KHN Morning Briefing

Summaries of health policy coverage from major news organizations

First Edition: September 29, 2017

Today's early morning highlights from the major news organizations.

Kaiser Health News: Podcast: ‘What The Health?’ Repeal And Replace Is Dead. What Now?
As predicted, the last-ditch GOP effort to “repeal and replace” the Affordable Care Act ended the way its predecessors did this week — in failure. With a Saturday midnight deadline fast approaching, Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) conceded Tuesday that they lacked even the 50 votes necessary to pass their bill using a truncated budget process. (9/28)

Kaiser Health News: Out-Of-Pocket Costs Often Keep Pricey New Cholesterol Drugs Out Of Reach, Study Finds
Access to powerful new cholesterol-lowering drugs is so tightly controlled and patients’ out-of-pocket costs are so high that fewer than a third of people whose doctors prescribe the drugs get them, a new study found. While highly effective, the new drugs cost as much as $14,000 annually, leading some insurers and pharmacy benefit managers to require doctors to get preapproval for them. For example, only 47.2 percent of people who were prescribed the drugs, Praluent and Repatha, received that insurance green light, and just under two-thirds of those patients filled their prescriptions. (Andrews, 9/29)

Kaiser Health News: Years After Silently Combating Sexual Trauma, Female Veterans Seek Help
Sheila Procella joined the Air Force in 1974 to “see the Earth,” she said. She enlisted at the tail end of the Vietnam War, shortly after graduating from high school. Although she never left her home state of Texas during eight years of service, her office job proved to be its own battlefield. “Some of us actually went to war, some of us had war right here in the States, going to work every day knowing we are going to be harassed,” said Procella, now 62 and living in Plano, Texas. (Casey, 9/29)

California Healthline: Bringing Former Hospitals Back To Life – Ghosts And All
When Juana Monroy moved into Hollenbeck Terrace in 2015, she learned that the towering senior apartment building was once a busy hospital that had appeared in dozens of movies and television shows. Then she heard the rumors that the old Linda Vista Community Hospital building was haunted. “I was a little scared,” said Monroy, 60. But she hasn’t seen a ghost yet, and now she loves living in a building with such history. “It’s gorgeous,” she said. (Gorman and Galewitz, 9/28)

California Healthline: Imagining A Single-Payer Health System In California
With the crumbling of the latest GOP plan to repeal and replace the Affordable Care Act, many Americans seem more willing to discuss what a single-payer system might look like and whether it is desirable — or even possible. This story can be republished for free (details).U.S. Sen. Bernie Sanders (I-Vt.) recently introduced a Medicare-for-All Act, which would gradually expand the government-financed system to the general population while eliminating private insurance companies and consumer cost sharing, such as copays and deductibles. (9/28)

Politico: Price Took Military Jets To Europe, Asia For Over $500K
The White House approved the use of military aircraft for multi-national trips by Health and Human Services Secretary Tom Price to Africa and Europe this spring, and to Asia in the summer, at a cost of more than $500,000 to taxpayers. The overseas trips bring the total cost to taxpayers of Price’s travels to more than $1 million since May, according to a POLITICO review. (Pradhan and Diamond, 9/28)

The Associated Press: Price Says He's Reimbursing Costs For His Private Flights
Fighting to keep his job, health secretary Tom Price says he'll write a personal check to reimburse taxpayers for his travel on charter flights taken on government business and pledged to fly commercial — "no exceptions." The repayment — $51,887.31, according to Price's office — covered only the secretary's seat. Price did not address the overall cost of the flights, which could amount to several hundred thousand dollars and is under investigation. (Alonso-Zaldivar and Lucey, 9/29)

The New York Times: Chastened, Tom Price Tries To Deflect Anger Over Chartered Flights
Through intermediaries and the media, Mr. Trump has let it be known that offering reimbursement as repentance was no guarantee that Mr. Price would keep his job. On Thursday, Mr. Price tried anyway. “I look forward to gaining, regaining the trust that the American people, some of the American people, may have lost in the activities that I took,” Mr. Price said in an appearance on “Special Report with Bret Baier” on Fox News. (Rogers, Thrush and Haberman, 9/28)

The Hill: Price Says He's Working To 'Regain' Trump’s Trust 
Health and Human Services (HHS) Secretary Tom Price said Thursday evening he looks forward to regaining President Trump's trust after the president said he was not happy about his Cabinet member using pricey private charter jets for official government business. "I work at the pleasure of the president. The president is a remarkable leader. I'm incredibly privileged to serve in his Cabinet and work on behalf of the American people," Price told Fox News's Bret Baier on "Special Report." (Manchester, 9/28)

The Washington Post: Tom Price Apologizes For Private-Charter Flights, Pledges To Repay Taxpayers Nearly $52,000
The move came as House and Senate investigators are pressing Price, as well as other Cabinet members, to disclose the extent to which they have relied on noncommercial travel to travel across the United States and overseas. The recent revelations about these costly trips on military and private aircraft, at a time when the same officials have proposed dramatic cuts in the agencies they oversee, has put the administration on the defensive. (Eilperin, 9/28)

Vox: Tom Price Will (Partially) Pay The Bill For His Expensive Charter Planes
The practice was a sharp departure from his predecessors under the Obama administration, Politico noted, who usually flew commercial. Ethics experts have questioned the propriety of such trips. “This wasteful conduct reflects disdain for the ethical principle of treating public service as a public trust,” Walter Shaub, who ran the US government ethics office under President Barack Obama, told Politico. “Public office isn’t supposed to come with frivolous perks at taxpayer expense.” (Scott, 9/28)

The Washington Post: Tom Price Apologizes For Private-Charter Flights, Pledges To Repay Taxpayers Nearly $52,000
House and Senate investigators are pressing Price, as well as other Cabinet members, to disclose the extent to which they have relied on noncommercial transportation to travel across the United States and overseas. The recent revelations about these costly trips on military and private aircraft, at a time when the same officials have proposed dramatic cuts in the agencies they oversee, have put the administration on the defensive. (Eilperin, 9/28)

Politico: Trump Fuming Over Price's Charter Flights
President Donald Trump and his top aides are fuming over Health and Human Services Secretary Tom Price’s use of expensive private jets, with some advisers privately calling for Price’s ouster. Trump rebuked Price in sharp terms Wednesday but declined to bat down speculation that the HHS chief could be fired for his lavish spending of taxpayer dollars. (Dawsey, Restuccia and Nelson, 9/27)

The Hill: Democrats Unveil Bills To Ban Cabinet Members’ Private Jet Travel 
House Democrats introduced legislation on Thursday to prevent Trump administration officials from using private jets on the taxpayers’ dime as multiple Cabinet heads come under fire for the practice. Two groups of Democrats unveiled bills with correspondingly flashy titles. ...The Swamp Flyers Act prohibits executive branch officials from using private jets with taxpayer funds unless they certify that no commercial flights were available. The Taxpayers DIME Act, meanwhile, ensures that senior federal officials can’t spend more funds on travel than is necessary and directs the Office of Government Ethics to report on ways to enhance current rules. (Marcos, 9/28)

Reuters: Senators Close To Bipartisan Deal On Health Exchanges: Schumer
Two U.S. senators from both parties are close to finalizing a bipartisan deal to shore up the health insurance exchanges created under Obamacare, the chamber's top Democrat said on Thursday. The move, which Senate Democratic Leader Chuck Schumer said was "on the verge" of completion, would stabilize the market for individuals who buy their own insurance plans on the federal or state-based exchanges. (Heavey, 9/28)

Politico: Alexander, Murray Inching Toward Deal To Stabilize Obamacare
A pair of deal-making senators is inching toward a bipartisan agreement to fund Obamacare's insurance subsidies and provide some certainty to health insurance markets just two days after the GOP’s latest Obamacare repeal effort failed. Senate Health, Education, Labor, and Pensions Committee Chairman Lamar Alexander (R-Tenn.) and ranking member Patty Murray (D-Wash.) are moving toward a plan to stabilize Obamacare in the short term after meeting on Wednesday. Though they have not yet clinched a deal, their progress could ignite a new battle over how or whether to improve the law. (Haberkorn and Everett, 9/28)

The Hill: Senators Zero In On Deal To Stabilize ObamaCare Markets 
It’s far from clear that any deal Murray and Alexander work out could win approval from the full Senate, let alone pass the House. Many other Senate Republicans, including Senate Finance Committee Chairman Orrin Hatch (R-Utah), are more skeptical of a deal to stabilize ObamaCare than Alexander is. (Sullivan, 9/28)

The Hill: Graham-Cassidy Sponsors Vow To Press On With Health-Care Reform 
The main sponsors of the last ObamaCare repeal bill committed on Thursday to hold hearings in the coming months in an effort to eventually pass their legislation. “Over the coming weeks and months, we are committed to holding congressional hearings and working with our [nation's] governors who believe returning power to states is a vast improvement over Obamacare,” Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) said in a joint statement. (Weixel, 9/28)

The Hill: ObamaCare Repeal Authors Meet With Trump 
The main sponsors of the last ObamaCare repeal bill met Thursday with President Trump to discuss health care, despite the effort appearing dead for the foreseeable future. The bill from Sens. Bill Cassidy (R-La.) and Lindsey Graham (R-S.C.) had gained momentum last week, but ultimately Republicans decided Tuesday against holding a vote this week after it became clear the legislation wouldn’t pass. (Roubein, 9/28)

The Hill: Trump Repeats Claim That Hospitalized Senator Is Preventing ObamaCare Repeal
President Trump in an interview broadcast early Thursday again maintained that Republicans have enough votes to repeal ObamaCare and repeated his claim that a hospitalized GOP senator is preventing a vote before Friday. ... The lawmaker Trump mentions appears to be Sen. Thad Cochran (R-Miss.), who said Wednesday that he is not hospitalized but recovering at home. ... Republican Senate leaders this week chose not to have a vote on the latest ObamaCare repeal bill due to its lack of support among several GOP senators. (Shelbourne, 9/28)

The Hill: Dems Urge Price To Change ObamaCare Site Shutdown Planned During Open Enrollment 
A group of nearly 80 Democratic House members is calling on the Department of Health and Human Services (HHS) to shorten the 12 hour-long maintenance shutdowns of the federal ObamaCare exchange website that are planned during the next open enrollment period. HHS officials announced last week that the website will be shut down for maintenance for 12 hours from midnight to noon almost every Sunday of the next ObamaCare enrollment period, which lasts from Nov. 1 to Dec. 15, as well as overnight on the first day of the enrollment period. (Manchester, 9/28)

The Washington Post: Here’s How The Trump Administration Is Hurting Enrollment In Obamacare
At its heart, the Affordable Care Act — Obamacare — is about figuring out how to pay to provide more people with insurance coverage. Before the policy was enacted, insurers balked at covering those with preexisting conditions for the simple reason that such customers are expensive. Cover a lot of expensive people and you either need to enroll more healthy people (who will pay premiums but use fewer resources) or raise premiums. ... In other words, enrolling those healthy people is central to making Obamacare work. (Bump, 9/28)

The Associated Press: Iowa's Proposed Medicaid Cut Could Signal New GOP Strategy
Iowa is seeking permission from President Donald Trump's administration to cut a key benefit for all its Medicaid recipients, a move that could foreshadow other state-level efforts to change the safety net program after Congress repeatedly failed to repeal the Affordable Care Act. Federal health officials could decide soon whether to back Iowa's proposal, which would cut retroactive payments for poor or disabled residents for medical needs incurred up to three months before they registered for or re-enrolled in Medicaid. The state wants a decision by Oct. 1, though such a timeline appears unlikely. (Rodriguez, 9/28)

The Washington Post: Is The GOP Plan For Medicaid Caps Really Bill Clinton’s Idea?
In touting the latest GOP effort to repeal the Affordable Care Act, which collapsed Sept. 26, former senator Rick Santorum asserted that a key element — capping the per person growth of Medicaid according to a formula — had actually been proposed by Bill Clinton during his presidency. Santorum was a critic of Clinton at the time — as a senator, Santorum voted to find Clinton guilty during the impeachment trial — and so it is striking to see him cite Clinton as a source for a key GOP policy proposal. (Kessler, 9/28)

The New York Times: Illinois Governor Signs Abortion Bill, Angering Fellow Republicans
Bruce Rauner, the Republican governor of left-leaning Illinois, won praise on Thursday from some unlikely corners. The American Civil Liberties Union and the Chicago Abortion Fund stood behind Mr. Rauner as he announced that he would sign a bill expanding abortion coverage for women on Medicaid. His usual allies were far less pleased. Just outside the state office here where Mr. Rauner announced his decision, the Republican floor leader for the Illinois House of Representatives called the decision “an absolute betrayal” and said he was withdrawing all future support for the governor. (Smith, 9/28)

The Associated Press: Illinois Governor Agrees To Allow Medicaid For Abortions
The Legislature, which is run by Democrats, approved the measure in May but delayed sending it to Rauner until Monday, in part because he has wavered on where he stands. As a candidate, Rauner supported expanding coverage for abortions, but in April said he opposed the legislation and Illinois should focus on economic issues. Rauner's final word came at a news conference Thursday before signing the bill privately. He said while he'd talked to advocates on both sides, he always supported abortion rights and had to take action "consistent" with his views. (O'Connor and Tareen, 9/28)

Politico: Illinois Governor Signs Bill Expanding Public Funding For Abortion
"No woman should be forced to make a different decision than another woman would based purely on her income," Rauner said. “I am personally pro-choice, I always have been. I made no qualms about that when I was elected governor. I have not and never will change my views. I personally believe that a woman must have the right to decide what goes on in her own body.” (Korecki, 9/28)

The Wall Street Journal: Washington State Joins Legal Challenges Over Opioids
Lawsuits seeking to hold the pharmaceutical industry accountable for widespread opioid addiction are mounting, with Washington state and Louisiana joining more than half a dozen other states that already have filed actions against drugmakers and distributors. Washington state sued Purdue Pharma L.P. on Thursday for allegedly misrepresenting the addiction risk of opioid painkillers including OxyContin. (Randazzo, 9/28)

Stat: Can Marijuana Wean The Nation Off Opioids? This Doctor Wants To Know
Dr. Chinazo Cunningham has treated thousands of chronic pain patients over the past two decades. Many of them have asked for opioids; they sometimes even request a specific kind of prescription painkiller. But the ones who don’t seek out opioids have intrigued the primary care physician. There’s a common refrain among those patients: Marijuana helped. ...But with thousands of fatal opioid overdoses each year, she started to wonder: Does marijuana work well enough to lower the amount of painkillers prescribed? (Blau, 9/29)

Stat: Demanding Action From Trump On MS Drug Prices, Elijah Cummings Takes To Twitter
Rep. Elijah Cummings (D-Md.) has always been outspoken on the issue of drug pricing, even wrangling a meeting with President Trump in March to discuss how to reduce costs for Americans struggling with the cost of their prescriptions. Cummings, who recently returned to Capitol Hill after recuperating from heart surgery, used a decidedly different medium — one preferred by the President — on Thursday in resurfacing the issue. (Facher, 9/28)

Stat: To Lower Costs, Massachusetts Seeks To Limit Medicaid Drug Coverage
Alarmed by rising prescription drug prices, Massachusetts officials are seeking permission from the federal government to limit the number of medicines that would be covered by the state Medicaid program, which is currently required to provide coverage for all treatments. In making their request, state officials argue they should be able to use some of the same tools that commercial insurers employ to contain costs. And they insist such a move is needed in order to preserve the larger mission of providing adequate health coverage. (Silverman, 9/28)

The Wall Street Journal: AbbVie, Amgen Reach Settlement In Humira Patent Dispute
Drugmakers AbbVie Inc. and Amgen reached a patent-dispute settlement requiring Amgen to wait until 2023 to start selling a lower-price copy of the world’s top-selling drug, AbbVie’s arthritis treatment Humira, in the U.S. The deal could give AbbVie an unusually long 20-year U.S. monopoly on sales of the expensive biotech drug that went on sale in early 2003, assuming no other rivals manage to bring copies to market before 2023. Humira costs more than $57,000 annually a patient and had U.S. and global sales last year of $10.4 billion and $16 billion, respectively. (Loftus, 9/28)

Reuters: U.S. Brings New Charges Over Tenet Healthcare Fraud Scheme
The U.S. Justice Department has brought new charges over a scheme that it says enabled Tenet Healthcare Corp to fraudulently bill state Medicaid programs for $400 million, according to an indictment made public on Wednesday. William Moore, the ex-chief executive of Atlanta Medical Center Inc, which had been operated by Tenet; and Edmundo Cota, the ex-head of a clinic operator that provided prenatal care to Hispanic women, were charged in an indictment filed in Atlanta federal court. (Raymond, 9/27)

The Washington Post: Mutation In Zika Virus Caused Birth Defects And Dangerous Outbreak
When the Zika virus became a global terror two years ago — inflicting severe birth defects on the babies of pregnant women who were infected with the virus and alarming health officials worldwide — scientists were mystified. How did such an obscure, relatively harmless pathogen that had been known for more than half a century suddenly blossom into a monster virus? (Wan, 9/28)

The New York Times: The Zika Virus Grew Deadlier With A Small Mutation, Study Suggests
An intriguing study in mice, which has prompted some skepticism among experts, suggests that a single genetic mutation helped transform the Zika virus into a devastating force in Latin America. The report was published on Thursday in the journal Science. The mutation, called S139N, first arose in an Asian strain of the Zika virus in 2013, just before a small outbreak in French Polynesia — the first linked to an increase in babies born with microcephaly. (Belluck and McNeil, 9/28)

The New York Times: They Swallowed Live Typhoid Bacteria — On Purpose
“I was curious.” That’s how James M. Duggan, an Oxford University medical student, explains why he agreed to swallow a big dose of live typhoid bacteria. “This may sound odd,” he continued, “but as a medical student, it’s quite interesting to go through the process of being very ill. It does help to create empathy for your patients.” (McNeil, 9/28)

Los Angeles Times: Julia Louis-Dreyfus Has Breast Cancer: 'Today, I'm The One'
Just when we thought she was invincible, Julia Louis-Dreyfus dropped a bombshell on Thursday. The "Veep" star has breast cancer. "1 in 8 women get breast cancer. Today, I'm the one," the actress shared in a post on Instagram and Twitter. The iconic "Seinfeld" alum spun the announcement into a political statement on healthcare, which has remained a hot-button national issue. (Saad, 9/28)

NPR: Breakthrough Pain Treatment Or Snake Oil? You Decide.
Let's say you're a scientist, and you've invented what you think is a useful treatment for pain. But you have a problem. You don't have the money to go through the regulatory approval process. Should you try to sell it to consumers anyway, and run the risk of being accused of selling snake-oil? That's the dilemma Ted Price and his colleagues faced. Price is a researcher at the University of Texas, Dallas. His work focuses on solving a vexing question about pain: why does pain persist even after injuries heal? (Palca, 9/28)

NPR: Many Teen Moms In Labor Can't Choose An Epidural In Some States
In Ohio, people under 18 who are in labor cannot consent to their own health care. They can receive emergency services, but nothing considered to be elective. For the many Ohio minors who become pregnant, it's a painful gap in coverage. It's also complicated by the fact that in Ohio, there is no legal process for emancipation: A minor's parents must be deceased, or the minor must be married or enlisted in the armed forces to be granted independent legal status. (Honig, 9/28)

NPR: A New Approach To Postpartum Depression: Mom Mentors
Becoming a mother is often portrayed as a magical and glorious life event. But many women don't feel joyful after giving birth. In fact, according to the American Psychological Association, almost 15 percent of moms suffer from a postpartum mood disorder like anxiety or depression, making maternal mental health concerns the most common complication of childbirth in the U.S. And even though these mental illnesses affect millions of women each year, new research shows 20 percent of mothers don't disclose their symptoms to healthcare providers. (Fraga, 9/29)

The Associated Press: San Diego Increases Homeless Citations In Hepatitis Outbreak
The city of San Diego issued citations and cleared a downtown street where hundreds of homeless people regularly camp during ongoing efforts to sanitize neighborhoods to control the spread of hepatitis A. Officers are asking homeless people to leave the street and nearby blocks where tarps and tents have regularly lined sidewalks and an area near a freeway onramp, police Lt. Scott Wahl said Wednesday. Those who refuse are given citations and those who resist further are arrested. Police over the past two weeks have been issuing about 50 citations a week — up from 30 a week before the crackdown, Wahl said. (Watson, 9/28)

Stat: West Nile Virus Cases Are Spiking In LA. The First Line Of Defense: Chickens
More than six dozen sentinel chickens, living in coops dotted around Los Angeles, make up one of the first lines of defense in this sprawling county’s fight against West Nile virus. The disease has been a background threat for years here, but cases have spiked this fall to worrisome levels. Six deaths have been reported by Los Angeles County this year — including three just last week. And the cases are alarmingly severe: Of 98 reported infections here this year, 79 have led to serious neurological side effects, and 87 have required hospitalization. Because it’s still peak mosquito season, more deaths are expected. (Maxwell, 9/29)

The Associated Press: Mistakes Made Before Hospital ER Shooting, Vegas Police Say
Mistakes were made in leaving a suicidal man alone in a hospital emergency room, where he wielded a stun gun pilfered from a jail guard’s unattended equipment bag before a patrol officer shot him dead, a police official said Thursday. One policy was changed immediately, Assistant Clark County Sheriff Todd Fasulo told reporters, and the arresting officer, Thomas Rybacki, could face departmental discipline after internal affairs reviews of the killing early Monday of Cody Leighland O’Bryan, 31, at University Medical Center. (Ritter, 9/28)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.