KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Kaiser Health News Original Stories

Widow Unleashes Court Fight Against Scope Maker Olympus Over Superbug Outbreak

The Seattle case, the first to reach trial in the U.S., offers possible glimpse into fate of some two dozen lawsuits against manufacturing giant Olympus, accused of failing to address scope contamination linked to numerous deaths. The company faults poor hospital cleaning practices. (Chad Terhune and JoNel Aleccia, 6/14)

Political Cartoon: 'Main Squeeze?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Main Squeeze?'" by Nate Beeler, The Columbus Dispatch.

Here's today's health policy haiku:

LEGAL BATTLE UNDERWAY AGAINST SCOPE MAKER

“I’ll see you in court!”
Sometimes, it’s just a threat. But
This widow meant it.

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

Lawmakers That Trump Pushed Into Signing 'Mean' Bill Peeved At The President's Candid Comments

Although President Donald Trump personally helped champion the legislation through the House and called it a "great plan" when it passed, he is now saying it's "mean" and that the Senate should be more "generous" in its version. The about-face has left lawmakers scratching their heads. Meanwhile, in the upper chamber, each senator is fighting for their own state's best interest, but not everyone is going to win, and Democrats hit pause on the health fight after Wednesday's shooting.

The Associated Press: Trump Labeling House Health Care Bill 'Mean' Frustrates GOP
President Donald Trump's labeling of a House-passed health care bill as "mean" is aggravating some of the conservatives he pressed to back it, even as Senate attempts to reshape the measure increasingly threaten to spill into July. "In terms of strategery, I hope he's just trying to motivate the Senate," Rep. Dave Brat, R-Va., said Wednesday, employing a mangled word used [in a parody of] former President George W. Bush. "Because he put all sorts of pressure on us to move the bill we passed." (Fram, 6/14)

The Washington Post: In GOP Health Care Struggle, It’s Senator Vs. Senator
Here’s one unique, easy-to-grasp way to understand the continued gridlock among Senate Republicans on how to change the health-care industry: Each senator is trying to get the best deal for his or her state. It’s a somewhat obvious observation, because that’s what happens in most congressional debates. But the last six weeks of Senate consideration of the Republican effort to overturn the Affordable Care Act has been somewhat lost in the weeds of Medicare regulations, the size and scope of tax credits and proposals to phase out benefits over a couple years or much longer. (Kane, 6/14)

Kaiser Health News: Descent Into Secrecy: Senate Health Talks Speak To Steady Retreat From Transparency
Congress struggling to finish a huge budget reconciliation bill. A GOP president pushing a major overhaul of federal payments for health insurance that could transform the lives of sick patients. Sound familiar? The year was 1986. I was a rookie health reporter on Capitol Hill and watched a Medicare bill move from introduction, to hearings, to votes in subcommittees, to full committees and then to the entire House — an operation that took months and was replicated in the Senate, before the two chambers got together to iron out their differences for final passage. Everything was published in the official Congressional Record in almost excruciating detail for everyone to see — as long as they could read really tiny type. (Rovner, 6/14)

CQ Roll Call: Republicans Weigh Higher Medicaid Growth Rate For Some States
Senate Republicans may provide higher federal funding to states with low Medicaid costs in their health care bill. The proposal under consideration gets to the heart of a key sticking point in the ongoing GOP discussions to overhaul the U.S. health care system: how to equitably treat states with drastically different Medicaid spending levels. Medicaid, the structure of tax credits and other issues are among the big disputes that Senate Republicans need to resolve, said Senate Majority Whip John Cornyn, R-Texas, on Wednesday. When asked if the Senate would vote by its self-imposed July Fourth goal, he demurred. (Young and Williams, 6/14)

Politico: Liberals Ease Up On Health Care Fight — For A Moment
Liberal activists on Wednesday hit pause on their all-out battle to thwart Republicans trying to fast track an Obamacare repeal-and-replace plan through the Senate. But Democratic lawmakers and outside groups say the mass shooting that wounded House Majority Whip Steve Scalise can’t slow down the overall effort. (Schor, 6/14)

And in more news —

The Washington Post Fact Checker: President Trump’s Mangled ‘Facts’ About Obamacare
Not a day goes by without President Trump bashing the Affordable Care Act, a.k.a. Obamacare, as he tries to urge the Senate to pass its own version of a repeal-and-replace bill. He’s become a torrent of statistics as he has tried to make the case that the law is “dead,” as he puts it. Increasingly, the president is aided by reports churned out by the Department of Health and Human Services, which under President Barack Obama used to issue dubious reports defending the law but now offers dubious reports to undermine it. (Kessler, 6/15)

The Hill: Dems Request Review Of Whether Health Department Tweets Broke Law 
Congressional Democrats are requesting an investigation of whether the Department of Health and Human Services (HHS) under President Trump has been violating the law by advocating for the passage of legislation on its Twitter accounts. The Democrats, in a letter to the head of the nonpartisan Government Accountability Office, point to messages on the official HHS Twitter feed calling for the passage of the Republican bill to repeal and replace ObamaCare, known as the American Health Care Act. (Sullivan, 6/14)

Divided And Shunted To The Sidelines, Insurance Industry Loses Voice In Health Care Debate

Some insurers have decided a low-key role is best, but others are frustrated that their concerns aren't being heard. In other news, outlets look at what consumers could expect to pay under the Republicans' health care plan, the effect it would have on jobs and the amount of support the legislation has in Missouri and Kansas.

The Wall Street Journal: Insurers Take Low-Key Approach In Health-Law Debate
Nearly every health group has taken a stand on the Republican legislation to overhaul the Affordable Care Act, but a split among insurance companies, who are arguably most central to the overhaul, has prevented the industry and its powerful lobby from picking a side in the debate. The divisions, along with a desire to remain involved in the negotiations, have quieted an industry that had a vocal role in shaping the ACA. (Hackman, 6/14)

The Associated Press: Gov't Report: Health Care Deductibles Higher Under GOP Bill
President Donald Trump promised to make health care more affordable but a government report finds that out-of-pocket costs — deductibles and copayments — would average 61 percent higher under the House Republican bill. And even though the sticker price for premiums would be lower than under Obama-era law, what consumers pay would actually go up on average because government financial assistance would be reduced. (Alonso-Zaldivar, 6/15)

The Fiscal Times: The GOP Health Care Plan Could Wipe Out Nearly A Million Jobs: Study 
The American Health Care Act passed by the House of Representatives could be a serious job killer. If the bill were to pass the Senate in its current form (the Senate is working on its version of the bill in secret so it’s hard to say just how different the Senate version is), the economy would lose 924,000 jobs over the next decade, according to a new report from George Washington University’s Milken Institute School of Public Health and the Commonwealth Fund. (Braverman, 6/14)

KCUR: Analysis: Less Than A Third Of Missourians And Kansans Support House Health Care Act 
Just 31 percent of Kansans and 32 percent of Missourians support the House-approved bill to repeal Obamacare, according to new estimates published Wednesday in The New York Times. In fact, not one state has a majority of residents who are for the measure, with support ranging from a low of 22 percent in Massachusetts (Washington, D.C., is even lower at 16 percent) to a high of 38 percent in Oklahoma, according to the estimates. (Margolies, 6/14)

Senate GOP Walking Tightrope With Abortion, Planned Parenthood Language In Health Plan

The Senate parliamentarian, Elizabeth MacDonough, won’t make an official ruling until she is given specific language on the provisions, but they could threaten the future of the entire bill. However, dropping the language could result in loss of support among conservative lawmakers.

CQ Roll Call: Senators Watch For Decision On Abortion Language In Health Bill
Senators are debating what to do about retaining anti-abortion language in the House bill, which could violate Senate budget rules. Opponents have raised concerns about new tax credits in the bill, which could not be used to buy insurance that includes abortion coverage. A provision to defund Planned Parenthood is also vulnerable. The parliamentary question is whether these would be considered non-budgetary provisions that violate the Byrd rule, which prohibits the inclusion of extraneous issues that don't have a fiscal impact. Republicans argue it would be a “term and condition" of the tax credit, which is allowed under the Byrd rule. (Raman, 6/14)

Denver Post: Doug Lamborn, In Letter To Senate GOP Leaders, Asks That “Pro-Life Priorities” Be Included In Health Care Bill 
U.S. Rep. Doug Lamborn, a Colorado Springs Republican, has penned a letter signed by 70 members of the U.S. House asking GOP leadership in the Senate to ensure “our pro-life priorities” are included in any health care legislation they draft to replace the Affordable Care Act...The request was addressed to Senate Majority Leader Mitch McConnell, R-Kentucky, as well as the chairs of the Senate budget, health and finance committees. Colorado’s other House Republicans — U.S. Reps. Mike Coffman, Ken Buck and Scott Tipton — did not sign the letter. (Paul, 6/14)

ACA Rate Hikes In Michigan Could Reach Record Levels Depending On Future Of Insurer Subsidies

If Republicans opt to defund the subsidies, Michigan residents buying coverage through the exchanges could face a 31 percent increase. Media outlets report on news in the marketplaces of Connecticut and Ohio as well.

Detroit Free Press: Obamacare Rates In Michigan Could Skyrocket As Much As 31% In 2018
Some health insurers in Michigan will be seeking record-level rate hikes next year for plans they sell to individuals — potentially as much as 31% — as debate continues to swirl in Washington over overhauling the Obama-era Affordable Care Act. Wednesday was the deadline for insurance companies to submit to Michigan regulators their proposed 2018 premiums for health plans that can be bought on or off the Healthcare.gov exchange, as well as for small groups of 50 or fewer employees. (Reindl and Spangler, 6/14)

The CT Mirror: Health Insurers Skewered For Again Seeking Double-Digit Rate Increases
Two of the state’s largest health insurers came face to face with hostile customers and dissenting advocates at a hearing Wednesday over another year of requests for double-digit rate hikes. The stakes are even higher this year because the state Insurance Department’s final decision on the rate requests will influence whether the two remaining insurers on Connecticut’s health insurance exchange, Access Health CT, return in 2018. (Constable, 6/14)

Meanwhile, on Capitol Hill —

Modern Healthcare: House Passes Bill Mandating Verification Of Immigration Status Before Tax Credits Are Paid 
The U.S. House of Representatives Tuesday passed a bill that denies premium assistance under the replacement for Obamacare until the applicant's immigration status or citizenship has been determined. Under the current law, immigrants who reside in the U.S. illegally can not buy insurance on the exchanges —or receive tax credits—but coverage can begin while the federal government verifies citizenship or residency.  (Lee, 6/14)

Modern Healthcare: Democrats Introduce Bill To Bring Back Reinsurance In Individual Market 
Four Democratic senators have introduced a bill that would make reinsurance a permanent part of the Affordable Care Act's individual exchanges. The bill, introduced Wednesday and led by Senators Tim Kaine of Virginia and Tom Carper of Delaware, would provide federal funding to cover 80% of claims from $50,000 to $500,000, starting next year, with the same level of support through 2020. (Lee, 6/14)

Medicaid

Advocates Hope Effects Of Kansas' Austere Cuts Serve As 'Canary In Coal Mine' For Rest Of Country

In what Republican Gov. Sam Brownback deemed a "real-live experiment," Kansas championed a plan of deep tax cuts and severe spending cuts, and at the same time rejected Medicaid expansion. The Washington Post looks at those results.

The Washington Post: These Are The People Who Suffered When Kansas’s Conservative Experiment Failed
Suzan Emmons has done the most she can for the girls. Her small green house has bunnies in the back yard, class pictures proudly displayed on the living room wall, food in the refrigerator. She has scrimped from her annual salary of $14,000 to pay for one dance class each: tap for Elizabeth, jazz for Jaiden. But far-off political decisions have made the haven that Emmons built for them more precarious. Five years ago, she rescued Jaiden, her granddaughter, and Elizabeth, her granddaughter’s half sister, from a dangerous home. Today, she doesn't make enough money to qualify for health insurance subsidies under the Affordable Care Act. She would qualify for Medicaid under Obamacare’s proposed expansion of the program, but because the Kansas governor turned down federal funds for that expansion, she doesn't qualify there either, leaving her unable to afford insurance coverage. (Swanson and Ehrenfreund, 6/14)

In other Medicaid news —

NPR: Proposed Medicaid Cuts Threaten Services For Disabled Adults
It's morning meeting time at Our Place Day Services, a day center for adults with disabilities, housed in a small concrete and glass building on Lovers Lane in Slinger, Wis. About 30 people are gathered here, around a long table, reciting the pledge of allegiance. One man paces alongside the table, another sits in a wheelchair a few feet away. There's a woman holding a baby in her lap and a friendly dog — a goldendoodle — wandering around greeting people with a sniff and a lick. (Kodjak, 6/14)

The Philadelphia Inquirer/Philly.com: Pa. Recovery Community Fearful Over GOP Medicaid Plans
[Charlene] Yurgaitis is one of more than 124,000 Pennsylvanians who depended on Medicaid to get help for their drug or alcohol addiction last year. The Republican health care bill that passed the U.S. House of Representatives in May would reduce spending on Medicaid by more than $800 billion across 10 years. The Senate is modifying that bill but has been deliberating in secret. Deep cuts to Medicaid are expected in the Senate version of the bill, too. (Allen, 6/14)

New Hampshire Union Leader: Study: NH Among The Worst For At-Home Care Services To Aging 
New Hampshire is among the worst in the nation for spending on health care programs to keep people at home as they age, a study released today shows.New Hampshire ranked 47th of all states in Medicaid spending on home- and community-based care services, according to the 2017 Long-term Services and Supports Scorecard compiled by The Commonwealth Fund, AARP, and The SCAN Foundation. It also ranked 46th in access to these programs for new Medicaid users. (Grosky, 6/15)

Pharmaceuticals

Proposal Requiring Manufacturers To Include Retail Prices In Drug Ads Approved By AMA

The group hopes the measure will push federal regulatory agencies to enact such pricing disclosures, but critics say it's unlikely under a Republican administration. In other news, the pharmaceutical industry eyes genetic analysis as a method for improving drug treatments.

Stat: AMA Votes To Require Drug Makers To Disclose Prices In Ads
Seeking to restrain drug prices, the American Medical Association passed a resolution that would require drug makers to disclose pricing in ads that are aimed at consumers. The proposal, which was approved by AMA delegates at their annual meeting in Chicago, came in response to concerns over rising drug costs and an unsuccessful bid by the medical organization to convince Congress to ban so-called direct-to-consumer advertising altogether. (Silverman, 6/14)

Stat: Should Every Patient Have Genetic Analysis To Map Their Drug Responses?
Dr. Richard Weinshilboum is asking a big question: What if your doctor knew which drugs to treat you with before you got sick? The growing field of pharmacogenomics has made that possible. Patients’ genetic variants can be analyzed to determine their response to medicines used to treat everything from mental illness to cardiovascular disease. Typically, that information is used to help treat patients with existing health problems. But Weinshilboum and his colleagues at Mayo Clinic and Baylor University have launched one of the largest studies ever to examine the effect of testing patients before they become ill, so doctors can act quickly when problems arise. (Ross, 6/14)

Meanwhile, licensing of a potential Zika vaccine is disputed —

Stat: Lawmakers Ask U.S. Army To Hold A Hearing On Zika Vaccine Licensing
Agroup of Florida lawmakers is urging the U.S. Army to hold a hearing on its plan to give Sanofi an exclusive license to develop a Zika virus vaccine, a move that has raised concerns the product may be priced too high for many Americans, even though it was developed with taxpayer funds. In a June 13 letter, eight U.S. House Democrats and one Republican expressed concern about the “potential for monopolistic practices that would, effectively, keep this life-saving vaccine out of reach for far too many of our constituents.” At the same time, U.S. Sen. Bill Nelson, who is also a Democrat, sent his own letter in which he urged the Army to limit the price for the vaccine. (Silverman, 6/14)

Miami Herald: Florida Congressional Members Want Hearings On Zika Vaccine 
A bipartisan group of members of Congress from Florida has asked the acting secretary of the U.S. Army to hold public hearings before awarding exclusive rights to a French pharmaceutical manufacturer to develop a Zika vaccine using technology invented by the Walter Reed Army Institute of Research and funded by American taxpayers. The lawmakers expressed concern about the affordability of a Zika vaccine once one becomes available because the pharmaceutical manufacturer, Sanofi Pasteur, rejected a request from the U.S. Army to set an affordable price for the drug. (Chang, 6/14)

Administration News

Veterans' Choice Program Facing Surprise $1B Shortfall

"If there is no action at all by Congress, then the Choice program will dry up by mid-August," VA Secretary David Shulkin said while asking the Senate Veterans' Affairs Committee for help.

The Associated Press: VA Warns Of Surprise Budget Gap, Insists No Delays In Care
The Department of Veterans Affairs warned Wednesday it was unexpectedly running out of money for a program that offers veterans private-sector health care, forcing it to hold back on some services that lawmakers worry could cause delays in medical treatment. It is making an urgent request to Congress to allow it to shift money from other programs to fill the sudden budget gap. (6/14)

In other news from the administration —

Modern Healthcare: Mistaken EHR Incentive Payments May Have Been Unavoidable 
After it was announced that the CMS potentially made mistaken payments to providers for meaningful use, healthcare policy advisers questioned the agency's oversight capabilities. But some wondered whether the overpayments, which totaled an estimated 12% of incentive payments, may have just been the price of doing business. (Arndt, 6/14)

Public Health And Education

Mich. Health Department Chief Charged With Involuntary Manslaughter In Connection To Flint's Water Problems

Michigan Department of Health and Human Services Director Nick Lyon and four other state officials face involuntary manslaughter charges stemming from the government's failure to alert the majority-black population about Legionnaires' disease in the Flint area. That outbreak is linked to the city's lead-contaminated water and caused the death of an 85-year-old man.

The Associated Press: Health Chief, 4 Others Charged With Manslaughter In Flint
Five people, including the head of Michigan's health department, were charged Wednesday with involuntary manslaughter in an investigation of Flint's lead-contaminated water, all blamed in the death of an 85-year-old man who had Legionnaires' disease. Nick Lyon is the highest-ranking member of Republican Gov. Rick Snyder's administration to be snagged in a criminal investigation of how the city's water system became poisoned after officials tapped the Flint River in 2014. (6/14)

USA Today: 5 Michigan Officials Face Manslaughter Charges Over Flint Water Crisis
Six officials were charged in all — five with involuntary manslaughter — according to Michigan Attorney General Bill Schuette. "We will turn to the prosecution of this investigation," he said in at a morning news conference. "We are confident that the charges that we have filed will be upheld in the courts." (Egan and Anderson, 6/14)

The Washington Post: Top Michigan Health Official, Four Others Charged With Manslaughter In Flint Water Crisis
While much of the attention in Flint has focused on the lead-tainted water that exposed thousands of young children to potential long-term health risks, the crisis also has been linked to an outbreak of Legionnaires’ disease that contributed to at least a dozen deaths. Those cases ultimately led to the charges Wednesday for Lyon, as well as for the state’s chief medical executive, Eden Wells, who faces charges of obstruction of justice and lying to a police officer but is not accused of manslaughter. (Dennis, 6/14)

The Wall Street Journal: Michigan Health Chief, Four Others Charged In Flint Water Probe
Michigan Attorney General Bill Schuette said the latest charges reflected the determination of investigators to hold government officials responsible for Flint’s water crisis. “There are those who assumed this would be swept under the rug,” Mr. Schuette said. “That arrogance that people would want to sweep this away, that there were nameless, faceless bureaucrats that caused this, is outrageous.” (Maher, 6/14)

The Associated Press: Man At Center Of Flint Death Case Lived There All His Life
Robert Skidmore was born in Flint, raised a family there and lived his entire life in and around the blue collar town that — next to Detroit — was synonymous with manufacturing of cars and trucks. But his December 2015 death has been blamed on Legionnaires’ disease and linked to a tainted water crisis that on Wednesday led to involuntary manslaughter and other charges against five officials, including the director of Michigan’s Health and Human Services department. Skidmore, 85, was one of 12 people to die from the disease and nearly 100 cases of people being sickened from it. (Eggert and Wililams, 6/15)

State AGs To Investigate Drugmakers' Marketing Of Prescription Painkillers

The probe is the latest effort in a growing trend to address the epidemic through the courts. In other news, the crisis is undermining the battle against HIV, women are being prescribed too many opioids after c-sections and Massachusetts' high court rules on a needle-exchange case.

The Wall Street Journal: States Launch Bipartisan Probe Of Opioid Marketing And Addiction
A bipartisan group of state attorneys general is jointly investigating the marketing of prescription painkillers and the causes of widespread opioid addiction, according to people familiar with the matter, in another sign of growing pressure on the pharmaceutical industry. The probe, which includes a majority of U.S. states, is expected to be publicly announced in the coming days, the people said. The investigation is focused on manufacturers of prescription painkillers, one of the people said, and, like other opioid investigations launched in recent years, will focus on the allegedly deceptive marketing of the drugs. The full range of targets of the investigation isn’t yet clear and could change. (Randazzo and Whalen, 6/14)

The Washington Post: The Opioid Epidemic Is Making The Fight Against HIV More Difficult
Bringing down the rate of HIV infection in one of the United States’ great public health triumphs of the past quarter-century. Now, thanks to the opioid epidemic, some of those hard-won gains may be reversed. Opioids, as well as being harmful on their own, also increase the risk of HIV outbreaks, as users sometimes inject the drugs using shared, infected syringes. That drove a clustered outbreak in Scott County, Indiana, where then-Governor Mike Pence declared a public health emergency in 2015 because of a spate of new HIV infections. (Humphreys, 6/14)

The New York Times: Too Many Opioids After Cesarean Delivery
Doctors may be overprescribing opioids to women who have had cesarean sections. Researchers tracked prescriptions and pill use in 179 women discharged from an academic medical center after cesarean delivery. On average, they left the hospital with a prescription for the equivalent of 30 pills containing 5 milligrams of oxycodone or hydrocodone. Then, using interviews, the scientists tracked how much of the medicine they used during the two weeks after discharge. The study is in Obstetrics & Gynecology. (Bakalar, 6/14)

Boston Globe: SJC: Private Groups Can Operate Clean Needle Exchange Programs 
Massachusetts law allows anyone to distribute syringes without approval by local authorities, the state’s highest court ruled Wednesday in a case involving a Hyannis needle exchange. The ruling was hailed by advocates for the eight-year-old Hyannis program, who said the decision would lead to the expansion statewide of a service that saves lives and prevents the spread of disease among injection-drug users — at time when Massachusetts is battling an opioid-addiction crisis. (Freyer, 6/14)

Watchdog Agency Asked To Investigate 'Serious Ethical Lapses' In Preemie Study

Researchers who tested oxygen levels delivered to premature infants have long faced questions over whether the work was ethically and accurately performed.

The Wall Street Journal: Group Calls For Expanded Probe Of Premature-Infant Clinical Trial
The consumer group Public Citizen said it has found new, “serious ethical lapses” in a premature-infant study that it contends should lead a federal medical-research watchdog agency to expand an investigation into the research. Public Citizen said it has unearthed documents showing that oxygen-measurement instruments used in the baby study gave inaccurate readings, which could have harmed the babies. The group called for the federal Office for Human Research Protections (OHRP) to look into the matter. (Burton, 6/14)

Public Health Roundup: Conjoined Twins; A Shot For Incontinence; And Home Health Care For Seniors

Also in the news: a tool to detect Parkinson's, transgender talk and salt caves as the new health trend.

The Washington Post: Doctors Just Separated Twin Girls Joined At The Head In One Of The World’S Rarest Surgeries
For the first time, conjoined twins Abby and Erin Delaney can sleep in separate beds. The 10-month-old girls from North Carolina were born connected at the head, an extremely rare condition. Following months of planning and preparation, the pair underwent a successful 11-hour separation surgery last week at Children’s Hospital of Philadelphia in southeastern Pennsylvania, according to the hospital. (Bever, 6/14)

The Philadelphia Inquirer: The O-Shot: Incontinence Fix Or Empty Promise?
Urinary incontinence is a common condition in women. Approximately 25 percent of young women, around half of middle-aged and postmenopausal women, and three-fourths of older women experience some involuntary urine loss, according to the American Congress of Obstetricians and Gynecologists. The group estimates that $19.5 billion a year is spent on treatments, which run the gamut from behavior modification to surgery. Then there’s the O-Shot, meant for the 15 percent of women who have stress incontinence — leakage associated with a strain such as sneezing or lifting. Rush, 6/14)

Kaiser Health News: Some Seniors Just Want To Be Left Alone, Which Can Lead To Problems
The 84-year-old man who had suffered a mini-stroke was insistent as he spoke to a social worker about being discharged from the hospital: He didn’t want anyone coming into his home, and he didn’t think he needed any help. So the social worker canceled an order for home health care services. And the patient went back to his apartment without plans for follow-up care in place. (Graham, 6/15)

KCUR: Lenexa Teen’s Tech Tool Could Identify Early Symptoms Of Parkinson’s 
Erin Smith doesn’t watch a lot of TV. Instead, the 17-year-old spends her evenings perfecting an online tool she created. The tool, called FacePrint, can detect Parkinson’s disease years before current diagnosis methods by recording your facial reactions with a webcam at home. Smith, a senior at Shawnee Mission West High School, has traveled to Twitter and Google headquarters, won a $10,000 prize from the #BuiltByGirls Future Founder competition to continue her research, and has been recognized by the Michael J. Fox Foundation. (Marleah Campbell, 6/14)

The New York Times: A New Lure For Spa Customers? A Salt Cave
Two young women in white chamois robes exited the Himalayan salt sauna at Premier57, a spa in Midtown Manhattan, looking rosy and happily spent. The salt sauna, lined with burnt orange and yellow blocks of sodium chloride, is a popular destination at the spa, where a day pass is $75 and the tagline urges guests to “immerse, indulge, intrigue.” Options include an infrared lounge, a meditation room, an igloo room, a gold sauna and a clay sauna, “but we have a lot of guests who just come here for the salt room, especially if they have arthritis,” said the spa’s general manager, Ellis Kim. “It’s very good for arthritis and for regulating blood pressure.” (Kaufman, 6/14)

State Watch

Missouri Senate OKs Abortion Bill Amidst Dueling Rallies By Supporters And Opponents

The state legislation would nullify a city ordinance in St. Louis that prohibits housing and employment discrimination based on "reproductive health decisions," such as abortion or pregnancy. The bill now goes to the Missouri House. Elsewhere, a Iowa council considers a controversial measure to bar abortion providers from state-financed family planning efforts.

KCUR: Missouri Senate Stays Up Late To Pass Abortion Restrictions; House To Take Up Bill Next Week
On the third day of the Missouri legislature’s second special session, abortion rights supporters and opponents gathered to make their voices heard in the Capitol. But the Missouri Senate sat Wednesday. Instead of convening in the morning as scheduled, they negotiated behind closed doors on a smaller-than planned abortion bill that Republicans hope Democrats won’t try to filibuster. (Griffin, 6/14)

Des Moines Register: State Council Balks At Barring Abortion Providers From Birth-Control Program
A state council that usually rubber-stamps human services changes balked Wednesday at a controversial plan to bar abortion providers from participating in state-financed family planning efforts. Several members of the Council on Human Services criticized the new approach, which was approved by the Legislature in April and signed by then-Gov. Terry Branstad, a staunch abortion opponent. (Leys, 6/14)

State Highlights: N.H. Gov. Signs Mental Health Reform Bill; Md. Insurance Officials OK Evergreen Health Conversion To For-Profit Status

Media outlets report on health-related news from New Hampshire, Maryland, Massachusetts, Minnesota, Florida, California, Texas, Kentucky, Georgia and Colorado.

The Baltimore Sun: Maryland Insurance Administration Approves Evergreen Health Acquisition 
Maryland Insurance Administration on Wednesday approved plans for Evergreen Health to be acquired by investors and convert to a for-profit insurance company. Evergreen was one of 23 so-called consumer oriented and operated health plans created under the federal Affordable Care Act and one of the few still operating. In a bid to stay in busines amid mounting financial pressure, Evergreen sought investors to shore up its finances. (Gantz, 6/14)

Boston Globe: State Approves Plan For UMass Medical To Reduce Psychiatric Beds 
State public health officials on Wednesday approved a $30 million renovation project at UMass Memorial Medical Center in Worcester that includes a controversial plan by the hospital to cut about half of its psychiatric beds. Hospital officials want to convert 13 psychiatric beds into space for medical and surgical patients, arguing that they are facing greater demand from those patients than from people with severe mental illness. (Dayal McCluskey, 6/14)

Pioneer Press: Minnesota Teen Pregnancy Rates Continue Declining, But STD Infections Soar
Teenage pregnancy and birth rates are continuing to tumble in Minnesota, according to a report released Wednesday by University of Minnesota researchers. But they tend to be higher in rural counties than elsewhere. Overall, teen pregnancy rates dropped almost 70 percent from 1990 to 2015 in Minnesota, according to the report. Just between 2014 and 2015 — the last year for which data are available — the decline was a little more than 11 percent. (Lundy, 6/14)

Los Angeles Times: Torrance Memorial Hospital Receives $32-Million Donation
Philanthropists Melanie and Richard Lundquist have donated $32 million to Torrance Memorial Medical Center to improve neurological, orthopedic and spinal care at the hospital. The gift announced this week brings the couple’s total contributions to the hospital to $100 million over the last 11 years. The sum is the most a single donor has given to a hospital that isn’t a research or teaching facility since the Chronicle of Philanthropy began tracking donations over $1 million in 2005. (Karlamangla, 6/14)

East Bay Times: East Bay Water: Cancer-Causing Contaminants On The Rise
Cancer-causing compounds in East Bay drinking water have increased sharply over the past several years, and water in some areas is close to violating a federal public health standard, the East Bay Municipal Utility District reported Tuesday. Water-quality managers said the drought is at least partly to blame for the increase in contaminants called trihalomethanes or THMs,  a byproduct of chlorine used to kill germs reacting with natural organic matter in water. (Cuff, 6/13)

San Francisco Chronicle: SF’s Proposed Ban On Flavored Tobacco Sales Upsets Store Owners 
San Francisco officials are looking at a ban on flavored tobacco products, ranging from cherry cigarillos and blueberry blunt wraps to menthol cigarettes, e-cigarettes, hookahs and smokeless tobacco. Berkeley recently passed a similar law. The proposed ban is the latest in a string of restrictions on tobacco products, including a $2-per-pack tax that went into effect in the state in April. (Johnson, 6/14)

Ventura County Star: Surprise Witness Backs Mother's Story In Pesticide Trial
A surprise witness testified Tuesday that he had seen pesticides regularly sprayed close to strawberry harvesters at a farm near Oxnard, completely supporting the plaintiff's version of events in a birth defect trial. Jose Antonio Madrigal, a former supervisor for Well-Pict Berries, said he had seen tractors spraying two or three times a week in fields at Anacapa Berry Farms while workers were present in 2007. The tractors were applying the chemicals well under 100 feet from the workers, he said. (Wilson, 6/13)

WBUR: Innovation Boost: 3 Digital Health Startups Win Cash To Accelerate Business 
Three digital health startups — one to help detect concussions, another to streamline emergency medicine, and a third to improve the mental health of seniors — were awarded a total of $200,000 Tuesday as part of an innovative accelerator program aimed at boosting such ventures across the state... The top winners of PULSE's cash prizes were selected based on their ability to demonstrate impact and meet milestones while working over the past six months with established corporate partners, including leading health care companies and big-name medical institutions. (Zimmerman, 6/14)

Austin American-Statesman: Baylor Scott & White May Bring Health-Care Options To Spicewood Ar
Baylor Scott & White Health officials and Thomas Ranch Development Interests announced a partnership this week that could bring a clinic or other health-care facility to Thomas Ranch, a proposed 2,200-acre master-planned community to be built off Texas 71 and Paleface Ranch Road. The proposed development, which straddles western Travis County and eastern Burnet County, is one of the largest master-planned communities announced in recent years for Central Texas. (Novak, 6/14)

San Jose Mercury News: New Sex Ed Curriculum To Be Tested Next Year
A new sexual health curriculum will be tested next spring for seventh- and eighth-grade students in the Cupertino Union School District.The move comes a few months after the school board, in a 2-2 vote, failed to adopt sex education curriculum that conforms to new state standards. Parents in March told school officials the proposed curriculum was “too graphic” and “not age-appropriate,” while others suggested it did not align with their cultural values, and some complained that it explicitly described different types of sex. (Myllenbeck, 5/14)

The Associated Press: Lawsuit Challenges Kentucky's Medical Marijuana Ban
Kentucky's criminal ban against medical marijuana was challenged Wednesday in a lawsuit touting cannabis as a viable alternative to ease addiction woes from opioid painkillers. The plaintiffs have used medical marijuana to ease health problems, the suit said. The three plaintiffs include Dan Seum Jr., the son of a longtime Republican state senator. (6/14)

Georgia Health News: Her Home Showed High Lead; She Wasn’t Told 
In Georgia, the state apparently has not taken any action against the North Fulton County water utility, though the system has received repeated written warnings — five since 2004 — for failing to tell consumers about their water quality quickly enough. State officials did not respond to our inquiry about the situation. (Goodman and Miller, 6/14)

WBUR: Proposed Changes To Mass. Pot Law Would Bump Tax To 28 Percent
Taxes on recreational marijuana products could be as high as 28 percent under a bill about to be taken up by the Massachusetts House on Thursday, according to a draft copy of the legislation obtained by WBUR late Tuesday. The bill, drafted by the House chairman of the Legislature's Marijuana Policy Committee, makes some major changes to the way legal pot would be regulated when compared to how the law was written in a voter-approved referendum last November that legalized recreational marijuana in the state. (Brown, 6/14)

Denver Post: Domestic Cat Contracts Plague In Rural Northwest Weld County 
A domestic cat contracted plague in rural northwest Weld County in early June but is receiving treatment and is expected to recover. Although plague is rare, it occurs naturally in Colorado and can be found in wildlife such as rodents and rabbits, according to the Weld County Health Department. People most commonly contract the disease from infected fleas but can also contract it from direct contact with an infected animal. (Worthington, 6/14)

Weekend Reading

Longer Looks: Prescription Heroin; Smartphone Psychiatry; And Obamacare Repeal

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

Vox: The Case For Prescription Heroin
A clinic where patients use heroin may sound shocking and irresponsible, particularly now, as a deadly and devastating opioid epidemic ravages North America. But this approach is meant to treat the victims of that epidemic. The idea is this: If some people are going to use heroin no matter what, it’s better to give them a safe source of the stuff and a safe place to inject it, rather than letting them pick it up on the street — laced with who knows what — and possibly overdose without medical supervision. Patients can not only avoid death by overdose but otherwise go about their lives without stealing or committing other crimes to obtain heroin. (German Lopez, 6/12)

The Atlantic: The Smartphone Psychiatrist
Sometime around 2010, about two-thirds of the way through his 13 years at the helm of the National Institute of Mental Health (NIMH)—the world’s largest mental-health research institution—Tom Insel started speaking with unusual frankness about how both psychiatry and his own institute were failing to help the mentally ill. Insel, runner-trim, quietly alert, and constitutionally diplomatic, did not rant about this. It’s not in him. You won’t hear him trash-talk colleagues or critics. (David Dobbs, 6/8)

FiveThirtyEight: Facts Alone Won’t Convince People To Vaccinate Their Kids
Measles is a highly contagious and potentially deadly viral infection. Although the MMR vaccine that prevents it is quite effective, some children — including those with pre-existing health conditions, like cancer or compromised immune systems, and those who are younger than 6 months old — cannot receive it. These vulnerable populations rely on herd immunity to protect them. When vaccination levels reach a critical threshold — 83 percent to 94 percent for measles — the high concentration of immune people squelches the spread of the disease, preventing it from reaching large numbers of unprotected people. (Erin Hare, 6/12)

Vox: “This Is Red Alert”: Inside The Left's Game Plan For Beating The GOP Health Bill
Progressive activists and Senate Democrats are trying to mount an all-out campaign to sink a Republican health care bill that Senate Majority Leader Mitch McConnell wants to pass before Congress’s July 4 recess. ... There’s just one key problem with this effort: Nobody on the left knows exactly what they’re fighting against, because Senate Republicans haven’t yet released their bill. (Jeff Stein, 6/14)

The Guardian: One Community Garden At A Time: How New Yorkers Are Fighting For Food Justice
As part of New York mayor Bill de Blasio’s Building Healthy Communities initiative, the city recently upped the number of GreenThumb gardens in underserved neighborhoods with limited access to healthy food. The new grants include gardens in East Harlem and Bedford-Stuyvesant and the H.E.A.L.T.H for Youths garden on police department property.But even as community food production programs gain in number, the overall picture is darkening. (Edward Helmore, 6/12)

Editorials And Opinions

Different Takes: Hitting The Right Note On State Medicaid Flexibility; The Secrets In Play In The Repeal-And-Replace Debate

Opinion writers take a hard look at ongoing issues to undo the Affordable Care Act and make system changes regarding Medicaid, Medicare and the individual health insurance market.

JAMA Forum: State Flexibility For Medicaid: How Much?
President Trump’s budget proposal and the recent House health legislation included substantial reductions in Medicaid. Understandably, those cuts have focused attention on the potential effect on coverage for lower-income individuals. But there’s another important and related conversation that needs attention: how much flexibility should states have in redesigning the federal-state Medicaid program? (Butler, 6/14)

The New York Times: Daughters Will Suffer From Medicaid Cuts
Nearly one in five adult children at some point provide care for at least one elderly parent, according to a new study by the Center for Retirement Research at Boston College. The burden is particularly demanding for daughters, who spend as much time on such care as spouses of older adults, and as much time as sons, in-laws, grandchildren and other relatives combined. (6/15)

The Wall Street Journal: ObamaCare’s ‘Secret’ History
Senate Republicans continue to negotiate the details of their health-care reform, and one measure of progress is that their opponents are more manic and disingenuous. Progressives who used to deride the GOP for incompetence are now panicked that they may really succeed, and thus the faux tantrums. The distortion du jour is that the GOP is operating “in secret.” This week Minority Leader Chuck Schumer accused Republicans of working “behind closed doors, writing a bill they won’t let the public read. . . . Today, no Member of Congress can read the bill because we don’t know what it is.” (6/14)

The Washington Post: Republicans Are Privately Angry At Trump For Accidentally Unmasking Their Big Scam
House Republicans are angry with President Trump for blurting out an inconveniently candid view of their health-care bill, Politico reports today. Trump reportedly told a closed-door gathering of GOP senators that the House repeal-and-replace bill is “mean” and called on them to make it “more generous.” This promptly leaked, and a lot of people are noting that Trump undercut House Republicans politically and provided Democrats with ammo for a thousand attack ads. (Greg Sargent, 6/14)

The Washington Post: The GOP’s Fantastically Anti-Democratic Quest To Kill Health Care In The Dark
Senate Majority Leader Mitch McConnell once had passionate views about how carefully Congress should consider sweeping changes to the health-care system. “Fast-tracking a major legislative overhaul such as health care reform or a new national energy tax without the benefit of a full and transparent debate does a disservice to the American people,” McConnell said in 2009, referring to the two big issues of the moment. Democrats using such means, he added, “would make it absolutely clear they intend to carry out their plans on a purely partisan basis.” Republican hypocrisy is now so rampant that it’s typically ignored or, worse, granted the political class’s all-purpose form of absolution: “Everybody does it.” (E.J. Dionne, 6/14)

USA Today: The GOP Health Bill Will Hurt Americans. Bad Backroom Deals Won't Cure That.
A new health care system affecting millions of families is being designed right now in closed-door meetings attended by a small group of Republican senators and their aides. Access to insurance, needed treatments and affordable premiums are being bargained away in exchange for the few votes needed to drag the American Health Care Act over the finish line. Given the narrowest of margins in the Senate, the fate of the AHCA is likely to be decided by one of several senators you might have never heard of, and by a handful of raw deals that are being dangled in front of them. (Andy Slavitt, 6/15)

Los Angeles Times: Trump’s Follies Distract While Mitch McConnell Brews Healthcare Poison
Mitch McConnell has never let concerns about hypocrisy get in the way of advancing his legislative agenda. Now, while the media and American citizens are fixated on each daily warp of the soap operatic presidency of Donald Trump, McConnell has huddled behind locked doors with his Republican loyalists and favored lobbyists to assemble a healthcare scheme that will disassemble Obamacare. (David Horsey, 6/14)

St. Louis Post-Dispatch: GOP Senate Quietly Resuscitates A 'mean' Health Care Bill
When the U.S. House finally sent the Republicans’ American Health Care Act to the Senate on May 4, consensus was that it was dead on arrival. One reason, as even President Donald Trump this week acknowledged — six weeks after holding a Rose Garden ceremony to celebrate it — is that the House bill is “mean.” It turns out the bill wasn’t DOA; it was only sleeping. (6/14)

The Wichita Eagle: Moran, Colleagues Can’t Hide On Health Care
Sen. Jerry Moran of Kansas met with 500 constituents at a town hall meeting Monday in Lenexa, the biggest such assembly of his career. Voters are paying attention — not only to what Moran and his colleagues say, but to what they do. Sen. Jerry Moran walked into a town hall buzz saw Monday morning, one with about 500 razor-sharp sets of teeth ready to slice him to ribbons. (Dave Helling, 6/15)

The Wall Street Journal: Medicare Could Learn A Thing Or Two From The VA
Everyone agrees prescription drugs are too expensive, but what to do about it? One popular idea—supported in the past by President Trump, and by 80% of the public in some polls—is for Medicare to negotiate lower drug prices directly. But such negotiation would work only if there were some limitations on the drugs available to patients, raising many questions about the feasibility of creating a national formulary. Would beneficiaries accept that? (Walid F. Gellad, 6/14)

Viewpoints: Hearing About Hearing Aid Costs; The FDA's Fear And Loathing Of Off-Label Communications

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

RealClear Health: Why Is The FDA So Frightened Of Off-Label Communications?
Former HHS General Counsel and Deputy FDA Commissioner Bill Schultz recently expressed his belief that FDA policies developed 50 years ago remain sufficient to govern life in the 21st century. He’s wrong. Time marches on and regulatory practices must evolve to better serve the public health. Nowhere is this more urgent than in making sure physicians and patients have unencumbered access to accurate information about FDA-approved medicines. (Peter Pitts, 6/15)

JAMA: Physician Certification And Recertification: The Role Of Empirical Evidence
Physicians are faced with the challenge of lifelong learning in a field so vast and complex that no physician can ever hope to master all medical knowledge. Nonetheless, physicians have a duty and responsibility to patients to continuously hone their knowledge, skills, and judgment while appreciating their limits. Striking this balance requires that physicians remain current with the literature, engage with colleagues, identify and address gaps in knowledge, and maintain relevant professional certifications. (Adam B. Schwartz and J. Sanford Schwartz, 6/13)

St. Louis Post-Dispatch: I Am Celebrating Life Thanks To Proton Therapy
At first glance, you would never suspect that I am a brain cancer survivor. I am young, energetic and, seemingly, the picture of health. I have competed in a total of 554 endurance sport events including marathons, Ironman events, 10Ks and 5Ks and everything in between over the last 23 years. As an endurance athlete, I spend many hours a week training, so it’s easy to see how a person might be surprised by my diagnosis. But looks can be deceiving. (Brad Eastman, 6/15)

JAMA: Gray Areas
When I was young, I had a painfully simple philosophy that could be summarized like this: there are good guys and there are bad guys. Bad guys get locked up and good guys roam free. It was straightforward and couched in the comforting illusion of a just, safe world. As a result, I believed that everyone who wound up in prison deserved to be there, and that every sentence was fair. I believed in “an eye for an eye” and enthusiastically supported capital punishment. Incidentally, I also believed that the US criminal justice system was too nice and was alarmed to learn that bad guys in prison got free food, shelter, and health care while so many good guys suffered. (Alia Moore, 6/13)