First Edition: June 5, 2018
DID YOU TAKE YOUR VITAMINS? If so, you are one among millions of Americans. But what evidence is there that they ward off chronic disease? Tune in to the next KHN Facebook Live on Wednesday, June 6, at 3 p.m. ET, when senior correspondent Liz Szabo will separate fact from fiction. You can submit your questions and watch here.
Kaiser Health News:
A Hospital ER Charges An ‘After-Hours’ Fee. Who Has To Pay It?
Tacking on an after-hours surcharge to an emergency department bill strikes some consumers as unfair, since the facilities are open 24 hours a day. The practice is “pretty rare” but defensible, said Dr. Paul Kivela, an emergency physician in Napa, Calif., who is president of the American College of Emergency Physicians. He noted that the cost to staff an emergency department at night is higher than by day. The surcharge is typically modest, often less than $100, experts say. (Andrews, 6/5)
Kaiser Health News:
Suspension Of California’s Aid-In-Dying Law Leaves Sick Patients In Limbo
Dozens of terminally ill patients in California who counted on using the state’s medical aid-in-dying law may be in limbo for a month after a court ruling that suspended the 2016 measure. A judge who ruled in May that the law was improperly enacted refused to vacate that decision at the request of advocates last week. Riverside County Superior Court Judge Daniel Ottolia set a hearing for June 29, however, to consider a separate motion by state Attorney General Xavier Becerra to reverse the decision. (Aleccia, 6/5)
Kaiser Health News:
Listen: Disrupted Lives, Delayed Care And A Revised Death Toll In Puerto Rico
KHN senior correspondent Sarah Varney, on assignment in Puerto Rico, spoke with Mina Kim, host of KQED Forum, on Friday — the first day of hurricane season. A study published in the New England Journal of Medicine last week showed that more than 4,600 people perished during and after the Sept. 20 storm. A third of the deaths were attributed to delayed medical care or no medical care at all, according to the study. Varney has seen firsthand how devastation wrought by the storm harmed citizens of the island, especially the sick and elderly. (6/4)
The New York Times:
Maine Voted To Expand Medicaid. Judge Orders The State To Get Moving.
Seven months after Maine voters approved a ballot measure to expand Medicaid to tens of thousands of additional residents, a state judge on Monday ordered Gov. Paul LePage’s administration to stop stonewalling and move ahead with the plan. It was the second victory in a week for Medicaid expansion, which became possible under the Affordable Care Act. Lawmakers in Virginia voted last week to open the program to an additional 400,000 residents. Advocates in Utah have succeeded in getting a question on the November ballot about expanding Medicaid, and similar efforts are underway in Idaho and Nebraska. (Goodnough, 6/4)
The Hill:
Judge Orders Maine To Implement Voter-Approved Medicaid Expansion
Maine voters approved expansion in November through a citizen-led ballot measure, but LePage has fought back at every turn.
He said he wouldn't implement expansion unless state legislators found a way to pay for it without raising taxes. But expansion supporters argued the governor's estimate was too high. His administration missed the April 3 deadline to send a plan to the federal government, prompting lawsuits from the Maine Equal Justice Partners and Consumers for Affordable Health Care. (Hellmann, 6/4)
The Washington Post:
Trump Administration Inaugurates Medicaid Scorecard For State Programs
The Trump administration is embarking on a basic change to Medicaid that for the first time evaluates states based on the health of millions of Americans and the services they use through the vast public insurance program for the poor. Seema Verma, administrator of the federal Centers for Medicare and Medicaid Services, announced on Monday an initial version of a “scorecard” that compiles and publicizes data from states for both Medicaid and the Children’s Health Insurance Program (CHIP), a companion for youngsters in working-class families. (Goldstein, 6/4)
The Washington Post:
How Virginia Came To Embrace Medicaid Expansion After Four Years Of Refusal
Virginia’s vote to expand Medicaid last week was a striking turnaround for a Republican-controlled legislature that had fought expansion for four straight years. Although November’s election added Democrats to the House of Delegates, that alone doesn’t explain the shift. So many Republicans swung over to support Medicaid expansion that — mathematically, anyway — it could have been done even without the new bloc of Democrats. (Schneider and Vozzella, 6/4)
The Associated Press:
About 2 Dozen Arrested At North, South Carolina Legislatures
Nearly two dozen demonstrators were arrested Monday at legislatures in North Carolina and South Carolina as part of a national movement highlighting what organizers call injustices to the poor. An official with the General Assembly Police in North Carolina says 13 people were led away in zip ties from outside the offices of House Speaker Tim Moore and Senate leader Phil Berger. Those arrested were charged with second-degree trespassing. ... Nearly two dozen people participated in the protest, calling for a "moral revival" of the health care system and an immediate expansion of Medicaid. Following the "lie-in," about a dozen demonstrators blocked U.S. Highway 1 in front of the capitol and were arrested by Columbia police. Those arrested were holding two signs, "Death Runs the Statehouse" and "Our Blood Your Hands!" (6/4)
The Hill:
New York, Washington State Propose Double Digit Rate Hikes For ObamaCare Plans
ObamaCare insurers in New York and Washington state are proposing double-digit rate hikes for 2019, citing recent and upcoming changes to the law. In New York, 14 insurers are asking state regulators to approve an average rate hike of 24 percent, while 11 insurers in Washington state want to increase premiums by an average of 19.08 percent. (Hellmann, 6/4)
Politico:
Texas Plaintiffs Personalize Uphill Legal Challenge To Overturn Obamacare
Two self-employed Texans, John Nantz and Neill Hurley, have leading roles in the latest legal effort to kill Obamacare. The men are the named plaintiffs in a lawsuit by 20 states that argues Congress fatally undercut the law when it repealed the individual mandate penalty in tax cut legislation. Nantz and Hurley say the mandate compels them to buy costly insurance that doesn't fit their needs — even though the financial penalty for not complying is disappearing next year. (Rayasam, 6/4)
The Associated Press:
High Court Rules In Dispute Over Immigrant Teen's Abortion
The Supreme Court ruled Monday in a case about a pregnant immigrant teen who obtained an abortion with the help of the American Civil Liberties Union, siding with the Trump administration and wiping away a lower court decision for the teen but rejecting a suggestion her lawyers should be disciplined. The decision is about the teen's individual case and doesn't affect an ongoing class-action case about the ability of immigrant teens in government custody to obtain abortions, the ACLU said. The justices ruled in an unsigned opinion that vacating a lower court decision in favor of the teen, who had been in government custody after entering the country illegally, was the proper course because the case became moot after she obtained an abortion. (Gresko, 6/4)
Politico:
Supreme Court Wipes Out Appeals Court Ruling In Immigrant Abortion Case
The action means the question is all but certain to arise again, particularly given the Trump administration’s policy of resisting actions it views as facilitating abortions for minors. The high-profile case, which dates back to last fall, was the first in a series of court battles over abortion policy in the relatively obscure Health and Human Services’ Office of Refugee Resettlement (ORR), which is responsible for the care of unaccompanied minors who enter the country illegally. Monday’s court order, one of the first of abortion cases with Supreme Court Justice Neil Gorsuch on the bench, comes after weeks of delay suggesting that there might have been conflicting opinions behind the scenes of the court, but no dissenting opinion was issued. (Gerstein and Rayasam, 6/4)
The Wall Street Journal:
Supreme Court Vacates Ruling On Undocumented Minor’s Abortion
The high court’s action hands a potential boost to the administration as it continues to defend its stance because the lower-court precedent will no longer exist. Related litigation is continuing, and the issue could come back to the Supreme Court. The court’s action came in an unsigned opinion with no recorded dissents. A Washington, D.C., appeals court ordered the administration in October to let the teenager leave government custody so she could get an abortion. The girl—from an unnamed country—had crossed the southern U.S. border in September when she was eight weeks pregnant. (Kendall, 6/4)
The Associated Press:
Long Waits Under VA's Private Health Program
A health care program being expanded by the Trump administration to give veterans greater access to private doctors has failed to provide care within 30 days as promised due to faulty data and poor record-keeping that could take years to remedy. That's according to a government investigation. The Government Accountability Office found veterans often waited between 51 and 64 days for appointments with private doctors under the Choice program. The scheduling process took as long as 70 days. (Yen, 6/4)
Modern Healthcare:
Primary Season: Democrats' Next Healthcare Ideas Go To The Polls
Sitting congressional Democrats are increasingly comfortable with the idea of a public option. Over the past year, lawmakers have proposed several bills involving public option ideas. They counter the "Medicare for all" proposal by Vermont's liberal independent Sen. Bernie Sanders that critics have panned as impractical and costly while shifting the majority of Americans off their employer coverage. Current polling for both these options track in their favor at a time when Obamacare has never been more popular. (Luthi, 6/4)
Los Angeles Times:
Where The Candidates For California Governor Stand On The State's Biggest Issues
Welcome to your guide to some of the key policy positions of six top candidates in California’s race for governor. The candidates listed have met certain criteria, including: previous election to public office; at least 5% support from likely voters in an independent, established public opinion poll; or demonstrated fundraising ability. Here’s where they stand. (6/4)
The New York Times:
She Went To Jail For A Drug Relapse. Tough Love Or Too Harsh?
As soon as Julie Eldred was granted probation for stealing jewelry to buy drugs, she got busy fulfilling the judge’s conditions. She began an intensive all-day outpatient treatment program. She even went an extra step and started daily doses of Suboxone, a medication that can quell opiate cravings. Then she relapsed and snorted her drug of choice — fentanyl.To stop from plunging into free fall, she asked her doctor for a stronger dose of Suboxone. She stayed clean the next day. And the next. (Hoffman, 6/4)
Reuters:
Florida Doctor Admits Taking Kickbacks From Insys, Others
A Florida doctor has admitted, as part of a plea deal, that he received kickbacks from Insys Therapeutics Inc in exchange for writing prescriptions for a powerful fentanyl-based pain medicine. Dr. Michael Frey, 46, pleaded guilty on Monday in federal court in Fort Myers, Florida, to conspiring to receive kickbacks from a medical equipment provider and a pharmacy sales representative. (Raymond, 6/4)
The Washington Post:
Researchers Use Immune-Cell ‘Army’ To Battle Another Tough Cancer
A Florida woman diagnosed with advanced breast cancer, generally considered incurable, is free of the disease two-and-a-half years after a novel therapy used her own immune cells to target her tumors, researchers said Monday. Striking recoveries were reported earlier for a patient with deadly liver cancer and another with advanced colon cancer. The three patients were treated by a team at the National Cancer Institute led by Steven Rosenberg, an immunotherapy pioneer who is chief of the surgery branch. For each patient, the team sequenced the genomes of their tumors to find mutations, then tested immune cells extracted from the cancers to identify which ones might recognize the defects. Those cells were expanded by the billions in the laboratory, then infused back into the patients, where they attacked the tumors. (McGinley, 6/4)
Los Angeles Times:
'I Have Definitely Hit The Jackpot.' Advanced Breast Cancer Disappears After New Immunotherapy
The patient’s “complete durable cancer regression” followed a single infusion of her own immune cells, which were painstakingly chosen for their ability to recognize and fight her tumors — then expanded into an army of 82 billion identical cells. More than three years later, the patient, Judy Perkins, is not only alive, but seemingly cancer-free, according to a report published Monday in the journal Nature Medicine.“I have definitely hit the jackpot,” said Perkins, a retired engineer from Port St. Lucie, Fla. In the fast-moving world of cancer research, the new report is being hailed as a development that could open a broad new front in cancer immunotherapy. (Healy, 6/4)
The Wall Street Journal:
Novel Immunotherapy Method Led To Complete Regression Of Breast Cancer In Patient
Dr. Rosenberg, who has investigated for three decades how the immune system can be employed to fight cancer, said he is hopeful this approach “holds the best opportunities for finding effective immunotherapies for patients with the solid tumors that last year caused over 500,000 deaths in this country.” “This research has promise for many malignancies,” said Cleveland Clinic medical oncologist Megan Kruse. “We rarely see such deep and durable responses with conventional therapies and we have not seen such dramatic responses with other immunotherapies in breast cancer to date.” (Burton, 6/4)
NPR:
Breast Cancer Treatment With T Cells Eradicates Advanced Disease In Patient
But Rosenberg and others caution that the approach doesn't work for everyone. In fact, it failed for two other breast cancer patients. Many more patients will have to be treated — and followed for much longer — to fully evaluate the treatment's effectiveness, the scientists say. Still, the treatment has helped seven of 45 patients with a variety of cancers, Rosenberg says. That's a response rate of about 15 percent, and included patients with advanced cases of colon cancer, liver cancer and cervical cancer. (Stein, 6/4)
Stat:
As CAR-T Advances, Washington Grapples With Ideas For How To Pay For It
They are among the most promising new cancer therapies available, but they come with sky-high prices to match. And now the Trump administration is grappling with just how the federal government, through Medicare and Medicaid, will pay for them. The government’s payment policies for CAR-T treatments — which cost hundreds of thousands of dollars — are just beginning to take shape, but will likely have trickle-down effects on insurance coverage decisions throughout the country. They will also likely affect how enthusiastically doctors and hospitals start offering the therapies to patients. (Mershon, 6/5)
Stat:
New Calculator Could Change Aspirin, Statin, And Blood Pressure Prescribing
More than 11 million people may need to reconsider taking medications to avoid heart attack and stroke, according to new research that says current guidelines overestimate risk for some people, but underestimate risk for others, especially African-Americans. Right now, doctors can consult a calculator found online or in electronic health records to decide whether patients might benefit from aspirin, statins, or blood pressure medications. Those estimates of 10-year risk for cardiovascular disease were derived in 2013 and endorsed by the American College of Cardiology and the American Heart Association. They were based on statistical analyses that combined data from large studies such as the original Framingham Heart Study, whose participants were 30 to 62 years old in 1948. (Cooney, 6/4)
The Washington Post:
A Big Question Answered About Treating Early-Stage Breast Cancer
One of the big questions facing women with early-stage breast cancer is whether to be treated with chemotherapy to reduce their risks that the cancer will return. A new study presented Sunday at the annual meeting of the American Society of Clinical Oncology provides much-needed clarity: Most of these women can safely skip chemo. Although chemotherapy for early-stage breast cancer has been declining, physicians said the latest research findings will have a major effect by either giving patients more confidence in their decisions or encouraging them to take a different treatment approach. There are some important nuances, however. (McGinley, 6/4)
The Wall Street Journal:
Research Yields Progress Against Lung Cancer
Cancer researchers presented more evidence of advances against one of the deadliest and most common forms of the disease—lung cancer—at a major medical meeting here. Studies released at the annual meeting of the American Society of Clinical Oncology in recent days showed that a range of newer approaches, from immune-boosting drugs to treatments targeting genetic traits of tumors, can help patients. Some of the drugs are supplanting or augmenting chemotherapy, which has been commonly used to treat lung cancer for years but with limited effectiveness. (Loftus, 6/4)
The Washington Post:
Live Like Lola: A Young Girl Confronts Deadly Brain Cancer With Resolve
It was several months after learning she had a rare brain tumor — and several more before she would turn 13 — when Lola Muñoz drove from Upstate New York to Tennessee with her mother. The choice had been Lola’s: to enter a clinical trial testing whether two chemotherapy drugs might be safe for patients with DIPG. Diffuse intrinsic pontine gliomas, striking in childhood at the base of the brain, are especially aggressive, difficult to treat and deadly. Lola opted to take part in the trial at St. Jude Children’s Research Hospital in Memphis with a singular hope. “I’d rather help find something for the other kids that will get DIPG than to not help at all,” she explained. (Levine, 6/4)
The Associated Press:
Licking Cancer: US Postal Stamp Helped Fund Key Breast Study
Countless breast cancer patients in the future will be spared millions of dollars of chemotherapy thanks in part to something that millions of Americans did that cost them just pennies: bought a postage stamp. Proceeds from the U.S. Postal Service's breast cancer stamp put researchers over the top when they were trying to get enough money to do the landmark study published on Sunday that showed genetic testing can reveal which women with early-stage breast cancer need chemo and which do not. (Marchione, 6/4)
Stat:
At CRISPRCon, Talk Of Designer Babies, IP Fights, And Scientific Colonialism
While lacking the costuming of Comic-Con or revelry of SantaCon, CRISPR’s second annual geek-out dealt with a concept weightier than superheroes or public drunkenness: How should society deal with a technology that can literally reshape the world? CRISPRcon brought hundreds of academics, industry scientists, and public health officials to Boston this week to answer just that question, moving past the beaker-and-pipette specifics of gene-editing to tackle the ethical, cultural, and democratic implications of science’s favorite new toy. The event runs through Tuesday. (Garde, 6/5)
The New York Times:
The Ideal Subjects For A Salt Study? Maybe Prisoners.
Suppose you wanted to do a study of diet and nutrition, with thousands of participants randomly assigned to follow one meal plan or another for years as their health was monitored? In the real world, studies like these are nearly impossible. That’s why there remain so many unanswered questions about what’s best for people to eat. And one of the biggest of those mysteries concerns salt and its relationship to health. (Kolata, 6/4)
Reuters:
Medical Workers In Congo City Finish Vaccinating Contacts Of Ebola Patients
Medical workers in Democratic Republic of Congo have given all the immediate contacts of Ebola patients in the city of Mbandaka an experimental vaccine as they try to thwart a disease that has killed around 25 people, the health ministry said. Ebola spreads easily through bodily fluids and the medical strategy involves vaccinating all the people a patient may have infected and then vaccinating a second "ring" of contacts around each of those potential sufferers. (Mwarabu, 6/4)
The Washington Post:
New Report Finds No Evidence That Having Sex With Robots Is Healthy
Sex sells, and robots are no exception. One of the most expensive consumer robots under development, a machine named Harmony, is a $15,000 union of silicone curves and silicon chips. Part of an estimated $30 billion industry, Harmony has software that remembers birthdays and can quote Shakespeare, per the Guardian. Harmony is also equipped for intimate human-robot relations. Sex doll maker Realbotix, in its marketing materials, bills Harmony as “the perfect companion.” But healthy companionship is too bold a claim to make about sex robots, warn a pair of doctors in a report published Monday in the journal BMJ Sexual & Reproductive Health. (Guarino, 6/4)
The New York Times:
That Time Of The Month Can Be Fun, Too
When it comes to periods, every woman has a story about “that time” — that time she first saw the blood in her underwear and thought death was knocking; that time she tied a sweatshirt around her waist to hide a stain on her white paints; that time her cycle made its presence known at the most inopportune moment. “We’re making out like crazy, and I remember feeling extra wet,” said Njambi Morgan, a spoken word performer and poet, sharing her own “that time” story with a crowd of several dozen listeners. “I thought, that’s how it is in the movies. I got this. One thing led to another, and then he jumped up. I’ve never seen a face like that.” The audience of mostly women groaned in sympathy, knowing where the story was headed. Ms. Morgan imitated the voice of a teenage boy: “OH. You bled all over my mom’s couch!” (Safronova, 6/4)