KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Kaiser Health News Original Stories

Zika In America: One Mother's Saga

So far, 72 affected babies have been born in the continental U.S. One young mother, infected in Mexico last year, and her infant face an uncertain future in rural Washington. (JoNel Aleccia, 6/13)

Political Cartoon: 'Tired Out?'

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

Here's today's health policy haiku:


Every day I mean
To walk 10,000 steps — but ...
Some days I just veg.

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

Rank-And-File Senators Kept In Dark As GOP Leaders Claim They Are Getting Close To A Bill

"[T]his is not the best way to do health care, but it’s the way we’re having to do it,” said Sen. Lindsey Graham (R-S.C.). Republicans, though, are trying to rein in expectations about when the vote will come.

USA Today: Obamacare Repeal Drafted Quietly By Senate Republicans
Top Senate Republicans and their staff are plowing ahead with a plan to repeal and replace Obamacare in the hopes of getting legislation on the floor by mid-summer — even if their own GOP colleagues have no idea what the bill will contain. “It’s coming together and there’s a lot of feedback of (Congressional Budget Office) trying to get scores on different policy options ... but it’s coming,” South Dakota Sen. John Thune, the third-ranking Republican in the Senate, told reporters Monday evening. (Collins, 6/12)

Roll Call: Republican Senators Unaware Of Health Care Details
Several Republican senators have no knowledge of the specific policy proposals GOP leadership is weighing for inclusion in the pending legislation to overhaul the U.S. health care system. The lack of widespread knowledge among members about the exact policy under review calls into question whether Republicans will be able to advance a bill before the Fourth of July recess, the timeline that GOP aides say Senate Majority Leader Mitch McConnell is operating under. (Williams, 7/12)

Politico: Senate GOP Reins In Expectations For Killing Obamacare
Senate Republicans are aggressively trying to rein in expectations for their Obamacare repeal effort, wary of blowing a deadline or falling short of 50 votes on a promise that has driven the GOP's political strategy for much of the past decade. Senate Majority Leader Mitch McConnell is still aiming for an Obamacare repeal vote in June, though his lieutenants acknowledge that deadline could slip into July. And while GOP leaders want to hold the vote as soon as possible, Republicans continue to avoid hard deadlines and say factors outside their control could strike. (Everett, 6/12)

CQ Roll Call: Republicans Signal Uncertainty About June Vote On Health Bill
Senior Senate Republicans on Monday signaled doubts about meeting their goal of voting on a major health care bill before the July Fourth recess. Republicans continue to debate among themselves how to make major revisions to Medicaid and insurance policies...Senators have already begun sending pieces of their legislation to the Congressional Budget Office, said John Thune of South Dakota, the third-ranking Republican in that chamber. But several GOP senators said they want to analyze the legislation as a complete bill. (Young, 6/12)

The Hill: Senate GOP Considers Adding Opioid Funding To ObamaCare Repeal Bill
Senate Republicans are considering adding funding for opioid abuse treatment to their ObamaCare repeal bill, according to senators and aides. The move would be meant to ease concerns about the effect on opioid addiction treatment from rolling back ObamaCare’s expansion of Medicaid, which currently plays a major role in providing coverage for that treatment. But it's unclear how much funding would be included and whether that could meaningfully fill the gap. (Sullivan, 6/12)

The Hill: Insurer Exits Bolster GOP Case For ObamaCare Repeal 
The departure of insurers from ObamaCare is emboldening Republicans, helping them make the case to the public and to each other that the time has come to repeal the law. In recent weeks, insurers in many states have grown skittish about offering ObamaCare plans in 2018, raising the possibility that large swaths of the country will be left without a coverage option on their exchanges next year. (Weixel, 6/13)

Meanwhile, the congressman-elect from Montana, who got in a scuffle with a reporter following a question about health care, is sentenced to anger management classes —

The Washington Post: Congressman-Elect Gianforte Gets Anger Management But No Jail Time For Assaulting Reporter
Congressman-elect Greg Gianforte will perform community service and anger management classes but serve no jail time for body-slamming a reporter on the eve of his election last month. Gianforte pleaded guilty to charges that he assaulted Guardian reporter Ben Jacobs at the politician’s campaign headquarters on May 24 — an incident that was witnessed by other journalists and captured on audiotape. (Mettler, 6/12)

As Senators Write Health Overhaul Behind Closed Doors, Health Groups Fight To Get Access

Patient and industry groups are organizing rallies, ad campaigns and lobbying efforts while conservatives are trying to make sure the health law's taxes are repealed.

The Hill: Health Groups Band Together To Highlight Concerns With House Obamacare Repeal 
Eight influential healthcare and consumer advocate groups are partnering to ... highlight concerns about the House-passed ObamaCare repeal-and-replace bill. As the Senate works to dismantle ObamaCare, the groups plan to host events in four states — Ohio, Colorado, Nevada and West Virginia — aimed at showcasing the need for affordable and adequate healthcare. The first event will take place on Thursday in Cleveland. (Roubein, 6/13)

The Hill: Health Groups Want Their Say On Senate Republicans’ Plan 
Healthcare groups are decrying Republican senators for closing their doors to the public as they write legislation repealing and replacing ObamaCare. Senate Republicans are not holding public hearings or committee markups for their bill, a major departure from the traditional lawmaking process. Healthcare groups fear the final product will be released just a couple of days before the vote, minimizing time for feedback or for opposition to build. (Sullivan, 6/12)

The Hill: Conservative Groups Ask Senate To Repeal ObamaCare Taxes
Conservative groups are demanding the Senate repeal all ObamaCare taxes in its healthcare reform bill. In a letter to Senate Finance Committee Chairman Orrin Hatch (R-Utah), 45 groups, led by Americans for Tax Reform, called on the Senate to repeal nearly 20 taxes created under ObamaCare. ... Some GOP senators have expressed support for keeping some ObamaCare taxes to pay for their new healthcare bill as they negotiate a plan they will eventually merge with the House-passed measure. (Hellmann, 6/12)

The Hill: AARP Targets Six More GOP Senators With Seven-Figure Ad Buy 
AARP is ramping up pressure on senators to vote against provisions in the House-passed ObamaCare repeal-and-replace bill that the influential lobbying group says would hurt older adults. It's launching another seven-figure television ad buy that will run as long as the Senate healthcare reform debate lasts. It’s targeting six more GOP senators than a previous ad buy in May. (Roubein, 6/12)

Kasich, A GOP Moderate Who Has Criticized Hill Efforts On Health Overhaul, Offers Olive Branch

Ohio Gov. John Kasich says he could accept the phaseout of the health law's Medicaid expansion if Republicans writing the bill add more money for states and make the pull back more gradual. In other Medicaid news, a look at how states are remolding the program for low-income residents, concerns among nonprofit insurers about proposed changes to the law, and developments in Indiana, Wisconsin and Ohio.

The New York Times: John Kasich Backs Slow Medicaid Rollback, But With More Money
Ohio’s influential Republican governor, John R. Kasich, said on Monday that he could accept a gradual phaseout of the expansion of Medicaid under the Affordable Care Act, but only if Congress provides states with more money than the House health care bill included and more flexibility to manage the health program for the poor. Mr. Kasich’s statement could prove significant as Senate Republicans try to find near unanimity on a bill to repeal and replace President Barack Obama’s signature domestic achievement. His position points to a compromise that moderate Senate Republicans could embrace — but that could challenge the chamber’s most conservative members. (Pear, 6/12)

Politico: With Or Without Washington, States Are Already Remaking Medicaid
Medicaid is now the biggest health program in the country, covering more than 70 million people, or 1-in-5 Americans. Spending surpassed $545 billion in 2015. Yet Medicaid, “the other M,” is often overshadowed by Medicare. But the depth and breadth of innovation in Medicaid in states across the country under Democratic and Republican governors, deserves more attention. That’s particularly true now as the Trump administration and Republicans in Congress consider sweeping changes and deep spending cuts that would fundamentally change the program that provides health care for Americans with low income, the disabled, and millions of older Americans needing long-term services and support in nursing homes or in the community. (6/12)

Modern Healthcare: Not-For-Profit Health Insurers Warn Medicaid Cuts Would Endanger Essential Care-Management Programs 
Not-for-profit health insurers warned Monday that federal Republican lawmakers' proposed Medicaid funding cuts would endanger programs essential to caring for members who are elderly, disabled or suffering from substance use disorders. Vulnerable Medicaid members would go without necessary care and some would even lose coverage, driving up the cost of uncompensated care at hospitals throughout the states, medical directors at regional health plans Geisinger Health Plan and UCare said during a teleconference organized by the Alliance of Community Health Plans, which represents not-for-profit insurers. (Livingston, 6/12)

Modern Healthcare: Indiana Skipped Legal Steps In Requesting Medicaid Waiver
Indiana has opened up its pending request for a Medicaid work requirement to legal challenges by skipping a crucial step in the submission process. The state submitted the amendment as part of its renewal application for its Healthy Indiana Plan 2.0 waiver to the CMS on May 25, the CMS said in a notice released Friday. The comment period for the request doesn't end until later this month. The amendment proposes requiring Medicaid beneficiaries to be employed or searching for work in order to be eligible for the program. ... CMS and Indiana may be violating federal public comment standards for waiver requests, according to St. Louis University health law professor Sidney Watson. (Dickson, 6/12)

Milwaukee Journal Sentinel: Wisconsin Continues To Lose Out Under Republicans' Obamacare Repeal Legislation
States like Wisconsin that didn't fully expand their health programs under Obamacare would still miss out on billions of dollars under a proposed Republican repeal of the federal law, an industry report has found. In a bit of political irony, mostly GOP-led states that didn't join the Obamacare party would get little in the way of credit — even from Republicans in Congress who are promoting a repeal bill. (Stein, 6/13)

Cincinnati Enquirer: Senate Slashes $1B From State Budget, Including Cuts To Prisons, Medicaid
Senate Republicans slashed $1 billion from the state's proposed two-year budget, cutting money from Medicaid and prisons as part of their plan to keep the state in the black. Cuts would include $200 million from Medicaid, $20 million from the state's prisons, at least three percent from many state agencies' budgets and dozens of earmarks. Republicans, who control the Ohio Senate, did add $6.4 million to tackle the state's drug epidemic, bringing the total to more than $176 million, Senate President Larry Obhof announced Monday. (Balmert, 6/12)

Cleveland Plain Dealer: State Agencies, Medicaid Take Brunt Of $1 Billion Budget Cut Proposed By Senate GOP 
Ohio Senate Republicans said Monday they were able to close a projected $1 billion shortfall in the next two-year state budget without raising taxes or cutting essential public services. State lawmakers have been grappling since April with how to fill an estimated $800 million revenue gap in the 2018-19 budget. ... [Senate President Larry] Obhof said his chamber's version of the budget made across-the-board agency cuts of 3 to 4 percent and trimmed Medicaid spending by $200 million, including a $75 million cut to hospitals. (Borchardt, 6/12)


Iowa Proposes Stopgap Plan To Save Its 'Collapsing' Marketplace As Congress Works On 'Repeal'

The proposal would rewrite major parts of the Affordable Care Act for the state, and needs approval from the administration.

The Washington Post: Iowa Asks To Rewrite Affordable Care Act Rules To Prop Up Its Insurance Exchange
Iowa is asking the Trump administration for permission to jettison fundamental aspects of its Affordable Care Act marketplace, contending that a large-scale rewriting of the rules is the only way to prevent the state from becoming the first without any health plans available under the law next year. In an extreme plan that Iowa’s insurance commissioner submitted to federal health officials on Monday, the state would essentially take an estimated $350 million in federal ACA money that its residents and insurers would ordinarily receive next year and use it for different purposes. (Goldstein, 6/12)

The Associated Press: Iowa May Be First State With No Health Insurers On Exchange
"While legislation appears to slowly be moving at the federal level, it is unlikely any changes to the ACA will be enacted in time to keep Iowa's individual health insurance market from a total collapse leaving nearly 72,000 individuals with zero options to purchase health insurance for 2018," [Iowa Insurance Commissioner Doug] Ommen said.(6/12)

Des Moines Register: Iowa's Rickety Health-Insurance Market Could Be Propped Up Under State's 'Stopgap' Plan
Commissioner Doug Ommen said his proposal would tweak Obamacare rules in ways to encourage more young and healthy people to buy such coverage. Those customers could be a counterweight to the health-care costs of older Iowans with chronic health problems. Ommen’s plan also would help insurers shoulder the burden of extremely expensive patients. And it would boil down carriers’ offerings to one standard plan, with uniform benefits. (Leys, 6/12)

Bloomberg: Iowa Asks U.S. For Obamacare Help Facing ‘Collapse’ Of Market 
Under Iowa’s plan, a 40-year-old making about $42,000 a year would pay an estimated $384 a month out of pocket next year to buy coverage, compared to $291 under Obamacare. In general, younger and wealthier people would fare better under the Iowa proposal, while older and poorer people would face higher costs. The program doesn’t include Obamacare’s cost-sharing reductions, which help poorer people afford to use their insurance plans by reducing their deductibles and out-of-pocket costs. (Tracer, 6/12)

The Wall Street Journal: Iowa Seeks To Revamp Affordable Care Act
Trump administration officials said they were open to supporting the Iowa proposal to the extent possible under the current health law. A White House official said the administration welcomed suggestions from the states to tweak the workings of the ACA within their borders, and officials “want to get to ‘yes’ with states. ”The Iowa proposal, which would offer one type of insurance plan and revamp the law’s subsidies that help people buy coverage, among other changes, would be in effect for 2018, though it could be extended. (Wilde Mathews and Radnofsky, 6/12)

The Hill: Iowa Proposes Plan To Stabilize Its Insurance Market
Two carriers, including Wellmark, exited the marketplace earlier this year. The two remaining — one of which only sells plans in about five counties — hadn’t yet committed to selling health plans in Iowa’s insurance marketplace for 2018, a decision affecting 72,000 of the state’s residents. (Roubein, 6/12)

Politico Pro: Iowa’s Obamacare Rescue Plan Could Set National Trend 
Iowa’s emergency proposal to prevent an Obamacare collapse will test how far the Trump administration is willing to go to let states prop up shaky insurance markets. The state’s stopgap plan to prevent 72,000 Obamacare customers from not having any options next year would represent a broad rewrite of Obamacare's architecture. (Pradhan, 6/12)

Dropout Rate For ACA Exchanges Stays Steady To Previous Years

The nearly 2 million people who canceled their plans through the exchanges reflect the normal up and down of the program and does not reflect the politics of the moment, experts say.

The Associated Press: HealthCare.Gov Dropout Trend Continues Under Trump
Continuing a dropout trend seen in the Obama years, about 16 percent of consumers who signed up for coverage this year through public health insurance markets had canceled their plans by early spring, the government said Monday. Figures released from the Health and Human Services department show that 10.3 million people were signed up and paying their premiums as of March 15. That's 1.9 million fewer than the 12.2 million who initially signed up during open enrollment season, which ended Jan. 31. (6/12)

Politico: Nearly 2M Fell Off Obamacare Coverage Rolls Through Mid-March
CMS said high costs and lack of affordability were the most common factors individuals cited when asked why they didn't keep their coverage. A separate report on enrollment trends attributed the drop-off to other factors, including securing a job with employer-sponsored insurance. (Pradhan, 6/12)

Modern Healthcare: Nearly 2 Million Dropped Obamacare Coverage Through Mid-March
For the nearly 4,000 people who dropped coverage prior to paying the first month's premium, 49% said they found coverage elsewhere and 46% attributed the move to premium increases or ineligibility for financial assistance, the CMS said. Enrollment data also showed that individuals whose insurer left the market were more likely to forgo coverage. (Livingston, 6/12)

Meanwhile, Sen. Patty Murray (D-Wash.) wants to investigate the administration's actions regarding the marketplaces —

The Wall Street Journal: Sens. Murray, Warren Request Probe Of Whether Trump ‘Undermined’ Obamacare
Two Senate Democrats have sent a letter to the Department of Health and Human Services’s independent watchdog, asking for an investigation into Trump administration actions that could have “undermined” the Affordable Care Act. Sen. Patty Murray (D., Wash.), the top Democrat on the Senate’s Health, Education Labor and Pensions Committee, and Sen. Elizabeth Warren (D., Mass.), a member of the committee, requested that the department’s inspector general make public any actions taken by the Trump administration to destabilize the individual health-insurance market. (Hackman, 6/12)

What's Going On With The Health Law's Marketplaces?

Bloomberg gives a quick rundown of what's happening with the exchanges created under the Affordable Care Act. Meanwhile, two insurers are jumping back into the marketplace in Arizona.

Bloomberg: Why Insurers Are Getting Antsy About Obamacare: QuickTake Q&A 
U.S. President Donald Trump says Obamacare, the health-insurance system created by his Democratic predecessor, is collapsing and needs to be replaced. Democrats say Trump is sabotaging Obamacare by scaring insurers away. As proof, both sides point to double-digit premium increases and the departure of a string of national insurers from the individual-policy market under Obamacare, officially known as the Affordable Care Act (ACA). Climbing prices and narrowing choices. On June 6, Anthem Inc. announced its decision to quit Ohio’s ACA market, a step that may leave 13,000 people without any coverage option under the program next year. Anthem offers ACA plans in 13 other states, where its continued participation largely remains a question mark.  (Edney, Tracer and Recht, 6/12)

Arizona Republic: Arizona's 'Obamacare' Insurers To Stay Put In 2018
Arizona has been described as "ground zero" for "Obamacare's" woes because of the departure last year of all but two health insurance companies and massive customer rate hikes. But those two insurance companies appear content enough with Arizona's health-insurance marketplace this year that they have pursued steps to again offer plans in 2018. (Alltucker, 6/12)


Biosimilar Drugmakers Score Huge Victory With Supreme Court Ruling

The court, in a unanimous ruling, ruled that companies making biosimilars don't have to wait an extra six months after gaining Food and Drug Administration approval before selling the drugs.

Stat: In Amgen-Sandoz Case, Supreme Court Rules To Allow Lower-Cost Biosimilars To Market Faster
In a highly anticipated decision, the U.S. Supreme Court reduced the time that companies will have to wait before selling lower-cost versions of expensive biologic medicines, a move that is expected to save the health care system piles of money. The 9-to-0 ruling came in response to sharply contrasting views of the complex procedures found in the Biologics Price Competition and Innovation Act, which is supposed to determine when biosimilar drugs can be launched. In this instance, Sandoz and Amgen are squabbling over competing interpretations. (Silverman, 6/12)

The Associated Press: High Court Ruling Speeds Up Generic Biotech Drug Approval
A unanimous Supreme Court is speeding up the time for generic biotech drugs to become available to the public in a ruling that means a loss of billions in sales to the makers of original versions. The justices ruled Monday in favor of generic drug maker Sandoz in its dispute with rival Amgen over a near-copy of Amgen’s cancer drug Neupogen. (Hananel, 6/12)

The Hill: Supreme Court Rules To Speed Marketing Of Lower-Cost 'Biosimilar' Drugs 
The decision is a huge victory for other biosimilar manufacturers. Biologics are an ever-increasing share of the U.S. drug market. They are made from living cells instead of chemicals and, as a result, they can't be copied to make generic versions. But while they've helped advance disease treatments, they can be expensive. (Weixel, 6/12)

In other news about generics —

Stat: When Will Truvada Will Go Generic? Teva Won't Say, Per Settlement
A mid widespread confusion over when the HIV prevention pill will go generic, a spokeswoman for Teva on Monday told STAT that the company has reached a confidential settlement controlling when it can enter the marketplace. ... The Food and Drug Administration last week approved Teva’s bid to sell the first generic pill for the HIV prevention method known as pre-exposure prophylaxis, or PrEP. That news initially brought excitement and hope in the HIV/AIDS community that the new option would usher in lower prices. (Robbins, 6/12)

Senate Panel Hearing On High Prices Will Focus On 'Delivery System' Of Getting Drugs To Market

The hearing comes amid increasing scrutiny of pharmacy benefit managers, the middlemen in the system.

Stat: Senate Set To Hear Pitch On Three Ideas To Bring Down Drug Prices
The Senate health committee will finally train its spotlight on the high cost of prescription drugs in a highly anticipated public hearing Tuesday, the first major congressional examination of the issue since President Trump took office buoyed in part by his promises to lower prices. Trump famously accused pharmaceutical companies of “getting away with murder” in January — but don’t expect the panel to be a slugfest. (Mershon, 6/12)

Morning Consult: Capitol Hill Debate Over Drug Prices Shifts To PBMs
While lawmakers continue to disagree about the pharmaceutical industry’s role in soaring prices for medicines, there are bipartisan calls on Capitol Hill to probe the middlemen in the distribution chain: pharmacy benefit managers. The new focus comes amid an effort by the drug industry to shift the blame from drugmakers, which have faced the brunt of the public backlash for exorbitant pricing, by exposing what it considers opaque business practices by PBMs. The Senate Health, Education, Labor and Pensions Committee is set to hear testimony on Tuesday about how the drug delivery system affects what patients pay for their medications. (Reid, 6/12)

Veterans' Health Care

A Simple Shot Could Offer Relief From The Worst OF PTSD's Symptoms

It's not a cure, experts warn. But the anesthetic injection, which interrupts messages along nerve fibers that control the fight-or-flight response, has shown promising results in early clinical experience.

The Wall Street Journal: Can A Single Injection Conquer PTSD? The Army Wants To Find Out
The U.S. Army has commissioned a study to determine whether an anesthetic injection to the neck alleviates symptoms of post-traumatic stress disorder—a treatment that, if proven effective, could be a big step toward easing an affliction affecting hundreds of thousands of troops who have returned from combat. The $2 million Army study constitutes the first large-scale randomized control research into use of the shots—called stellate ganglion blocks—to treat PTSD. The injections have been used for decades for arm pain and shingles. (Phillips, 6/12)

In other veterans' health care news —

ProPublica: Veterans Affairs Official Downplays Agent Orange Risks, Questions Critics 
A key federal official who helps adjudicate claims by veterans who say they were exposed to Agent Orange has downplayed the risks of the chemical herbicide and questioned the findings of scientists, journalists and even a federal administrative tribunal that conflict with his views. Jim Sampsel, a lead analyst within the Department of Veterans Affairs’ compensation service, told a VA advisory committee in March that he believes much of the renewed attention to Agent Orange — used during the Vietnam War to kill brush and deny cover to enemy troops — is the result of media “hype” and “hysteria,” according to a transcript of the meeting released to ProPublica. (Ornstein, 6/12)

Health IT

We May Be Moving Toward A Future Where Visits To The Doctor's Office Are Unnecessary

Media outlets look at how technology is playing a role in shaping the health care landscape.

San Francisco Chronicle: Why Doctors’ Offices Could Become Obsolete 
Technological advancements are ushering in a new era of health care, eroding the long-held model of hospitals and doctors’ offices as the physical center of the health system... This rapidly changing landscape raises the question: Will there come a day when we won’t need to go to the doctor’s office anymore? (Ho, 6/12)

San Francisco Chronicle: Why Doctors Hate Electronic Records — And What Could Change That
The health care industrial complex has spent billions of dollars and untold amounts of time trying to make medical records as flexible, invisible and unobtrusive as possible for patients and clinicians alike... But after nearly two decades of concerted innovation, amid a push to do away with paper records, many physicians say they’re still hamstrung by issues that have dogged them for years. (Francassa, 6/12)

San Francisco Chronicle: Did You Take Your Pill? Ingestible Sensors Can Tell 
Some experts say ingestibles — also dubbed “smart pills” — can help solve one of the biggest problems plaguing the health care industry: patients simply not taking their medication as prescribed. The Proteus sensor can indicate if and when a pill is taken. It was approved by the Food and Drug Administration in 2012 — the first such device to receive the agency’s OK. (Thadani, 6/12)

San Francisco Chronicle: How Apple AirPods Could Make Future Hearing Aids Cool 
Inside Starkey’s Shattuck Avenue lab, Carlile and his team are researching brain-sensing technologies that may enhance hearing aids in the next five or six years... Using a skullcap dotted by round electrodes, the researchers are measuring brain-wave activity to pinpoint which talker a person is trying to hear in noisy situations. (Evangelista, 6/12)

Arizona Republic: Hacking A Heart Pacemaker Isn't Science Fiction. See What Experts Are Doing To Prevent It
Newer models of medical devices like pacemakers, insulin pumps and medication pumps have wireless connectivity so doctors can remotely access the device to monitor the patient or to make changes to how it operates. But those very features also provide a backdoor for hackers to gain access to the device, just as they could hack into any other information stored online. (Stanford, 6/12)

Public Health And Education

10% Of World's Population Is Now Obese. In U.S., That Rate Rises To 26.5%.

Combining children and adults, the United States reported the largest increase in percentile points of any country, a jump of 16 percentage points.

The New York Times: More Than 10 Percent Of World’s Population Is Obese, Study Finds
More than 10 percent of the world’s population is now obese, a marked rise over the last 30 years that is leading to widespread health problems and millions of premature deaths, according to a new study, the most comprehensive research done on the subject. Published Monday in The New England Journal of Medicine, the study showed that the problem had swept the globe, including regions that have historically had food shortages, like Africa. (Richtel, 6/12)

USA Today: 2 Billion People Are Overweight Or Obese Globally, Study Says.
The findings represent "a growing and disturbing global public health crisis," said the authors of the paper, which was published Monday in the New England Journal of Medicine. Among the 20 most-populous countries, the highest level of obesity among children and young adults was in the U.S., at nearly 13%. Egypt topped the list for adult obesity at about 35%, while the lowest rates were in Bangladesh and Vietnam, respectively, at 1%. (Rice, 6/12)

The South's HIV Epidemic Looks Different Than The Rest Of Country's, So Officials Are Taking A New Approach

Public health officials are starting to have hope that innovative solutions are making a difference in the South's HIV crisis. In other public health news: pregnancy and autism, fasting diets, the liver, dog ownership, hearing aids and Zika.

Stateline: Fighting AIDS In The Deep South: Glimmers Of Hope
Louisiana and other Southern states have the highest rates of new HIV and AIDS diagnoses, the largest percentage of people living with the disease, and the most people dying from it. As AIDS death rates decline in the U.S., they are also declining in the region, albeit more slowly. But in pockets around the Deep South, public health officials say new policies and programs are providing a glimmer of hope...In Alabama, Louisiana and Tennessee, state public health officials and AIDS activists are focusing on getting people tested and linked up with medical care. Treatment, they say, helps prevent the spread of the virus, because patients with lower levels of HIV in their bodies are much less likely to pass it on to others. Their efforts could serve as models for other states battling the epidemic, public health officials across the country say. (Wiltz, 6/13)

The Washington Post: Fever During Pregnancy May Increase Autism Risk In Offspring
A mother’s fever during pregnancy, especially in the second trimester, is associated with a higher risk that her child will be diagnosed with autism spectrum disorder, researchers reported Tuesday. Three or more fevers after 12 weeks of gestation may be linked to an even greater risk of the condition. The study by researchers at Columbia University’s Mailman School of Public Health adds support for the theory that infectious agents that trigger a pregnant woman’s immune response may disrupt a fetus’s brain development and lead to disorders such as autism. (Bernstein, 6/13)

Stat: He Wants To Sell You A $300 'Fasting Diet.' It Might Not Be Crazy
Intrigued, STAT reviewed dozens of scientific studies and talked to a half-dozen aging and nutrition experts about fasting in general and ProLon in particular. We visited [Valter] Longo’s lab at the University of Southern California’s Longevity Institute, where slender black and white rodents pass their days in clear plastic boxes labeled “DO NOT FEED.” We even tried Longo’s diet for one long and rather hungry week. Our conclusion? Fasting does appear to boost health — certainly in mice, and preliminary evidence suggests it might do so in humans as well, at least in the short term. It’s not yet clear whether that’s because abstaining from food prompts cellular changes that promote longevity, as some scientists believe — or because it simply puts a brake on the abundant and ceaseless stream of calories we consume to the detriment of our health. Either way, it can be a powerful force. (McFarling, 6/13)

The New York Times: The Liver: A ‘Blob’ That Runs The Body
To the Mesopotamians, the liver was the body’s premier organ, the seat of the human soul and emotions. The ancient Greeks linked the liver to pleasure: The words hepatic and hedonic are thought to share the same root. The Elizabethans referred to their monarch not as the head of state but as its liver, and woe to any people saddled with a lily-livered leader, whose bloodless cowardice would surely prove their undoing. Yet even the most ardent liverati of history may have underestimated the scope and complexity of the organ. (Angier, 6/12)

NPR: Owning A Dog Leads To More Walking And Exercise For Older Adults
Dog owners often say the best thing about dogs is their unconditional love. But new research suggests there's another benefit, too. Dog owners walk more. In a study published Monday in the journal BMC Public Health, dog owners on average walked 22 minutes more per day compared to people who didn't own a dog. And they weren't just dawdling. (Aubrey, 6/12)

The New York Times: Hearing Aids At The Mall? Congress Could Make It Happen
A few years hence, when you’ve finally tired of turning up the TV volume and making dinner reservations at 5:30 p.m. because any later and the place gets too loud, you may go shopping. Perhaps you’ll head to a local boutique called The Hear Better Store, or maybe Didja Ear That? (Reader nominees for kitschy names invited.) Maybe you’ll opt for a big-box retailer or a kiosk at your local pharmacy. (Span, 6/12)

Kaiser Health News: Zika In America: One Mother’s Saga
When her daughter was born at Providence St. Peter Hospital in January, the first thing Maria Rios checked was the baby’s head. She’d seen the terrifying photos on the internet — infants in Brazil and in Puerto Rico whose skulls were misshapen, even collapsed, ravaged by the Zika virus that has engulfed Latin America. Days earlier, U.S. doctors had told Rios — a 20-year-old, first-time mother — that she was infected with Zika, likely spread by a mosquito bite at her parents’ home in Colima, Mexico, last summer. Rios desperately wanted them to be wrong. (Aleccia, 6/13)

N.Y. County Latest To Take Swing At Drugmakers Over Opioid Epidemic

There's a new trend of local and state governments pursuing legal action over the crisis.

The Wall Street Journal: Nassau County Sues Drugmakers Over Opioid Epidemic
Nassau County filed a lawsuit Monday against several pharmaceutical companies, alleging their prescription painkillers helped fuel the opioid epidemic that costs the county millions of dollars annually to combat. The complaint, filed in Nassau County Supreme Court, targets several companies including Teva Pharmaceutical Industries Ltd. , Purdue Pharma LP and Janssen Pharmaceuticals Inc. The defendants also include drug distributors and doctors. (De Avila, 6/12)

In other news —

Boston Globe: In An Office Close To Home, Wareham Youths Get Addiction Treatment
Since March, the providers at Wareham Pediatrics have been treating substance misuse within their primary-care office, in a pilot project that might be unique in the nation... The doctors hope their experience — made possible by a foundation grant, guidance from Boston specialists, and months of planning — will provide a roadmap for other practices. (Freyer, 6/12)

New Hampshire Public Radio: N.H.'s Largest Drug Recovery Organization Faces Allegations Of Verbal Abuse, Dysfunction 
Over the past two years, the nonprofit organization HOPE for New Hampshire Recovery has expanded from a single modest space in Manchester to seven drug recovery centers statewide, making it the largest such organization in New Hampshire... Former employees spoke with NHPR about what they call serious problems for a key player in the state’s fight against opioid addiction. (Sutherland, 6/12)

Women’s Health

Family Planning Provision Could Derail New Hampshire Budget Talks

Meanwhile in Texas, activists speak out against the state's plan to ask the U.S. government to fund a state-run women’s health program excluding abortion providers.

And in other news —

The Associated Press: Missouri Lawmakers Return For Special Session On Abortion
Missouri lawmakers returned to the Capitol on Monday after Republican Gov. Eric Greitens called for a special session aimed at imposing more abortion restrictions and undoing a St. Louis ordinance that bans discrimination over abortion and pregnancies. Greitens, an abortion opponent, announced last week he was bringing legislators back to work, the second time he's done so in less than a month. At issue now are a federal judge's ruling striking down some state laws on abortion and the St. Louis ordinance, which prohibits discrimination in housing and employment based on "reproductive health decisions." (6/12)

KCUR: Greitens Rebukes ‘Radical Politicians In St. Louis’ Over Abortion Measure 
Missouri Governor Eric Greitens on Monday said a special session of the legislature was a necessary response to abortion measures adopted recently by “radical politicians” in St. Louis. Greitens made the  comments after signing the Real ID bill, ensuring that Missourians can use their driver’s licenses to board planes and enter military bases and federal buildings. Missouri had been one of only a handful of states that was not compliant with the federal Real ID Act, meaning Missourians could have been turned away from the facilities because their driver’s licenses were not deemed to be valid identification. (Margolies, 6/12)

State Watch

Conn. Spent Hundreds Of Millions To Make Hospital Viable, But Now It's In Worse Shape Than Ever

Media outlets report on hospitals news out of Connecticut, Pennsylvania and Tennessee.

The CT Mirror: UConn Health Finds Itself Pretty Ill Fiscally
University leaders for years said UConn Health’s John Dempsey Hospital was too small and outdated to be financially viable, but three separate attempts between 2008 and 2010 to overhaul the campus or merge the hospital with a larger network of hospitals failed to cross the finish line... Now heading into the second full year that many of the new facilities have been open, university officials say UConn Health’s fiscal picture is the worst it has been in a long time – and it is going to continue to deteriorate unless major changes are made. (Rabe Thomas, 6/12)

The Philadelphia Inquirer: Suburban Hospital Sales Expected To Hit School Districts Financially
The pending sale of Pottstown Memorial Medical Center presents a troubling prospect to school district officials in the Montgomery County borough. The hospital, now owned by the for-profit Community Health Systems Inc., is the school district’s largest real estate taxpayer by far. The assessment of the main hospital alone, is $20.26 million, about twice the value of the next-biggest property, a shopping mall. Altogether, Pottstown Memorial’s property tax bill for the school district, including two smaller properties, was $923,998, public records show. That amounts to 3.2 percent of the $28.65 million the school district budgeted from real estate taxes for the 2016-17 school years. (Brubaker, 6/12)

Nashville Tennessean: Commission Strikes Down Proposal To Study Sale Of Hospital
Despite public support from citizens, Williamson County Commissioners won't create a task force to study the feasibility of selling Williamson Medical Center anytime soon. With 16 commissioners voting against the proposal, drafted by Gregg Lawrence, and seven voting in favor, there was widespread confusion and disagreement about what state law actually says about how money from the sale of county-owned hospitals can be used. While state law says proceeds from such a sale must be used for health purposes, commissioners found the language to be arbitrary and worth questioning. (Sauber, 6/12)

State Highlights: Va.'s 'Looming' Behavioral Health Challenges; Baltimore Offers Companies New Workplace Wellness Designation

Media outlets report on health-related news from Virginia, Maryland, Arizona, Missouri, Illinois, Florida, California and Massachusetts.

Richmond Times-Dispatch: Virginia's Top Behavioral Health Official Outlines Looming Mental Health Challenges
Even as Gov. Terry McAuliffe ceremonially signed two bills Monday that take the state closer to providing more immediate access to mental health care for people in crisis and those behind bars, Virginia’s top behavioral health official outlined looming challenges. Among the most urgent: overcrowded mental hospitals, significant staffing shortages and the need for millions more to complete an overhaul of the state’s community-based mental health care system. (Kleiner, 6/12)

The Baltimore Sun: Baltimore Health Department Offers Firms A Wellness Designation 
The Baltimore City Health Department has launched a new program aimed at encouraging local companies to provide healthier work environments by offering them a Workplace Wellness designation. Company leaders can use a questionnaire adapted from a scorecard generated by the U.S. Centers for Disease Control and Prevention to help them identify priorities, or gaps, in their health promotion programs in nutrition, physical fitness and emotional health. (Cohn, 6/12)

KCUR: ‘Chemical Straight-Jackets:’ Lawsuit Claims Missouri Foster Kids Prescribed Too Many Meds 
Two national child advocacy organizations have filed a federal lawsuit against the Missouri Department of Social Services, alleging that children in the state’s foster care system are over-prescribed psychotropic medications with little oversight...The five plaintiffs, identified by their initials, include two- and three-year-old sisters who were allegedly prescribed Risperdal, an antipsychotic not approved by the Food and Drug Administration for children under five. Another plaintiff, aged 12, was prescribed five medications at once, and experienced hallucinations. (Bouscaren, 6/13)

Chicago Tribune: University Of Chicago Medicine May Soon Be Out Of UnitedHealthcare's Network 
About 8,000 UnitedHealthcare customers who get care from University of Chicago Medicine might have to switch doctors this summer — or pay significantly more for services because of a contract disagreement between the insurer and the medical system. UnitedHealthcare — the state's second-largest health insurer — and University of Chicago Medicine have been unable to agree on a contract to keep the medical center and the system's doctors in the insurer's network. (Schencker, 6/12)

Health News Florida: Study: Florida Still Behind In Providing For Children 
The number of uninsured children in Florida dropped to a record low of 7 percent, according to the study, which used data from 2015. The state also saw lower teen pregnancy rats and more teens in school or working full-time. But the study ranked Florida 44th in health and 45th in economic well-being. (Ochoa, 6/13)

EdSource Today: California Law Spurs Reforms After Heartbreaking Student Suicide Cluster
While suicide is the second-leading cause of death for teenagers ages 15 to 19, it is rare, with 150 suicide deaths in California in that age group in 2013... The California Department of Education released a model youth suicide prevention policy last month that calls for schools to create strategies to encourage students to talk about depression and stress. (Adams, 6/12)

WBUR: Mass. House To Take Up Pot Bill This Week
The Massachusetts House of Representatives will begin debate Thursday on a bill making changes to the state’s voter-passed recreational marijuana law... As passed by voters, the law gave all regulatory power to a three-person Cannabis Control Commission (CCC) that would fall under the office of state Treasurer Deborah Goldberg, with all members to be appointed by the treasurer. (Brown, 6/12)

Editorials And Opinions

Perspectives: Medicare Should Be Part Of Health Policy Conversation; How Medicaid Cuts Play Out In States

Opinion writers take on health policy issues related to repealing and replacing the Affordable Care Act as well as health care cost transparency, among others.

RealClear Health: Medicare Can’t Be Ignored Forever
For now, Medicare is not part of the national conversation on health care. While campaigning, Donald Trump promised not to touch Medicare, and, in his first budget, he basically kept that commitment to voters. In addition, Congress and the new administration are consumed with rolling back key elements of the Affordable Care Act (ACA) and replacing them with different provisions. Medicare does not feature prominently in that debate. That will need to change at some point because Medicare is simply too big and important, both in terms of its fiscal consequences and its effect on the overall health system, to leave on autopilot indefinitely. (James C. Capretta, 6/12)

Dallas Morning News: Cuts To Medicaid Would Badly Damage Health Care In Rural Texas
Six-week-old Lilly was born premature and is struggling to gain weight. She needs regular weight checks to monitor her progress, breastfeeding support for her mother, and a nutritionist to ensure her caloric intake is sufficient. Her difficulties are particularly stressful for her mother because Lilly's family lives in a rural county in northeast Texas with limited health care resources. ... Thankfully, Lilly and thousands of other children in rural Texas have health coverage through Medicaid to provide them the best chance to grow and thrive. ... Included in the American Health Care Act passed by the U.S. House of Representatives in May was an $800 billion cut to Medicaid. This goes far beyond rolling back the Medicaid expansion created in the Affordable Care Act and will create deep cuts to existing programs and shift burdens to states for care for children, the disabled and the elderly. (Valerie Borum Smith, 6/12)

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

The New York Times: You’re Probably Going To Need Medicaid
Imagine your mother needs to move into a nursing home. It’s going to cost her almost $100,000 a year. Very few people have private insurance to cover this. Your mother will most likely run out her savings until she qualifies for Medicaid. This is not a rare event. Roughly one in three people now turning 65 will require nursing home care at some point during his or her life. (David Grabowski, Jonathan Gruber and Vincent Mor, 6/13)

The New York Times: The Halfhearted Opposition To The G.O.P.’s Health Care Misery
The Republican health care bill now sneaking its way through the Senate has a good chance of becoming law, even though it would do miserable damage. And it has a good chance partly because some of the bill’s most influential opponents have not had the courage of their convictions. I realize that sounds harsh. These opponents generally have good intentions. But they haven’t been very effective so far, and they don’t have much time to summon the courage to become more effective. (David Leonhardt, 6/13)

The New York Times: The Senate Hides Its Trumpcare Bill Behind Closed Doors
A coterie of Republicans is planning to have the Senate vote before July 4 on a bill that could take health insurance away from up to 23 million people and make changes to the coverage of millions of others. And they are coming up with the legislation behind closed doors without holding hearings, without consulting lawmakers who disagree with them and without engaging in any meaningful public debate. There is no mystery why the Senate majority leader, Mitch McConnell, is trying to push this bill through quickly. The legislation would repeal major provisions of the Affordable Care Act. Opening it to scrutiny before a vote would be the congressional equivalent of exposing a vampire to sunlight. (6/13)

Los Angeles Times: Trump Wants To Deny Nursing-Home Residents And Their Families The Right To Sue
Let’s say your elderly parent was neglected or abused in a nursing home. In the past, your only recourse might have been arbitration, rather than going to court. But thanks to a rule put in place last fall by the Centers for Medicare and Medicaid Services, nursing homes that receive federal funding — which is most of them — could no longer include so-called mandatory arbitration clauses in their contracts. In other words, residents and their family members were given back the right to sue. (David Lazarus, 6/13)

Viewpoints: Improving Veterans' Access To Health Care; How Doctors Should Handle Racist Patients

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

The Des Moines Register: Veterans Deserve Better Access To Health Care
You’d think a U.S. senator who chairs one of the chamber’s most powerful committees could get reliable, accurate information about a federal agency’s operations. But back in February, officials with the U.S. Department of Veterans Affairs told Sen. Chuck Grassley’s Judiciary Committee that no veterans were currently waiting more than 90 days for care at Iowa’s two VA medical centers. (6/12)

Stat: When The Patient Is Racist, How Should The Doctor Respond?
Hospitals have policies protecting against workplace discrimination at the hands of colleagues or supervisors. But when a patient is racist or biased towards a physician or other health care provider, there is often no recourse. Through silence and inaction on this issue, hospitals may reinforce the isolation that clinicians of racial and religious minorities can sometimes feel in medicine. Particularly at a time when some Americans feel emboldened to speak and act in bigoted ways, clinicians need support managing patients who make derogatory and abusive remarks. (Lachelle Dawn Weeks, 6/12)

Bloomberg: Fight The Illegal Opioid Crisis, Too
Desperate for more effective ways to confront the opioid crisis, cities and states are reining in doctors who prescribe too many opioid painkillers and suing drugmakers for downplaying how addictive their products are. But the epidemic has moved beyond prescription pills to illicit drugs, so it also makes sense to try an approach that's more aggressive -- and controversial: giving addicts a safe place to use drugs. (6/12)

Louisville Courier-Journal: No Déjà Vu – Control Rogue Doctors Prescribing Suboxone
There’s no mistaking Kentuckian’s heroin and opioid addiction is a public health crisis. There are not enough spots in urban detox and inpatient treatment centers. It’s worse in rural areas. One hope for addicts seeking sobriety is treatment that combines Suboxone, to help the deadly craving for heroin and opioids, and counseling. It’s called MAT – medication-assisted treatment. If taken correctly, it can save lives. (6/9)

Bloomberg: Virtual Reality Can Conquer Real Pain
Despite all efforts to combat the opioid epidemic, the crisis continues to destroy lives and contribute to the growing gap in life expectancy by income and education in the U.S. But it appears that some relief may come from an unexpected source: virtual reality. Anyone who thinks virtual reality is just a sideshow for gamers should pay close attention to the stunning results it’s achieving in the medical world. (Peter R. Orszag, 6/13)

RealClear Health: A Cautionary Tale: Medicine (and Medical Meetings) Are Now Digital
Over the last 48 hours, Twitter has exploded with angry commentary directed at the American Diabetes Association (ADA) after the organization actively attempted to censor what was posted on twitter during their annual sessions this past weekend in San Diego. The fiasco began when an attendee posted a picture of slides on twitter—in an attempt to “LIVE Tweet” during a session on the recommended #ADA2017 Hashtag. The @AmDiaAsso twitter feed then began to post tweets instructing individual attendees to take down specific tweets that involved photography. In fact, the ADA twitter feed at one point was dominated by their repeated requests for attendees to delete tweets. Quickly, the censorship became the focus of the hashtag—not the science. (Kevin Campbell, 6/13)

WBUR: Leaving No Kid Behind: The Need For More Child Psychiatrists 
According to the Department of Health and Human Services, four million children and adolescents in the United States have serious mental disorders that cause significant functional impairments at home, at school and with peers. Despite this huge number, a 1999 report from the Surgeon General suggests that only 20 percent will receive treatment within any given year. (Nancy Rappaport and J. Wesley Boyd, 6/13)

The Columbus Dispatch: Protect Kids From ‘Silent’ Poison
Most people grasp, with horror, the poisoning of an estimated 6,000 to 12,000 young children in Flint, Michigan, by lead that leached into that city’s water system. But one doesn’t need to look north to find poisoned kids: An Ohio State University analysis determined that at any given time in Franklin County, about 5,500 children younger than 6 suffer from lead poisoning. (6/13)

Los Angeles Times: Someone You Know Needs A Kidney. Through A Donor Exchange, You Can Make Sure They Get One
It t is extremely unlikely anyone you know will ask you to donate a kidney. So don’t worry, you’re safe. Or are you? It is extremely likely that someone you know needs a new kidney, and that means someone in your life needs you to donate one. ... It seems that people, myself included, are far more willing to donate a kidney to someone they know over someone they don’t. We want the altruistic pleasure of knowing the recipient, and perhaps the pleasure of knowing that the recipient knows us. (Terry Wood, 6/13)