KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Kaiser Health News Original Stories

In Texas, Abstinence-Only Programs May Contribute To Teen Pregnancies

Across the U.S., the number of teenagers having babies has hit a record low — it’s down to about 1 out of every 45 young women. That trend hasn’t extended to certain parts of Texas, however, where the teen birth rate is still nearly twice the national average. (Lauren Silverman, KERA, 6/12)

Political Cartoon: 'Bed Check?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Bed Check?'" by Rina Piccolo.

Here's today's health policy haiku:


I'm on Medicare.
But what if I were 60?
Pray to keep my job.

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:

Health Law

McConnell's Gloomy Attitude Over Health Law Has Some Wondering If Larger Strategy Is At Play

Majority Leader Mitch McConnell (R-Ky.) has been downplaying the chances the Republicans' legislation has of passing the Senate. But some think his reserved comments might be all part of the game. In other news about the efforts: lawmakers begin to see a path they can take; a look at how the measure could affect middle- and working-class Americans; Twitter cheers on Sen. Claire McCaskill and more.

The Wall Street Journal: McConnell’s Reserved Approach On Health Bill Leaves Lawmakers Guessing
Before he began clicking through a PowerPoint presentation on Republican health-care options this week, Senate Majority Leader Mitch McConnell delivered a private warning to his Senate Republicans: If they failed to pass legislation unwinding the Affordable Care Act, Democrats could regain power and establish a single-payer health-care system. Mr. McConnell (R., Ky.) has been nearly as downcast in his public comments about Senate Republicans’ chances of passing sweeping legislation to overhaul the country’s health-care system. (Peterson, Armour and Radnofsky, 6/9)

The Associated Press: GOP's Pursuit Of Health Care Overhaul Comes With Risks
Republicans are taking a big political risk on health care. They're trying to scale back major benefit programs being used by millions of people. And they're trying to do it even though much of the public is leery of drastic changes, and there's no support outside the GOP. It's not stopping them. (Alonso-Zaldivar, 6/12)

The Hill: Senate GOP Sees Path To ObamaCare Repeal
A path is emerging for Senate Republicans to pass their ObamaCare repeal bill, even though there are major obstacles ahead. Critically, Senate moderates are indicating that they can agree to ending the additional federal funds for ObamaCare's expansion of Medicaid, albeit on a slower timetable than other Republicans want. A compromise on Medicaid funding would remove one of the biggest obstacles for the bill. (Sullivan, 6/11)

The New York Times: Flexibility That A.C.A. Lent To Work Force Is Threatened By G.O.P. Plan
In recent years, millions of middle- and working-class Americans have moved from job to job, some staying with one company for shorter stints or shifting careers midstream. The Affordable Care Act has enabled many of those workers to get transitional coverage that provides a bridge to the next phase of their lives — a stopgap to get health insurance if they leave a job, are laid off, start a business or retire early. (Abelson, 6/11)

The Hill: GOP Looks To Blunt Impact Of Health Bill On Older People
GOP senators are trying to strike a balance that’s proving difficult: lowering healthcare insurance premiums for young adults while shielding older people from massive price hikes. At issue is an ObamaCare provision that essentially caps how much insurers can charge older people for premiums. Republicans want to raise that cap, saying it vastly undercharges older people for their healthcare services, creating higher costs for younger, healthier adults. (Hellmann, 6/11)

Bloomberg: Cruz Goes From ‘Lucifer’ To Dealmaker In Health-Care Overhaul 
The first-term senator from Texas is seeking to unite warring wings of the Republican Party around an effort to kill Obamacare and is showing a new willingness to compromise with colleagues to devise a replacement plan. It’s a significant departure for the formerly obstructionist [Ted] Cruz, who lost the Republican presidential contest to Donald Trump and has long had icy relations with other lawmakers. Cruz once called Majority Leader Mitch McConnell a liar on the Senate floor, and former Republican House Speaker John Boehner once called Cruz “Lucifer in the flesh” and the most “miserable son of a bitch” he had ever worked with. His most notable legislative accomplishment so far has been to help force a shutdown of the government for 16 days in 2013 in an unsuccessful effort to strip funding from Obamacare. (Dennis, 6/12)

Kansas City Star: Twitter Reacts To Claire McCaskill Tirade About GOP Health Plan
In a three-minute scolding during a Senate Finance Committee meeting, McCaskill, a Missouri Democrat, dressed down committee chairman Orrin Hatch, a Utah Republican, for what McCaskill called a legislative process even more partisan than what transpired during passage of the Affordable Care Act. ... By mid-morning Friday her remarks had triggered more than 12,000 retweets on Twitter. (Montgomery, 6/9)

Roll Call: Democrats Stick To Health Care Message Amid Russian Intrigue
Despite the daily drip about Russia and the Trump administration, national Democrats who hope to exploit Republicans’ vulnerabilities in 2018 are focusing their messaging squarely on health care before the July 4 recess. Just minutes after former FBI Director James B. Comey concluded his testimony Thursday before the Senate Intelligence Committee — in which he said the president lied to the America people — the Democratic Senatorial Campaign Committee blasted out a release. The subject? Nevada Sen. Dean Heller’s reported support for phasing out Medicaid expansion. (Pathé, 6/12)

The Hill: Ex-Medicare Head: GOP Using 'Sabotage, Speed And Secrecy' To Pass ObamaCare Repeal
Andy Slavitt, acting administrator for Centers for Medicare and Medicaid Services (CMS) under President Obama, penned an op-ed in The Washington Post Saturday that slams Senate Majority Leader Mitch McConnell (R-Ky.) for using “sabotage, speed and secrecy” to work on passing the GOP healthcare bill in the upper chamber. ... He cited instances where Republican senators will break from the party vote if the bill proves to negatively impact a lawmaker’s state, pointing states dealing with the opioid crisis that may be hurt if Medicaid gets drastically cut. He acknowledged that McConnell may try to appease these senators by including "a small 'opioid fund'" in the bill. (Beavers, 6/11)

Meanwhile, crowdfunding sites are poised for a wave of medical requests if the legislation is passed —

Bloomberg: America’s Health-Care Crisis Is A Gold Mine For Crowdfunding
Crowdfunding platforms such as GoFundMe and YouCaring have turned sympathy for Americans drowning in medical expenses into a cottage industry. Now Republican efforts in Congress to repeal and replace Obamacare could swell the ranks of the uninsured and spur the business of helping people raise donations online to pay for health care. But medical crowdfunding doesn't have to wait for Congress to act. Business is already booming, and its leaders expect the rapid growth to continue no matter what happens on the Hill. (Woolley, 6/12)

These Two GOP Senators May Play Role Of Planned Parenthood Funding Saviors

To get the support of Sens. Susan Collins of Maine and Lisa Murkowski of Alaska, Mitch McConnell (R-Ky.) may have to drop language in the Republicans' health law to defund the organization.

The Wall Street Journal: Senate GOP Plans To Strip Planned Parenthood Funding In Health Bill
Senate Republicans plan to strip federal funding from Planned Parenthood Federation of America and add several other abortion restrictions to their health-insurance overhaul bill, creating another potential concern for centrist GOP senators who are considering whether to back the legislation. Republican leaders believe they have the votes to keep the defunding measure in any final Senate bill, people familiar with the discussions said, though they still could remove it should that be the deciding factor in the bill’s passage. (Hackman, 6/10)

Politico: Fate Of Planned Parenthood Funding Tied To Senate Moderates
Two female Senate Republicans could stop the anti-abortion movement from achieving its most significant win against Planned Parenthood in decades. Most Republicans want to eliminate the group’s $555 million in federal funding as part of their bill to repeal Obamacare. But as Majority Leader Mitch McConnell tries to solve the legislative Rubik’s Cube of finding 50 votes for repeal, he may have to drop the Planned Parenthood cut to win the support of the two Republican moderates, Sens. Susan Collins of Maine and Lisa Murkowski of Alaska. (Haberkorn, 6/11)

Concerns Over Ever-Worsening Opioid Crisis Could Throw Wrench In Plans To Roll Back Medicaid

Republicans' plans to dismantle and replace the Affordable Care Act could affect efforts to curb the epidemic that's ravaging the country.

The Wall Street Journal: Opioid Crisis Complicates GOP’s Health-Law Push
The nation’s worsening opioid crisis has become another sticking point in Republican plans to dismantle major portions of the Affordable Care Act, with key GOP senators hesitating to support a bill that could threaten addiction treatment for millions of people. Several provisions of the ACA, also known as Obamacare, allowed millions of Americans seeking substance-abuse treatment to gain coverage, including through an expansion of the Medicaid health program for the poor. But the House bill repealing the ACA, passed in early May, would roll back that Medicaid expansion beginning in 2020 and allow insurance companies to charge some people with drug addictions higher premiums or deny them substance-abuse coverage. (Nunn, 6/11)

NPR: GOP Cuts To Medicaid Would Threaten Addiction Treatment, Doctors Say
Republicans in both the House and the Senate are considering big cuts to Medicaid. But those cuts endanger addiction treatment, which many people receive through the government health insurance program. Charlene Yurgaitis is one of the people who's been helped. She's 35 and lives in Lancaster, Penn., and once supervised 17 people at an insurance company. But when some college students moved in next door about a decade ago, they became friends and she started doing oxycontin with them. Then she moved onto heroin and harder drugs. (Allen, 6/11)

Once A Model Of ACA's Success, Kentucky Is Now Busy Unwinding Law's Provisions

Gov. Matt Bevin says his overhaul of the state's health system would steady the market by gradually moving people from Medicaid to private insurance plans.

The Wall Street Journal: Before Repeal And Replace, Kentucky Is Dismantling Health Law
As Congress works to repeal President Barack Obama’s signature health law, Kentucky Republican Gov. Matt Bevin is already at work unwinding some of its provisions in his state. Mr. Bevin has dismantled the state’s health-insurance exchange, moving patients to the federal website last year. He has proposed introducing new conditions for recipients of Medicaid, the federal-state health program for the poor, that would require patients to pay premiums of up to $15 a month and perform employment-related or community-service activities, among other provisions. (Campo-Flores, 6/11)

Entrepreneurs, Early Retirees Among 70,000 Iowans Threatened By Possible Insurer Pullout

State officials are working to convince the three carriers serving the individual market to stay in Iowa. In Washington state, two counties face the prospect of no insurers next year, and in Florida BlueCross BlueShield officials say the company will continue to operate next year.

Des Moines Register: Iowa Insurance Market Collapse Could Ground Young Entrepreneurs' Dreams, Early Retirees' Plans
The three insurance carriers selling individual policies in most of the state have said they likely will pull out for 2018, because of financial losses and uncertain risks. As things stand now, the companies have until June 19 to file proposed rates if they plan to sell such insurance here for 2018. Iowa Insurance Commissioner Doug Ommen expressed optimism this past week that he could work out a last-minute agreement with federal officials to offer incentives that would keep two of the three carriers — Medica and Wellmark Blue Cross & Blue Shield — in the market. Everyone recognizes the stakes, including for young entrepreneurs, he said. “We know it is an emergency, and we will deliver,” Ommen told independent insurance brokers in a Des Moines meeting Thursday. “…We are trying to thread the needle.” (Leys, 6/10)

Seattle Times: Blame Game Begins As Health Insurers Shun Two Washington Counties 
Two rural Washington counties have been thrust into the national health-care debate after new rate filings revealed that no insurers planned to offer coverage next year in the individual markets in Klickitat and Grays Harbor counties. Democratic elected officials pounced, blaming the insurer pullout on uncertainty caused by Republican plans to repeal the Affordable Care Act (ACA). State Insurance Commissioner Mike Kreidler issued a news release Thursday saying the pullout affecting an estimated 3,350 people “clearly indicates to me that the uncertainty the Trump administration and the GOP-controlled Congress has sowed for months is sabotaging the progress we’ve made.” (Young, 6/9)

Orlando Sentinel: Florida Blue Planning To Stay In ACA Marketplace 
Florida Blue plans to stay in the health insurance marketplace in 2018, though the future of Obamacare and its subsidies are still unclear, officials told the Orlando Sentinel on Friday. ... [Tony Jenkins, market president for Florida Blue’s Central Florida Region] said he couldn’t disclose the 2018 rates until they are submitted to the Florida Office of Insurance Regulation later this month and then made public by the agency. (Miller, 6/9)

Administration News

During Its Move To Electronic Records, Medicare Erroneously Paid $729M To Health Professionals

The Centers for Medicare & Medicaid Services should review its incentive payments, recoup any money erroneously paid and do more to scrutinize spending, the inspector general audit recommended.

The Wall Street Journal: Medicare Erroneously Paid Millions In Electronic Records Push, Audit Finds
Medicare erroneously paid an estimated $729 million to doctors and other health professionals under a multibillion-dollar federal initiative designed to shift the health-care system from paper records to computer files, according to a new federal audit. The U.S. Department of Health and Human Services Office of Inspector General, which conducted the audit, said Medicare, over a three-year period, improperly paid health professionals who vouched they earned bonus payments under the initiative, but who either lacked required proof or failed to meet bonus criteria. (Evans, 6/12)

In other news from the administration —

The Washington Post: UNC Oncologist And Researcher Named Head Of The National Cancer Institute
President Trump has named Norman “Ned” Sharpless, the director of the University of North Carolina Lineberger Comprehensive Cancer Center, to lead the National Cancer Institute. The oncologist and geneticist will succeed Doug Lowy, who has been acting director of NCI since early 2015. Lowy is expected to remain at the institute as deputy director and a researcher. Sharpless, 50, has done extensive work on how cells age and become malignant. He sees patients at North Carolina Cancer Hospital, which is the clinical home for UNC Lineberger. (McGinley, 6/10)

States Taking Steps To Protect Birth Control Coverage From Trump Administration Threats

“The feds can set a floor,” said Andrea Miller, president of the National Institute for Reproductive Health. “States can decide to do better.”

The New York Times: States Lead The Fight Against Trump’s Birth Control Rollback
Not long after President Trump took the oath of office, a busload of women’s health advocates made the first of a series of 860-mile round trips from Las Vegas to the Nevada capital, Carson City. Their mission: to push state legislators to expand insurance coverage for contraception. It worked. On Saturday, Gov. Brian Sandoval of Nevada, a Republican, signed a measure requiring insurers to cover 12 months of birth control at a time, with no co-payment. (Stolberg, 6/9)

The Washington Post Fact Checker: Planned Parenthood’s Claim About Birth Control Access For ’99 Percent Of Sexually Active Women’
According to a draft regulation obtained by Vox, the Trump administration wants to overhaul the birth control mandate under the Affordable Care Act, also called Obamacare. Reproductive rights groups opposed these proposed changes, and Planned Parenthood Action Fund used this statistic in its tweets about the draft regulation. It’s worth noting that Planned Parenthood’s wording for this statistic includes the caveat “sexually active,” which other organizations don’t always do. Still, it needs more context, especially when juxtaposed against Obamacare’s birth control mandate. (Lee, 6/12)

Women’s Health

Delaware Becomes First State Under Trump To Ensure Abortion Remains Legal

President Donald Trump campaigned on a promise to overturn Roe v. Wade.

In other news —

North Carolina Health News: Budget Abortion Language Could Jeopardize Hospital Procedures
A four-line provision in the North Carolina Senate’s budget could make it more difficult for hospitals and other providers who receive state dollars to perform abortions in North Carolina. In past years further restrictions on abortion have come in the form of high-profile bills making their way through raucous committee hearings. But this has been a quiet swipe at abortion services, a 65-word section tucked into the 360-plus page budget passed by the Senate on May 15 states that “no State funds shall be allocated to any provider that performs abortions.” The language in Section 11F.4 resembles language placed by legislators in the final 2011 budget which prohibited North Carolina Medicaid or the health insurance plan for state employees from reimbursing for any abortion procedures. (Hoban, 6/9)


States Weigh Changes To Medicaid As They Struggle 'To Pay For Their Share'

Both states that expanded the health care program for low-income residents and states that didn't are looking for creative ways to keep costs down. News outlets also report on the American Medical Association meeting and doctors' views of the Medicaid expansion, a Missouri hospital study and prospects for an extension of the federal Children's Health Insurance Program.

Washington Examiner: Medicaid Faces Growing Pains As Possible Overhaul Looms
Facing the need to balance their budgets next year, states are examining a variety of changes to their Medicaid programs even as Republicans weigh a major spending overhaul to the healthcare program for the poor. The changes underscore the difficulties of structuring the Medicaid program, which has little consensus across states or residents over who should qualify for it and what constitutes an appropriate level of spending. Obamacare aimed to make Medicaid more uniform by requiring states to expand it to more low-income people, but the Supreme Court ruled that portion of the bill would be optional. The District of Columbia and 31 states expanded Medicaid, leaving uneven strides in coverage from state to state. (Leonard, 6/12)

Forbes: Doctors Fight GOP Senate's Medicaid Clawback
The nation’s physicians are mobilizing once again to battle attempts to end health insurance coverage millions of Americans have gained over the last four years under the Affordable Care Act. Several groups within the American Medical Association are voicing support for policy that expands coverage even as the Republican-led U.S. Senate looks to reduce health benefits. The AMA’s policy-making House of Delegates meets through Wednesday in Chicago, amending and debating the advocacy agenda for the nation’s largest doctor group. (Japsen, 6/11)

Kansas City Star: Missouri Hospital Association Study Finds Medicaid Expansion States Win With Republican Health Care Bill 
A Missouri Hospital Association study of the American Health Care Act found that the Republican health care bill leaves Missouri and 18 other states that didn’t expand Medicaid short of federal money and continuing to feel the strain of uncompensated care. ... The rollback of Obamacare’s Medicaid expansion has been a point of contention in the repeal talks on Capitol Hill because some Republican governors accepted the federal expansion money starting in 2014 and want it to keep flowing now that their Medicaid programs are covering more people. (Marso, 6/9)

CQ Roll Call: Congress Weighs Kids' Coverage Options
Advocacy groups are pushing lawmakers to make decisions on the Children's Health Insurance Program, which faces a funding lapse on Sept. 30 unless Congress passes a renewal. Congressional aides say they have received preliminary information from the Congressional Budget Office about several options lawmakers are expected to discuss in more depth next week. The House Energy and Commerce Committee plans an initial hearing on June 14 on extending safety net programs, specifically funding for CHIP as well as community health centers and federally qualified health centers. The committee has not yet announced who will testify. (Raman, 6/9)

Health IT

Amazon To Make A Move In The Medical Supply Industry

Meanwhile, in other health IT news, health care leaders focused on ways to bring state-of-the-art technology to patients and on how health care providers should focus on the nexus of data and medicine at the University of Miami’s fourth-annual Latin American Innovation Forum.

Modern Healthcare: Amazon Poised To Deliver Disruption In Medical Supply Industry 
Amazon is on the healthcare industry's doorstep. The e-commerce giant continues to transform virtually every segment of the economy as it leverages its massive distribution network to deliver logistical harmony. With a stronghold on the consumer market, Amazon is eying the business-to-business segment as it builds its seller base. Soon, that familiar smiling brown box will make its way from porches to providers' front doors and that may make for some disgruntled medical supply distributors. Since launching two years ago, more than 45,000 sellers have signed on to the Amazon Business platform, which essentially serves as the middleman for third-party vendors. (Kacik, 6/10)

Miami Herald: Latin American Leaders Look To Technology For Health-Care Access
More than 120 Latin American leaders — government officials, CEOs, doctors and healthcare executives from both the public and private sectors — gathered at the university’s Coral Gables campus for the one-day forum... Although the forum touched on access to healthcare on many fronts, technology was the linchpin discussion at the event, which included panel discussions on healthcare access, the intersection of data and technology and creating partnerships in Latin America to increase prevention and treatment options. (Gross, 6/9)

Public Health And Education

At Front Lines Of Opioid Battle, Police Embrace Role Of Ally Over Enemy

Departments across the country are taking on different ways to help fight the crisis that don't involve mass arrests. In other news, the drug epidemic is causing death rates to spike in the U.S.

The New York Times: When Opioid Addicts Find An Ally In Blue
In this college town on the banks of Lake Champlain, Chief Brandon del Pozo has hired a plain-spoken social worker to oversee opioids policy and has begun mapping heroin deaths the way his former commanders in the New York Police Department track crime. In New York City, detectives are investigating overdoses with the rigor of homicides even if murder charges are a long shot. They are plying the mobile phones of the dead for clues about suppliers and using telltale marks on heroin packages and pills to trace them back to dealers. And like their colleagues in Philadelphia and Ohio, they are racing to issue warnings about deadly strains of drugs when bodies fall, the way epidemiologists take on Zika. (Baker, 6/12)

The Washington Post: Drug Crisis Is Pushing Up Death Rates For Almost All Groups Of Americans
The opioid epidemic that has ravaged life expectancy among economically stressed white Americans is taking a rising toll among blacks, Hispanics and Native Americans, driving up the overall rate of death among Americans in the prime of their lives. Since the beginning of this decade, death rates have risen among people between the ages of 25 and 44 in virtually every racial and ethnic group and almost all states, according to a Washington Post analysis. The death rate among African Americans is up 4 percent, Hispanics 7 percent, whites 12 percent and Native Americans 18 percent. The rate for Asian Americans also has increased, but at a level that is not statistically significant. (Achenbach and Keating, 6/9)

And in the states —

Denver Post: Colorado Hospitals Launch Program To Reduce Opioid Addiction
Now, [Dr. Don] Stader is part of a group of doctors and administrators who have come up with an ambitious plan for Colorado hospitals to dramatically reduce the amount of opioids they prescribe while still treating pain effectively. The program will roll out this year in a six-month pilot program at eight hospitals and three freestanding emergency rooms. Health officials hope to analyze data from the program at the three-month mark to figure out what is working best and what’s not, said Diane Rossi MacKay, with the Colorado Hospital Association. The effort is part of a broad rethinking in the medical world about the place opioids, blamed for an epidemic of addiction and overdose, should hold in medicine. As Stader says, doctors for years treated opioids as a panacea. (Ingold, 6/12)

Nashville Tennessean: 'Cash Money Talks' When It Comes To Finding A Drug Treatment Bed In Tennessee
The wait time for inpatient mental health and substance abuse treatment often depends on money or insurance. Not everyone with a mental health or substance use disorder need inpatient treatment. For some, outpatient services will suffice. But for those who do need inpatient treatment, "cash money talks," said Dr. Daniel Sumrok, director of UT Health Science Center's Center for Addiction Science in Memphis. Demand for inpatient treatment outweighs what's available because the state is in the throes of an opioid abuse and misuse epidemic. The number of overdose deaths hit a record 1,451 in 2015. (Fletcher, 6/10)

Kaiser Health News: Medical Responses To Opioid Addiction Vary By State, Analysis Finds
Location, location, location. That mantra may apply even when it comes to how opioid addiction is treated. Specifically, patients with private insurance who are diagnosed with opioid dependency or abuse may get different medical services depending on where they live, a white paper to be released in the upcoming week by a national databank indicates. (Appleby, 6/12)

Zika Threat Retreats, But Localities Still Look For New Ways To Fight Mosquito-Borne Diseases

Health officials say that the risk of contracting the virus in the Americas is receding, but that there is still a danger. Meanwhile, researchers look for easy, low-cost Zika testing as well as at the health impact of pesticides being used to combat mosquitoes.

NPR: Zika Travel Advice Still Holds For Pregnant Women And Their Mates
There's no doubt about it: Zika is on the retreat in the Americas. In Brazil, cases are down by 95 percent from last year. Across the Caribbean, outbreaks have subsided. And in Florida, the virus seems to have gone into hiding. Health officials haven't investigated a new Zika case for more than 45 days in Miami-Dade County. (Doucleff, 6/12)

Orlando Sentinel: Florida Researchers Develop Cheap, Fast Test For Zika, But Widespread Use May Be Years Away 
Florida researchers have developed a new device for detecting the Zika virus quickly and cheaply — although it might take years for it to come to market. Called the “Diagnoskeeter,” the portable, low-cost testing kit processes samples in 30 minutes and is “meant to [test for] all the families of the Zika virus,” said co-creator Ozlem Yaren, of the Foundation for Applied Molecular Evolution in Alachua. (Cheatham, 6/9)

The Star Tribune: Pesticide Used To Fight Zika Is Tied To Motor-Skill Deficits 
The pesticide widely used to fight Zika-carrying mosquitoes in Florida and across the nation has been linked to deficits in motor functions in Chinese babies, according to a new study. The study, whose authors say it is the first to examine real-world exposure to naled outside workplace accidents or lab experiments, used cord blood from 237 mothers who gave birth to healthy babies at a hospital in southeast China between 2008 and 2011. (Staletovich, 6/9)

Emotional Wounds From Pulse Shooting Have Yet To Heal For Some First Responders

Orlando City Commissioner Patty Sheehan says there are people who go to war and don't see what officers saw inside Pulse.

NPR: First Responders In Florida Struggle With PTSD
Gerry Realin says he wishes he had never become a police officer. Realin, 37, was part of the hazmat team that responded to the Pulse Nightclub shooting in Orlando on June 12, 2016. He spent four hours taking care of the dead inside the club. Now, triggers like a Sharpie marker or a white sheet yank him out of the moment and back to the nightclub, where they used Sharpies to list the victims that night and white sheets to cover them. (Aboraya, 6/12)

Miami Herald: One Year After Pulse, The LGBTQ Community Of Color Still Struggles
It may never be known whether the gunman behind the deadliest mass shooting in U.S. history targeted Pulse on June 12, 2016, because it was an LGBTQ club filled with people of color. But that’s who he hurt the most, and the small, increasingly vocal community at the intersection of those identities want its stories to be known. (Harris and Flechas, 6/9)

'Brain Hackers' Turning To Smart Drug To Enhance Cognitive Abilities

These drugs — nootropics — are said to improve memory, attention, creativity and motivation. But researchers say there is no evidence that the drugs help in the long-run. In other public health news: baby boxes, genital mutilation, day passes at psychiatric hospitals, gene editing, and cancer.

The Washington Post: Tweaking Brains With ‘Smart Drugs’ To Get Ahead In Silicon Valley
George Burke has a talent for tossing back his daily cocktail — which contains vitamins, minerals, muscle-building compounds, some little-known research drugs and a microdose of LSD — in almost a single gulp. It’s a weird but handy trick for someone who swallows 25 pills a day, most of them purchases off the Internet. Burke credits the regimen with giving him the cognitive edge he needs to thrive in California’s Silicon Valley, where he’s the co-founder of a food service that caters to athletes and fitness devotees. (Solovitch, 6/11)

NPR: Will Baby Boxes Really Keep Children Safer?
When Maisha Watson heard about baby boxes, her first reaction was: "Why would I want to put my baby in a box?" She was talking with Marcia Virgil — "Miss Marcia" to her clients — a family support worker with the Southern New Jersey Perinatal Cooperative. True, it's a cardboard box, Miss Marcia told her. But it's also a safe place for a baby to sleep: It comes with a firm mattress and a snug sheet, in line with American Academy of Pediatrics recommendations meant to protect against sleep-related deaths, including sudden infant death syndrome, or SIDS. (Pao, 6/12)

The New York Times: Michigan Case Adds U.S. Dimension To Debate On Genital Mutilation
As more details emerge about the first-ever charges of female genital mutilation in the United States, the case is opening a window onto a small immigrant community, while stirring impassioned discussion about genital cutting among women who have experienced it. At a hearing in Michigan this past week, a federal prosecutor said the defendants — two doctors and a clinic manager from a small Shiite Muslim sect — were believed to have arranged cutting for up to 100 girls since 2005. The prosecutor, Sara Woodward, said investigators had so far identified eight girls. (Belluck, 6/10)

The Baltimore Sun: Day Passes For Vulnerable Patients Of Psychiatric Hospitals Can Have Dangerous, Even Fatal Consequences
The use of day and overnight passes, sometimes called home passes, trial passes, leave of absence or convalescent leave, by psychiatric hospitals is part of a patient's recovery process, even in cases where the patient is in long-term care, said Vaile Wright, a psychologist and director of research at the American Psychological Association. Spending time outside the hospital can prepare patients for returning to independent life...But such passes are not without risk. On occasion, patients out on a pass either seriously harmed or killed themselves or others, or committed violent assaults and other crimes. Other patients used the passes to escape the treatment facilities and evade being returned. (Woodruff, 6/9)

Stat: CRISPR Pioneer Doudna Foresees World Of Woolly Mammoths And Unicorns
A biochemist who co-led a breakthrough 2012 study of CRISPR-Cas9, [Jennifer] Doudna repeatedly emphasized in interviews the challenges of repurposing the molecular system, which bacteria use to fend off viruses, to edit human genomes. The U.S. patent office, in a February ruling that let the Broad keep its CRISPR patents (for now), relied heavily on those statements — “We weren’t sure if CRISPR/Cas9 would work in … animal cells,” for example — to conclude that when scientists at the Broad CRISPR’d human cells in 2013, it was a non-obvious advance and therefore deserving of patents. (Begley, 6/11)

NPR: Got Cancer Questions? This Little-Known Hotline Can Help
If you were worried you had cancer, who would you call for information? Chances are a federally-funded cancer helpline isn't the first place that pops into your mind. But for 40 years, a helpline funded primarily by the National Cancer Institute has been answering people's questions about cancer. (Columbus, 6/9)

Kaiser Health News: Why Many Cancer Patients Don’t Have Answers
In the past four years, Bruce Mead-e has undergone two major surgeries, multiple rounds of radiation and chemotherapy to treat his lung cancer.Yet in all that time, doctors never told him or his husband whether the cancer was curable — or likely to take Mead-e’s life. “We haven’t asked about cure or how much time I have,” said Mead-e, 63, of Georgetown, Del., in a May interview. “We haven’t asked, and he hasn’t offered. I guess we have our heads in the sand.” (Szabo, 6/12)

State Watch

Traces Of Legionnaires' Disease Found In Water At New York Police Department

Officers can still work in the building, but the Health Department has advised them to avoid taking showers there.

The Washington Post: Officers At New York Precinct Told Not To Shower At Station After Fears Of Legionnaires’ Disease
Officials are investigating after a New York Police Department officer contracted Legionnaires' disease, a potentially life-threatening form of pneumonia. Preliminary test results indicate that traces of the bacteria causing Legionnaires' disease were found at the police station in East Harlem. Officials have started inspecting the facility's systems and testing the precinct's water supply. The officer, who was not named, is recovering at a hospital outside of the city, according to the New York City Department of Health. (Phillips, 6/11)

The New York Times: Bacteria Behind Legionnaires’ Disease Found At New York Police Station
Traces of the bacteria that cause Legionnaires’ disease have been found in the water at a Manhattan police station where an officer who recently fell ill works, the police and health officials said on Sunday. The police officer, whose name was not released, was recovering from Legionnaires’ disease at a hospital outside the city, while city Health Department workers looked for the source of the contamination discovered at the 23rd Precinct station house on East 102nd Street in East Harlem. (Southall, 6/11)

Colo. State Mental Hospital In Pueblo Faces Severe Staffing Shortage; Medical College Of Wisconsin Ups Focus On Lack Of Child Psychiatrists

News outlets report on these and a variety of other state-related mental health developments.

Denver Post: State Mental Hospital In Pueblo Found In 'Immediate Jeopardy' Of Patient Safety, Could Lose Federal Funds 
Colorado’s 449-bed mental health hospital in Pueblo has a staffing shortage so severe it poses an “immediate and serious threat to the health and safety” of its patients, say federal authorities who have given the hospital a little more than three weeks to improve before funds are cut off. The hospital for people who are committed by courts or found innocent by reason of insanity was placed on a 23-day “termination track” for failing to comply with federal regulations, the Colorado Department of Human Services said Friday. Investigators who inspected the psychiatric hospital Monday found it did not meet conditions of the federal Centers for Medicare and Medicaid Services. (Brown, 6/9)

Milwaukee Journal Sentinel: Medical College Of Wisconsin Program Expands Treatment Of Children's Mental Disorders
The Medical College's Child Psychiatry Consultation Program was created to help address a severe shortage of child psychiatrists and now is available in Milwaukee, Waukesha and Ozaukee counties as well as 15 counties in northern Wisconsin... It can take several months to get an appointment with a child psychiatrist, and as long as nine months depending on the severity of the child's condition, [Renee] Szafir said. (Boulton, 6/10)

North Carolina Health News: State Targets Linville Hospital For Expanded Mental Health Services In WNC 
State public health officials have announced that the Charles A. Cannon, Jr. Memorial Hospital in Linville is the recipient of a $6.5-million grant to expand mental health and substance abuse services at the Avery County facility. The Cannon Hospital, as well as the Duke Life Point Maria Parham Medical Center in Vance County, which was awarded more than $10 million, was given the grant “ to increase the number and availability of inpatient psychiatric and substance use treatment beds in rural hospital beds across the state,” according to a press release from the North Carolina Department of Health and Human Services. Grant applications are being accepted from hospitals in the eastern portion of the state until June 9. (Gebelein, 6/12)

San Antonio Press-Express: State Can Step Up Mental Health Awareness For Jails 
In the two years since Bland was found hanged — three days after her arrest — the mental health issues facing criminal defendants prompted numerous studies, reports and, most recently, the passage of the Sandra Bland Act. The bill, awaiting Gov. Greg Abbott’s signature, requires improved mental health standards in jails and mandates mental health training for law enforcement. (Padilla, 6/9)

Boston Globe: Families Trusted Arbour's Hospital System To Care For Their Relatives. It Systematically Failed Them 
The 89-bed hospital in Westwood is one of seven operated by Arbour Health System, which Massachusetts relies on to treat many of its sickest and most fragile mentally ill children and adults... During at least 19 visits to Arbour-operated hospitals since 2013, inspectors found filthy conditions — split, ripped, and stained mattresses, walls covered with food, obscene graffiti, and an overpowering smell of urine in bathrooms. (Kowalczyk, 6/10)

State Highlights: Ga. Falls To 41st In Older People's Health; Ohio Senate Contemplates State Versus Local Authority For Lead Regulation

Media outlets report on health-related news from Georgia, Ohio, California, Massachusetts, Colorado, Maryland, Pennsylvania and Texas.

Georgia Health News: State Slips To 41st In Senior Health Rating 
Georgia ranks 41st among states on older people’s health, down two spots from last year’s ranking, a new report says... Georgia had a 12 percent decrease in senior poverty in the past two years; a 16 percent increase in health screenings over that time; and a similar rise in seniors with “high health status.’’ (Miller, 6/9)

Cleveland Plain Dealer: Lawmakers Deciding Future Of Ohio's Lead Laws Hear Debate Over State Versus Local Control
The Senate is currently considering the future of an amendment to the pending budget added in May by Rep. Derek Merrin, a real estate investor who represents parts of Lucas and Fulton counties. The amendment essentially would give exclusive power for regulating lead poisoning to the Ohio Department of Health (ODH). The impetus was a Toledo ordinance that requires certain rental units to be inspected for lead hazards. (Dissell and Zeltner, 6/12)

Columbus Dispatch: Columbus To Sue Landlords On Lingering Lead-Paint Hazards
Columbus city attorneys and public-health officials are preparing dozens of court cases against landlords who haven’t removed hazardous lead paint from their properties despite city orders. The officials acknowledge that they haven’t compiled cases as a group like this before, and are doing so only after an Ohio Department of Health report in May said that 51 Columbus residences, most of them rentals, must be vacated because of lead hazards. (Viviano and Ferenchik, 6/12)

Los Angeles Times: Health Officials Urge Meningitis Vaccination Amid L.A. Pride Festival
Los Angeles County health officials on Friday again urged gay and bisexual men to get vaccinated against meningitis, as an outbreak that began last year continues to grow. Twenty-nine people in the county have been diagnosed with meningitis since March 2016, with the latest case identified a few weeks ago. Earlier this year, one patient died from the infection. (Karlamangla, 6/9)

Boston Globe: Dentists Fault Compensation Levels For Delta Dental’s Executives 
Delta Dental of Massachusetts has argued that its recently proposed contract changes, which would reduce some reimbursements to dentists, are necessary for the nonprofit insurer to grow and remain competitive. But dentists, many of them concerned about absorbing the cuts, say the company should be looking elsewhere for savings: at its executive compensation, which exceeds the pay at other Massachusetts nonprofit insurers. (Dayal McCluskey, 6/11)

Denver Post: Pride Week: Dr. Daniel Reirden Of Children's Hospital On Trans Youth
Hearing the national debate surrounding so-called “bathroom bills,” the laws that would require people to use gender-segregated facilities based on their sex at birth, just makes Dr. Daniel Reirden shake his head. Just as the controversy surrounding Rosa Parks wasn’t about the bus, this conversation around who gets to use which toilet isn’t really about the bathroom, says Reirden...From 2013 to 2016, 24 states — including Colorado — considered bathroom bills. And this is just one of the things transgender youth have to listen to, along with people reciting statistics of alarmingly high suicide rates, people testifying about why the process to change their birth certificates shouldn’t be simplified, or parents of peers who have problems with their gender identity. (Worthington, 6/11)

The Baltimore Sun: Dimensions Completes Next Step To Becoming Part Of UM Medical System
The Dimensions Healthcare System board of directors said Friday it has unanimously approved a plan to become a part of the University of Maryland Medical System. The Prince George's County health system said it is "an important step" in a process that has been several years in the making to become an affiliate of the University of Maryland. There are several more steps still needed before a deal is completed. The board of the University of Maryland must now review and approve the plans, something it plans to do this summer, said spokeswoman Karen Lancaster. Lancaster said the goal is to have the affiliation completed this year. (McDaniels, 6/9)

The Philadelphia Inquirer: The Nursing Gap In Nursing Homes
Brookside Healthcare & Rehabilitation Center near Jenkintown provided 39 percent of the registered nursing a day expected by federal regulators during a recent three-year period. Advocates and some academics say that’s a sign of a company out to boost profits...For overall nursing care, which includes RNs, LPNs, and nursing assistants, Brookside’s 4.1 hours per patient day easily topped the state minimum of 2.7 hours per day of care, but was well below the 4.9 hours a day expectation calculated by federal regulators based on the mix of patients at Brookside during annual inspections. (Brubaker, 6/11)

Sacramento Bee: Students Use Art As Activism At California State Capitol 
Members of Brown Issues, Fathers and Family of San Joaquin County, and We’Ced Youth Media painted puzzle pieces of what “We Are All Californians” meant to them and then assembled them Tuesday at the Capitol into the shape of the bear on the California flag. All members are active participants in the California Endowment’s #Health4All campaign that aims to raise awareness that undocumented immigrants lack affordable health care in California. (Marks, 6/9)

The Baltimore Sun: Chase Brexton Says Executive's Departure Unrelated To Suspension Of License 
An executive at Chase Brexton Health Care, whose license as a social worker was suspended recently by the state, resigned several weeks ago, but officials at the chain of health clinics said his departure is not related to the suspension. Jermaine Anton Wyatt, vice president of psychosocial services since 2015, is leaving next month to take a job in Washington, confirmed Becky J. Frank, the organization's vice president of development and marketing. (McDaniels, 6/10)

Editorials And Opinions

Perspectives: The GOP's Health Plan Steeped In 'Secrecy' And 'Sabotage': Could Exchange Meltdown Trigger Medicaid Extension?

Opinion writers parse a variety of issues related to the Affordable Care Act, the American Health Care Act, Medicaid's ups and downs, the future of single-payer proposals and other health policy developments.

The Washington Post: The Senate’s Three Tools On Health Care: Sabotage, Speed And Secrecy
Senate Majority Leader Mitch McConnell (R-Ky.) had a problem when the American Health Care Act arrived from the House last month. What to do with a bill that is clogging your agenda but only 8 percent of Americans want you to pass and members of your own caucus swore was dead on arrival? McConnell couldn’t have missed the town halls filled with angry Americans who rely on Medicaid and see the Affordable Care Act’s protections for those with preexisting conditions as a godsend. The House bill — which the Congressional Budget Office estimates would cause 23 million to lose coverage and end those protections for many — threatened all of that. (Andy Slavitt, 6/10)

The Washington Post: The GOP’s Obamacare Sabotage Continues
Another week, another insurance company deserting patients in a wide swath of the country. Last Tuesday, Anthem announced it would pull out of the Obamacare marketplace in Ohio, potentially leaving individual insurance-buyers in about a fifth of the state’s counties without Affordable Care Act coverage to purchase. ... Are these moves more evidence that Obamacare is fundamentally unworkable? Hardly. ... Anthem explained clearly what is responsible for its retreat: Republican sabotage of the health-care system. (6/10)

The New York Times: Republicans’ Secretive Plan For Health Care
While many Americans make sense of James Comey’s testimony on his meetings with President Trump, Republican senators are quietly moving toward something that has been their party’s goal for nearly eight years: dismantling the Affordable Care Act. The question, of course, is how they plan to replace it. ... The Senate aims to vote by the end of the month, and will probably do so with no hearings. This stands in stark contrast to the process leading up to the passage of the Affordable Care Act, which included over 100 congressional hearings. (Miranda Yaver, 6/9)

RealClear Health: How Obamacare May Morph Into Medicaid
The slow-motion consideration by Congress and the president to change the Affordable Care Act is likely to produce surprising results. The insurance market does not go into suspended animation while Washington debates. (JB Silvers, 6/12)

Bloomberg: Republicans Aim To Win The Health-Care Blame Game
What to make of the seeming momentum for a Republican health-care bill in the Senate? On the one hand, a bit of caution might be in order. There still isn't a bill. There isn't a Congressional Budget Office score. Republicans must keep their relative moderates on board without losing the most conservative senators; they may be achieving that, and they're still a few steps away from that. It wouldn't be the first time that a bill seemed to have momentum only to fall short once the actual votes were counted. That said, it's also quite possible that Mitch McConnell and other Republican leaders have threaded the needle. (Jonathan Berstein, 6/9)

Detroit Free Press: Key Republican Wants To Rescue Obamacare, For Now
The tumultuous past week provided reassuring evidence that there are still a few fully-functioning adults in the U.S. Congress — and not all of them sit on the Senate Intelligence Committee. U.S. Rep. Kevin Brady, a Texas Republican who chairs the powerful House Ways and Means Committee, is one such grown-up. ... Brady acknowledged publicly what Republican governors and health care experts have been saying privately for months: Unless his party does something to shore up the Affordable Care Act until a new, Republican-branded system is in place, millions of Americans may lose access to affordable health care just in time for next year's congressional elections. (Brian Dickerson, 6/9)

The Wall Street Journal: A Single-Payer Test Drive
California’s state Senate recently passed a single-payer health-care bill, and we’re warming to the idea as an instructive experiment in progressive government. If Democrats believe the lesson of ObamaCare is that the government should have even more control over health care, then why not show how it would work in the liberal paradise? (6/11)

Sacramento Bee: Single Payer: Democrats' New Litmus Test
Following California’s lead, Democrats nationally are embracing plans to expand Medicare to provide all Americans with health insurance. ... Single-payer has not yet been endorsed by the Democratic leadership in Congress. But growing grassroots and political support for Medicare for All soon could make it the de facto Democratic health care plan, with or without the leaders. (Ben Tulchin and Ben Krompak, 6/9)

Chicago Tribune: Obamacare, Medicaid And Illinois: Springfield, What's Your Plan?
If you've been following the Obamacare repeal and replace struggle, you know this much: The GOP-backed bill that passed the House won't become law. It's DOA in the Senate. Senators are crafting their own version. But that House bill, known as the American Health Care Act, was valuable because it reminded us of a larger truth about the 2010 law President Barack Obama championed: America has not one Obamacare population, but two. (6/11)

Milwaukee Journal Sentinel: Medicaid Drug Tests Punishes Wisconsin's Poorest People
Wisconsin last week became the first state in the country to submit a request for a waiver to allow for the drug testing of applicants for Medicaid. Gov. Scott Walker's plan would require able-bodied, childless adults to undergo drug screening when applying for benefits. If they fail the test, they would get treatment paid for by taxpayers through the Medicaid program, though no details have yet been released about the type of treatment, where it would be offered or what amount or what kinds of drugs would trigger a failed result. ... some of the poorest people in the state are being targeted by this new plan and would be punished should they decide that the government has no business forcing them to reveal private medical data or undergo treatment that could be offered by religious-based or unproven providers. (Emily Mills, 6/9)

San Antonio Press-Express: Don’t Mess With Texans’ Part D Coverage 
Nearly 1.7 million Texas seniors could lose access to their medications if some members of Congress convince President Donald Trump to sign off on their alterations to Medicare. These lawmakers want the government to directly negotiate the prices of medicines covered by Medicare’s prescription drug benefit, known as Part D. (Betty Lee Streckfuss, 6/11)

Viewpoints: Problems With E.R. Care; For Dayton, Heroin Epidemic Is Drug-Addiction Déjà Vu

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

KevinMD: There’s Something Wrong With Emergency Care. Here’s What It Is.
I am an emergency physician, forever grateful of the responsibilities entrusted by my patients. This is a relationship I hold dear. ... One popular misconception is that emergency care can be compared to urgent care and primary care physicians. Recent media coverage of freestanding emergency rooms — ERs not attached to a hospital — has compared their costs to urgent care clinics. This is like comparing apples to oranges. These are two completely different entities that undoubtedly provide different levels of services. Urgent care is for treating minor complaints when access to a primary provider is not available, either due to scheduling or after hour illnesses. Freestanding ERs are fully functional emergency departments, capable of treating complex injuries and illness with charges comparable to hospital-based emergency departments. (Jeffrey McWilliams, 6/11)

Cleveland Plain Dealer: Dayton, Ohio Survived Crack, Now It's Fighting To Survive Heroin
I remember well Dayton's economic and moral dilemma as its political and business leaders struggled for solutions to the soaring spike in users seeking to feed their crack addictions, and to the collateral social costs. ... Like much of Ohio, Dayton finds itself smack dab in the middle of a heroin tsunami that is stretching the city to its breaking point. (Phillip Morris, 6/9)

Los Angeles Times: Texas Anti-Abortion Forces Now Want Fetuses To Be Buried Or Cremated
Texas has become the most recent state to shift the focus of its antiabortion efforts from protecting the woman to humanizing the fetus. Texas Senate Bill 8, signed into law Tuesday by Republican Gov. Greg Abbott, is an omnibus of abortion restrictions, none of which even pretend to be about protecting women’s health. But several of the provisions clearly aim to conflate fetuses with babies in the eyes of the law, a move that is understandably threatening to supporters of abortion rights. The most obnoxious of these requires that fetal remains be given a “dignified disposition” by cremation, burial in a cemetery or a scattering of ashes. (6/12)

Cleveland Plain Dealer: Husband's Stroke Is Cautionary Tale For All Of Us
Lacking fine-motor skills, Ron has great difficulty even typing one sentence or writing his name. The lifestyle we once enjoyed is just a memory; my husband, once the proud, primary breadwinner, can no longer work. Ron now receives Social Security Disability Income, and I struggle to work as well as care for him. With many bills to pay, we constantly make major cutbacks. (Jerilyn Friedman Burgess, 6/11)

The Washington Post: When Mentally Ill Parents Murder Their Children
"These two babies . . . they never had a chance.” That was the grim appraisal of Prince George’s County State’s Attorney Angela Alsobrooks as she catalogued the failures that led to the murders of two young children by their mentally ill mother. There were clear warnings that a troubled young mother needed help and that her children were in danger. The tragic case exposes fault lines in systems set up to treat mental illness and protect children, underscoring the need for improvements. (6/11)

Cleveland Plain Dealer: Salmonella Warning - Playing With Backyard Chickens Is Not Wise
Ohioans, unhand those chickens. And no kissing or hugging them, either, please. That's the important takeaway from a report by the federal Centers for Disease Control and Prevention, which has investigated 372 cases of stomach-churning salmonella from Jan. 4 to May 13 of this year, mostly connected to backyard flocks. Luckily, that has not included any deaths. (6/11)