a vaccine to prevent addiction? "One of the things they're actually working on is a vaccine for addiction, which is an incredibly exciting prospect," said Dr. Tom Price, secretary of Health and Human Services. (Harris, 8/10)

Kaiser Health News: A Long And Winding Road: Kicking Heroin In An Opioid ‘Treatment Desert’
Heather Menzel squirmed in her seat, unable to sleep on the Greyhound bus as it rolled through the early morning darkness toward Bakersfield, in California’s Central Valley. She’d been trapped in transit for three miserable days, stewing in a horrific sickness only a heroin addict can understand. Again, and again, she stumbled down the aisle to the bathroom to vomit. She hadn’t used since Chicago. She told herself that if she could just get through this self-prescribed detox, if she could get to her mother’s house in her hometown of Lake Isabella, Calif., all her problems would be solved. (Rinker, 8/11)

NPR: Insurance Scams Plague 'Sober Home' Recovery Industry In South Florida
Delray Beach's charming downtown, palm trees and waves attract locals, vacationers and, increasingly, drug users who come here to try to get off opioids. In some parts of the small Florida community, there's a residential program for people recovering from addiction — a sober living house or "sober home" — on nearly every block. Sometimes two or three. On a block where resident Michelle Siegel was walking a dog recently, there are at least six sober homes. She says "you can usually tell" by the white vans and "no trespassing" signs out front. (Allen, 8/10)

San Francisco Chronicle: Strong Support For Safe Injection Centers In SF
On Thursday, the S.F. Safe Injection Services Task Force, created to explore the options and obstacles surrounding a safe injection site, met for the final time before the Department of Public Health, which oversaw the group, presents recommendations to the Board of Supervisors next month. While questions remain on where a site might be located and how it would be run, remarks from many of the task force members, including health department Director Barbara Garcia, suggested there was strong support for moving ahead. (Fracassa, 8/10)

The Philadelphia Inquirer/ Third Of Philadelphians Used Prescription Opioids In The Last Year, Survey Finds
The findings of the survey indicate that a projected 168,000 city residents age 18 and older are using prescription opioids, putting them at higher risk of developing an addiction. That figure is “shockingly high,” Farley said. “Doctors have given out way too many opioids.” More than 900 city residents died last year from drug overdoses, most from heroin, fentanyl, and other opioids, a toll that is projected to exceed 1,200 this year. (Sapatkin, 8/10)

Boston Globe: Fatal Opioid Overdoses Have Declined In Parts Of Eastern Massachusetts
Fatal opioid overdoses have declined in parts of Eastern Massachusetts this year, health and law enforcement officials said, offering a glimmer of hope that preventative measures are helping to save lives in the ongoing epidemic. The reported drop-off this year comes after alarming increases in fatal overdoses in recent years around the United States, including a 16 percent jump in 2016 in Massachusetts, fueled by the widespread availability of fentanyl. (Edmondson, 8/11)

New Hampshire Union Leader: Granite Recovery Center Moving To Salem 
The administrative team for a full spectrum drug and alcohol addiction treatment facility will soon be setting up shop in town. Over the next two weeks, a team from Granite Recovery Center will move into the 6 Manor Parkway space. The 30,000-square-foot building previously housed Stantec, Inc. before the company moved to Auburn. (Proulx, 8/10)

Gene-Edited, Virus-Free Piglets Revive Hope For Organ Transplants Between Animals, Humans

Dr. George Church, a geneticist at Harvard who led the experiments, said the first pig-to-human transplants could occur within two years.

The New York Times: Gene Editing Spurs Hope For Transplanting Pig Organs Into Humans
In a striking advance that helps open the door to organ transplants from animals, researchers have created gene-edited piglets cleansed of viruses that might cause disease in humans. The experiments, reported on Thursday in the journal Science, may make it possible one day to transplant livers, hearts and other organs from pigs into humans, a hope that experts had all but given up. (Kolata, 8/10)

The Washington Post: Scientists Create The First Mutant Ants
Despite what you might've seen in 1950s monster movies, it's difficult to raise mutant ants. For years biologists have altered the genetics of organisms as varied as mice and rice. Mutant fruit flies are a laboratory staple. But ants' complex life cycle hampered efforts to grow genetically engineered ants — until now. On Thursday, two independent research teams described their work deleting ant genes. Two papers chronicling the first mutant ants appeared in the journal Cell, along with a third study that altered ant behavior using an insect brain hormone. (Guarino, 8/10)

NPR: Public Opinion On Gene Editing Varies Depending On Knowledge, Religion
People generally think that editing human genes might be OK, but most think that there's a clear line that's shouldn't be crossed when it comes to changing traits that would be passed down to new generations, according to a survey reported Thursday. It's not an abstract question. Earlier this month, gene editing made headlines after scientists in Oregon reported they had successfully corrected a genetic defect in human embryos in the laboratory. (Columbus, 8/10)

In A Place Where Suspicion Has Dug In Roots, Researchers Want To Demystify Science

A small community in Georgia sees a nuclear plant as the source of their health woes. Scientists know otherwise, but getting that message across isn't going to be easy. In other public health news: natural disasters, mental health clues on Instagram, obesity and depression, sinus cancer, hospital violence and more.

Stat: The Feds Are On An Unusual Mission Here: Getting Locals To Trust Science
Testing required by independent and federal regulators has repeatedly found no sustained heightened risks of contamination. But officials at the Department of Energy’s Savannah River Site recognized that all the suspicion itself was toxic. For some locals, it’s become a force that’s made life feel as unstable as a radioactive atom. So the federal government has launched an unusual effort to put residents at ease — by teaching them to trust science.In the final year of the Obama administration, the University of Georgia received a grant of nearly $665,000 to send a team of ecologists and educators to this poor, rural stretch of northeast Georgia, where life revolves around farms and faith. Launched this summer, the program is designed to demystify the science that officials use to monitor the air and water for radioactive contamination — and explain to residents of Burke County why there’s no need for alarm. (Blau, 8/11)

Stat: Prepare For Natural Disasters, Experts Urge Biomedical Researchers
Biomedical research centers are not at all prepared for natural disaster. That’s the conclusion of a new National Academies of Science report released Thursday that analyzed the disaster resilience of the biomedical research community. The expert panel came up with 10 recommendations. Among them: Mandating disaster resilience education for students and staff, developing shelter and evacuation procedures for research animals, and giving researchers incentives to duplicate critical samples and data and store them offsite. (Thielking, 8/10)

The New York Times: Your Instagram Posts May Hold Clues To Your Mental Health
The photos you share online speak volumes. They can serve as a form of self-expression or a record of travel. They can reflect your style and your quirks. But they might convey even more than you realize: The photos you share may hold clues to your mental health, new research suggests. From the colors and faces in their photos to the enhancements they make before posting them, Instagram users with a history of depression seem to present the world differently from their peers, according to the study, published this week in the journal EPJ Data Science. (Chokshi, 8/10)

Kaiser Health News: Obesity And Depression Are Entwined, Yet Scientists Don’t Know Why
About 15 years ago, Dr. Sue McElroy, a psychiatrist in Mason, Ohio, started noticing a pattern. People came to see her because they were depressed, but they frequently had a more visible ailment as well: They were heavy.McElroy was convinced there had to be a connection. “Many of my [depressed] patients were obese. And they were very upset by obesity,’’ McElroy recalled. ”I looked into the literature, and it said there was no relationship. It didn’t make sense.” (Luthra, 8/11)

Chicago Tribune: Blood Test Can Screen For Rare Sinus Cancer
new DNA blood test can catch a rare but deadly form of cancer that occurs in the sinuses, researchers report. The test, which looks for DNA evidence of Epstein-Barr virus in blood samples, was 97 percent accurate at detecting the presence of nasopharyngeal cancer, according to the results of a clinical trial. (Thompson, 8/10)

Chicago Tribune: As Hospital Violence Grows, Nurses Seek Reforms: 'Too Many Of Us Are Being Hurt' 
U.S. Bureau of Labor Statistics data show that the rate of hospital employees intentionally injured on the job at the hands of another person is significantly higher than the rate across all private industries. In 2015, the most recent year available, there were 8.5 cases of injuries per 10,000 full-time hospital workers, versus 1.7 cases for all private industries. The data also shows that injury number for hospital workers steadily rose from 2011 to 2014 but dropped slightly the following year. (Thayer and Leone, 8/11)

The New York Times: ABC’s ‘Pink Slime’ Report Tied To $177 Million In Settlement Costs
The Walt Disney Company said in its latest quarterly financial statement that it had $177 million in costs related to settling litigation. The announcement came just weeks after ABC News, a Disney unit, reached a settlement with a meat producer that accused the network of defamation for its reports about so-called pink slime, a processed beef product used as low-cost filler. (Hauser, 8/10)

Los Angeles Times: Food-Borne Parasite Infections On The Rise In L.A. County
Health officials warned this week that an unusually high number of patients in Los Angeles County have been infected with a parasite that causes a severe stomach illness and can last for months if not treated. Between June and Aug. 1 this year, 14 people in the county had been diagnosed with the intestinal infection cyclosporiasis, according to local health officials. (Karlamangla, 8/10)

NPR: Hospice, Designed For The Dying, Is Discharging Many Live Patients
Hospice care is for the dying. It helps patients manage pain so they can focus on spending their remaining time with loved ones. But in recent years, nearly one in five patients have been discharged from hospice before they die, according to government reports. A study published last month in the journal Health Affairs finds that hospices with the highest rate of so-called "live discharges" also have the highest profits. The lead author is Rachel Dolin, a David A. Winston fellow researching health policy. Her paper found an association between high live discharge rates and high profit margins, but it didn't determine the cause. (Jaffe, 8/11)

State Watch

State Highlights: Arizona's Ambulance Wars; Conn. Budget Cuts Undo Investments In School Mental Health Services

Media outlets report on news from Arizona, Connecticut, Florida, Washignton, Texas, Missouri, New York, Delaware, Ohio, Wisconsin and Maryland.

The CT Mirror: Budget Cuts May Erode Gains In School Mental Health Services
Since the horrific shooting of children and faculty at Sandy Hook Elementary School in December 2012, Connecticut has made significant investments in school mental health services and specifically in identifying and treating victims of trauma. But with no state budget and school beginning in less than a month, many Connecticut districts may have to cut back on recently expanded mental health services or make room for them in their own budgets. (Werth, 8/11)

Miami Herald: A Mental-Health Facility 13 Years In The Making Is One Vote Away From Becoming Reality
Leifman, a Miami-Dade circuit judge who has spent much of his life working to change state laws for mentally ill inmates, will lead the effort to take the former South Florida Evaluation and Treatment Center and turn it into a state-of-the-art mental health diversion facility. If they meet certain criteria, people can be housed, treated and taught to manage their illnesses and their lives. (Bordas, 8/10)

Seattle Times: Investigators Find ‘Numerous’ Issues Related To Patient Safety At Swedish’s Cherry Hill Site
Hospital regulators have identified a wide range of recent troubles at Swedish Health’s Cherry Hill facility, including failures of oversight and “numerous” issues related to patient safety, according to records released Thursday. Federal officials said the Cherry Hill site will be terminated from the Medicare program in 90 days unless Swedish can bring itself into compliance on a couple of key issues. (Baker, 8/10)

San Antonio Press Express: Superior HealthPlan Scales Back Medical Supply Contract With Illinois Company After Complaint
Superior HealthPlan, which operates Medicaid and Medicare programs in Texas, is delaying its switch to a new medical supplier and notifying patients that they can choose another company for glucose monitors, catheters and other supplies. Superior originally awarded a sole source contract to Illinois company Medline starting on Sept. 1, but decided to delay the agreement until Oct. 1 after a San Antonio medical supplier sent a protest letter last month to the Texas Health and Human Services Commission. (Pound, 8/10)

Kansas City Star: Hospital Firm Disputes Missouri Audit Alleging Billing Scheme
A Florida company is pushing back on a report from Missouri Auditor Nicole Galloway’s office that says the company engaged in a $90 million billing scheme in the course of managing a small Missouri hospital. The audit, released by Galloway’s office Wednesday, found that Putnam County Memorial Hospital in north-central Missouri had accepted millions in questionable insurance payments for patients who were treated across the country. (Lowry, 8/10)

The Wall Street Journal: New York To Broaden Medical Marijuana Program
The state of New York is about to make it more convenient for patients to use medical marijuana. The drug will be available in lotions, lozenges, patches and chewable tablets for the first time this fall. Currently, patients have to use an inhaler, a vaporizer or ingest capsules. Smoking marijuana remains prohibited under the new rules. (Alfaro, 8/10)

The Associated Press: Police Continuing Probe Into Alleged Prescription Fraud
Delaware State Police say more arrests are expected in an investigation involving a Philadelphia woman accused of distributing fraudulent prescriptions for controlled substances. Police said Thursday that 49-year-old Annette Scott stole blank prescription pads from a Wilmington-area doctor’s office where she worked and forged the doctor’s signature. Investigators say she then distributed 23 prescriptions to several individuals, who would fill the prescriptions at area pharmacies and use their Medicaid insurance to pay for them. (8/10)

Columbus Dispatch: Pot Growers Worry Ohio Will Miss Deadline For Finished Product
Ohioans were promised medical marijuana would be available by September 2018, but that legal deadline is in jeopardy because the state is taking so long to review the applications of potential cultivators. ... That means the nascent cannabis industry will have only about 10 months to build growing facilities, grow and process a crop, go through inspections and permitting processes and get products in the hands of patients. (Keiper, 8/10)

Milwaukee Journal Sentinel: OSHA Inspects Wisconsin Barrel Plant
The federal agency charged with workplace safety has opened an inspection of an industrial drum refurbishing plant in St. Francis — but only months after reports of dangerous working conditions and action by environmental regulators uncovered numerous violations. Inspectors from the U.S. Occupational Safety and Health Administration opened an inspection of Mid-America Steel Drum last week — on the same day the Milwaukee Journal Sentinel posted a story examining why the agency had inspected just one of six plants in the chain. (Diedrich, 8/10)

The Baltimore Sun: University Of Maryland Adds Inpatient Floors To Planned Midtown Tower
The University of Maryland Medical Center plans to add three inpatient floors atop a planned 10-story outpatient center at its Midtown campus, center officials said Thursday. The hospital is adding the floors in anticipation of future patient care needs and an expected expansion of services offered at the Midtown campus, according to Karen Lancaster, a spokeswoman for the center. (Cohn, 8/10)

Health Policy Research

Research Roundup: FDA Expedited Drug Approvals; Effectiveness Of Flu Vaccines

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

Health Affairs: Drugs Cleared Through The FDA’s Expedited Review Offer Greater Gains Than Drugs Approved By Conventional Process
We investigated whether drugs approved by the Food and Drug Administration (FDA) through expedited review have offered larger health gains, compared to drugs approved through conventional review processes. ...We found that drugs in at least one expedited review program offered greater gains than drugs reviewed through conventional processes (0.182 versus 0.003 QALYs). (Chambers, Thorat, Wilkinson, et. al., 8/1)

JAMA Internal Medicine: Social Determinants Of Health In Managed Care Payment Formulas 
Using data from MassHealth, the Massachusetts Medicaid and Children's Health Insurance Program, we estimated regression models predicting Medicaid spending using a diagnosis-based and SDH-expanded model, and compared the accuracy of their cost predictions overall and for vulnerable populations. ...Overall, the SDH model performed well, but only slightly better than the diagnosis-based model, explaining most of the spending variation in the managed care population (validated R2 = 62.4) and reducing underpayments for several vulnerable populations. (Ash, Mick, Ellis, et. al., 8/7)

New England Journal of Medicine: Influenza Vaccine Effectiveness In The United States During The 2015–2016 Season 
The A(H1N1)pdm09 virus strain used in the live attenuated influenza vaccine was changed for the 2015–2016 influenza season because of its lack of effectiveness in young children in 2013–2014.  ...Influenza vaccines reduced the risk of influenza illness in 2015–2016. However, the live attenuated vaccine was found to be ineffective among children in a year with substantial inactivated vaccine effectiveness. (Jackson, Chung, Jackson, et. al., 8/10)

Annals Of Internal Medicine: HCV Infection Treatment By Nonspecialist Providers 
In a real-world cohort of patients at urban FQHCs, HCV treatment administered by nonspecialist providers was as safe and effective as that provided by specialists. Nurse practitioners and PCPs with compact didactic training could substantially expand the availability of community-based providers to escalate HCV therapy, bridging existing gaps in the continuum of care for patients with HCV infection. (Kattakuzhy, Gross, Emmanuel, et. al., 8/8)

Editorials And Opinions

Viewpoints: Why The Ohio A.G. Decided To Take Legal Action Against The Big 5 Opioid Manufacturers; Health Reforms Advance Without Congress

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

The Washington Post: This Is Why I’m Suing Five Opioid Manufacturers In My State
Opioid addiction has become all too familiar in my home state of Ohio. The man-made public health-care disaster has spread to every county in the state. This is why, as state attorney general, I have filed suit against five of the largest manufacturers of brand-name and generic opioids. We believe evidence will show that they flooded the market with prescription opioids, such as OxyContin and Percocet, and grossly misleading information about the risks and benefits of these drugs. And as a result, we believe countless Ohioans and other Americans have become hooked on opioid pain medications, all too often leading to the use of cheaper alternatives such as heroin and synthetic opioids. Almost 80 percent of heroin users start with prescription opioids. (Ohio Attorney General Mike DeWine, 8/10)

The New York Times: On Health Care, Who Needs Congress?
Regardless of whether Congress enacts health care reform, the private sector isn’t waiting. Health care for our employees is too expensive, and the employer-based system must be reformed. More Americans — 146 million people, or 57 percent of the country — get health insurance through their employers than they do through Medicare or Medicaid, each with more than 50 million enrollees. But for years, premiums and co-payments have been rising for the workers at America’s private-sector companies. (Robert Andrews, 8/11)

The New England Journal Of Medicine: Repeal, Replace, Repair, Retreat — Republicans’ Health Care Quagmire
Republicans have been bedeviled by internal party divisions, strategic miscalculations, the absence of a viable replacement plan, the resilience of the status quo, and the constraints of American political institutions. Given their slim 52–48 majority, passing health care legislation in the Senate required forging a near-consensus among GOP lawmakers. Conservative and centrist Republicans could not, however, agree on whether the party’s repeal proposals went too far or not far enough. While Speaker Paul Ryan and GOP leaders found a way to navigate such tensions in the House of Representatives, they had a larger majority to work with and could afford more defections (even then, House repeal efforts initially imploded before a remarkable turnaround led to passage of the American Health Care Act [AHCA] on May 4 by a 217–213 vote). (Jonathan Oberlander, 8/9)

The Wall Street Journal: The Trump-McConnell Spat
The damage from the GOP’s health-care debacle has only just begun, and the latest evidence is this week’s public spat between President Trump and Senate Majority Leader Mitch McConnell. The big potential winner here is Democratic leader Chuck Schumer. Mr. McConnell has been getting the Kim Jong Un treatment this week, as Mr. Trump has pounded away for the Senate’s recent failure to reform ObamaCare. “Can you believe that Mitch McConnell, who has screamed Repeal & Replace for 7 years, couldn’t get it done. Must Repeal & Replace ObamaCare!,” the President tweeted Thursday morning from his vacation redoubt in Bedminster, N.J. (8/10)

The Wall Street Journal: John McCain’s Defense Cut
There is no more passionate and principled advocate for greater military spending than Senator John McCain, so we wonder if the Arizona Republican appreciates that he recently voted to guarantee weaker U.S. defenses. To wit, his vote to kill health reform means that entitlements like Medicaid will continue to squeeze the Pentagon like an ever-tightening vise long after he has retired. (8/10)

Detroit News: Medicaid Bridges Care Gap For Disabled Kids
The first time services were cut for my disabled daughter, I cried in the restroom at work. ... Watching the most recent debates to dismantle the Affordable Care Act, or Obamacare, I remembered those feelings as I watched the Senate debate massive cuts to Medicaid that would’ve potentially left millions without insurance. I wondered how many of those same senators had ever spent time with someone who relies on Medicaid, especially children with serious disabilities. There’s a perception that Medicaid is only for low-income families. It isn’t. It’s also for families like mine — two working parents trying desperately to give their daughter the life she deserves. (Maureen Feighan, 8/10)

The New England Journal Of Medicine: Small Change, Big Consequences — Partial Medicaid Expansions Under The ACA
Though congressional efforts to repeal and replace the Affordable Care Act (ACA) seem to have stalled, the Trump administration retains broad executive authority to reshape the health care landscape. Perhaps the most consequential choices that the administration will make pertain to Medicaid, which today covers more than 1 in 5 Americans. Much has been made of proposals to introduce work requirements or cost sharing to the program. But another decision of arguably greater long-term significance has been overlooked: whether to allow “partial expansions” pursuant to a state Medicaid waiver. Arkansas has already submitted a waiver request for a partial expansion, and other states may well follow its lead. (Adrianna McIntyre, Allan M. Joseph and Nicholas Bagley, 8/9)

Bloomberg: Sugar Is Finally More Popular Than Corn Syrup Again
All of that decline, as is apparent from the chart, has been in corn sweeteners -- consumption of sugar made from cane or beets is actually up a bit since the 1990s. And the overall drop in sweetener use seems to have stalled over the past four years. The biggest story in the data, really, is the rise and fall of high-fructose corn syrup, which came from nowhere in the 1960s to become a ubiquitous sweetener of soft drinks and other things. Then, around the turn of the millennium, it was identified as a prime suspect in the country's obesity epidemic. (Justin Fox, 8/10)

Bloomberg: Amazon Could Probably Conquer Drugstores, Too
Can Amazon do to the pharmacy business what it’s done to … well, everything else? Rumor has it they’re thinking about doing just that. They’ve reportedly created a new general manager position to look into such an expansion. In May, when those rumors started floating, Bloomberg’s own Max Nisen explained why they might find the business attractive. (Megan McArdle, 8/10)