KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Kaiser Health News Original Stories

Political Cartoon: 'Super Woke?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Super Woke?'" by Steve Sack, The Minneapolis Star Tribune.

Here's today's health policy haiku:


Health bill rebirth hope
Will fall like cherry blossoms
In late April rain.

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

Preliminary Filings From Insurers Give Hint Of Things To Come For ACA Marketplaces

As deadlines loom for announcing 2018 plans, all eyes are on which insurers will stay in the exchanges. But, with the fate of some key subsidies still up in the air and possibly tied to the spending bill, the future is just as uncertain for the companies themselves.

The Wall Street Journal: Insurers Offer Early Sign Of ACA Exchange Plans For 2018
Anthem Inc. made preliminary filings indicating it will offer plans on the Affordable Care Act marketplaces in Virginia and Kentucky next year, providing an early signal on the insurer’s exchange business. Cigna Corp.and Aetna Inc., which like Anthem have said they are reconsidering their exchange offerings, are among the insurers that made similar filings in Virginia. But one current Virginia ACA insurer, UnitedHealth Group Inc., didn’t file 2018 forms, and a spokesman confirmed it would leave the state’s marketplace next year. (Wilde Mathews and Radnofsky, 4/20)

The Washington Post: Trump Must Decide Whether To Support Or Undermine Obamacare
President Trump is pressuring Congress to sink parts of the Affordable Care Act. But now that the first attempt at a GOP health-care overhaul has failed, he must decide whether to throw the law a line. The White House and Republican lawmakers are facing key decisions that could either improve the insurance marketplaces established by the ACA next year or prompt insurers to further hike rates or withdraw from those marketplaces entirely. Republicans had hoped to protect those with marketplace coverage while lawmakers replaced Obamacare. (Winfield Cunningham, 4/19)

Politico: 5 Reasons The Government Might Shut Down
The deadline to keep the federal government open is just about here, but a deal is far from done. With just five workdays left until government funding expires, lawmakers return next week to all the same sticking points that have made full-year funding so elusive and now threaten a government shutdown.  ... Democratic leaders declared that any spending bill must provide money for a key Obamacare subsidy program after Trump threatened to defund the cost-sharing subsidies; the president sees the program as a way to force Democrats to the negotiating table. (Scholtes and Ferris, 4/20)

The Hill: Health Subsidy Demand Jams Up Shutdown Fight
Democrats’ demand that ObamaCare subsidies be wrapped into a must-pass spending package is complicating GOP efforts to prevent a government shutdown at the end of next week. Speaker Paul Ryan (R-Wis.) has signaled no plans to include the subsidies in a bill to keep the government open, but President Trump’s recent threat to withhold the subsidies to insurers has led several top Republicans to intervene. (Lillis and Marcos, 4/19)

The Hill: Groups Warn Of Rural Health 'Crisis' Under ObamaCare Repeal 
Rural areas would be hit particularly hard if Congress and the Trump administration don’t send clear signals that they’re committed to helping keep ObamaCare’s insurance marketplaces stable next year, advocates warn. Insurers are in the midst of deciding which ObamaCare markets to enter, and they need assurances that they won’t have to pay billions for out-of-pocket costs for certain low-income consumers. Rural areas already have fewer care options than their urban peers.  (Roubein, 4/19)

Administration News

Program Allowing Veterans To Seek Care Outside VA Health System Extended

President Donald Trump signed the extension of the Veterans Choice Act on Wednesday. There won't be much noticeable change from the action, but a new bill dubbed "Choice 2.0" is slated to be introduced to Congress in the fall.

The Wall Street Journal: Trump Signs Legislation Extending Private-Care Program For Veterans
President Donald Trump signed an extension of a Department of Veterans Affairs law on Wednesday to continue a program that helps veterans seek health care outside the VA system. The original legislation, commonly known as the Veterans Choice Act, was slated to expire in August. The measure signed Wednesday by Mr. Trump extends the program until the remaining funds are used, which is expected to happen by the end of the year. (Kesling, 4/19)

In other news on veterans' health care —

NPR: Veterans Gain Health Coverage Through The Affordable Care Act
Almost half a million veterans gained health care coverage during the first two years of the Affordable Care Act, a report finds. In the years leading up to the implementation of the ACA's major coverage provisions, from 2010 to 2013, nearly 1 million of the nation's approximately 22 million veterans didn't have health insurance. (Boddy, 4/19)

Pharma, Big Tobacco Opened Up Wallets For Trump's Inauguration

The industries, which are often the focus of federal scrutiny, ponied up millions for the new president's inauguration festivities.

The New York Times: Trump Inaugural Drew Big Dollars From Donors With Vested Interests
Documents released this week by Mr. Trump’s inaugural organizers provide a glimpse of the big-dollar frenzy of influence-seeking and peacemaking surrounding Mr. Trump’s swearing-in, which raised $107 million, twice as much money as any other inauguration. ...  While Mr. Trump promised during the campaign to give Medicare and Medicaid the power to negotiate prices they pay for prescription drugs, two of the biggest drugmakers, Pfizer and Amgen, gave a combined $1.5 million in December. (Confessore, Fandos and Shorey, 4/19)

Kaiser Health News: With Drug Costs In Crosshairs, Health Firms Gave Generously To Trump’s Inauguration
Drugmaker Pfizer gave $1 million to help finance the inauguration, according to documents filed with the Federal Election Commission. Amgen, another pharmaceutical company, donated $500,000. Health insurers Anthem, Centene and Aetna all gave six-figure contributions. They joined a surge of corporate donors from multiple industries to break inauguration-finance records even as then-President-elect Donald Trump promised to “drain the swamp” of Washington influence-peddling. (Hancock, Lupkin and Lucas, 4/19)

Stat: Pharma, Tobacco, And Food Companies Fuel Inaugural Festivities
Two law firms with large health care practices also chipped in. Holland & Knight, which lobbies for the Alliance for Regenerative Medicine, America’s Essential Hospitals, and the Biosimilars Forum, among other clients, donated $100,000 and Mintz Levin Cohn Ferris Glovsky and Popeo, which has a busy health law group, gave $35,000. (Kaplan, 4/19)

Miners Who Helped Carry Trump To Victory Terrified As Threat Of Losing Benefits Looms

The president often spoke about miners during his campaign, but as the deadline to renew benefits for them nears, he's remained quiet.

In other administration news —

Morning Consult: Senate Panel To Vote Next Week On FDA Commissioner
The Senate Health, Education, Labor and Pensions Committee will vote Wednesday on the nomination of Scott Gottlieb to serve as the commissioner of the Food and Drug Administration. If confirmed, Gottlieb, a former deputy commissioner at the FDA, would oversee an agency that President Donald Trump has vowed to reform. (McIntire, 4/19)


Oregon Lawmakers Seeking Budget Cuts Weigh Proposal To End Medicaid Expansion

The state is facing a $1.6 billion deficit and dropping the Medicaid expansion could save $256 million over two years. The hospital industry is fighting the proposal and the governor has called it "unacceptable." News outlets also report on other Medicaid news in Alabama, Mississippi and Michigan.

Modern Healthcare: Oregon Lawmakers Consider Ending Medicaid Expansion To Shore Up Budget
Democratic lawmakers in Oregon are considering ending the state's Medicaid expansion in an effort to address a $1.6 billion budget shortfall. The state's Ways and Means committee, which includes both senators and representatives, suggested cutting Medicaid expansion in an effort to curb Oregon's $1.6 billion budget deficit. "We are simply laying out possibilities for how the state may deal with the stark realities of a projected $1.6 billion deficit," Rep. Nancy Nathanson, co-chair of the Ways and Means committee said in an email. Ending Medicaid expansion, which has led to 350,000 people gaining coverage, would save the state $256 million over the next two years. (Dickson, 4/19) Medicaid Mandate Causing Confusion For Autism Insurance Bill
A hotly debated bill to require most private insurers to cover behavioral therapy for children with autism is first up in the House chamber on Thursday morning. Concern over costs is once again causing confusion. ... Alabama is one of five states with no requirement that insurance companies cover applied behavior analysis (ABA), the most common and scientifically supported treatment for autism. In committee, the bill faced stiff opposition from members of the business and insurance communities. Though it passed the House Insurance committee, HB284 emerged with extra baggage, including caps on coverage, a provision to end coverage if insurance premiums rise beyond one percent, and a mandate to include coverage for children eligible for Medicaid. (Powell Crain, 4/19)

Modern Healthcare: Michigan Senate Panel OKs Language That Could Push Medicaid Mental Health Funding To Health Plans
A Michigan Senate subcommittee voted Tuesday for budget language that instructs the state Department of Health and Human Services to develop pilot projects for Medicaid health plans to integrate behavioral and physical health and work toward a single contracting model by Sept. 30, 2020. Under the plan, which has been heavily opposed by the state's current public system of mental health providers and advocates, Michigan's 11 Medicaid HMOs could eventually manage both the state's $9 billion physical health and $2.6 billion behavioral health system. (Greene, 4/19)


Upset By Insurers' Guidelines To Try Cheaper Drugs First, Doctors Issue Recommendations

The American Society of Clinical Oncology have one message to insurers: Put patients, not cost, first.

Stat: Cancer Doctors To Insurers: Not ‘Fail First,’ But ‘Patients First’
Cancer patients are locked in an intensifying struggle with insurers, who sometimes force them to try less expensive drugs before moving to more expensive ones, even against doctors’ wishes. Now the American Society of Clinical Oncology, or ASCO, is deepening its involvement in the fight, issuing a set of recommendations Tuesday that it hopes insurers will follow as they confront a growing lineup of expensive cancer drugs. (Tedeschi, 4/20)

In other news on health care costs —

Modern Healthcare: Stricter Chargemaster Regulations Needed To Rein In Healthcare Costs
After a three-hour visit to the emergency room, a young girl left with a headache and a $4,875 bill. A Southern California hospital charged the girl and her family three times the fair and customary price for a CT scan — about $2,000 — to see if the girl's fall caused head trauma, according to Lisa Berry Blackstock, a patient advocate the family hired to negotiate a lower fee. The family's high-deductible health plan meant they had to cover the entire cost. (Kacik, 4/19)

Health IT

In Ambitious Health Data Project, Researchers Happily Trade 'Moonshots' For Day-To-Day Drudgery

Verily Life Sciences, formerly Google Life Sciences, is launching its initiative to collect information on 10,000 volunteers to create a baseline of health for the population. But, despite the scope of the project, those running it say they have their feet firmly planted on the ground and in reality.

Bloomberg: Google’s Health Moonshot Comes Back To Earth 
Opening on April 19, the study is called Baseline, as in a starting point for what healthy biometric data should look like. It’s the first serious public test for Verily Life Sciences, formerly Google Life Sciences. While Verily has separated from Google’s internet business within the Alphabet Inc. holding company, it’s taking a page from the playbook of its former parent, which aims to collect and organize information online. Verily wants to collect data from our bodies, using it to guide better health decisions. While that sounds ambitious, it’s much more modest than the missions Verily promoted when it was officially part of Google. Years ago, the biotech division promised projects such as glucose-monitoring contact lenses and all-in-one medical scanners; those remain in the lab. (Chen and Bergen, 4/19)

Atlanta Journal-Constitution: Google Verily Project Baseline: New Study To Predict How We Get Sick
In partnership with both Duke University School of Medicine and Stanford Medicine, the landmark study, part of its Project Baseline, aims to collect health data from 10,000 participants over the course of at least four years, the company announced in a news release Wednesday... Using physical and biochemical traits of the study population, researchers hope to better understand how people get sick, when they get sick and identify any additional risk factors and biomarkers leading up to disease, including diseases related to both cardiovascular disease and cancer. (Pirani, 4/19)

In other health technology news —

The Oregonian: Kept In The Dark: Sen. Jeff Merkley Pushed For Database After Father's Surgery 
Jeff Merkley, now one of Oregon's U.S. senators, remembered the difficulty his family had after his father had back surgery in the 1990s. Physicians wanted him moved to a care center from the hospital. But the state had no quality comparison that people could quickly search on a computer. "This is really hard on families," Merkley said. "You have to make a decision right now and you don't have any information. Why not?" A site eventually went online, but it lacks about 8,000 records, around 60 percent of all substantiated complaints. Merkley was stunned when The Oregonian/OregonLive told him in March that the site was far from complete. He had spent years in the Oregon House pressing for online records. (Terry, 4/19)

The Wall Street Journal: Cybersecurity Startup Tanium Exposed California Hospital’s Network In Demos Without Permission
For years, cybersecurity startup Tanium Inc. pitched its software by showing it working in the network of a hospital it said was a client, according to people familiar with the matter and videos of the demonstrations. That and other efforts helped the company grow quickly, notching a valuation of $3.5 billion and a big investment from Andreessen Horowitz, one of Silicon Valley’s most prominent venture firms. But Tanium never had permission to present the demos, the hospital said, meaning a company selling security actually was giving outsiders an unauthorized look at information from inside its customer’s system. (Winkler, 4/19)

Public Health And Education

Protein Found In Umbilical Cord Could Hold Key To Rejuvenating Memory Center In Brain

In a study, cold blood improved the performance of aged mice as they engaged in memory and learning tasks, such as maze-running and fear-conditioning exercises.

The Washington Post: A Protein From Human Umbilical Cords Revitalizes Memory — At Least In Mice
You leave your car in a vast, crowded parking lot, and when you return, you have no idea where it is. The ensuing search is frustrating, time-consuming and a little embarrassing. That experience occurs more frequently as we get older, because the functions of the part of the brain that encodes spatial and episodic memories — the hippocampus — decline with age. But now neuroscientists at the Stanford University School of Medicine have shown that — in mice — an infusion of plasma taken from human umbilical cords improves the hippocampus's functioning, resulting in significant gains in memory and cognition needed for tasks such as finding a car in a full parking lot. (Bernstein, 4/19)

NPR: Blood From Human Umbilical Cords Helps Aging Mice Remember
From the beginning, the findings were exciting, complex and, sometimes, contradictory. For example, scientists have shown that young blood can restore cell activity in the muscles and livers of aging mice. They've also found that linking old mice to young ones helped reverse heart muscle thickening. On the other hand, researchers weren't able to replicate some of the most eye-catching findings and another study concluded that, in mice that swapped blood without being connected surgically, the negative effects of being exposed to old blood outweighed the benefits of getting young blood. (Bichell, 4/19)

'I Need Medicine For This Pain': The Landmines Of Treating Someone Addicted To Opioids

There's no definitive guidance for doctors on what to do when their patient is someone who is in recovery from an opioid addiction, but also in need of pain relief. In other public health news: antidepressants, mysterious diseases, antibiotic-resistant infections, stress in kids and sexual enhancement pills.

NPR: Opioid Addiction Complicates Pain Relief After Surgery
Nearly one and a half million Americans were treated for addiction to prescription opioids or heroin in 2015, according to federal estimates, and when those people get seriously hurt or need surgery, it's often not clear, even to many doctors, how to safely manage their pain. For some former addicts, what begins as pain relief ends in tragedy. (Lemoult, 4/20)

The Washington Post: Antidepressants Not As Harmful During Pregnancy As Previously Thought, A New Study Shows
Women who take antidepressants early in pregnancy are not at a higher risk of having children who develop autism or attention deficit hyperactivity disorder (ADHD), contrary to earlier reports, a study published Tuesday found. The new study, published in the Journal of the American Medical Association, found only a slight increase in the risk of premature birth for infants of mothers who used antidepressants during the first trimester of their pregnancy. But the researchers found no increase in the risk of autism, ADHD or reduced fetal growth among children exposed to antidepressants during fetal development. (Naqvi, 4/19)

Kaiser Health News: Stalking The ‘Unknown Enemy’: Doctors Turn Scope On Rare Diseases
Lynn Whittaker stood in the hallway of her home looking at the framed photos on the wall. In one, her son, Andrew, is playing high school water polo. In another, he’s holding a trombone. The images show no hint of his life today: the seizures that leave him temporarily paralyzed, the weakness that makes him fall over, his labored speech, his scrambled thoughts. Andrew, 28, can no longer feed himself or walk on his own. The past nine years have been a blur of doctor appointments, hospital visits and medical tests that have failed to produce answers. (Gorman, 4/20)

St. Louis Public Radio: What You Should Know About The Rising Problem Of Antibiotic Resistance
Antibiotic-resistant infection is a rising issue in American society and thousands of people die each year when they develop infections that no antibiotic can control... A person is most vulnerable to antibiotic-resistant infection in the hospital, because that is a place that is more likely to harbor bacteria that has become resistant … and people in the hospital are more vulnerable and unable to fight the infection off. (Moffitt, 4/19)

Miami Herald: These Sexual Enhancement Pills Recalled Due To Problem Ingredients
From A to Zrect, Organic Herbal Supply has recalled its sexual assistance pills for men and women. The men’s pills — Uproar, Monkey Business, Zrect, Rectalis, Cummor, Tornado, ZDaily, Enhancerol, BigNHard — all contain tadalafil, the active ingredient in Cialis. While tadalafil is FDA-approved for dealing with male erectile dysfunction, the recall notice says, “the presence of tadalafil in these male enhancement products renders it an unapproved drug for which safety and efficacy have not been established and, therefore, subject to recall.” (Neal, 4/19)

Women’s Health

Citing Supreme Court Ruling On Similar Restrictions, Judge Blocks Mo. Abortion Rules

The state was requiring that doctors who perform abortions have admitting privileges at nearby hospitals and that clinics meet hospital-like standards for outpatient surgery. Outlets report on other news from Illinois, Iowa and Wisconsin as well.

The Associated Press: Judge Blocks Missouri's Abortion-Restricting Rules
A federal judge followed through on his promise Wednesday and blocked abortion-restricting rules in Missouri, saying he's bound by a U.S. Supreme Court ruling and that the state is denying abortion rights "on a daily basis, in irreparable fashion. "Missouri's attorney general swiftly pledged an appeal, calling the ruling "wrong." (Suhr, 4/19)

KCUR: Judge Blocks Missouri Abortion Restrictions 
“The abortion rights of Missouri women, guaranteed by constitutional rulings, are being denied on a daily basis, in irreparable fashion,” Sachs wrote of Missouri’s abortion restrictions. “The public interest clearly favors prompt relief.” In Hellerstedt, the Supreme Court found that, “in the face of no threat to women’s health,” Texas had required women to travel to distant surgery centers. (Margolies, 4/19)

Chicago Tribune: Rauner's Abortion Bill Veto Pledge Puts Issue At Early Forefront Of Governor's Race
Amid a historic impasse and financial crisis in state government, the early campaign for Illinois governor has quickly shifted to the always-volatile issue of abortion rights following Republican Gov. Bruce Rauner's vow to veto a bill aimed at keeping the procedure legal while expanding taxpayer-subsidized coverage for it. Rauner's decision helps him shore up support from conservative Republicans in a legislature that has seen the number of socially moderate GOP lawmakers dwindle, as well as from groups opposed to abortion rights. (Pearson, 4/19)

The Associated Press: Group: Rauner Deceived Illinois Voters On Abortion Stance
Campaigning as a pro-choice Republican in 2014, Bruce Rauner said he would sign legislation to ensure abortion remains legal in Illinois and to expand abortion coverage for state workers and Medicaid recipients. But last week Rauner said he would veto a measure pending in the Legislature that supporters say would do both, citing "sharp divisions of opinion of taxpayer funding of abortion." (Burnett, 4/19)

Des Moines Register: Iowa House OKs Cutting Off Funding To Planned Parenthood
The Iowa House on Wednesday approved a $1.77 billion health and human services budget that blocks state funding from going to Planned Parenthood and other clinics that provide abortions. ...The bill calls for Iowa's Department of Human Services to discontinue the federal Medicaid family planning network waiver, foregoing about $3 million in federal funding. Instead, the state will use about $3.3 million to recreate its own family planning network so that it can prohibit the funding of clinics that provide abortions. (Pfannenstiel, 4/19)

Milwaukee Journal Sentinel: Wisconsin Bill Would Block Abortion Coverage For Government Workers
Public workers could not use their government-sponsored health insurance plans for abortions in most cases, under a bill Republicans in the Legislature are considering. Republicans are seeking to advance the measure more than three years after abandoning an earlier version of the legislation that state Sen. Jon Erpenbach (D-Middleton) said at the time would unleash "all out hell" in the Senate. (Marley, 4/19)

State Watch

Initiative To Raise Cost Of Cigarettes To $13-A-Pack Gets NYC Mayor's Support

If passed, the plan would make the city the most expensive place in the nation to buy cigarettes.

The New York Times: De Blasio Backs Plan To Lift Base Price Of Pack Of Cigarettes To $13
Mayor Bill de Blasio pledged his support on Wednesday to a series of initiatives to cut tobacco use, proposing to raise the minimum price of a pack of cigarettes in New York City to $13 and vowing to sharply reduce, over time, the number of stores that may sell tobacco products. Raising the minimum price of a pack to $13, from the current $10.50 minimum, would make New York the most expensive place in the nation to buy cigarettes, city officials said. (Neuman, 4/19)

State Highlights: Calif. Patient Files Lawsuit Over Hospital Denying Him Hysterectomy; N.J. Goes After Psychologist For Disclosing Diagnoses

Media outlets report on news from California, New Jersey, Texas, Wisconsin, Pennsylvania, Minnesota, Florida, Illinois and New Mexico.

Sacramento Bee: Transgender Patient Sues Dignity Health For Discrimination Over Hysterectomy Denial 
More than seven months after a Dignity Health hospital refused a hysterectomy to a Sacramento-area transgender patient, the American Civil Liberties Union filed a lawsuit Wednesday on his behalf. The lawsuit, filed in San Francisco Superior Court, alleges that Dignity discriminated against Evan Michael Minton, 35, a former state Capitol legislative aide, when he sought a hysterectomy as part of his transition from female to male. (Buck and Caiola, 4/20)

ProPublica: New Jersey Seeks To Sanction Psychologist For Disclosing Patients’ Diagnoses In Court Filings 
The State of New Jersey is moving to revoke or suspend the license of a prominent psychologist, accusing him of failing to prevent details of patients’ mental health diagnoses and treatments from being disclosed when his practice sued them over unpaid bills. The complaint against the psychologist, Barry Helfmann, a past president of the New Jersey Psychological Association, followed a ProPublica story published in The New York Times in December 2015 that described the lawsuits and the information they contained. (Ornstein, 4/19)

Texas Tribune: For Troubled Texas Foster Kids, Sleeping In Offices Is "Rock Bottom" 
No one is supposed to sleep or spend more than a few hours in this little building at the Harris County Youth Services Center, called the Point of Entry... But Texas’ embattled child welfare system doesn't have enough available beds, so office spaces like the Point of Entry are now being used as temporary homes for foster kids that nobody else wants. (Satija, 4/20)

Los Angeles Times: Mother Of Baby Who Caught Superbug Says UC Irvine Hospital Didn’t Tell Her About The Outbreak
The mother of one of 10 infants hit by a potentially lethal superbug at UC Irvine Medical Center disputed this week the hospital administration’s claim that parents were told about the outbreak. Briana Walker of Mission Viejo said the hospital staff did not explain when her son tested positive for the bacteria last month that other infants were already being treated for the same infections. She had begun to believe, she said, that her husband or another family member had unknowingly brought the superbug into the intensive care unit from outside. (Petersen, 4/19)

The Philadelphia Inquirer/ Siemens Healthineers Buys Health Tech Firm
Siemens Healthineers, of Malvern, has agreed to buy Medicalis Corp., a health care technology company based in San Francisco and Kitchener, Ontario, Siemens said Wednesday. The price was not disclosed. Medicalis is expected to add to Siemens's services in population health management, which is a term used to describe the practice of keeping track of patients even when they are not in the clinic, Siemens said. (Brubaker, 4/19)

The Star Tribune: 2 New Measles Cases Bring Total To 11 In Recent Minn. Outbreak 
State health officials confirmed two additional measles cases on Wednesday, bringing the total to 11 in an outbreak first detected last week. With the case count still rising, public health officials have asked more than 200 people to voluntarily quarantine themselves if they might have been exposed to the highly contagious virus. (Howatt, 4/20)

California Healthline: California Lawmakers Consider Mandatory Labels On Salon Products To Protect Workers
Beauty salon workers who paint the nails and treat the hair of millions of Californians are regularly exposed to toxic chemicals — and they may not know it, advocates say. The advocates are asking California lawmakers to approve legislation requiring cosmetic companies to list the ingredients of beauty products used in professional salons. The bill, which passed the Assembly health committee Tuesday, will next be heard by the environmental safety committee. (Bartolone, 4/20)

Chicago Tribune: Area Senior Services Provider To Shutter Its Personal Care Program 
CJE SeniorLife will close its Personal Care Program later this month due to inadequate state funding and the financial crisis in Springfield, officials recently announced." For eligible older adults, CJE provides personal care services at home through a subsidized program for low income seniors administered by the Illinois Department on Aging," CJE SeniorLife says about the program on its website. "These services, for those who qualify, include assistance with bathing, grooming, dressing, errands, light housekeeping, meal preparation and respite." (Isaacs, 4/20)

Texas Tribune: West Texas Nuclear Waste Project On Hold — For Now
Waste Control Specialists, which currently stores low-level radioactive waste in Andrews County, has asked the U.S. Nuclear Regulatory Commission to temporarily suspend a review of its application to store tens of thousands of metric tons of spent nuclear fuel currently scattered at reactor sites throughout the country. The Dallas-based company pitched the massive expansion as a solution to a problem that has bedeviled policymakers for decades. (Malewitz and Collier, 4/19)

The Associated Press: Audit: US Grant Funds Misused To Pay For Medical Marijuana
An audit by independent investigators with the U.S. Justice Department has determined a New Mexico program that helps crime victims allowed federal grant funds to be used to reimburse the purchase of medical marijuana by crime victims. The review released this week by the agency’s inspector general identified $7,630 in questionable costs for four marijuana purchases. (Bryan, 4/19)

Weekend Reading

Longer Looks: Overcoming Opioids; Single Payer; And American Anxiety

Each week, KHN's Shefali Luthra finds interesting reads from around the Web.

The Associated Press: Overcoming Opioids: The Quest For Less Addictive Drugs
This growing dependence on opioids has mushroomed into a national health crisis, ripping apart communities and straining police and health departments. Every day, an overdose of prescription opioids or heroin kills 91 people, and legions more are brought back from the brink of death. With some 2 million Americans hooked on these pills, evidence is growing that they're not as good a choice for treating chronic pain as once thought. (Marilynn Marchione, 4/17)

The Atlantic: Why America Has Fewer Types Of IUDs Than Other Countries
My uterus needs more options. In 2013, a gynecologist told me that it was too short to fit any FDA-approved IUD. So I traipsed from Colorado to Canada to get a smaller IUD called the GyneFix. This IUD isn’t shaped like a “T”—as all American IUDs are—but, rather, a rod. (Caroline Beaton, 4/18)

The New York Times: America’s New ‘Anxiety’ Disorder
In 1947, W.H. Auden published a very long poem that, despite winning a Pulitzer Prize, is now remembered less for its contents than for its title: “The Age of Anxiety.” Something about the idea that an age can be anxious must resonate deep in America’s cultural bones, because the phrase has been used to describe countless moments since, from the vogue for tranquilizers like Miltown and Valium in the ’50s and ’60s to the coronation of today’s young adults as, in The New York Post’s recent estimation, “The Anxious Generation.” At this point, it’s difficult to imagine a slice of time whose resident humans would not agree with the notion that their lives were more hectically modern — more anxiety-inducing, more in need of the occasional benzo — than any before. (Nitsuh Abebe, 4/18)

The Atlantic: Did Obamacare Increase Voter Turnout? 
The ACA expansion established Medicaid as the bedrock of public insurance and public assistance in America. Now, there’s evidence that it not only expanded health insurance coverage, but the electorate itself. (Vann Newkirk, 4/18)

The New York Times: Why The Menace Of Mosquitoes Will Only Get Worse
The outbreak began so slowly that no one in Dallas perceived it at first. In June 2012, a trickle of people began showing up in emergency rooms broiling with fever, complaining that their necks were stiff and that bright lights hurt their eyes. The numbers were initially small; but by the middle of July, there were more than 50 victims each week, slumping in doctors’ offices or carried into hospitals comatose or paralyzed from inflammation in their brains. In early August, after nine people died, Dallas County declared a state of emergency: It was caught in an epidemic of what turned out to be West Nile virus, the worst ever experienced by a city in the United States. By the end of the year, 1,162 people had tested positive for the mosquito-borne virus; 216 had become sick enough to be hospitalized; and 19 were dead. (Maryn McKenna, 4/20)

New York Magazine: The Pharmacist Who Tries Not To Judge You
We don’t get any training in how to spot a drug user; it’s just through experience. A definite red flag is when they bring in a prescription for a narcotic — say, Percocet — and tell me, “I want to pay full price in cash.” (Alexa Tsoulis-Reay, 4/14)

Editorials And Opinions

Viewpoints: GOP House Factions Brokering Health Deal; Will Trump Let Law 'Explode'?

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

Huffington Post: Some Republicans Think They May Have A Health Care Deal
GOP moderates and conservatives are nearing a deal on health care that in theory could get the Republican alternative to the Affordable Care Act out of the House and over to the Senate. The changes also might move Republicans even further away from passage ― no one really knows. The deal, brokered between House Freedom Caucus chairman Mark Meadows (R-N.C.) and Tuesday Group co-chairman Tom MacArthur (R-N.J.), would allow states to get waivers eliminating the so-called community rating provision ― the rule that prohibits insurers from charging higher premiums to people with pre-existing conditions. In order to obtain the waiver, states would have to participate in a federal high-risk pool or establish their own, and satisfy some other conditions. (Matt Fuller and Jonathan Cohn, 4/19)

The New York Times: Donald Trump Threatens To Sabotage Obamacare
After Republican leaders in Congress failed to destroy the Affordable Care Act last month, President Trump tweeted that the law would “explode.” Now he seems determined to deliver on that prediction through presidential sabotage. Mr. Trump is threatening to kill a program in the A.C.A. that pays health insurers to offer plans with lower deductibles and out-of-pocket expenses to about seven million lower-income and middle-class people. The president thinks that this will get Democrats to negotiate changes to the 2010 health law. This is cruel and incredibly shortsighted. (4/19)

Axios: Why Trump's Dealmaking Model Doesn't Fit Health Care Policy
President Trump's threat to withhold Affordable Care Act payments to insurers shows how he thinks of health care: Everything is negotiable, like it is in a real estate deal. In this case, it's his bargaining chip to get Democrats to negotiate on an ACA replacement plan. But in reality, it could panic insurers and crash the marketplaces. (Drew Altman, 4/20)

USA Today: Republicans Must Protect Vulnerable Patients
[T]he reality of healthcare remains for many Americans: As a country, we spend an average of $10,000 per person per year on health care, and that growth will continue at a faster rate than our overall economy over the next decade. Health care is an issue that demands immediate attention from our national leaders. Yet as the White House and congressional leaders regroup after the failure of the AHCA, reports indicate that they are currently working on a health care deal with members of the House Freedom Caucus that would severely weaken politically popular and policy savvy protections for America’s most vulnerable patients. (Michael Steele, 4/20)

Bloomberg: Government Shutdown Is Logical But Not Likely
All the elements of a debacle will be in place next week when congressional authorization expires for financing the U.S. government. Lawmakers, on recess now, will have only four days to iron out a deal. Right-wing Republicans see a chance to enact abortion curbs and anti-immigrant measures that opponents won't countenance. Democrats are in no mood to offer concessions. And the administration of President Donald Trump has trouble getting its act together. Sound like a government shutdown in the making? It's very unlikely. (Albert R. Hunt, 4/19)

The Washington Post: The March For Science Could Save Lives
When Ebola began to spread in West Africa in December 2013, it was invisible. A 2-year-old who had been playing near a bat-filled tree in southeastern Guinea died, apparently the first victim, but it took months for health workers to detect and report the spread of a disease with a high mortality. Soon it raged across Guinea, Sierra Leone and Liberia, sickening 28,000 people and killing 11,000. Scientists have now tracked the pathways of the virus in once-unimaginable detail, providing important lessons for preventing another outbreak. This is a terrific example of science at work for society, and it shows why this weekend’s March for Science is relevant. (4/19)

Forbes: March For Science, Or Against Republican Politicians?
The April 22 March for Science, focused on Washington, D.C., but accompanied by some 400 complementary events worldwide, promises to be a motley affair. According to one of the young scientist-organizers, it is intended to help inexperienced science advocates develop the skills they need “to make their concerns heard” and to “have an effect on politics,” while maintaining a nonpartisan atmosphere. Nonpartisan atmosphere? They’re about to discover what Dr. Victor Frankenstein felt like when his creation ran amok. It’s clear that the march will be hyper-partisan, an outlet for Trump-haters of every description. (Julie Kelly and Henry I. Miller, 4/20)

Los Angeles Times: The Ignoble History Of The 3-Drug Death Penalty Cocktail
When Ohio announced in 2009 that it planned to abandon the three-drug lethal injection protocol that virtually all jurisdictions had employed for the past three decades, many assumed that most other states would soon follow suit. After all, Ohio’s new protocol, which involved an overdose of a single barbiturate, was touted as being easier to administer and less risky. Eight years later, however, the three-drug protocol is still very much in use, and its current application likely violates the 8th Amendment’s prohibition on cruel and unusual punishment. (Ty Alper, 4/20)

The New York Times: A Focus On Health To Resolve Urban Ills
On a crisp morning in the struggling Bay Area city of Richmond, Calif., Doria Robinson prepares a community vegetable garden for an onslaught of teenagers who will arrive that afternoon. Beyond the farm, a Chevron refinery pumps plumes of smoke into the atmosphere. The farm won’t remove the pollution, but Robinson believes it can make the city’s residents healthier in other ways, specifically by showing them that “their actions have an impact.” (Amy Maxmen, 4/19)

Milwaukee Journal Sentinel: Keep Funding In Place For Dementia Care Specialists
About 115,000 individuals in Wisconsin age 65 and older are living with some form of clinically diagnosable dementia, and by 2040 that population is expected to grow to 240,000. ... Unfortunately, all of the progress we’ve seen as a result of these efforts is at risk, as the 2017-'19 state budget removes funding for dementia care specialists throughout Wisconsin. (Chris Abele and Troy Streckenbach, 4/19)

Los Angeles Times: My Mom's Dementia Has Stripped Her Of All But Her Least-Endearing Personality Trait: Worry
Before dementia, my sweet 90-year-old mama taught elementary school, sang in a Yiddish chorus, told great stories, had lots of friends, entertained often and with ease, and did volunteer work. Her one aggravating quality was the watchful worrier that lurked within, ready to explode into full, undistractable panic at any moment. ... And now that she has forgotten so much and lost so many parts of herself — her charm, her humor, her musicality and her ability to befriend — you’d think it only fair she’d finally be rid of her anxiety. But no. The last reverberation of her personality is the one trait that brought her and those she loved the most unhappiness. Like a cruel joke, she has been whittled down to her core, and her core is worry. (Amy Koss, 4/20)