First Edition: April 24, 2018
Today's early morning highlights from the major news organizations.
Kaiser Health News:
4 New Hardship Exemptions Let Consumers Avoid ACA Penalty For Not Having Health Insurance
There are already more than a dozen reasons people can use to avoid paying the penalty for not having health insurance. Now the federal government has added four more “hardship exemptions” that let people off the hook if they can’t find a marketplace plan that meets not only their coverage needs but also reflects their view if they are opposed to abortion. It’s unclear how significant the impact will be, policy analysts said. That’s because the penalty for not having health insurance will be eliminated starting with tax year 2019, so the new exemptions will mostly apply to penalty payments this year and in the previous two years. (Andrews, 4/24)
California Healthline:
Study: Nearly Three-Quarters Of Commonly Used Medical Scopes Tainted By Bacteria
In an ominous sign for patient safety, 71 percent of reusable medical scopes deemed ready for use on patients tested positive for bacteria at three major U.S. hospitals, according to a new study. The paper, published last month in the American Journal of Infection Control, underscores the infection risk posed by a wide range of endoscopes commonly used to peer deep into the body. It signals a lack of progress by manufacturers, hospitals and regulators in reducing contamination despite numerous reports of superbug outbreaks and patient deaths, experts say. (Terhune, 4/23)
California Healthline:
Choice Of Bay Area For AIDS Conference Exposes Tension Among Activists
After George Ayala learned last month that San Francisco and Oakland had been chosen to co-host the International AIDS Conference in 2020, he quickly published a statement of disapproval. Ayala, an Oakland-based AIDS advocate, does not want the conference in his own city — or anywhere else in the United States, for that matter. (Wiener, 4/20)
The Washington Post:
Senate To Postpone Confirmation Hearing For Ronny Jackson To Head Veterans Affairs, White House Officials Told
Senate lawmakers have postponed the confirmation hearing for Ronny L. Jackson, President Trump’s nominee to lead the Department of Veterans Affairs, after top Republicans and Democrats raised concerns about his qualifications and oversight of the White House medical staff, White House and other administration officials were told Monday. The development came just two days before Jackson, the White House physician, was scheduled to testify before the Senate Committee on Veterans’ Affairs and threw what was looking to be a difficult confirmation process into further jeopardy. (Kim, Rein and Dawsey, 4/23)
The Hill:
New Allegations Could Threaten Trump VA Pick: Reports
Members of the Senate Veterans Affairs Committee have reportedly been informed of unverified allegations of misconduct against Rear Adm. Ronny Jackson, President Trump's pick to the lead the VA, posing a new roadblock for his nomination. The Washington Post first reported Monday evening that the Senate panel is delaying a confirmation hearing for Jackson previously scheduled for Wednesday as members look into the new claims. (Manchester, 4/23)
Politico:
Ronny Jackson’s VA Nomination On The Rocks
Republicans and Democrats alike have been talking over the weekend, and in person on Monday, about the potential for allegations to derail Jackson’s nomination, senators said. But the nature of discussions now going on about the material is “conversational,” said Sen. Thom Tillis (R-N.C.). Tillis suggested that the Jackson confirmation hearing scheduled for Wednesday may be "pushed back pending a review of some of this stuff that, like I said, I've only heard on a conversational basis. I think that's where we'll spend our time this week." (Everett and Schor, 4/23)
The Associated Press:
CDC Chief Makes $375K, Far Exceeding His Predecessors’ Pay
The new head of the nation’s top public health agency is getting paid nearly twice what his predecessor made and far more than other past directors, government officials confirmed. Dr. Robert Redfield Jr., 66, has long career as a top HIV researcher, but he had no experience working in public health or managing a public health agency. The U.S. government is paying him $375,000 a year to run the Atlanta-based Centers for Disease Control and Prevention.That’s nearly twice the annual compensation given to Dr. Brenda Fitzgerald, who had the job for six months before resigning in January. Her annual pay rate was $197,300. (Stobbe, 4/23)
The Hill:
New CDC Chief Makes Double His Predecessor's Salary: Report
Redfield's salary also eclipses his boss's, Department of Health and Human Services (HHS) Secretary Alex Azar's, earnings. Azar’s salary is set by law, but Redfield is being paid under a program called Title 42 — a program that was created to draw in health scientists with rare and critical skills to government work. According to HHS, Title 42 enables the agency to quickly fill knowledge gaps so medical research can progress and to respond to medical emergencies. (Weixel, 4/23)
The Washington Post:
Trump Proposal Could Mean Healthy People Save On Insurance While Others Get Priced Out
The Trump administration’s proposal to build up short-term health insurance plans as a "lifeline" for people who can’t afford Affordable Care Act coverage could split the insurance market in two, siphoning young, healthy people into cheaper, more minimal plans — while those who remain in ACA plans face premiums that spiral upward even faster. The comment period ends Monday on a Centers for Medicare and Medicaid Services proposal to extend short-term plans to 364 days, from the current three-month limit. (Johnson, 4/23)
The Hill:
Insurer Group Issues Warning On Trump Administration's Short-Term Health Plan Proposal
The nation's largest trade group for health insurance companies is sounding the alarm on a proposal from the Trump administration that would expand the sale of plans that cover fewer services. America's Health Insurance Plans (AHIP) says the proposal could lead to more people being uninsured or underinsured and result in higher health-care costs in the long run. (Hellmann, 4/23)
The Washington Post Fact Checker:
Is Health Care The ‘Number One Issue In America’?
Politicians are often eager to cite polling as a reason for action. In an article that highlighted a proposal by [Sen. Chris] Murphy and Sen. Jeff Merkley (D-Ore.) to allow individuals and large employers to purchase health insurance coverage through Medicare, Murphy described health care as the “number one issue” in America. Does polling back up that assertion? (Kessler, 4/24)
The Hill:
ObamaCare Call Center Contractor Accused Of Wage Theft
The federal contractor that operates ObamaCare call centers was accused of wage theft totaling more than $100 million over five years in complaints filed Monday. The Communications Workers of America (CWA) brought the complaints with the Department of Labor, alleging that the contractor, General Dynamics Information Technology (GDIT), has been underpaying its workers. (Sullivan, 4/23)
The New York Times:
Trump Administration Pushes Abstinence In Teen Pregnancy Programs
The Trump administration has issued new rules for funding programs to prevent teenage pregnancy, favoring those that promote abstinence and not requiring as rigorous evidence of effectiveness. While the funding announcement, issued Friday by the Department of Health and Human Services, does not exclude programs that provide information about contraception and protected sex, it explicitly encouraged programs that emphasize abstinence or “sexual risk avoidance.” (Belluck, 4/23)
The Hill:
Trump Admin Announces Abstinence-Focused Overhaul Of Teen Pregnancy Program
"Projects will clearly communicate that teen sex is a risk behavior for both the physical consequences of pregnancy and sexual transmitted infections; as well as sociological, economic and other related risks," the funding announcement reads. "Both risk avoidance and risk reduction approaches can and should include skills associated with helping youth delay sex as well as skills to help those youth already engaged in sexual risk to return toward risk-free choices in the future." In total, tier one will award up to $61 million in funds, ranging from $200,000 to $500,000 per year. The second tier solicits applications to develop and test "new and innovative strategies" to prevent teen pregnancy while improving adolescent health and addressing "youth sexual risk holistically by focusing on protective factors." (Hellmann, 4/20)
The Associated Press:
Planned Parenthood Sues Indiana Over New Abortion Rules
A new Indiana law that requires medical providers who treat women for complications arising from abortions to report detailed patient information to the state "imposes unique and burdensome obligations" that are unconstitutional, Planned Parenthood said in lawsuit filed Monday that seeks to block two of the law's provisions. The federal suit — the latest of several filed in recent years challenging abortion restrictions passed by Indiana lawmakers — contends that the reporting rules and a separate provision requiring annual inspections of abortion clinics are both unconstitutional because they target only abortions and abortion providers and not other procedures or clinics. (4/23)
The Wall Street Journal:
U.S. Hospital Profits Fall As Labor Costs Grow And Patient Mix Shifts
One important measure of U.S. hospital profits last year reached a low not seen in the past decade, as a tight labor market and other factors pressure hospital finances. The median hospital operating cash flow margin—monitored by Moody’s Investors Service as a signal of financial strength—fell to 8.1% last year from 9.5% a year earlier, in a preliminary analysis of 160 nonprofit and public hospitals and hospital systems with credit ratings from the agency, a Moody’s report said. (Evans, 4/23)
The Wall Street Journal:
Humana-Led Group To Buy Hospice Operator In $1.4 Billion Deal
Three different firms, including health insurer Humana Inc., HUM 0.13% are buying hospice operator Curo Health Services for about $1.4 billion as the consortium looks to expand its footprint in the home health-care business. Humana, TPG Capital and Welsh, Carson, Anderson & Stowe said Monday they reached a deal to buy privately held Curo and ultimately plan to combine it with Kindred at Home Division’s hospice business. The same three firms announced plans to purchase Kindred Healthcare Inc., the parent firm of Kindred at Home, in December. (Prang, 4/23)
The New York Times:
‘Whole Again’: A Vet Maimed By An I.E.D. Receives A Transplanted Penis
In a 14-hour operation, a young military veteran whose genitals were blown off by a bomb received an extraordinary transplant: a penis, scrotum and portion of the abdominal wall, taken from a deceased organ donor. The surgery, performed last month at Johns Hopkins Hospital, was the most complex and extensive penis transplant to date, and the first performed on a combat veteran maimed by a blast. (Grady, 4/23)
The Associated Press:
Veteran Who Survived Blast Receives Unusual Penis Transplant
Saying they wanted to address "an unspoken injury of war," Johns Hopkins University surgeons rebuilt the man's entire pelvic region — transplanting a penis, scrotum and part of the abdominal wall from a deceased donor — in a highly experimental 14-hour operation last month. Such transplants "can help those warriors with missing genitalia just as hand and arm transplant transformed the lives of amputees," Dr. W.P. Andrew Lee, Hopkins' chairman of plastic and reconstructive surgery, told reporters Monday. (Neergaard, 4/23)
The Washington Post:
Veteran, Injured By A Roadside Bomb, Receives Transplanted Penis And Scrotum
Doctors said they hoped that the patient, who is expected to be released from the hospital this week, would regain “near-normal” urinary and sexual functions as he recovers and his nerves heal over the coming months. “It’s a real mind-boggling injury to suffer; it is not an easy one to accept,” the patient said in a release. “When I first woke up, I felt finally more normal.” (Rosenberg, 4/23)
NPR:
First Penis And Scrotum Transplant, Johns Hopkins Surgeons Say
The man's fertility won't be restored, however. His testicles did not survive his ordeal and a testicle transplant would raise deep ethical issues, because the genetic material in the sperm would be from the donor, not the recipient. (Harris, 4/23)
Stat:
Weight Loss Drugs Were Commercial Flops. Can They Be Used For Addiction?
If dependence on cocaine or cigarettes is the result of addiction, is obesity in essence an addiction to food? Some scientists certain think so, which is why several weight loss drugs are being studied as potential addiction therapies. There are plenty to choose from: A wave of prescription weight loss drugs hit the market in recent years, and they were initially expected to perform well. But medications including Qsymia, Belviq, and Contrave have all flailed on the market — doctors and patients alike have been reticent to take them. (Keshavan, 4/24)
Stat:
DEA Plan To Stem Supply Of Prescription Drugs Draws Skepticism
With pressure building on the the Drug Enforcement Administration to stem the supply of prescription drugs, a new proposal aims to empower the agency to more aggressively limit manufacturing levels and to put hundreds of drug makers on notice. It’s not yet clear whether the proposal will achieve either goal. According to a rule introduced last week, the DEA would be able to tighten overall quotas and individual quotas issued to manufacturers if it suspects supplies are being diverted for misuse — particularly in cases of “pill dumping.” (Facher, 4/24)
Stat:
How A Patient Advocacy Group Is Used To Promote Insys' Fentanyl Drug
Two months ago, a Senate report suggested that Insys Therapeutics (INSY) provided $2.5 million to a patient advocacy group in order to influence usage and providing of its Subsys opioid painkiller. The link, however, was not fully explored, but a new essay in a bioethics blog takes us a step closer to understanding how that relationship may benefit the company. To do so requires a familiar exercise: follow the money. But it also helps to understand why Subsys and a handful of similar powerful medications, all of which are forms of fentanyl, are often favored by doctors for treating so-called breakthrough cancer pain. (Silverman, 4/23)
The Associated Press:
Opioid Treatment Gap In Medicare: Methadone Clinics
One in three older Americans with Medicare drug coverage is prescribed opioid painkillers, but for those who develop a dangerous addiction there is one treatment Medicare won't cover: methadone. Methadone is the oldest, and experts say, the most effective of the three approved medications used to treat opioid addiction. It eases cravings without an intense high, allowing patients to work with counselors to rebuild their lives. (Johnson, 4/24)
The New York Times:
Prince Heirs Sue Illinois Hospital, Walgreens Pharmacy Chain Over Singer's Death
Heirs of Prince have sued an Illinois hospital and pharmacy chain Walgreens, saying they could have prevented the singer's 2016 death if they had properly diagnosed and treated his overdose days earlier, a court document showed on Monday. The wrongful death lawsuit, filed in Cook County Circuit Court in Chicago on Friday, accuses a doctor and pharmacist at Trinity Medical Center in Rock Island, Illinois, of failing to properly investigate the overdose or see that the pop star received appropriate counseling. (Whitcomb and Herskovitz, 4/24)
Los Angeles Times:
In Human Cells, Scientists Find DNA That Looks Like A Twisted Knot Instead Of A Double Helix
Biology textbooks may be due for a rewrite. For the first time, scientists have detected a DNA structure inside living human cells that looks more like a four-stranded knot than the elegant double helix we learned about in school. The tangled shape, known as an i-motif, had been seen before in the lab, but few researchers expected it to occur in human cells. The new work shows not only that i-motifs do indeed exist in human cells, but that they may be quite common. (Netburn, 4/23)
The Wall Street Journal:
Who’s In Charge Here? Aging Parents Resist Interfering ‘Helicopter’ Children
Joshua Coleman remembers watering down a glass of wine before giving it to his father, then in his 90s. “What the hell is this?” he recalls his father asking. “I feel a little guilty about that now,” says Dr. Coleman, whose father died in 2001. “The poor old guy had few remaining pleasures left. But I would have felt bad had he gone back to assisted living and slipped.” (Ansberry, 4/23)
The Washington Post:
Source Of E. Coli-Contaminated Romaine Lettuce Still A Mystery, FDA Says
Eight sick prisoners in Nome, Alaska, have provided a clue to authorities about the origin of a nationwide outbreak of dangerous E. coli infections from romaine lettuce, but U.S. officials said Monday they still haven't pinpointed the source of the contamination. Instead, the Food and Drug Administration and the Centers for Disease Control and Prevention are sticking with a broad warning to consumers, telling them to throw away romaine, in any form, that comes from the Yuma, Ariz., growing region, and to avoid eating romaine of unknown origin. Most of the romaine sold in the United States during the winter is grown in the Yuma region. (Sun and Achenbach, 4/23)
Los Angeles Times:
With Money Tied Up In Court, California Lawmakers Try Again With New Plan To Spend $2 Billion On Homeless Housing
A measure to spend $2 billion on housing homeless Californians could be on the November statewide ballot. State Sen. Kevin de León (D-Los Angeles) is pushing the idea to deal with what he said was a “burgeoning humanitarian crisis whose epicenter is here in California.” De León’s new measure is a do-over for a 2016 plan passed by the Legislature to redirect $2 billion toward building homeless housing from a voter-approved 1% income tax surcharge on millionaires that funds mental health services. (Dillon, 4/24)
The Washington Post:
These Teens Saw How Poor Mental Health Hurt Their Peers. So They Got A Law Passed.
Lucas Johnson’s résumé is characteristic of any high-achieving high school senior. There’s the raft of Advanced Placement classes, a dozen during his four years at Monticello High School in Virginia’s Albemarle County. There are the extracurriculars — tutoring and Model United Nations and student council and cross-country. During his junior year, there was the stress that accompanied all of it — stress that, at times, made him ask: “What is the point of all of this?” The 18-year-old witnessed distress among his peers, too — troubling Facebook and Instagram posts, bullying that went unaddressed, students without a place to turn. (Truong, 4/23)
The Associated Press:
Norovirus Confirmed After 100 College Students Fall Ill
Health officials have confirmed that norovirus sickened about 100 students at Western Connecticut State University and prompted the school to close for the day for disinfecting. State Department of Public Health officials said Monday that testing confirmed norovirus, which is a highly contagious bug that causes diarrhea, nausea, muscle pain, vomiting and other symptoms.University officials said both campuses in Danbury are closed Monday as maintenance crews clean and disinfect school buildings. About 5,700 students attend WCSU. (4/23)