KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Kaiser Health News Original Stories

Crippling Medicaid Cuts Could Upend Rural Health Services

Patient advocates say that the Senate Republicans’ proposal to change federal funding for Medicaid could lead to more shutdowns of rural facilities, reduced payments to doctors and fewer programs for people with health needs or disabilities. (Virginia Anderson, 7/11)

Political Cartoon: 'Means Test?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Means Test?'" by Steve Kelley.

Here's today's health policy haiku:

LIFETIME LIMITS MAY COME BACK

Young and old alike:
Return of lifetime limits
Can limit lifetimes.

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

'We Need To Start Voting': GOP Leaders Press For Progress Even As Divisions Grow Deeper

Senators are back from break after facing angry constituents at home, but they only have three weeks before the upcoming August recess to smooth out disagreements over the proposed health care bill.

Reuters: Healthcare Disagreements Roil U.S. Senate Republicans
With only three weeks left before a summer recess scheduled to stretch until Sept. 5, Senate Majority Leader Mitch McConnell appeared determined to keep trying to find agreement on a partisan, all-Republican bill. If he cannot, he will be faced with giving up on a seven-year Republican promise to repeal the 2010 Affordable Care Act, popularly known as Obamacare - and possibly turning to Democrats for help in fixing problems with U.S. health insurance markets. (Cornwell and Becker, 7/10)

The Associated Press: Senate GOP Leaders Hope For Health Care Vote Next Week
"We need to start voting" on the GOP bill scuttling much of President Barack Obama's health care law, No. 2 Senate GOP leader John Cornyn of Texas told reporters Monday. Some Republicans said a revised version of the bill could be introduced Thursday, and Cornyn said the "goal" was for a vote next week. (Fram and Werner, 7/11)

The Wall Street Journal: Senate Republicans Set Sights On Revised Health Bill
The biggest sticking point in recent days has centered on a provision supported by GOP Sens. Ted Cruz of Texas and Mike Lee of Utah that would allow insurers that sell plans complying with ACA regulations to also sell health policies that don’t. Health analysts say that would likely lower premiums for younger, healthier people, who would buy more limited policies, while causing premiums to rise for people with pre-existing conditions, who would buy the more comprehensive plans that comply with the ACA. (Peterson, 7/10)

The Hill: GOP: Cruz-Lee Proposal Hinges On Budget Score 
Senate Republican leaders say whether they make a controversial conservative change to their healthcare bill depends on the results of an analysis from the Congressional Budget Office. The proposal from Sens. Ted Cruz (R-Texas) and Mike Lee (R-Utah), which is key to winning their support, is currently being analyzed by the CBO. (Sullivan, 7/10)

Modern Healthcare: McConnell Wonders What's The Matter With Kansas On Repeal Bill
No one was terribly surprised that some centrist Republican senators like Maine's Susan Collins balked at backing a bill to roll back Obamacare's coverage expansions, weaken its consumer protections, and slash Medicaid. But what about Sen. Jerry Moran of Kansas, who led the GOP's successful campaign to win control of the Senate in 2014? When a conservative party stalwart like Moran from a deep-red state voices opposition, Senate Majority Leader Mitch McConnell knows he has big trouble ahead in securing the votes of 50 of his 52 GOP colleagues to pass his repeal-and-replace bill. (Meyer, 7/10)

The CT Mirror: GOP Still Trying, But Blumenthal Says Obamacare Repeal In ‘Total Disarray’
The Senate returns from its Fourth of July break this week without a firm strategy on how to move forward on a health care bill that has little public support and has split Republicans. Senate Majority Leader Mitch McConnell is trying to fashion a bill that would win 50 votes, probably all Republican, which would allow Vice President Mike Pence to cast a tie-breaking ballot. (Radelat, 7/10)

Des Moines Register: At Town Meeting Dominated By Health Care, Ernst Says She's Undecided On Senate Legislation
U.S. Sen. Joni Ernst faced a barrage of questions on health care, but offered few firm answers at an early-morning town meeting here Monday. Ernst, a Republican, declined to take a position on the GOP-written health care bill now under consideration in the Senate, telling a crowd of about 150 at the forum and reporters in a press conference afterward that she wanted to see changes to the bill before publicly declaring her support. (Noble, 7/10)

Cleveland Plain Dealer: Ohio Health Care CEOs To Portman: Don't Back The GOP Health Care Proposal
Two days after Sen. Rob Portman announced that he couldn't support the bill advanced by Senate GOP Leader Mitch McConnell, the CEOs of the MetroHealth System, UC Health, Summa Health System, Premier Health and Sisters of Charity Health System sent Portman a joint letter to thank him for his opposition and urge him to "remain steadfast unless our patients - your constituents - and the providers they trust to take care of them are better protected"... The CEOs' letter said Medicaid cuts in the bill would harm low-income communities in Ohio and their medical providers. (Eaton, 7/10)

Houston Chronicle: Health Care Protesters Target Cruz, Republicans In Capitol Hill Demonstrations 
Police arrested 80 health care protesters Monday at more than a dozen offices around the U.S. Capitol, including several who laid down and tried to block the doorway to the offices of Texas U.S. Sen. Ted Cruz. Several were detained after a group entered Cruz's office in the Senate's Russell building and stood chanting for about 15 to 20 minutes, according to congressional staffers who witnessed the incident. There were no reports of violence, but officers were seen carrying at least one protester out of the building. Others were led out in plastic cuffs. (Diaz, 7/10)

GOP May Unveil New Health Bill This Week

But some lawmakers are skeptical of the ambitious timeline.

Bloomberg: Revised Health-Care Plan To Be Unveiled This Week In Senate 
Senate Republican leaders plan to unveil a revised version of their health-care bill later this week after making little progress on winning over party holdouts. GOP leaders will hold a vote on the measure next week, John Cornyn of Texas, the No. 2 Senate Republican, told reporters on Monday. They haven’t said publicly how they’re planning to change the proposed legislation to win more support. Senate Majority Leader Mitch McConnell has been negotiating with his Republican colleagues over revisions to a bill he proposed last month that combines tax cuts with deep reductions in health spending. (Litvan, 7/10)

Roll Call: Senators Skeptical Of Leadership Health Care Timeline
But some Republicans appear skeptical of that timeline. “We’re going to want to see the amendments, and we’re also going to want to make sure that we have a chance to see what the score is and understand it. And then also, we’re going to want to be able to talk to people in the industry,” Sen. John Hoeven of South Dakota told reporters. “It’s going to take some time to work through that and understand that.” (Williams, 7/10)

CQ Roll Call: Senate GOP Aiming For Health Care Vote Next Week
Republicans are weighing a number of different changes to the legislation to appease both flanks of the caucus. While conservatives have called for insurance policies that don’t meet the health law’s requirements to be sold on the individual exchanges, moderates are seeking to mitigate cuts to Medicaid and provide more generous tax credits than the original draft to help individuals afford insurance, among other potential changes. (McIntire, 7/10)

USA Today: Senate Health Care Bill: Republicans Aim To Vote Next Week
When asked about a timeline for a new draft bill, McConnell’s spokesman David Popp was more vague. “I don't have any expectations of an exact bill release date, but the Leader said over the past couple weeks that a (Congressional Budget Office) score is forthcoming,” Popp told USA TODAY. The nonpartisan CBO analyzes costs and impacts of legislation and is reviewing changes to the draft health care bill Republicans are floating in hopes of winning support from more senators. (Collins, 7/10)

The Hill: Senate GOP To Get Briefing On Healthcare Bill Changes Tuesday 
Senate Republicans are scheduled to be updated on legislation repealing and replacing ObamaCare during a closed-door caucus meeting on Tuesday. "We're supposed to find out more at lunch," GOP Sen. Shelley Moore Capito (W.Va.) told reporters, after saying she wasn't able to comment on any changes made to the bill during the July Fourth recess.  (Carney, 7/10)

Atlanta Journal-Constitution: CBO Did Use Outdated Data In Scoring Health Bill
White House Legislative Affairs Director Marc Short said recently that the CBO is counting millions of nonexistent people in its estimate of the number of Americans who stand to lose insurance coverage under the Senate’s proposed health care bill. Short’s claim is a variation on a recent Republican talking point: The CBO report did not use its most recent baseline estimates when scoring the Senate health care bill. (Carroll, 7/11)

Trump: 'I Cannot Imagine Congress Would Dare To Leave Washington' Without A Health Bill

President Donald Trump pressured lawmakers on Monday to make progress on their proposed legislation before the looming August recess. Meanwhile, Vice President Mike Pence backs the idea that Congress should pass a repeal bill first if lawmakers can't reach an agreement on their plan.

The Hill: Pence Endorses Repeal And Delay Strategy On ObamaCare
Vice President Mike Pence on Monday said congressional Republicans should pass a “repeal only” bill if they can’t come to a consensus on legislation to replace ObamaCare. “If they can’t pass this carefully crafted repeal and replace bill — do those two things simultaneously — we ought to just repeal only,” Pence said in an interview with Rush Limbaugh. (Weixel, 7/10)

Democrats Turn To Unlikely Allies To Stop GOP's Health Plan: Republican Governors

The concerns of Republican governors from states that expanded Medicaid over the GOP proposal to roll back expansion provide an opening for Democrats to put their money where their mouth is when it comes to bipartisanship.

The Washington Post: Senate Democrats Seek New Allies In Effort To Scuttle Obamacare Overhaul: Republican Governors
Senate Democrats have identified potential new allies in their effort to scuttle the current health-care proposal: Republican governors, particularly those who helped expand Medicaid in their states under the Affordable Care Act. Sen. Thomas R. Carper (Del.), who is leading the effort with the support of fellow Democrats, called “a couple dozen” senators and governors from both parties over the recess, he said in an interview, to say “this is a good time for us to hit the pause button in the Senate, and step back and have some good heart-to-heart conversations” about how to revise the 2010 law. (Eilperin, Sullivan and O'Keefe, 7/10)

The Washington Post: Kaine Lobbies Against Republican Health-Care Plan
With the Republican health-care bill facing an uncertain fate, Sen. Tim Kaine (D-Va.) on Monday addressed the potential effects of the legislation on children with complex medical conditions who rely on Medicaid — an effort to shame GOP members of Congress into compromise. “It’s important that we share stories about what Medicaid really does,” Kaine said before convening a roundtable discussion with parents of children with disabilities and health-care providers on Northern Virginia Community College’s Medical Education campus. “For many, Medicaid is about enabling them to live more independently, enabling them to be more successful in school.” (Olivo, 7/10)

Marketplace

After Months Of 'Death Spiral' Hand-Wringing, Marketplaces Have Most Profitable First Quarter Ever

Total profits in 2017 will probably be lower than the first-quarter numbers suggest though, because Q1 earnings are typically higher than subsequent quarters. In other news, Democrats ask Senate Majority Leader Mitch McConnell to take steps to help stabilize the marketplace, while officials announce that 38 percent fewer insurers applied to sell on the federal Affordable Care Act exchange for 2018.

The Washington Post: Obamacare Marketplaces Just Had Their Most Profitable First Quarter Ever
Insurers in the Affordable Care Act marketplaces earned an average of nearly $300 per member in the first quarter of 2017, more than double what they earned in a similar period in the marketplaces’ previous three years, according to new analysis by the Kaiser Family Foundation. That figure puts insurers on track to make a profit in the marketplaces after years of losses, according to Cynthia Cox, a researcher at the Kaiser Family Foundation who worked on the analysis. (Soffen, 7/10)

McClatchy: New Report Finds Obamacare "Death Spiral" Greatly Exaggerated
For months, Republican leaders from President Donald Trump and Health and Human Services Secretary Tom Price to House Speaker Paul Ryan have said Obamacare was crumbling under its own weight and could not be saved. And this week, when HHS announced a 38 percent decline in the number of insurers that want to offer coverage next year in states that use the federal marketplace, Price said, “The situation has never been more dire.” But new research released Monday by the Kaiser Family Foundation shows that profitability and other financial measures for individual insurers have dramatically improved over the last year. (Pugh, 7/10)

The Hill: Dems To McConnell: Work With Us To Stabilize Health Insurance Market 
Top Senate Democrats are urging Majority Leader Mitch McConnell to take up legislation stabilizing the healthcare insurance market after the Kentucky Republican warned senators would need to act if the GOP's ObamaCare repeal bill fails. Sens. Charles Schumer (N.Y.), Dick Durbin (Ill.), Patty Murray (Wash.) and Debbie Stabenow (Mich.) — the top four Democrats in the Senate — sent McConnell a letter on Monday asking him to "focus on immediately advancing policies" to stabilize the market. (Carney, 7/10)

Morning Consult: Senate Democrats Want McConnell To Work With Them On Health Care
Democratic leaders are urging Senate Majority Leader Mitch McConnell to work with them to bolster the nation’s health insurance marketplaces, as lingering disputes among Senate Republicans threaten to derail the GOP effort to overhaul the Affordable Care Act. In a letter sent Monday, as the Senate returned from a weeklong recess, Senate Minority Leader Chuck Schumer and other top Democrats highlighted several Democratic bills to improve the exchanges created under Obamacare. (Reid, 7/10)

USA Today: Feds Tout Data On Declining Number Of Obamacare Insurers, As Finger Pointing Continues
Federal officials announced Monday that 38% fewer insurers applied to sell on the federal Affordable Care Act exchange for 2018 and used the negative news to renew their pitch to repeal the law. Healthcare.gov is used by the 30 states that don't have their own exchanges. Governors of states that didn't set up exchanges generally opposed the law, while states including California and New York set up their own exchanges have considerably more competition. (O'Donnell, 7/10)

And —

Modern Healthcare: With BCRA Vote Looming, HHS Seeks Comments On Market Stabilization 
HHS is seeking information on how to make the healthcare system more patient-centric by, among other things, encouraging consumer choice in selecting insurance plans. The comment period opened in June in response to President Donald Trump's executive order aimed at easing any economic or regulatory burdens caused by the Affordable Care Act. (Arndt, 7/10)

CQ Roll Call: Trump, House Oppose Intervention In Key Obamacare Challenge
The House and the Trump administration told a federal appeals court Monday that attorneys general from 15 states and the District of Columbia should not be able to intervene in a high-profile lawsuit over 2010 health care law subsidy payments to insurers. The House originally sued the Obama administration over the appropriations process for the so-called cost-sharing subsidies that help especially low-income people afford the co-pays, deductibles and other out-of-pocket costs associated with their health insurance policies. (Ruger, 7/10)

Pioneer Press: Surprise! State Insurance Relief Program Coming In Way Under Budget
Minnesota taxpayers are getting a happy surprise: an expensive new state program is coming in massively under budget. The program in question is a $310 million plan to give 25 percent rebates to eligible Minnesotans’ health insurance premiums. It was passed in January amid estimates that more than 120,000 people might get state-funded discounts. Through the end of April, however, only around 95,000 Minnesotans per month had received the discounts. The total bill through the first third of the year: $46.9 million. If that rate continues for the rest of 2017, the state would only spend $140 million, less than half the projected $310 million cost. (Montgomery, 7/10)

Medicaid

Despite Common Rhetoric That Medicaid Offers Subpar Coverage, Beneficiaries Are Pretty Happy With It

In a new survey, more than 270,000 people covered by Medicaid in 46 states rate their health care at an average of 7.9, and nearly half of the respondents give Medicaid a 9 or 10, with 10 being the best possible score. Meanwhile, media outlets look at how the Republicans' proposed cuts would affect people across the country.

The Washington Post: Republicans Say Medicaid Is ‘Broken.’ Here’s How The People It Covers Feel.
Politicians call the Medicaid program that provides health care for the poor "broken." Academic studies have reported on its limited health benefits or the longer appointment wait times that people with Medicaid face. But as Republicans feverishly work to revise a health-care bill that would trigger deep cuts to the program over time, a massive new survey reveals that people enrolled in Medicaid rate their health care pretty high. (Johnson, 7/10)

NPR: Medicaid Beneficiaries Are Happy With Care
Is Medicaid the best health care possible? A lot of people who use it seem to think so. A new study released by Harvard's Chan School of Public Health shows that people enrolled in Medicaid are overwhelmingly satisfied with their coverage and care. (Kodjak, 7/10)

Chicago Tribune: Mother Of 6-Year-Old Cancer Patient Thankful For Medicaid, Fearful For Its Future 
Six-year-old Jamela Anthony — wearing a black shirt proclaiming "I Kicked Cancer's Butt" — ran through a hallway at Lurie Children's Hospital toward a golden bell. She rang it triumphantly, smiling before her mother scooped the tiny girl into a long, tight hug. Jamela rang it, a tradition at Lurie, to mark the end of chemotherapy more than a year after doctors found a type of rare, aggressive tumor on her spinal cord. She's now in remission. Jamela's mother, Tangela Watson, is thankful for her daughter's remission and that Medicaid, a state- and federally-funded health insurance program, covered the costs of Jamela's care. (Schencker, 7/10)

The Washington Post Fact Checker: McConnell’s Claim That Senate GOP Health Bill Would Not ’Cause Anyone Currently On Medicaid To Come Off It’
A reader asked us to fact-check this claim, reported in an article by the West Kentucky Star about a luncheon speech McConnell delivered in Kentucky during the Fourth of July recess. The impact of the Senate GOP health-care bill on Medicaid enrollees and financing is one of the major points of debate in the Senate. Previously, we awarded Three Pinocchios to President Trump’s claim that the Senate proposal, the Better Care Reconciliation Act (BCRA), actually increases Medicaid spending. (Lee, 7/11)

CNBC: Senate's Proposed Medicaid Cuts Could Make Long-Term-Care Unaffordable
If you're heading toward retirement and assume proposed cuts to Medicaid in the Senate's Obamacare replacement bill could never affect you, think again. The Better Care Reconciliation Act includes a $772 billion reduction in Medicaid funding through 2026, and a recent Kaiser Family Foundation report found that 62 percent of all nursing- home residents use Medicaid to pay for it. The study also found that a third of people turning 65 will need nursing-home care at some point. (O'Brien, 7/10)

Kaiser Health News: Millions Of Kids Fall Outside Senate Plan To Shield Disabled From Medicaid Cuts
Aidan Long is a 13-year-old from Montana who has suffered multiple daily seizures since he was 4. The seizures defy medical cure, and some of them continue for weeks, requiring Aidan to be airlifted to children’s hospitals in Denver or Seattle, said his father, Ben Long. The medical bills to Medicaid and his private insurance have been enormous. “I kept track of these until about 2 million bucks, and then I said I can’t spend any more time worrying about it,” his father said. (Rau, 7/10)

Kaiser Health News: Crippling Medicaid Cuts Could Upend Rural Health Services
Each day as Ginger Peebles watches daughter Brenlee grow, she sees the importance of having a hospital close by that delivers babies. Brenlee’s birth was touch-and-go after Peebles realized something was wrong. “I couldn’t feel the baby move, and my blood pressure was sky-high,” said Peebles, a nurse. Dr. Roslyn Banks-Jackson, then an OB-GYN specialist at Emanuel Medical Center in Swainsboro, Ga., diagnosed preeclampsia, a potentially lethal complication of pregnancy, and induced labor to save Peebles and the baby. Brenlee was born on Oct. 28, 2014, completely healthy. (Anderson, 7/11)

WBUR: Maine Family Will Visit D.C. To Fight For Medicaid
Congress has returned from its July recess and continues to debate health care. ... The current bill could deeply impact Medicaid, a government health insurance program for the poor and disabled, cutting $772 billion over the next decade, according to the Congressional Budget Office. (Bailey and Khalid, 7/10)

And in Maryland —

The Baltimore Sun: Making Dental Care More Affordable For The Elderly
Those concerns have prompted the state Department of Aging and Department of Health to explore ways to expand senior citizens' access to dental care. Children from low-income families in Maryland get dental coverage through Medicaid and the Maryland Children's Health Program. Some advocates hope that legislation passed in the General Assembly this year could lead to expanded coverage. Lawmakers agreed to study the possibility of expanding insurance coverage for dental care through Medicaid, the federal- and state-funded insurance program for low-income people. (McDaniels, 7/10)

Veterans' Health Care

In Fiercely Partisan Climate, Veterans Committees Quietly Show How Congress Should Work

Where elsewhere Congress is deadlocked, the Veterans' Affairs Committees keep racking up bipartisan victories.

The New York Times: A Bipartisan Congress That Works? Veterans Committees Show How It’s Done
Magnanimous hearings. Bipartisan votes. Substantial legislation on its way to becoming law. This is Congress? Something strange is happening in the staid hearing rooms of the House and Senate Veterans’ Affairs Committees here this summer, though few have taken notice. As the rest of Congress fights over the health care overhaul and looming budget deadlines, the committees responsible for writing legislation affecting veterans are quietly moving forward with an ambitious, long-sought and largely bipartisan agenda that has the potential to significantly reshape the way the nation cares for its 21 million veterans. It could also provide President Trump with a set of policy victories he badly wants. (Fandos, 7/10)

Administration News

FDA Commissioner Eyes New Drugmaker Rules, Including More Doctor Training On Opioids

Scott Gottlieb says the Food and Drug Administration will start to require that pharmaceutical companies offer more prescriber education for immediate-release opioids, which make up 90 percent of prescriptions.

The Washington Post: FDA Chief To Impose Tougher Doctor-Training Rules On Opioid Manufacturers
Food and Drug Administration Commissioner Scott Gottlieb, stepping up the agency's efforts against the nation's opioid epidemic, announced plans Monday to require manufacturers of painkillers to provide more extensive education for physicians and other health-care professionals who prescribe the drugs. In remarks that opened a two-day FDA meeting on painkiller abuse, Gottlieb said the agency will now require makers of immediate-release opioids to provide prescriber training. These formulations, which account for 90 percent of the opioids prescribed in the United States, include hydrocodone as well as oxycodone/acetaminophen combinations. (McGinley, 7/10)

The Wall Street Journal: FDA Commissioner Seeks New Standards For Some Opioid Prescriptions
“It’s time to take direct action to address the close to 200 million opioid analgesic prescriptions each year that are for the immediate release products,” the commissioner said. “The new training will be aimed at making sure providers who write prescriptions for the IR opioids are doing so for properly indicated patients, and under appropriate clinical circumstances.” (Burton, 7/10)

Bloomberg: FDA Chief Says Agency Must Do More To Stop Abuse Of Opioids 
The U.S.’s top drug regulator said on Monday that more must be done to stem the country’s tide of opioid addiction, proposing new guidelines and restrictions on some of the most widely used pain pills. Food and Drug Administration Commissioner Scott Gottlieb laid out plans to have drugmakers conduct doctor education programs on immediate-release opioids, which account for 90 percent of the 200 million opioid painkiller prescriptions written in the U.S. each year. The agency is also exploring whether pain-management training should be required for doctors as well as nurses, pharmacists or other health-care providers. (Edney, 7/10)

Politico Pro: FDA Takes Steps Toward Mandating Opioid Training For Docs
The FDA on Monday required that all immediate-release opioids come under a special safety regime known as a risk evaluation and mitigation strategy. Manufacturers will be required to make training available for health professionals who prescribe the drugs and patients will get counseling documents on how to safely use the powerful pain medications. (Karlin-Smith, 7/10)

And in other news on the opioid epidemic —

Modern Healthcare: Scramble Is On To Find New Ways To Stop Opioid Overdose Deaths 
Last April, after a paramedic helped a colleague's relative get treatment for his addiction, the city launched the Safe Station Program. Now, all 10 of Manchester's firehouses are a safe haven where people struggling with addiction can seek assistance. Paramedics are available 24 hours a day, 7 days a week, to conduct a full medical evaluation before transporting the patient to a local hospital's emergency department or a treatment facility. (Johnson, 7/10)

Pharmaceuticals

After Trump Meets With Pharma CEO, FDA Yanks Request For Company To Run Additional Drug Trial

Instead, Amicus Therapeutics gets the go-ahead by the agency to submit its treatment of a deadly rare disease for review. Meanwhile, a new analysis finds that there is only limited room for improvement in terms of the agency's speed for approving drugs.

Stat: FDA Reverses Course On Drug Developed By CEO With Ties To Trump
The Food and Drug Administration has changed its tune on an experimental drug for a deadly rare disease, withdrawing a request that the company developing it run another clinical trial. The unusual move comes after President Trump met with the company’s CEO —and promised to speed up what he called a “slow and burdensome” process for drug approvals. Amicus Therapeutics, a New Jersey biotech company, announced on Tuesday morning that the FDA had given it the all-clear to submit for review its treatment for Fabry disease, an inherited disorder that often leads to fatal organ damage. (Garde, 7/11)

Stat: Does The FDA Need Pep Pills To Review Drugs Any Faster?
After examining all 15 drugs approved between 2011 and 2015 by the cardio-renal division — purportedly, the slowest of FDA divisions — a pair of researchers believe there is “limited opportunity” to speed approvals by reducing the time taken for agency reviews and decision making. Instead, the authors suggested that drug makers could move more quickly to prepare applications.The analysis, which was published in BMJ, was undertaken in response to criticism the FDA is too slow to approve medicines, even though studies have found the agency compares favorably with regulators elsewhere. (Silverman, 7/10)

And in other news about the agency —

CQ Roll Call: House Expected To Vote On FDA Bill Wednesday
The House is expected to vote Wednesday on an updated version of a key Food and Drug Administration reauthorization bill, according to a congressional aide and multiple lobbyists. The House Energy and Commerce Committee on Monday evening released an updated version of the bill (HR 2430) that incorporated amendments adopted during a June 7 markup, as well as other changes. (Siddons, 7/10)

Women’s Health

Architects Responsible For Reversing Contraception Rule Draw On Experience Honed On Ideological Battlefield

Katy Talento and Matthew Bowman have been waging this campaign for years. Now they have the chance and the power to actually roll back the regulation they hate so much.

The New York Times: Foes Of Obama-Era Rule Work To Undo Birth Control Mandate
From the obscure perch of a backbench senator’s office, Katy Talento used to warn against what she saw as the health hazards of birth control pills — cancer, infertility and miscarriage. From his post at a Christian legal advocacy group, Matthew Bowman spent years attacking the requirement that most health insurance plans cover contraception under the Affordable Care Act. Now on the inside — one at the White House, the other at the Department of Health and Human Services — Ms. Talento and Mr. Bowman have a clear path to prosecute their strong belief that birth control coverage should not be a mandate from Washington. (Pear, 7/10)

In other women's health news —

The Washington Post: Can Less Invasive Uterine Fibroid Treatment Improve Fertility?
Women who are unable to conceive because of uterine fibroids may have an easier time getting pregnant after minimally invasive procedures to destroy the fibroids, a recent study suggests. For the study, researchers followed 359 women for an average of almost six years after they had what is known as uterine fibroid embolization, a procedure in which doctors destroy fibroids by blocking the arteries supplying them with blood. By the end of the study, 149 of the women, or 42 percent, had become pregnant one or more times, and 131 women had a total of 150 live births. (Rapaport, 7/10)

The New York Times: Are There Long-Term Risks To Egg Donors?
When patients consider a medical procedure, they may be told “there are no known long-term effects.” But unless such effects have been systematically studied, that does not mean there are no long-term effects. That’s a major concern for Dr. Jennifer Schneider, mother of a three-time egg donor, Jessica Grace Wing. Ms. Wing was a tall, lean, attractive, athletic and musically talented Stanford University student when she decided to donate her eggs to help pay for her education. Through her multiple donations, five healthy children were born to three formerly childless families. (Brody, 7/10)

Public Health And Education

Your Morning Cup Of Joe Is Actually Beneficial To Your Health, New Studies Find

Two massive studies show that a few cups of coffee a day won't hurt you and, in fact, lowers risk for dying prematurely.

Los Angeles Times: Two Big Studies Bolster The Claim That Coffee – Even Decaf – Is Good For You
If you’re the type of person who needs at least one cup of coffee to get out of the house in the morning and a few more to make it through the day, you might think the best thing about java is that it keeps you awake. But new research suggests that’s just a bonus. The best thing about your coffee habit might be that it extends your life by reducing your risk of death from heart disease, diabetes or even cancer. (Kaplan, 7/10)

Stat: Drink Coffee? It Won't Hurt You, And May Reduce Your Risk Of An Early Death
“Our results suggest that moderate coffee drinking, up to about three cups a day, is not harmful to your health, and that incorporating coffee into your diet could have health benefits,” said Neil Murphy, of the World Health Organization, a lead author on one of two studies published Monday in the Annals of Internal Medicine. “[We] found no evidence that coffee drinking above a certain level is detrimental to health.” (Blau, 7/10)

Scientists Stumble Upon Potential Vaccine For Gonorrhea At Best Possible Time

In an era where the sexually transmitted disease is becoming increasingly difficult to treat because of antibiotic resistance, researchers find that a vaccine for meningitis may also protect against gonorrhea. In other public health news: cervical cancer, sunscreen, double-booked surgeons, brain training, pigs' knees and more.

Stat: Vaccine Shows Protection Against Gonorrhea For First Time, Study Says
Finally, the world might be catching a break when it comes to drug-resistant gonorrhea. A new study suggests that a vaccine that protects against a strain of meningitis may also ward off the sexually transmitted infection. The research, conducted in New Zealand, found that the gonorrhea rate among teens and young adults there who had received a meningitis B vaccine during an emergency campaign in the early 2000s was significantly lower than the rate seen in people of the same age who weren’t vaccinated. (Branswell, 7/10)

Stat: Fewer Pap Screenings Mean More Cases Of Undiagnosed Chlamydia
When, a handful of years ago, the U.S. and Canada changed their screening guidelines for cervical cancer, it was an acknowledgment that screenings for young women carried unintended harms. However, a new study shows they also carried unintended benefits. As Pap screenings for women under 24 became less frequent in Ontario in 2012-2014, fewer cases of the bacterial infection chlamydia were caught — putting women at risk of potentially serious consequences. (Caruso, 7/10)

Stateline: Why More States Are Getting Serious About Sunscreen
Like ibuprofen or hay fever medication, sunscreen is considered an over-the-counter drug by the U.S. Food and Drug Administration, and therefore by almost all schools. That means kids can’t bring it to school without a doctor’s note, and even then must see the school nurse in order to use it. The result: Teachers leading a sunny field trip are free to cover themselves in a thick protective layer of sunscreen. But in most states, children can’t follow suit. In Indianapolis, for instance, kids go back to school July 31 — the height of summer — but they must have a doctor’s note to bring sunscreen to school, and visit the school nurse to put it on. (Moore, 7/11)

The Washington Post: Brain-Training Games Don’t Really Train Brains, A New Study Suggests
The first large study to rigorously examine brain-training games using cognitive tests and brain imaging adds to evidence that they are not particularly good at training brains and appear to have no more effect on healthy brains than video games. The study is another blow to companies such as Lumosity that have been accused of falsely claiming their programs can improve mental performance. (Gallegos, 7/10)

The Washington Post: New Drug Used On Mice Could Hold Potential For Traumatic Brain Injury.
For the first time, scientists have reversed memory and learning deficits in mice following traumatic brain injuries. This new research could someday lead to treatments for head trauma and debilitating cognitive diseases. More than 2 million Americans with traumatic brain injury (TBI) are seen in hospital emergency rooms every year. Millions more skip a hospital visit despite suffering a head injury that could cause lasting damage, according to researchers. (Gallegos, 7/10)

Stat: Turning To Pigs' Knees In The Quest To Delay Joint Replacements
Here in this hotspot for unregulated stem cell clinics, you don’t have to drive far to find a doctor offering unproven treatments for a bum knee involving stem cells derived from a patient’s own fat. In his lab here at the University of Southern California, Dr. Denis Evseenko wants to tackle knee problems with stem cells, too — but he’s a world away in his philosophy. He’s taking a stab at something much more ambitious. And he’s doing it by the book. (Robbins, 7/11)

Sacramento Bee: Trying To Eat Less Meat? You’re A Reducetarian
At the Reducetarian Foundation, Kateman and Alterman encourage people to eat less meat and remind people that vegans, vegetarians and reducetarians all share many of the same concerns about climate change, biodiversity loss, animal welfare and human health. It’s far easier, however, to imagine a meatless world once people have been successful at going without meat, Kateman said. (Anderson, 7/10)

Boston Globe: Study Eyes Sugary Beverage Intake During Pregancy
The children of mothers who consumed sugary drinks during their second trimester had a higher weight status than children of mothers who avoided the beverages, according to a study by Massachusetts researchers published Monday in the journal Pediatrics. For each additional serving per day, the child would weigh about half a pound more by age 8. (Feiner, 7/10)

Stat: This Doctor Helped Inspire A Controversial Netflix Movie About Anorexia
At age 78, Dr. Richard MacKenzie is having his Hollywood moment.He’s the physician who helped inspire a controversial Netflix movie about anorexia, “To the Bone,” which begins streaming on Friday. The film was written and directed by one of his former patients, Marti Noxon. She has credited MacKenzie with helping her overcome her struggles with anorexia and bulimia. (Robbins, 7/11)

State Watch

State Highlights: Cigarette Sales Plummet As Calif. Tax Goes Into Effect; Minn. Health Department Requests Special Funds To Fight Measles Outbreak

Media outlets report on news from California, Minnesota, Illinois, Texas, Tennessee, Wisconsin, Kansas and Ohio.

San Jose Mercury News: Early Returns Suggest Smoking Drop In Response To State Tax
Cigarette pack “distributions”—tax lingo for a pack of cigarettes typically sold from a distributor to a retailer, and a good proxy for consumption—dropped 56 percent year-over-year in the two months following the tax increase, according to data obtained from the California Department of Tax and Fee Administration and analyzed by CALmatters. That’s a decline of nearly 82 million packs. (Levin, 7/10)

USA Today: Chicago Becomes Latest Battleground Over Soft Drink Taxes
Chicagoans are getting a break when it comes to paying a soft drink tax -- but it may not last. A penny-an-ounce soda pop tax was slated to take effect on July 1, but its imposition was put off by a local judge after the state retail merchants association and a group of local grocers challenged its legality. On Tuesday, the judge is expected to set a date for a hearing. (Meyer, 7/11)

California Healthline: Blue Shield Improperly Denied Mental Health, Drug Treatment Claims, Suit Alleges
Blue Shield of California and its claims administrator wrongly restricted patients’ access to outpatient and residential mental health treatment, a class-action lawsuit says. Initially filed in the U.S. District Court for the Northern District of California, the complaint comes from two parents who allege their teenage children were repeatedly denied coverage under their employer-based plans despite serious mental and substance abuse problems. In June, a federal district judge granted a request for class-action status, meaning that patients whose claims were rejected under similar circumstances may join as plaintiffs. (Korry, 7/11)

Houston Chronicle: Health-Care Turmoil Brings Leadership Turnover In Houston, Across US 
After Michael Covert submitted his resignation as CEO of the St. Luke's Health System last month, the initial announcement came not from his Houston bosses, but from the Colorado headquarters of its owner, Catholic Health Initiatives. The internal email, sent to Catholic Health CEOs around the nation and absent customary expressions of thanks, widely was interpreted as evidence the move was driven by the national office, unhappy about St. Luke's multimillion-dollar losses. (Ackerman, 7/10)

Nashville Tennessean: Nashville's Metro Council Kills Latest Attempt To Cut Lifetime Health Benefits
For the fourth time in five years, a committee in Nashville's Metro Council voted last week to keep intact the city's controversial policy that gives lifetime health benefits to former council members, killing a plan to cut the generous perk. At-large Councilman Bob Mendes introduced an ordinance to reduce Metro's subsidy for lifetime health insurance that is reserved for former two-term council members after they leave office. But against his will, the council's Budget and Finance Committee last Wednesday voted to indefinitely defer the legislation, effectively killing the bill before it went to the full council. (Garrison, 7/10)

Kansas City Star: Children's Mercy To Bring Social Workers To Blue Valley Schools
Starting this school year, 19 masters-level social workers and one supervisor hired by Children’s Mercy will begin work at Blue Valley schools. The partnership marks a new venture for a hospital system interested in expanding its school-based services in the community, as well as a beneficial hiring solution for a school district that hosts 22,000 students but has only employed around a half dozen school social workers in the past decade. (Bergen, 7/10)

Sacramento Bee: Homeless Population Rises Sharply In Sacramento And Suburbs
The number of unsheltered homeless in the county skyrocketed by 85 percent in recent years, making up nearly half of the increase in overall numbers. About 800 of those are chronically homeless, meaning they have been homeless for more than a year or have had multiple bouts of homelessness in the past three years, and have a mental, physical or developmental disability that keeps them from working. (Chabria, Hubert, Lillis and Garrison, 7/10)

Columbus Dispatch: Ohio Marijuana Sellers Face High State Fees To Run Business
Potential medical marijuana dispensary owners in Ohio will have to shell out some green to sell some green if the latest round of suggested dispensary fees become law. Prospective business owners may have to pay more than $75,000 in state fees, and that’s before factoring in costs of a storefront, product or employee salaries. (Keiper, 7/11)

Editorials And Opinions

Opinions On Opioids: Reducing Medicaid Won't Help; Call On Pharmacists And Dentists

A selection of of opinions from around the country on the drug abuse epidemic and other topics.

Los Angeles Times: Slashing Medicaid Is Probably The Worst Way To Fight An Opioid Addiction Epidemic
Most readers know by now that deep cuts to Medicaid over the next decade are a central feature of the healthcare reform proposal before the U.S. Senate this week — and a terrible policy that would put health coverage out of reach for millions of Americans. But here’s yet another reason why senators should think twice about voting for the Better Care Reconciliation Act: Doing so would pull the rug out from under those fighting to stop the raging opioid epidemic. (7/11)

Morning Consult: Time To Put Limits On Opioid Prescribing
Last year the Centers for Disease Control and Prevention issued guidelines for prescribing opioids for chronic pain. That was definitely a step in the right direction, but those guidelines only addressed chronic pain and not short-term, acute uses for pain medication. And an individual pharmacist is not empowered to enforce these voluntary prescribing guidelines. As a leading stakeholder in pharmacy care, we believe it is time to institute limits on the quantity of opioids dispensed to patients who are receiving an opioid for the first time — and to ensure that the prescription fits the medical condition. (Larry J. Merlo, 7/11)

The New York Times: Breaking The Opioid Habit In Dentists’ Offices
Dentists and oral surgeons are by far the major prescribers of opioids for people ages 10 to 19. That’s an age when the growing brain, which doesn’t mature until 25, is particularly susceptible to being taken over by opioids — even if the dosage seems too small to produce addiction. In fact, even very short-term prescriptions have been associated with later drug misuse among teens who have not used illegal drugs before. (Tina Rosenberg, 7/10)

San Jose Mercury News: Drug Companies Opioids Experiment Backfires
Amid broad efforts to help people avoid prescription-opioid addiction, some pharmaceutical companies are taking an intriguing approach: making prescription opioids that can’t be misused. Although the tactic may at first blush seem a miracle cure, it has a decidedly mixed record of success. (Keith Humphreys, 7/10)

And on other health care topics —

The New York Times: Health Plans That Nudge Patients To Do The Right Thing
As health care costs rise, Americans are increasingly on the hook to pay more for their care. This trend is more than just annoying — asking consumers to pay more for everything deters many from getting the care they need. What would happen if, instead, health plans offered more generous coverage of high-value care, but less generous coverage of those services that provide little or no health benefit? (Austin Frakt, 7/10)

Los Angeles Times: The State Shouldn't Get To Decide If Your Baby Lives Or Dies.
Charlie Gard’s parents are doing the wrong thing — and I’d probably do it too. Charlie Gard, if you haven’t heard, is the 11-month-old baby whose plight has become a popular cause in England and, increasingly, the United States. ... A doctor in the United States reached out and suggested a treatment called nucleoside therapy. To call this treatment unproven and experimental is a bit of an understatement. (Jonah Goldberg, 7/11)

The New York Times: Doctors With Disabilities: Why They’re Important
More than 20 percent of Americans — nearly 57 million people — live with a disability, including 8 percent of children and 10 percent of nonelderly adults. And while the medical profession is devoted to caring for the ill, often it doesn’t do enough to meet the needs of the disabled. People with disabilities are less likely to receive routine medical care, including cancer screening, flu vaccines and vision and dental exams. They have higher rates of unaddressed cardiovascular risk factors like obesity, smoking and hypertension. (Dhruv Khullar, 7/11)

The Washington Post: A New Report Shows Just How Far D.C. Has Come In Fighting HIV/AIDS
D.C. officials in 2009 reported that the HIV rate in the nation’s capital was higher than that of West Africa. “On par with Uganda and some parts of Kenya” was the grim assessment of the director of the city’s HIV/AIDS Administration. Just how far the city has come in fighting the disease since that alarm was sounded eight years ago was reflected in a new report chronicling the ninth consecutive year in which the number of new HIV cases has decreased. (7/10)

Stat: Go Ahead And Hit 'Record' In The Doctor's Office
Many patients say they want to record clinical encounters. Doing this can lessen the anxiety of trying to remember and understand what was said. Most patients who are given a recording of a clinical visit share it with loved ones, suggesting that recordings can help patients better engage their support networks. ... But doctors worry that recordings could undermine trust between them and their patients. Will patients be candid about health behaviors, including sex and drug use, if the conversation is recorded and potentially discoverable by others? Doctors also worry that recordings could be used against them in malpractice suits, or made public in some way. (Tim Lahey and Glyn Elwyn, 7/10)

Viewpoints On Health Law: GOP's Time Crunch; The Need -- And Strategy -- For Bipartisanship

Opinion writers offer their analysis of the ongoing debate on Capitol Hill over health care.

The New York Times: Congress Is Facing A Time Crunch To Repeal Obamacare
Mitch McConnell, the Senate majority leader, told his Republican colleagues that they needed to vote on their health bill before the July 4 holiday — then he gave them an extension. But don’t expect the health care debate to drag on forever. There are legal and political reasons that Republicans really do need to decide in the next few weeks whether their legislative effort will succeed or go back on the shelf. (Margot Sanger-Katz, 7/10)

Vox: McConnell Should Let The Senate Try To Craft A Bipartisan Health Bill
"Either Republicans will agree and change the status quo or the markets will continue to collapse and we'll have to sit down with Senator Schumer," McConnell warned. ... This is the opposite of how legislative efforts are typically constructed. Usually you try for a bipartisan outcome first and resign yourself to a partisan outcome only if that fails. McConnell has reversed this structure. A partisan bill is his preferred result, and a bipartisan process is his threatened fallback. Welcome to American politics in 2017. (Ezra Klein, 7/10)

The New York Times: Health Reform, Both Real And Conservative
The American health care system has two core problems. It’s the world’s most expensive, and it still leaves many people uninsured. Congressional Republicans have not tried to solve either problem. They have instead offered a plan that cuts spending on the middle class and the poor, funnels the money into a tax cut for the affluent and masquerades as health policy. (David Leonhardt, 7/11)

Huffington Post: Why A Bipartisan Health Care Bill Might Make Sense — For Republicans
When [Senate Majority Leader Mitch McConnell] raised the possibility of bipartisanship last week during a town hall meeting, he seemed to be wielding it as a threat ― a warning, to reluctant members of his caucus, that failing to coalesce behind leadership’s bill to repeal the Affordable Care Act would be tantamount to failure. The threat might work. For all the talk about the Senate bill being on “life support,” and despite poll numbers that suggest it is the most unpopular piece of legislation in three decades, the bill remains just a few votes short of the 50 it needs to pass. (Jonathan Cohn, 7/10)

Milwaukee Journal Sentinel: Can We 'Delight In Compromise' Once More?
As the Senate Republican majority struggles to coalesce around a replacement for Obamacare, Majority Leader Mitch McConnell is using a novel threat to motivate them: Pass something or, horrors, negotiate with the Democrats. On Capitol Hill, what should be common sense — working together to solve common problems — now exists only as a cudgel to batter lawmakers into passing unpopular legislation. (7/10)

Los Angeles Times: More Evidence Shows Obamacare Is Getting Healthier, But Will That Stop The GOP Wrecking Crew?
Data in a new report issued Monday confirms that the Affordable Care Act market stabilized in the first quarter of this year, becoming more profitable for insurers offering individual policies. That’s good news for the millions of Americans who depend on Obamacare for their health coverage. But it may be bad news for congressional Republicans whose insistence that the ACA marketplace is collapsing in a “death spiral” undergirds their efforts to repeal the law. (Michael Hiltzik, 7/10)

USA Today: Senate GOP Health Bill Preserves Medicaid. The Math Proves It.
In 1994, President Clinton declared, “We all now, looking ahead, know that our number one entitlement problem is Medicare and Medicaid. They are growing much more rapidly than the rate of inflation plus population.” At that time Medicaid was just 5.6% of the federal budget, according to the Office of Management and Budget. Now it is 10% of the federal budget and growing. The Republican Medicaid reform plan builds on exactly the point President Clinton was making. It contemplates reducing the growth rate of Medicaid reimbursements by the federal government to the rate of overall inflation plus the growth in the number of Medicaid beneficiaries. Only in the never-never land of Washington budget accounting and the news media’s reporting on it would something that grows with both inflation and population be considered a “cut.” (Pat Toomey and Lawrence Lindsey, 7/10)

The Washington Post: Why Replacing Obamacare Is So Hard: It’s Fundamentally Conservative
In crafting their health-care plan, Republicans have come to the uncomfortable realization that there simply isn’t much room to the political right of Obamacare for a policy that covers as many people with high-quality insurance. Furthermore, many have realized that there isn’t much political will for a bill that covers meaningfully fewer people or that places low-income individuals in insurance plans with cost-sharing elements they can’t afford. (Craig Garthwaite, 7/10)

Real Clear Health: Senate Obamacare Debate Is About Money, Not Compassion
A new government report explains why Republicans, after nine years of opposing Obamacare, are having such a hard time repealing it. The answer: It’s pretty much about the money. It’s not about providing Medicaid coverage to low-income adults. Some moderate Republicans who profess concern for the needy are actually trying to shift more of the cost of providing them Medicaid coverage from their states to the federal government. They’re holding out for more federal cash for their states. And they just might get it – from Senate Democrats. (Doug Badger, 7/11)

The Washington Post: C’mon, Republicans. It’s Time To Do The Right Thing On Health Care.
When they went home for the July 4th recess, Republican members of Congress did one of two things: Either they met with constituents and were pummeled with angry questions about their disastrous health-care bill, or they hid out, trying to avoid their constituents so that they wouldn’t be pummeled with angry questions about their disastrous health-care bill. Predictably, support for the bill among Republican senators is slipping away, which is not surprising given that this is the most unpopular piece of legislation in the history of polling. (Paul Waldman, 7/10)

The New York Times: Republicans Take A Hatchet To Health Care
The latest Republican plan to overhaul the health care system would eliminate insurance coverage for millions of their own constituents, which should greatly concern senators who support the bill. An analysis by the Urban Institute shows how states will be affected by the Better Care Reconciliation Act .... The plan will be particularly devastating for the 31 states that expanded Medicaid under the Affordable Care Act. More than 14 million people gained health insurance under the expansion. The legislation would phase out the expansion. (Vikas Bajaj and Stuart A. Thompson, 7/7)