First Edition: November 1, 2018
Today's early morning highlights from the major news organizations.
Kaiser Health News:
In Search Of Insurance Savings, Consumers Can Get Unwittingly Wedged Into Narrow-Network Plans
[Donna] Catanuchi’s switch to a more affordable but restrictive plan reflects a broad trend in insurance plan design over the past few years. The cheaper plans offer far narrower networks of doctors and hospitals and less coverage of out-of-network care. But many consumers are overwhelmed or unaware of the trade-offs they entail, insurance commissioners and policy experts say. With enrollment for ACA health plans beginning Nov. 1, they worry that consumers too often lack access to clear information about which health plans have “narrow networks” of medical providers or which hospitals and doctors are in or out of an insurer’s network, despite federal rules requiring plans to keep up-to-date directories. (Findlay, 11/1)
California Healthline:
Billions In ‘Questionable Payments’ Went To California’s Medicaid Insurers And Providers
California’s Medicaid program made at least $4 billion in questionable payments to health insurers and medical providers over a four-year period because as many as 453,000 people were ineligible for the public benefits, according to a state audit released Tuesday. In one case, the state paid a managed-care plan $383,635 to care for a person in Los Angeles County who had been dead for more than four years, according to California State Auditor Elaine Howle. (Terhune, 11/1)
The Associated Press:
Stable Premiums, More Options As Health Law Sign-Ups Begin
The Affordable Care Act's sixth sign-up season opens Thursday amid stabilizing premiums and more choice for consumers. Nationally, average premiums are going up only by low single-digit percentages for 2019. In some states, and for some types of plans, premiums will decline. Fewer areas will see increases. Insurers also are expanding their participation. (Alonso-Zaldivar, 10/31)
The Wall Street Journal:
Health Law Faces Its Toughest Stress Test Yet
This is also the first open-enrollment period under a Trump-administration change expanding access to cheaper plans that don’t cover the panoply of benefits mandated by the ACA. Those less-expensive plans can also deny coverage to people with pre-existing conditions. Both of these change could weaken the exchanges where millions of Americans who don’t get insurance from an employer or government program go to obtain coverage. Health analysts say the moves will likely siphon off younger and healthier consumers who are needed to offset the health costs of older, sicker people remaining on the exchanges because they need more robust coverage. (Armour, 11/1)
The Washington Post:
Affordable Care Act Open Enrollment Begins And Will Test Republican Health Policies
During the enrollment season — which lasts six weeks, half as long as it used to be — consumers may buy the health coverage created under the ACA. This is the first enrollment since Congress removed the law’s penalty for people who fail to carry health insurance. With that federal fine scheduled to vanish in January, this year’s marketplaces will furnish evidence for a long-simmering debate: How much of the nation’s gains lately in health coverage have happened because of the law’s insurance mandate, and will coverage tumble without it? (Goldstein, 10/31)
NPR:
ACA Insurance Sign-Ups For 2019 Are Starting. Here's What To Expect
It's time for consumers who buy their own health insurance to start shopping for policies for next year. Open enrollment for Affordable Care Act coverage starts Thursday across most of the country. But the shopping and buying experience will vary widely, depending on where people live. (Kodjak, 10/31)
The Associated Press:
US Rejects Wisconsin's Drug-Testing Plan For Medicaid
President Donald Trump’s administration on Wednesday rejected a plan from Wisconsin Gov. Scott Walker to require drug screening and testing for adults on Medicaid with no dependent children, but approved a wide array of other get-tough changes to the program. Walker, who is seeking a third term in Tuesday’s election, argued the changes would better prepare Medicaid recipients to get a job. Walker’s administration agreed to revise the drug-testing plan amid concerns identified by the federal government and commenters, Seema Verma, administrator of the Centers for Medicare and Medicaid Services, said in a letter to the state. (Bauer, 10/31)
The Washington Post:
Trump Administration Allows Wisconsin To Question Medicaid Applicants About Risky Behavior
The Trump administration is allowing Wisconsin to become the first state to compel certain poor residents to disclose behavior such as drinking and exercise to qualify for Medicaid — and to charge more to people whose behavior the state judges as risky. Federal health officials, however, rebuffed an unprecedented effort by Wisconsin to impose drug tests on Medicaid applicants. The rejection placed a limit on the flexibility the administration has been urging states to embrace for the vast safety-net health insurance system, though illicit drug use can be an item in a health-risks questionnaire. (Goldstein, 10/31)
Reuters:
Privacy, Drug Price Bills Have A Fighting Chance In A Post-Election U.S. Congress
If Democrats win control of the House of Representatives in next week’s elections and create a divided U.S. Congress, as they are seen as likely to do, the number of bills with a chance of passing falls dramatically. But two areas of general agreement between the Democrats, Republicans and President Donald Trump stand out as having a high potential of successful legislation: lowering prescription drug prices and new regulations to protect online privacy. (Bartz, 10/31)
The New York Times:
First Up If Democrats Win: Campaign And Ethics Changes, Infrastructure And Drug Prices
If they win, they would then turn to infrastructure investment and the climbing costs of prescription drugs, answering voter demands and challenging President Trump’s willingness to work on shared policy priorities with a party he has vilified. The idea, said Representative Nancy Pelosi of California, the Democratic leader, is to show voters that Democrats are a governing party, not the leftist mob that Mr. Trump describes — and to extend an arm of cooperation to the president after an electoral rebuke. (Fandos, 10/31)
The Washington Post:
Abortion, Marijuana, Redistricting And Voting: What’s On State Ballots This Fall
This November, voters in 37 states will face 155 ballot questions. Taxation and bonds are common nationwide. Other ballots are more state-specific. ... In many states, however, ballot questions echo larger national trends. Voters in West Virginia and Oregon will decide whether to amend their state constitutions to limit Medicaid abortion funding to cases of life endangerment, rape and incest, the minimum federal requirement. Officials in both states had tried to curb Medicaid funds for abortion, but state courts overruled them. (Rabinowitz, 10/31)
NPR:
Voters In 4 States Set To Decide On Medicaid Expansion
On Election Day, Utah residents will be going to the polls to vote on whether the state will join 33 others and Washington, D.C., in expanding Medicaid coverage to a lot more low-income adults. Democrat and Republican states have expanded. Nebraska and Idaho also have the Medicaid question on ballots in their states. Idaho Gov. Butch Otter, a Republican, endorsed the expansion initiative Tuesday. And in Montana, voters will decide whether to approve a tobacco tax to continue that state's Medicaid expansion or let it roll back next year. (Kodjak, 10/31)
The Associated Press:
Washington Doctor Uses Experience To Fuel US House Campaign
In her election ads, Dr. Kim Schrier wears a white doctor’s coat as she declares that health care is a right. She talks about her Type 1 diabetes, her concern as a parent over President Donald Trump’s policies and how she counsels families of depressed teen boys as a longtime pediatrician. The Democrat running for an open U.S. House seat in Washington state is framing her candidacy around health care issues with a personal touch, hoping the popularity of aspects of former President Barack Obama’s health care law and support for improving access to medical care drives her to victory. (Ho, 11/1)
The Associated Press:
Enrollment To Start For Medicaid Expansion Population
About 400,000 newly eligible low-income Virginia adults can start enrolling in Medicaid. Medicaid expansion enrollment starts Thursday in Virginia for coverage that will start at the beginning of 2019. Gov. Ralph Northam is set to provide remarks at St. Mary’s Hospital in Richmond. Expanding Medicaid was one of Northam’s biggest legislative priorities. (11/1)
The Washington Post:
Fact Checker: GOP Hopefuls Say They Fight Insurance Companies, Just Like Obama
When Barack Obama first ran for president in 2008, he promised to force insurance companies to cover preexisting conditions, contrasting his stance with Republican nominee John McCain, who the ad said would let insurance companies “continue to do as they please.” ... Now some Republicans are stealing Obama’s rhetoric and claiming they will do what the ACA – which remains largely intact, despite President Trump’s efforts – already does. It’s certainly an interesting turnaround. (Kessler, 11/1)
USA Today:
Seema Verma Tweet: 'Scariest Halloween Costume' Is Medicare For All
The head of Medicare and Medicaid was being criticized online Wednesday after she took a Halloween-inspired jab at Medicare for all on Twitter. Seema Verma, Administrator for the Centers for Medicare & Medicaid Services, posted a photo of a man wearing a black T-shirt emblazoned with "Medicare for All" Wednesday afternoon with the comment "this year’s scariest Halloween costume goes to..." ... Verma, in a statement to USA TODAY, said the post was a way to get attention and said critics weren't wrong, changing the U.S. healthcare system isn't a joke. (Hayes, 10/31)
The New York Times:
Training The Next Generation Of Doctors And Nurses
For decades, medical education has followed a timeworn path — heaps of book learning and lectures, then clinical rotations exposing students to patients. But as technology explodes into patient care (surgeons can preview operations using virtual 3-D images built from a patient’s scans), the gap between medical education and real-world care has “become a chasm,” said Marc Triola, director of N.Y.U. Langone’s Institute for Innovations in Medical Education, created in 2013 to address the issue. (Pappano, 10/31)
ProPublica and Houston Chronicle:
Federal Inspectors Cite St. Luke’s In Houston For Problems In A Heart Transplant
The federal government has cited Baylor St. Luke’s Medical Center in Houston for not having working defibrillator paddles in the operating room during a January heart transplant. The transplant ultimately failed, and the patient died two months later. During a review this month, the federal Centers for Medicare and Medicaid Services found that “there were not sufficient quantities of emergency equipment (internal defibrillator paddles) immediately available during cardiac (open chest) surgery,” according to a copy of the report provided by the agency at the request of ProPublica and the Houston Chronicle. (Ornstein and Hixenbaugh, 10/31)
The Associated Press:
Rural Virginia County Hopes, After Years, To Reopen Hospital
There was nowhere local to go for care because Lee County's only hospital, about a mile down the road from where McElyea fell ill, abruptly shut its doors in 2013. In the five years since, local community leaders have been fighting to reopen the facility, and after a series of fits and starts, it looked for much of this year like that might happen thanks to a deal with a startup company. But financial challenges the company acknowledges it's been working through have thrown the plan into question at the last minute, officials say. It's a story that illustrates the herculean task of trying to revive a shuttered rural hospital and the harsh realities of disparate access to health care in many parts of America. (Rankin, 10/31)
NPR:
Cervical Cancer Patients Face Greater Risks With Minimally Invasive Surgery
A treatment for early stage cervical cancer that has rapidly gained acceptance in the United States turns out to be worse than standard surgery, according to two studies. The practice, now thrown into question, is called minimally invasive surgery. Instruments are threaded through small incisions, and surgeons use those to remove a diseased uterus. This technique has been growing in popularity since 2006 and has been widely adopted. (Harris, 10/31)
The New York Times:
Studies Warn Against Minimally Invasive Surgery For Cervical Cancer
Compared with the older, open abdominal operation, the minimally invasive approach was more likely to result in recurrence of the cancer and death, researchers found, in the first study that rigorously tested the two methods. The results, published on Wednesday in The New England Journal of Medicine, had been circulating among cancer specialists in recent months and are already changing medical practices. Minimally invasive surgery for cervical cancer had been regarded as an advance that would help women: It lets patients recover faster, and since it had proved safe for other cancers, it was expected to be safe for cervical cancer, too. (Grady, 10/31)
USA Today Network:
Cervical Cancer: Less-Invasive Hysterectomy Doesn't Raise Chances Of Survival, Study Shows
The study says more research is needed about the seemingly counterintuitive conclusion. But the results could change how cervical cancer is treated in the United States. “What’s interesting is that in no other study for any other cancer or any other benign condition have we ever found worse overall survival rates for minimally invasive surgical options,” said Dr. Daniel Margul of the University of Cincinnati Medical Center, the study’s co-author. (Saker, 10/31)
The New York Times:
Once Paralyzed, Three Men Take Steps Again With Spinal Implant
Mr. Mzee, now 33, is one of three men who lost the use of their legs years ago after severe spinal injuries, but who now are able to walk without any supports, if briefly and awkwardly, with the help of a pacemaker-like implant, scientists reported on Wednesday. The breakthrough is the latest achievement in the scientific effort to understand and treat such life-changing injuries. Several recent studies have restored motion to paralyzed or partially paralyzed patients by applying continuous electrical stimulation to the spinal cord. (Carey, 10/31)
The Associated Press:
Appendix Removal Is Linked To Lower Risk Of Parkinson's
Scientists have found a new clue that Parkinson’s disease may get its start not in the brain but in the gut — maybe in the appendix. People who had their appendix removed early in life had a lower risk of getting the tremor-inducing brain disease decades later, researchers reported Wednesday. (Neergaard, 10/31)
The Wall Street Journal:
Biotechs With No Drugs In Trial Are Raising Millions In IPOs
Biotech IPOs are on track for a near-record year, with a crop of offerings that are younger, more highly valued—and some say riskier—than any in recent memory. Driven by swift advances in medical science and an accommodative Food and Drug Administration that is increasingly willing to accelerate approval of innovative drugs, biotechnology companies are tapping the public markets at very early stages of development—some even before they have a drug in a clinical trial. (Walker, 10/31)
Reuters:
Anthem Predicts Better 2019 Than Wall Street Forecast, Shares Rise
Anthem Inc on Wednesday said its own expectations for 2019 earnings are ahead of current Wall Street estimates and the health insurer also raised its 2018 profit forecast, and its shares rose as much as 5 percent. The company also reported higher-than-expected third quarter profit as it reined in costs. (Mathias and Babu, 10/31)
The Wall Street Journal:
Anthem Reports Earnings Growth, Raises Outlook
Anthem’s medical loss ratio, or the share of premiums spent on health costs, was slightly worse than analysts’ expectations for the third quarter, according to early notes from analysts. But the company also said the number was consistent with its expectations and improved its full-year MLR outlook. During the insurer’s earnings call, analysts asked about slightly higher costs it cited in Medicaid, and Ms. Boudreaux said the business was “performing solidly within our target margins” and should show “continued ongoing strong performance for the full year.” (Prang and Wilde Mathews, 10/31)
Reuters:
GSK Feels Shingles Vaccine Boost, But Shares Slip On Drugs Mix
GlaxoSmithKline’s third-quarter earnings were lifted by demand for its new shingles vaccine on Wednesday, but the British drugs firm’s shares slipped despite an improved outlook as analysts focused on some drugs missing forecasts. (Sandle, 10/31)
The Wall Street Journal:
Glaxo’s Shingles Vaccine Gave Earnings A Shot In The Arm
Demand for Shingrix, which is aimed at people age 50 and over, has outpaced Glaxo’s expectations since it launched the vaccine late last year. The company says it now expects sales of £700 million to £750 million ($893 million to $957 million) this year, up from previous guidance of £600 million to £650 million. The vaccine protects against shingles, a disease that leads to a painful rash and that is caused by the reactivation of the chicken pox virus in people whose immune systems have weakened with age. Shingrix got a boost when the U.S. Centers for Disease Control and Prevention last year gave the vaccine favored status over a rival, Merck & Co’s Zostavax. The CDC also recommended that adults who had previously received Zostavax should still receive Shingrix. (Roland, 10/31)
Reuters:
Vaccines And Genzyme Help Sanofi Keep Promise Of Return To Growth
Sanofi lifted its 2018 profit target for the second time this year after robust sales of its vaccines and rare diseases division, Genzyme, helped it beat third-quarter profit expectations. (Blamont, 10/31)
NPR:
Millions Excluded By Language Barrier From Clinical Trials
According to interviews with doctors, government officials and pharmaceutical companies, few Alzheimer's studies include medical interpreters to help patients complete the specialized neuropsychological testing component required. One of the challenges is that clinicians and researchers have strongly cautioned against using interpreters to facilitate neuropsychological testing based on clinical experiences, observations and anecdotal evidence that they affect outcomes, according to a study published in Clinical Neuropsychology. (Eibelman, 10/31)
The Wall Street Journal:
San Francisco Businesses Are Split On Tax Boost To Fight Homelessness
Christin Evans and Gwen Kaplan both run small businesses in neighborhoods they say have become overrun with homeless encampments. Like most San Francisco residents, they agree the problem has grown to an unprecedented scale, with homeless people taking drugs, using the streets as toilets and showing signs of mental breakdown. ... But Ms. Kaplan and Ms. Evans hold opposing views on Proposition C, a ballot measure Nov. 6 that would impose a tax increase on large corporations to raise money to assist the homeless. Recent polling showed San Franciscans evenly divided on the proposal. (Carlton, 11/1)
The Wall Street Journal:
More U.S. Veterans Are Off The Streets
The number of homeless veterans declined in 2018 in response to long-established federal efforts and a push by dozens of local communities, according to the departments of Housing and Urban Development and Veterans Affairs. Nationwide, the number of homeless veterans fell to approximately 38,000, according to an overall count of the homeless taken in January. That represented a 5.3% decline since last year and about half the 73,367 veterans tallied in 2009. Dozens of towns, cities and states have declared an end to vet homelessness in their communities. (Kesling, 11/1)
NPR:
Why Are Premature Birth Rates On The Rise Again?
The rate of premature birth across the United States rose for the third year in a row, according to the annual premature birth report card from March of Dimes, a nonprofit organization that works to improve maternal and infant health. This comes after nearly a decade of decline from 2007 to 2015. In 2017, the premature birth rate was 9.93 percent of births, up slightly from 2016, when it was 9.85 percent. The report card draws from the latest Centers for Disease Control and Prevention data. (Chatterjee, 11/1)
USA Today Network:
Adenovirus Outbreak At New Jersey Pediatric Center: 10th Child Dies
A 10th child died Wednesday night from adenovirus after an outbreak at a New Jersey long-term care center that has infected 27 medically fragile children, the state Health Department said. The death came as the outbreak entered its sixth week at the Wanaque Center for Nursing and Rehabilitation. (Washburn, 11/1)
The Associated Press:
2nd Pediatric Facility In New Jersey Hit By Viral Outbreak
Patients at a second New Jersey pediatric facility have been found to have a respiratory virus, but authorities say it’s a different strain from the one linked to nine deaths. The state health department says there are four confirmed adenovirus cases among pediatric patients at Voorhees Pediatric Facility. But preliminary tests have ruled out Type 7, the strain linked to nine deaths at the Wanaque Center for Nursing and Rehabilitation. (11/1)
The New York Times:
Being Fit May Be As Good For You As Not Smoking
Being in shape may be as important to a long life as not smoking, according to an interesting new study of the links between fitness and mortality. The study also explores whether there is any ceiling to the benefits of fitness — whether, in essence, you can exercise too much. The answer, it found, is a reassuring no. (Reynolds, 10/31)
The Associated Press:
Whistleblower Says California Prison Officials Misled Judge
Top California corrections officials are misleading a federal judge and attorneys representing inmates about the quality of mental health care behind bars, according to a report released Wednesday that cites a case where a woman received care so poor she plucked out her eye and ate it. The whistleblower report by chief corrections psychiatrist Dr. Michael Golding that was made public by U.S. District Judge Kimberly Mueller says prison officials overruled psychiatrists and misrepresented how often inmates were receiving proper care. (Thompson, 10/31)
Los Angeles Times:
L.A. County Department Of Public Works Takes Over Long-Criticized Compton Water District
State officials on Wednesday removed the elected board and general manager of a water district that for years has been accused of serving brown, smelly water to its customers in Compton. With a 22-page decree, the State Water Resources Control Board abolished Sativa Los Angeles County Water District’s five-member board of directors and ousted its manager. In their place, the state appointed the county’s Department of Public Works to temporarily run the district while officials seek to merge the small district, which delivers water to about 1,600 homes, with a larger provider. (Jennings, 10/31)
NPR:
Groundskeeper Accepts Reduced $78 Million Award In Monsanto Cancer Suit
The groundskeeper who won a massive civil suit against Bayer's Monsanto claiming that the weedkiller Roundup caused his cancer has agreed to accept $78 million, after a judge substantially reduced the jury's original $289 million award. Dewayne "Lee" Johnson, a Northern Californian groundskeeper and pest-control manager, was 42 when he developed a strange rash that would lead to a diagnosis of non-Hodgkin's lymphoma in August 2014. (Sullivan, 10/31)
The Wall Street Journal:
EPA Allows Farmers To Keep Using Bayer’s Controversial Weedkiller
The Environmental Protection Agency will continue to allow farmers to spray crops with a controversial weedkiller, while tightening restrictions, the agency said. The EPA extended by two years its approval of XtendiMax, a version of the herbicide dicamba made by Bayer, which some farmers and researchers have blamed for damaging millions of acres of crops over the past two years. (Bunge, 10/31)
The Associated Press:
Families Take Step Toward Suing EPA For Toxic Paint Stripper
The mothers of two men killed by a toxic paint stripper took a step toward suing the Environmental Protection Agency on Wednesday for failing to take quick action to remove the product from the market. The EPA had pledged in May, after then-Administrator Scott Pruitt met with families of two victims, to wrap up action “shortly” on proposed Obama-era regulations that would eliminate most allowable uses of the paint-stripping solvent methylene chloride. (Knickmeyer, 10/31)