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THE UNKNOWN GENERALS

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Summaries Of The News:

Health Law

Senators Kick Off Efforts To Find Elusive Compromise On Health Care At Cordial Hearing

“Democrats will have to agree to something — more flexibility for states — that some may be reluctant to support. And Republicans will have to agree to something, additional funding through the Affordable Care Act, that some may be reluctant to support. That is called a compromise," Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander said. State insurance commissioners spoke at the session, urging Congress to continue funding subsidies for insurers.

The New York Times: Work Toward Bipartisan Fix For Health Markets Begins In Senate
The chairman of the Senate health committee said Wednesday that he hoped the panel would reach a consensus by the end of next week on a small, bipartisan bill to stabilize health insurance markets and prevent prices from skyrocketing next year under the Affordable Care Act. “The blame will be on every one of us, and deservedly so,” if senators fail to reach agreement, said the chairman, Senator Lamar Alexander, Republican of Tennessee. (Pear, 9/6)

The Associated Press: GOP, Dem Senators Calmly Discuss Bolstering Obama Health Law
Republicans and Democrats serenely discussed ways to curb premium increases for individual insurance policies on Wednesday at a Senate hearing that veered away from years of fierce partisanship over the failed GOP effort to revoke President Barack Obama's health care law. Senators and state insurance commissioners from both parties embraced the idea of continuing billions in federal subsidies to insurers for reducing out-of-pocket expenses for millions of people, flouting President Donald Trump's oft-repeated threats to halt those payments. (Fram, 9/6)

The Wall Street Journal: Senators Discuss Bipartisan Approach To Repair Obamacare
Mr. Alexander’s proposal, laid out at the beginning of Wednesday’s hearing, would formally authorize subsidy payments to insurers and loosen requirements governing the law’s state waivers. Mr. Alexander hopes to pass legislation with the panel’s top Democrat, Sen. Patty Murray of Washington, before the end of the month, when insurers must sign contracts to participate in next year’s markets. (Hackman, 9/6)

The Washington Post: A GOP Senate Leader Calls For Bipartisan Compromise On ACA Marketplaces
The set of ideas advocated in a large, crowded hearing room amount to a strategy to slow recent spikes in premium rates by some health plans sold on ACA marketplaces and to expand consumers’ choices given major insurers’ defections from some marketplaces. The ideas track the basic contours of changes being touted by Republicans or Democrats — though not necessarily by both — on the HELP committee. (Goldstein and Eilperin, 9/6)

Politico: Bid To Shore Up Obamacare Faces Time Crunch, Conservative Countereffort
A bipartisan group of senators has palpable momentum but little time to make good on a bid to shore up Obamacare insurance markets, even as conservative Republicans press a parallel attempt to make good on their promise to repeal the health care law. The stabilization effort, led by Republican Lamar Alexander (Tenn.) and Democrat Patty Murray (Wash.), could yield the first bipartisan Obamacare bill since the law was passed seven years ago. It could also provide some measure of certainty for insurance companies that have until Sept. 27 to make final decisions about whether to participate in Obamacare markets next year. (Haberkorn, Cancryn and Bade, 9/6)

Los Angeles Times: In The Face Of Major Premium Hikes, State Insurance Regulators Urge Congress To Act Quickly
State officials — both Republican and Democratic — urged lawmakers to maintain the federal funding that subsidizes poor customers’ deductibles and co-pays, even as the president continues to threaten to withhold that aid. And they called on Congress to move quickly in the face of mounting warnings from health insurers that without congressional action by the end of September, consumers will face major premium hikes next year. “Uncertainty destabilizes the market,” Lori Wing-Heier, Alaska’s nonpartisan insurance regulator, told senators at the Senate health committee. (Levey, 9/6)

The Hill: Insurance Official To Congress: ObamaCare Not Collapsing 
A Pennsylvania insurance official told Congress Wednesday that ObamaCare is not collapsing, as some Republicans have argued. Speaking at a Senate Health Committee hearing on efforts to stabilize Affordable Care Act (ACA) markets, Teresa Miller, Pennsylvania’s acting Human Services secretary and former insurance commissioner, said that the notion is “just false.” (Sullivan, 9/6)

Kaiser Health News: Insurance Commissioners Say Help Offered By Congress Is Not Enough To Save Market
“Insurers right now are already planning for 2019,” said Washington Insurance Commissioner Mike Kreidler, a former Democratic member of Congress. “In order to give them predictability, you would have to give them more certainty in the market” than a one-year extension. Added Alaska Insurance Commissioner Lori Wing-Heier, “Insurers have to have more than a one-year commitment” to persuade them to stay in the market and not raise premiums high enough to make up for the potentially lost payments from the federal government. (Rovner and Bluth, 9/6)

The Hill: State Officials Plead For Bipartisan ObamaCare Fix 
Health committee Chairman Lamar Alexander (R-Tenn.) wants to find consensus by the end of next week. To sell the fix, he and ranking member Patty Murray (D-Wash.) held a private meeting with senators not on the committee and the witnesses who testified as Wednesday's hearing. “If we can do two things, that would be two more things that we have agreed on in a bipartisan way in the last seven years in health insurance,” Alexander told reporters. (Hellmann, 9/6)

Nashville Tennessean: Despite Trump Threats To End Cost-Sharing, Tennessee Insurance Commissioner Says They Are Critical To Health Care
Tennessee Insurance Commissioner Julie Mix McPeak urged Congress on Wednesday to continue federal cost-sharing payments to insurers, arguing the subsidies are the key to strengthening insurance markets and potentially bringing down costs next year. Appearing before a Senate panel, McPeak insisted the payments should not be seen as an “insurer bailout.” To the contrary, she said, cost-sharing funding “ensures that some of our most vulnerable consumers receive assistance for copays and deductibles that are required to be paid under federal law.” (Collins, 9/6)

Bloomberg: GOP Turns To `Small Step' On Obamacare, Works With Democrats 
As Congress debates changes to the law, health insurers and state regulators are putting the finishing touches on how it will operate and what coverage will cost next year. Insurance companies were required to submit their 2018 premiums to regulators in many states on Sept. 5, though there’s some room for changes if Congress takes action. (Edney, Tracer and Dennis, 9/6)

Governors To Urge Senate That Reinsurance, Other Measures Needed For Marketplaces

The five governors who will testify before the Senate Health, Education, Labor and Pensions Committee today are expected to press for a series of changes to give the marketplace more stability over the coming years.

CQ: Governors Set To Provide More Details On Health Plan
Five governors testifying Thursday before the Senate Health, Education, Labor and Pensions Committee will likely echo the insurance regulators who appeared before the panel this week, while also raising new concerns. Committee members say they expect many of the themes they heard from insurance commissioners on Wednesday to re-emerge during the hearing. That includes reinsurance, the funding of cost-sharing reduction payments and outreach ahead of the open enrollment period. (McIntire, 9/7)

State House News Service: Baker To Offer Senate Suggestions On Stabilizing Health Care Markets
Governor Charlie Baker, in testimony Thursday before a Senate committee in Washington, plans to criticize the tenor of the debate over health care and urge a minimum two-year extension of premium payments worth millions of dollars to health insurers and residents in Massachusetts. Baker has been called to testify before the Senate’s Health, Education, Labor and Pensions Committee alongside four other governors, including Democrats and Republicans from Montana, Tennessee, Utah, and Colorado. (Murphy, 9/7)

WBUR: On Capitol Hill, Gov. Baker Will Push A Bipartisan Approach To Health Care Reform
Gov. Charlie Baker will testify alongside four other governors on Capitol Hill Thursday in the latest sign that he's playing a role in the next phase of federal health care reform. Baker — who will be joined by two fellow Republicans (Utah Gov. Gary Herbert and Tennessee Gov. Bill Haslam) and two Democrats (Montana Gov. Steve Bullock and Colorado Gov. John Hickenlooper) — has written or helped draft almost a dozen letters to Congressional leaders on health care in the last few months. (Bebinger, 9/6)

McCain Throws Support Behind Long-Shot Graham-Cassidy Bill, But Then Walks It Back

Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) are trying to scrape up support for a last-ditch effort bill to repeal the Affordable Care Act.

The Hill: McCain Backs Graham-Cassidy ObamaCare Repeal Effort
Sen. John McCain (R-Ariz.) said Wednesday that he supports a newer version of an ObamaCare repeal-and-replace bill, throwing some support behind the last-ditch effort. McCain said he backs a bill from Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) that would convert ObamaCare spending into block grants for states. ... In a statement later in the day on Wednesday, McCain took a step back from his earlier comments, saying he still needed to see the final bill and that committee hearings are in fact necessary. (Sullivan, 9/6)

The Hill: Conway: Trump Would Sign Graham-Cassidy ObamaCare Repeal Bill 
White House adviser Kellyanne Conway said Wednesday that President Trump would sign an ObamaCare repeal plan from GOP Sens. Bill Cassidy (La.) and Lindsey Graham (S.C.) if Congress passed it. “The president’s ready, he’s ready with pen in hand to sign health-care reform if, say, Graham-Cassidy moves forward. A lot of the governors seem to be supportive of that, people have been working on that very strongly over the recess,” Conway said on "America's Newsroom" on Fox News. (Roubein, 9/6)

Activists Try To Fill Gaps Left By Trump Gutting Health Law Outreach Budget

Organizations such as Protect Our Care and health care leaders like Andy Slavitt, former acting administrator of the Centers for Medicare & Medicaid Services, are trying to keep the momentum going to get people to enroll in health care coverage for next year. Media outlets report on marketplace news out of Virginia, Kentucky, Colorado and Ohio, as well.

The Wall Street Journal: Health-Care Sign-Up Groups Brace For Enrollment Challenge
Democrats and activists are trying to promote the Affordable Care Act’s open-enrollment period and raise money for outreach following a Trump administration decision to cut millions of dollars from programs that help people sign up for health coverage. That outside effort, unfolding alongside a push on Capitol Hill to restore some of the funds, includes more than 1,500 volunteers organizing on social-media sites such as Facebook under the name Indivisible ACA Signup Project, seeking to promote the open-enrollment season beginning Nov. 1. (Armour, 9/6)

The Wall Street Journal: Obamacare Insurer In Virginia To Scale Back Planned Expansion
Virginia became the latest state at risk of having regions that will lack Affordable Care Act exchange plans next year, after a small insurer announced it will scale back the area where it expects to offer marketplace insurance. The Virginia area that currently has no 2018 exchange insurer includes 48 counties and parts of six more, as well as 15 cities that are independent of counties, according to a Virginia state regulator. In total, the state has 95 counties and 38 independent cities. (Wilde Mathews, 9/6)

Richmond Times-Dispatch: Optima Health Pulls Out Of Some Virginia Insurance Marketplaces
As a handful of major insurance companies prepare to leave Virginia’s health exchanges for good, the Hampton Roads-based insurer Optima Health announced Wednesday that it will likely scale back its participation in some marketplaces next year. In the 2018 Affordable Care Act exchanges, Optima Health will offer coverage only in locations where there are Sentara Healthcare hospitals and physicians, including Hampton Roads, Harrisonburg, Charlottesville, and Halifax and Mecklenburg counties. (Connor, 9/6)

The Hill: Anthem To Exit ObamaCare Markets In Half Of Kentucky
Insurance giant Anthem is exiting ObamaCare markets in half of the counties in Kentucky, leaving many individuals with only one insurer choice for next year. The insurer has already announced plans to scale back participation in or leave the Affordable Care Act's (ACA) public exchanges in Indiana, Wisconsin, Missouri, Nevada and Ohio. (Weixel, 9/6)

Denver Post: Colorado Regulators Approve 27 Percent Increase In Individual Health Insurance Premiums For 2018
Coloradans who buy their health insurance on their own will see an average premium increase next year of nearly 27 percent, before taking federal tax credits into account. The Colorado Division of Insurance announced Wednesday that it has given final approval to rates proposed by nine different insurers expecting to offer plans both on and off of the state’s insurance exchange in 2018. In some cases, regulators knocked back the originally proposed rates — such as with Cigna, where regulators and the company negotiated to drop the proposed increase from above 40 percent down to about 31 percent. In other instances, regulators urged carriers to raise their rates higher, fearing that the low-ball proposals weren’t sustainable. (Ingold, 9/6)

Cleveland Plain Dealer: Ohio Premiums For Obamacare Policies To Rise By 34 Percent On Average, State Says
Ohioans who buy health insurance on the Affordable Care Act exchange will see premiums rise by 34 percent on average in 2018, the Ohio Department of Insurance said today. ... The average includes an extra 11 percent insurers built in with the expectation that President Donald Trump's administration will no longer provide cost-sharing payments, or payments insurers previously got for holding down out-of-pocket costs for lower-income customers. (Koff, 9/6)

Columbus Dispatch: Ohioans Face Sharp Premium Hikes, Fewer Insurers On Obamacare Exchanges
If President Donald Trump makes good on his threat to cut health-insurance subsidies, Ohioans will see sharply limited options on the state’s Obamacare exchanges next year. ... Residents of 20 Ohio counties were facing 2018 with not even one insurer offering coverage in the exchange, but the state reached an agreement this summer with five insurers to provide coverage. (Rowland, 9/7)

Administration News

Fallout From Rolling Back DACA Would Ripple Through Health Care Industry

Surveys of DACA beneficiaries reveal that about one-fifth of them work in the health care and educational sector, suggesting a potential loss of tens of thousands of workers from in-demand job categories like home health aide and nursing assistant.

The New York Times: What Older Americans Stand To Lose If ‘Dreamers’ Are Deported
When the Trump administration announced on Tuesday that it would end an Obama-era program that shielded young undocumented immigrants from deportation, Sherwin Sheik quickly sized up the potential toll on his business. Mr. Sheik is the chief executive and founder of CareLinx, which matches home care workers with patients and their families. The company relies heavily on authorized immigrant labor, making the looming demise of the program — which has transformed around 700,000 people brought to this country as children into authorized workers — a decidedly unwelcome development. (Scheiber and Abrams, 9/6)

In other news about the administration's decisions —

The Washington Post: Two Senators Aim To Challenge Trump’s Transgender Troops Order In Defense Bill
Two senators are preparing an amendment to challenge President Trump’s announced ban on transgender people serving in the military that they hope to attach to a sweeping defense bill the chamber is set to consider this month. Sen. Kirsten Gillibrand (D-N.Y.) said Tuesday that she is drafting the amendment with Sen. Susan Collins (R-Maine) to “try to protect the transgender troops” against the order that Trump initially issued via Twitter in July banning them from the military. (Demirjian, 9/6)

Capitol Hill Watch

Senate Panel Approves An Increase In Funding For NIH

The increase is part of the funding bill for the Departments of Health and Human Services, Education and Labor. House appropriators have a different plan. Also, senators today hold a hearing on the future of the Children's Health Insurance Program.

CQ: Senate Appropriators Back NIH, Pell Grant Boosts In Draft Bill
The Senate Labor-HHS-Education Appropriations Subcommittee on Wednesday approved by voice vote a bipartisan draft spending bill that would increase funding for the National Institutes of Health by $2 billion and provide more funding to low-income students attending college. The fiscal 2018 bill contains $3 billion more than the fiscal 2017 bill, putting funding for the largest non-defense discretionary spending bill at $164.1 billion, according to a subcommittee summary. ... The bill would provide $36.1 billion for the National Institutes of Health, a $2 billion increase over its fiscal 2017 levels. That builds upon similar increases for each of the last two years. Alzheimer’s research would get the biggest boost at NIH, with a $414 million increase, resulting in $1.8 billion total for those programs. (Wilkins and Siddons, 9/6)

Kaiser Health News: Congress’ Tight Timetable Complicates Renewal Of Children’s Health Plan
A popular federal-state program that provides health coverage to millions of children in lower- and middle-class families is up for renewal Sept. 30. But in a deeply divided Congress facing such pressing concerns as extending the nation’s debt ceiling, finding money for the Hurricane Harvey cleanup and keeping the government open, some health advocates fear that the program for children could be in jeopardy or that conservative lawmakers will seek changes to limit the program’s reach. (Galewitz, 9/7)

Public Health And Education

Evacuating A Hospital Isn't An Easy Undertaking. Here's How One Facility In Texas Managed It.

The New York Times takes a look at the intricate plan to remove patients from the Baptist Beaumont Hospital after Harvey hit. The lingering public health effects from the storm are also in the news.

The New York Times: After Harvey Hit, A Texas Hospital Decided To Evacuate. Here’s How Patients Got Out.
As floodwaters from Hurricane Harvey began filling his north Beaumont, Tex., home last week, Theodore Atwood waded outside to get a utility knife, so he could pull up his carpet and protect it. Coming back to his kitchen, he slipped and fell on the wet linoleum, and ended up at a local hospital with a severely broken pelvis. But that was only the beginning of his journey, as he became one of 243 patients evacuated from the hospital last Thursday and Friday, according to a hospital spokeswoman, after flooding from the storm damaged the city’s water system. (Fink and Burton, 9/6)

Stat: Preparing For Hurricane Irma, Hospitals In Florida Keys Evacuate Patients
Hospitals in the Florida Keys bracing for Hurricane Irma, a Category 5 storm with sustained winds of up to 185 miles an hour, are evacuating patients and preparing to close their doors. Three hospitals in the Florida Keys — Lower Keys Medical Center, Mariners Hospital, and Fishermen’s Community Hospital — have been discharging patients capable of going home since earlier this week and are coordinating air and ambulance transports for the 20 or so inpatients who remain inside their walls. (Blau, 9/6)

NPR: Houston Methadone Clinics Reopen After Harvey's Flooding
Medical workers in Houston are dealing with a secondary problem after last week's floods: Clinics that offer methadone and other opioid addiction therapies are just getting back up and running, and many people don't have access to the treatments they need. While the city flooded last week, Stormy Trout was going through opioid withdrawal at a detox center surrounded by water. "You know, cravings and anxiety, it's just treacherous, it really is," she said Tuesday while waiting for a ride outside an opioid treatment clinic in north Houston. "I'm like, I know I can do this, but I just need something to help with the cravings and the anxiety and stuff." (Hersher, 9/6)

The New York Times: High Levels Of Carcinogen Found In Houston Area After Harvey
High levels of the carcinogen benzene were detected in a Houston neighborhood close to a Valero Energy refinery, local health officials said Tuesday, heightening concerns over potentially hazardous leaks from oil and gas industry sites damaged by Hurricane Harvey. Preliminary air sampling in the Manchester district of Houston showed concentrations of up to 324 parts per billion of benzene, said Loren Raun, chief environmental science officer for the Houston Health Department. (Tabuchi, 9/6)

The New York Times: Harvey Swept Hazardous Mercury Ashore. The Mystery: Its Source.
Public health officials are investigating a case of dangerous liquid mercury that appears to have washed or blown ashore here, east of Houston, in the aftermath of Hurricane Harvey. Bobby Griffin found the clusters of shiny silver mercury globules scattered across his San Jacinto riverfront property on Tuesday, a few hundred yards from the San Jacinto Waste Pits, a Superfund site that was inundated during last week’s storm. (Healy and Kaplan, 9/6)

Bloomberg: Receding Floodwaters Expose Long-Term Health Risks After Harvey 
Benzene churns through Houston’s economy. The clear, sweet-smelling chemical is found in the crude oil processed in the region’s refineries and is used to make plastic, pesticides and other products. It’s also a carcinogen whose cancer-causing properties illustrate the risks that will linger for southeast Texas long after the floodwaters of Harvey have receded. Thousands of homes were submerged in murky water that may have been tainted with benzene and other runoff from an area that boasts the nation’s largest concentration of refineries and petrochemical plants. (Dlouhy, 9/7)

The New York Times: Seven Hard Lessons Federal Responders To Harvey Learned From Katrina
During Hurricane Katrina, as residents of New Orleans were left stranded in the floodwaters, thousands of firefighters who had assembled to help rescue people instead spent days wading through paperwork and completing training on federal sexual harassment policies. Disasters, of course, are never smooth. Last week in Houston, some residents reported trouble getting through to 911, and many said calls to officials for help went unanswered. And plenty of volunteers who splashed into the floods saw a tangle of miscommunication, wrenching delays and plain old incompetence. Now many are watching to see how the federal government will handle Irma, one of the most powerful Atlantic storms ever recorded, as it appears ready to hit Puerto Rico and Florida. (Philipps, 9/7)

Houston Chronicle: Health Insurers Urged To 'Do The Right Thing' After Harvey 
The Texas Department of Insurance is urging health insurers in Texas to loosen restrictions and show flexibility for people who have already sought or may need medical or mental health treatment in coming weeks. "We want to make sure that all of the people who are displaced by Harvey have the medical care they need without having to worry about their specific plan details," department spokesman Ben Gonzalez said Wednesday. (Deam, 9/6)

Houston Chronicle: County Giving Tetanus Shots At No Cost
The Galveston County Health District is making the tetanus vaccine available at no cost to those who have not received a shot within 10 years. According to the Centers for Disease Control and Prevention, floodwater exposure does not increase the risk for tetanus. However, those who have not received a tetanus shot in 10 years should do so as a matter of routine health care. (9/6)

In Response To Epidemic, Senators Advance 'Partial-Fill' Approach To Opioid Prescriptions

Sens. Elizabeth Warren (D-Mass.) and Shelley Moore Capito (R-W.Va.) say the clause would let patients decide if they wanted less than the full prescription in their homes. In other news, the Food and Drug Administration issues a warning to a drugmaker for its marketing tactics, a task force releases recommendations on fighting the epidemic, a new study finds addiction medication has little impact on users, and more.

Stat: To Fight Opioid Epidemic, Senators Make The Case For ‘Partial Fill’ Prescriptions
Sens. Elizabeth Warren (D-Mass.) and Shelley Moore Capito (R-W.Va.) wrote a series of letters on Wednesday asking major figures in the battle against the nation’s opioid epidemic to consider promoting and analyzing “partial fill” policies, which allow patients to receive less than a full prescription’s worth of medication on a single pharmacy trip. A clause in the Comprehensive Addiction and Recovery Act, passed in 2016, permits pharmacies to dispense portions of prescriptions for Schedule II drugs — a classification that includes many opioid-based painkillers with high potential for abuse — and for patients to return later if they feel the remainder of prescribed medication is needed. (Facher, 9/6)

Stat: Opioid Maker Is Slammed By FDA For Omitting Risk Info In Materials Given To Docs
In promotional materials that were distributed to doctors, Vertical Pharmaceuticals omitted some rather important risk information about ConZip, an opioid painkiller, according to a warning letter the Food and Drug Administration issued late last month and posted on its web site earlier this month. Specifically, Vertical did not mention that the drug should only be prescribed when alternative treatments are ineffective or inadequate, and also failed to note the painkiller is not approved for use as an “as-needed analgesic.” These points are clearly noted in the prescribing information under a section called “limitations of use.” (Silverman, 9/6)

Nashville Tennessean: Opioid Task Force Recommendations To Combat Tennessee Epidemic: More TBI Agents, Prescription Limits
A legislative task force released its recommendations on combating Tennessee's opioid epidemic Wednesday, issuing nearly two dozen recommendations to address what one lawmaker said could be "a mass casualty event in Tennessee." The seven-member special task force was convened by House Speaker Beth Harwell in January to examine new approaches to pain pill addiction and its impact. (Wadhwani, 9/6)

Cleveland Plain Dealer: Study: Relapse Prevention Medications Like Vivitrol And Suboxone Used In Drug Courts Have Minimal Impact On Recidivism
A new evaluation of more than two dozen Ohio drug courts found that the only apparent result of giving participants medication for addiction was that some stayed in the court programs longer. ... Since 2013, lawmakers have sunk more than $33 million into introducing MATs into drug courts, including $1 million it paid Treatment Research Institute, of Philadelphia, for the most recent evaluation that looked at about 600 drug court participants in 13 counties. (Dissell, 9/6)

Arizona Republic: Gov. Doug Ducey's Opioid Plan Seeks To Limit Initial Pain-Pill Fills
Arizona would limit all initial opioid prescriptions to five days for new patients under sweeping guidelines recommended Wednesday by Gov. Doug Ducey's administration. The plan also would limit maximum doses for pain medication, implement steps to taper down pain medications and require pain prescriptions to be filed electronically, rather than on paper, to limit diversion of drugs. (Alltucker, 9/6)

After Puzzling Over Mumps Outbreaks, Scientists Recommend Extra Dose Of Vaccine

There have been cases recently where the vast majority of a population affected by an outbreak had received the two doses of vaccine, yet people still contracted the virus. In other public health news: a pen that detects cancer, overtreatment, mosquitoes, breast cancer, romantic attraction and more.

Stat: Third Dose Of Mumps Vaccine Could Help Stop Outbreaks, Researchers Say
An extra dose of the combined measles, mumps, and rubella vaccine can help to stop mumps outbreaks, a new study suggests. The research, published in the New England Journal of Medicine and based on analysis of data from a large mumps outbreak at the University of Iowa in 2015-2016, showed that getting a third dose of MMR vaccine cut the risk of contracting the mumps by 78 percent. (Branswell, 9/6)

Stat: A Pen That Detects Cancerous Tissue Could Help Surgeons Remove Full Tumor
Anew handheld device could someday help cancer surgeons figure out what to cut and what to leave alone in real time. The device, called the MasSpec Pen, is (unsurprisingly) about the size of a pen and employs water, plastic tubing, and a mass spectrometer. It’s the latest in engineers’ efforts to speed up the pace at which samples collected during operations are processed for clinically valuable information. (Sheridan, 9/6)

The New York Times: Overtreatment Is Common, Doctors Say
Most physicians in the United States believe that overtreatment is harmful, wasteful and common. Researchers surveyed 2,106 physicians in various specialties regarding their beliefs about unnecessary medical care. On average, the doctors believed that 20.6 percent of all medical care was unnecessary, including 22 percent of prescriptions, 24.9 percent of tests and 11.1 percent of procedures. The study is in PLOS One. (Bakalar, 9/6)

The New York Times: Infectious Mosquitoes Are Turning Up In New Regions
A mounting number of citations on a popular disease-tracking website suggests that mosquitoes may be moving into new ecological niches with greater frequency. The website, ProMED mail, has carried more than a dozen such reports since June, all involving mosquito species known to transmit human diseases. (McNeil, 9/7)

The New York Times: Fitness May Lower Breast Cancer Risk
Aerobic fitness seems to alter the interior workings of cells in ways that may substantially lower the risk of breast cancer. A new study with female rats found that those that were the most fit were much less likely than other animals to develop cancer after exposure to a known carcinogen, even if they did not exercise. (Reynolds, 9/6)

Stat: Can Craig Venter Really Predict What Your Look Like From Your DNA?
Can genomics wizards make an informed guesstimate on what a person looks like, based on his or her DNA? J. Craig Venter sure thinks so, per a new PNAS paper. Yet his Human Longevity Institute study is facing Twitter blowback for that claim. Venter’s proof-of-concept study used a machine learning algorithm to analyze the genomic and biometric data of 1,061 volunteers. It looked at gender, facial structure, age, height, weight, skin color, eye color, and voice, generating a facsimile of the person based on their genetic analysis. (Keshavan, 9/6)

NPR: Dating App Questionnaires May Not Measure Real-Life Attraction
Dating sites claim to winnow a few ideal suitors out of a nigh-infinite pool of chaff. But the matches these algorithms offer may be no better than picking partners at random, a study finds. Researchers asked about 350 heterosexual undergrads at Northwestern University to fill out questionnaires assessing their personalities and romantic preferences. (Chen, 9/6)

Kaiser Health News: Shedding New Light On Hospice Care: No Need To Wait For The ‘Brink Of Death’
A few weeks ago, Kathy Brandt’s 86-year-old mother was hospitalized in Florida after a fall. After rushing to her side, Brandt asked for a consult with a palliative care nurse. “I wanted someone to make sure my mother was on the right medications,” Brandt said. For all her expertise — Brandt advises end-of-life organizations across the country — she was taken aback when the nurse suggested hospice care for her mother, who has advanced chronic obstructive pulmonary disease, kidney disease and a rapid, irregular heartbeat. (Graham, 9/7)

Women’s Health

Kentucky Could Become First State Without An Abortion Clinic, Depending On Trial

The fate of the clinic will be decided by a federal trial that kicked off on Wednesday.

The Associated Press: Kentucky Abortion Clinic’s Future At Stake In Federal Trial
Attorneys for Kentucky’s last abortion clinic said as a federal trial opened Wednesday that state regulators are using “onerous” rules to try to shut it down, predicting some women would “take the matter into their own hands” to end pregnancies if the state succeeds.“ There will be no abortions in Kentucky if they win,” clinic attorney Donald L. Cox said as proceedings began in a court case that could determine whether Kentucky becomes the nation’s first state without an abortion clinic. (Schreiner, 9/6)

Los Angeles Times: Kentucky Could Become First State With No Abortion Clinics
In the 37 years that Dr. Ernest Marshall has been performing abortions in Kentucky, he has seen more than a dozen clinics close in the state. He is now facing off against the governor in a legal fight that will decide whether Kentucky becomes the first state in the nation without an abortion clinic. State regulators tried to shut down EMW Women’s Surgical Center in March over allegations that the facility, which Marshall founded in downtown Louisville in 1981, does not have adequate agreements in place with a local hospital and an ambulance service in case a patient needs to be transferred. (Zavis, 9/6)

Pharmaceuticals

Calif. Startup Gambles On Development Of Alzheimer's Treatment

Also in the news, lobbyists double down on efforts surrounding a California prescription drug pricing transparency bill.

Stat: Billion-Dollar Gamble: Biotech CEO Takes A Second Shot At Alzheimer's Drug
Medivation, a California startup, was developing a treatment for Alzheimer’s disease, and pivotal results from a major clinical trial were finally available. An earlier study, conducted in Russia, had generated what Alzheimer’s experts hailed as the best results the field had ever seen. Dr. David Hung, the CEO, believed he had a billion-dollar product. ... The drug, Dimebon, failed all five of the trial’s key metrics, performing even worse than placebo on two of them. Medivation lost more than $1 billion in value in the first hour of trading as the company’s leaders struggled to process the startling failure. ...So he’s doing it again — headed for another crowded room and another make-or-break clinical trial. This time it’s with Axovant Sciences. (Garde, 9/7)

Los Angeles Times: Lobbying For California Bill To Crack Down On Prescription Drug Prices Intensifies
Backers of a measure to require pharmaceutical companies to disclose more information on the list prices of their drugs are stepping up their lobbying efforts in the closing days of the California legislative session. Labor unions, consumer groups, health plans and other high-profile advocacy organizations such as the AARP and NextGen, which is bankrolled by billionaire activist Tom Steyer, made the rounds at the state Capitol on Wednesday to urge Assembly members to back the bill, SB 17, by state Sen. Ed Hernandez (D-West Covina). (Mason, 9/6)

State Watch

State Highlights: Mass. Senate Leaders Focus On Curbing State Health Care Costs; Three Pa. Health Systems Report Fiscal 2017 Losses

Media outlets report on news from Massachusetts, Pennsylvania, Georgia, Connecticut, Wisconsin and Minnesota.

Boston Globe: Senate Leaders Honing Bill To Rein In State’s Health Care Costs
Massachusetts Senate leaders say they are developing an extensive bill aimed at curbing health care costs in the state budget and for consumers, in what could shape up to be the biggest state health care legislation in five years. Senators expect to finish drafting the bill in coming weeks and file it in October, after several months of research, including meetings with health officials in other states. (Dayal McCluskey, 9/6)

The Philadelphia Inquirer/Philly.com: Three Philadelphia-Area Health Systems Report Fiscal 2017 Losses
The Philadelphia region’s two smallest nonprofit health systems by revenue, Doylestown and Holy Redeemer, slipped into the red on an operating basis in the year ended June 30, according to preliminary operating results. Doylestown Health had a consolidated operating loss of $1.76 million on revenue of $322.45 million. That was the system’s first loss since 2010. Officials declined to comment before a presentation of audited results to the organization’s board on Sept. 25. (Brubaker, 9/7)

Georgia Health News: As Lead Poisoned A Child, A Slow State Response
When tests on a child reveal at least 10 micrograms of lead per deciliter of blood, the Georgia Department of Public Health is supposed to investigate to determine where the lead came from. ... The Poteets can’t be sure how Austin was poisoned because caseworkers for the Georgia Department of Public Health took months to contact the family after he tested high. (Goodman and Miller, 9/6)

The Associated Press: 6 More Arrested In Abuse Probe At Psychiatric Hospital
Six more staff members at a maximum-security psychiatric hospital have been arrested in connection with the repeated abuse of a patient, making it a total of nine workers charged with cruelty to persons and disorderly conduct, Connecticut State Police said. Authorities on Tuesday night announced the new arrests of workers at the Whiting Forensic Division of Connecticut Valley Hospital in Middletown. The facility is the state’s only maximum-security hospital for the criminally insane. (9/6)

Weekend Reading

Longer Looks: DACA And The Doctor Shortage; Cancer's Invasion Equation & Obamacare Sabotage

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

Forbes: How Trump's Move To End DACA May Worsen The Doctor Shortage
A decision by President Donald Trump to end the Deferred Action for Childhood Arrivals (DACA) program could exacerbate the U.S. doctor shortage and hurt patient care for thousands of Americans.There are hundreds of nurses, health-care workers, medical students and doctors-in-training with DACA status. That was put in jeopardy Tuesday when Trump ordered an end to the Obama-era program, which shields an estimated 800,000 young undocumented immigrants from being deported. (Bruce Japsen, 9/5)

The Atlantic: DACA Med Students Face Uncertain Futures 
Without DACA, there is no clear path for these students to complete their training, repay their loans, or practice medicine. For medical students committed to a decades-long career path with mortgage-sized student loans, the uncertainty makes it almost impossible for even type-A overachievers to plan for the future. (Jeremy Raff, 9/1)

The New Yorker: Cancer’s Invasion Equation
One evening this past June, as I walked along the shore of Lake Michigan in Chicago, I thought about mussels, knotweed, and cancer. Tens of thousands of people had descended on the city to attend the annual meeting of the American Society of Clinical Oncology, the world’s preëminent conference on cancer. Much of the meeting, I knew, would focus on the intrinsic properties of cancer cells, and on ways of targeting them. Yet those properties might be only part of the picture. We want to know which mollusk we’re dealing with; but we also need to know which lake. (Siddhartha Mukherjee, 9/4)

Vox: This Is What Obamacare Sabotage Looks Like
The Affordable Care Act’s success hinges on a large number of healthy people enrolling in marketplace coverage. These policy changes only make senses as ones that would undermine that goal. Experts expect that less outreach and less advertising will lead to fewer people enrolling in coverage, and those most likely to be left behind are the young, healthy enrollees who hold down premiums for everyone else. (Sarah Kliff, 9/5)

The Economist: Blame Congress For High Health-Care Costs
In America, nearly one in every five dollars spent is on health care, a larger share than in any other country. Many of the culprits are well-known. Americans have more procedures, pay more for them, and face exorbitant administrative costs. One driver of rising costs has often been overlooked, however: politicians. (9/2)

Bloomberg: Med School Grads Go To Work For Hedge Funds
Matthew Alkaitis, a third-year student at Harvard Medical School, is calm, friendly, and a good listener—the kind of qualities you’d want in a doctor. But though he spends 14 hours a day studying for his board exams, the 29-year-old isn’t sure how long he’ll be wearing a white coat. In September, Alkaitis, who also has a Ph.D. in biomedical sciences, will be starting a two-year fellowship at McKinsey & Co., where he’ll be advising clients in the health-care field. (Anna Mostue, 9/5)

The New York Times: Looking Into The Future For A Child With Autism
How do you write about the happy life you hope for your child to have when you have a hard time picturing it yourself? For 18 years, I’ve dreaded the yearly ritual of writing a “vision statement” for an Individualized Education Plan, or I.E.P., for our son, Ethan. He has autism and, as any parent of a child with significant special needs knows, the yearly team meeting to develop the I.E.P. can be emotional and fraught. For us it has felt, at times, like an annual adjustment of expectations downward. (Cammie McGovern, 8/31)

Editorials And Opinions

Viewpoints: 'Last-Ditch' Efforts At Repeal; DACA's Little-Recognized Impact On Anxiety, Mental Illness

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

USA Today: Health Care Smackdown: Last-Ditch Repeal Drive Threatens Bipartisan Fixes
While America has been distracted by Russia, North Korea, Charlottesville and Hurricane Harvey, two opposing forces have been gathering steam and are likely to bring the health care debate to an explosive head by the end of the month. On one side, powerful Republican Senate committee chairs and their Democratic counterparts are leading an effort this week to move health care reform in a bipartisan direction by focusing on small improvements to the Affordable Care Act. ... But not so fast. There is competition — yet another partisan effort to repeal the ACA, led by Republican senators Lindsey Graham of South Carolina, Bill Cassidy of Louisiana and Dean Heller of Nevada. (Andy Slavitt, 9/6)

The Washington Post: The Little-Known Benefit Of DACA: It Reduced Mental Illness In Dreamers’ Children
Among the many dramas of the Trump presidency has been whether he would fulfill his campaign promise to dismantle the DACA program. Months of speculation and mounting anxiety among immigrants and their advocates culminated Tuesday, when Attorney General Jeff Sessions announced that the Trump administration would rescind DACA protections in six months’ time. The program, Deferred Action for Childhood Arrivals, provided temporary relief from deportation and the right to work for unauthorized immigrants who had been brought to the United States as children. To date, some 800,000 of these “dreamers” have successfully applied for the deferred action. (David D. Laitin, Linna Martén and Jens Hainmueller, 9/6)

The Wall Street Journal: Teen-Pregnancy Subsidy Panic
Progressives defend some government programs as so inexpensive they aren’t worth cutting (the National Endowment for the Arts) and the rest as too large and important to touch (Medicaid). Witness the meltdown over the Trump Administration’s decision to redeploy funding for teen-pregnancy prevention. Earlier this summer the Health and Human Services Department decided to wind down the Obama Administration’s Teen Pregnancy Prevention Program, which offers grants to localities and organizations, ostensibly to import proven methods of preventing teen pregnancy or experiment with fresh approaches, mostly through education about birth control. HHS certifies “evidence-based” curricula for teens or underwrites new ideas. The program has handed out more than $800 million since its start in 2010. (9/6)

St. Louis Post-Dispatch: Missouri Lawmakers Should Hold A Special Session To Help Elderly And Disabled
About 8,000 elderly and disabled residents in Missouri are facing grim prospects that their in-home health care and medical services will be drastically reduced because $35.4 million was slashed from a tight state budget. Advocates are trying to persuade lawmakers headed back to Jefferson City for a veto session on Sept. 13 to hold a special session to stave off an impending health crisis. (9/6)

The Columbus Dispatch: Ohio Targets Killer Epidemic
Action by Gov. John Kasich last week to slow down the flood of painkillers in Ohio and prevent abuse and addiction, by limiting overprescribing, could have significant impact. It won’t be immediate, but it may mark a turning point in a state that has become the epicenter of the nation’s opioid crisis. (9/6)

JAMA: Delivering Emotions
Becca, push a little more. Come on. You can do this,” I said softly, encouraging the mother to deliver. I tried to focus on the task at hand. By doing so, I could push my emotions deep within me. Because if I thought about the details surrounding Becca’s current circumstances, I knew I might start to cry. “Stay strong,” I then said, for both of us. Keep it together, I muttered to myself. (Elizabeth Corey, 9/5)

JAMA: Using Outreach To Improve Colorectal Cancer Screening
Colorectal cancer (CRC) is the second leading cause of cancer death in the United States, with more than 50 000 deaths expected in 2017. Screening can reduce CRC mortality, and several methods of screening are available and recommended for average-risk adults aged 50 years to 75 years. Modeling studies suggest that several different methods of screening produce relatively similar levels of mortality reduction if there is good adherence to the underlying screening program. (Michael Pignone and David P. Miller Jr., 9/5)

Stat: I'm An Expert On Diagnosing Mental Illness. Trump Doesn’t Meet The Criteria
Confusing Trump’s behavior with mental illness unfairly stigmatizes those who are truly mentally ill, underestimates his considerable cunning, and misdirects our efforts at future harm reduction. And the three most frequent armchair diagnoses made for Trump — narcissistic personality disorder, delusional disorder, and dementia — are all badly misinformed. (Allen Frances, 9/6)

JAMA Forum: Science And The Trump Administration
In its first 6 months, the Trump administration has sent a few different signals to the scientific community. On one hand, President Trump has proposed major budget cuts to scientific funding agencies, including the National Institutes of Health. On the other, the administration has announced some promising initiatives, such as the US Food and Drug Administration’s (FDA’s) effort to reduce nicotine in cigarettes to nonaddictive levels. (Joshua M. Sharfstein, 9/6)

Lexington Herald Leader: Call On Congress To Adequately Fund Global-Health Programs
This week, the U.S. Senate is expected to make some serious decisions on funding levels for global health programs. Majority Leader Mitch McConnell is even on the key subcommittee. Such foreign assistance — less than one percent of the total U.S. budget — was cut by 32 percent in President Donald Trump’s first budget request. Our elected officials need to hear from the American people — and especially Americans of faith — advocating for helping those most in need, especially in fighting devastating epidemics. Voters’ expressions of support for global health could then help sustain U.S. leadership in the 2018 appropriations bills, a process which has markedly reduced the scourges of AIDS, TB and malaria over the past 15 years. (Josh Rouse, 9/5)