First Edition: February 1, 2019

Kaiser Health News: With Mom’s Green Card On The Line, Family Forgoes Autism Services For Citizen Child
As U.S. immigration enforcement becomes stricter under the Trump administration, more immigrant families are cutting ties with health care services and other critical government programs, according to child advocates who work with such families. In Texas, researchers studying the issue say it’s a major reason why more children are going without health insurance. (Lopez, 2/1)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Live From D.C.: A Look Ahead At Health Policy In 2019
The 2020 presidential campaign has begun and health is a big part of it, with Democratic candidates pledging their support for “Medicare-for-all” and many of its variations. Meanwhile, Republicans and Democrats are both promising to do something about drug prices and “surprise” medical bills. But whether they can translate that agreement on the broad problem to a detailed solution remains to be seen. (1/31)

The New York Times: Trump Officials Move To Lower Drug Prices By Passing On Rebates To Patients
The Trump administration proposed on Thursday to require health insurance companies and middlemen to give consumers the benefit of discounts they get on prescription drugs, a huge change that could substantially lower some patients’ costs but could also have unintended consequences. Drug makers now pay billions of dollars in rebates to such middlemen to increase the use and sales of their products. Under the proposal, these rebate payments would be viewed as illegal kickbacks, disrupting longstanding arrangements in the pharmaceutical industry. (Pear, 1/31)

The Associated Press: Prescription Discounts Channeled To Patients In Trump Plan
The proposed regulation from Health and Human Services Secretary Alex Azar would eliminate behind-the-scenes discounts among drugmakers, insurers and go-betweens and instead require that they be paid directly to consumers when they buy their medications. The idea is to do away with a hidden cost seen as contributing to artificially high list prices for prescription drugs. The proposal was co-authored with the Health and Human Services inspector general’s office. (2/1)

The Wall Street Journal: Trump Administration Moves To Curb Drug Rebates In Medicare, Medicaid
“This proposal has the potential to be the most significant change in how Americans’ drugs are priced at the pharmacy counter, ever, and finally ease the burden of the sticker shock that millions of Americans experience every month for the drugs they need,” HHS Secretary Alex Azar said in a statement. (Armour and Walker, 1/31)

The Washington Post: Trump Administration Proposes Big Changes In How Prescription Drugs Are Priced
Some drug policy experts praised the proposal as a strong first step, even though the changes would pertain just to the government’s two largest health insurance programs. As with many other health policies that began with those public programs and filtered into the private sector, they predicted that the government insurance plans would set a strong example for private insurers. (Goldstein and Rowland, 1/31)

Stat: Trump Administration Pitches An End To Certain Drug Rebates 
The amount of money patients might save depends on how drug companies, pharmacy benefit managers, and insurers respond to this proposal and change their pricing practices. For the first year, HHS cites a variety of estimates that range from Medicare beneficiaries saving $2.74 a month to spending an extra $1.25 a month. Meanwhile, the government might end up saving money or might not, depending on what companies do. (Swetlitz and Florko, 1/31)

The Hill: Drug Company Execs Under Pressure To Testify 
Drug company executives are resisting calls to testify publicly before a new GOP-led inquiry into their pricing practices, setting up a showdown with Senate Finance Committee Chairman Chuck Grassley (R-Iowa). The pressure for industry CEOs to appear before Congress is mounting as scrutiny on their business practices intensifies in Washington. On Tuesday, both the Democratic-led House Oversight and Reform Committee and the Republican-led Senate Finance Committee opened a series of hearings into drug prices.  (Sullivan, 1/31)

Stat: Romney To Drug Industry CEOs: ‘Change Is Coming’ 
In a closed-door meeting Thursday morning, Sen. Mitt Romney (R-Utah) warned the trade group for the United States’ largest drug companies that he and his new colleagues are working to address high prescription drug prices — and that the industry should participate in those discussions. “My view was that there is going to be change with regards to pharmaceutical pricing and that I think they would be wise to try and shape the reforms as opposed to hoping nothing will happen, because I think some change is coming,” Romney told STAT in a brief interview this afternoon, when asked about his message to the board of directors for PhRMA, the trade association that represents companies like Amgen, Gilead, and Eli Lilly. (Florko, 1/31)

Politico: Democrats’ Divisions Bust Open As 2020 Primary Heats Up
That didn’t take long. Barely a month into the 2020 Democratic primary, rifts between the party’s liberal and moderate factions burst open this week — pried loose by an intraparty feud over health care and taxes that could define the battle to take on President Donald Trump. It started with Sen. Kamala Harris’ comments at a town hall Monday that she backed eliminating the health insurance industry in order to achieve Medicare for all. Distancing herself from the proposal on CNN the next day, Sen. Amy Klobuchar (D-Minn.) cautioned against immediately “changing our entire insurance system where over half of Americans get private insurance.” (Siders and Cadelago, 1/31)

The Washington Post: Republicans Seize On Liberal Positions To Paint Democrats As Radical
Sen. Kamala D. Harris is raising the possibility of eliminating private health insurance. Sen. Elizabeth Warren and other prominent Democrats are floating new and far-reaching plans to tax the wealthy. In Virginia, Gov. Ralph Northam voiced support for state legislation that would reduce restrictions on late-term abortions. Democrats, after two years largely spent simply opposing everything President Trump advocated, are defining themselves lately in ways Republicans are seizing on to portray them as far outside the American mainstream. (Viser, 1/31)

The New York Times: Republicans Seize On Late-Term Abortion As A Potent 2020 Issue
When New York expanded abortion rights last week for the first time in 49 years, Democrats across the state were exultant. Now, that jubilation has been met with an equal and opposite reaction. Anti-abortion advocates, from grass-roots activists all the way to the White House, are taking aim at New York, Virginia and other states in a bid to halt similar legislative efforts by emboldened Democratic lawmakers and to mobilize supporters ahead of the 2020 presidential race. By Thursday, both President Trump and Vice President Mike Pence had leaned into the debate, homing in on provisions that would loosen some restrictions on late-term abortions. (Wang, 1/31)

The Washington Post: Abortion Case Provides An Unexpected Quick Test For Supreme Court Conservatives
Abortion providers in Louisiana have asked the Supreme Court for an emergency stay of a state law they say would leave only one doctor eligible to perform the procedure, an unexpectedly quick test on the issue for the court’s strengthened conservative majority. The Louisiana law — passed in 2014 but never allowed to go into effect — requires any physician providing abortion services to have admitting privileges at a hospital within 30 miles of the procedure. (Barnes, 1/31)

Politico: Trump To Throw Spotlight On Abortion In State Of The Union
President Donald Trump is telling conservative allies he wants to incorporate firm anti-abortion language into his State of the Union address Tuesday, and potentially include an anti-abortion figure among his list of invitees, according to four sources familiar with his plans. Trump sees an opening to energize his evangelical supporters and capture moderate voters who administration officials believe may be turned off by widespread coverage of New York’s newest abortion law, which allows for termination of some pregnancies after the 24-week mark for health reasons. (Orr and Restuccia, 1/31)

The Associated Press: Abortion Quickly Becomes Key Issue In Virginia Politics
A pitched debate about late-term abortions in Virginia erupted into all-out political warfare Thursday as Republicans — including President Donald Trump — sought to capitalize on Democratic missteps. Republicans accused Democratic Gov. Ralph Northam, a folksy pediatric neurologist who is personal friends with many GOP lawmakers, of backing infanticide. Republicans said recent statements by Northam and other Democrats have laid bare their support for on-demand abortions at any point of a pregnancy, including up to the moments before birth — or even after. (1/31)

The Washington Post: In Virginia, Abortion Furor Hits New Heights As Both Sides Double Down
Virginia Republicans doubled down Thursday on their effort to paint Gov. Ralph Northam and other Democrats as radicals who favor infanticide, a sharp shift in political strategy after years of trying to minimize socially divisive issues to win back suburban voters. And Democrats, who helped create the furor through missteps and unclear statements, also dug in on abortion, trying to paint Republicans as extremists looking to meddle in women’s health care. It was Day 2 of partisan warfare over an issue that hadn’t been on the Virginia political agenda for years. (Vozzella and Schneider, 1/31)

The Washington Post: Who Is Virginia Delegate Kathy Tran, The Lawmaker At The Center Of The Abortion Fight?
Virginia Del. Kathy Tran said Thursday that she “misspoke” during a legislative hearing earlier this week about a bill that would have loosened restrictions on late-term abortions. Her comments sparked death threats, and intense backlash from GOP politicians — including President Trump. “I wish that I was quicker on my feet and I wish that I was able to be more agile in that moment,” Tran, 41, a first-term Democrat from Fairfax County, said in an interview. “And I misspoke, and I really regret that.” (Olivo, 1/31)

The New York Times: Sackler Scion’s Email Reveals Push For High-Dose OxyContin, New Lawsuit Disclosures Claim
A member of the Sackler family that owns OxyContin’s maker directed the company to put a premium on selling high dosages of its potentially addicting painkillers, according to new disclosures in a lawsuit. Richard Sackler, a son of a founder of Purdue Pharma and its onetime president, told company officials in 2008 to “measure our performance by Rx’s by strength, giving higher measures to higher strengths,” according to an email written by Mr. Sackler, contained in the filing. The lawsuit, which was filed in June by the Massachusetts attorney general, Maura Healey, claims that Purdue Pharma and members of the Sackler family knew that putting patients on high dosages of OxyContin for long periods increased the risks of serious side effects, including addiction. (Meier, 1/31)

Stat: Massachusetts Releases Its Full Lawsuit Against Purdue Pharma 
The Massachusetts attorney general’s office on Thursday made public a full copy of its lawsuit against Purdue Pharma, which it accuses of igniting the opioid epidemic through the deceptive marketing of its painkillers, including OxyContin. The court filing details how the company considered expanding into addiction treatment, how much the Sackler family that controls Purdue and company executives were paid, and how the company was advised by McKinsey & Co. to improve its image in the face of concerns about addiction and overdoses. (Joseph, 1/31)

Bloomberg: Insys Trial: Greed And Lust Drove Doctor To Push Opioids 
A Michigan doctor convicted of illegally distributing Insys Therapeutics Inc.’s opioid painkiller Subsys said the company’s beautiful sales reps and “easy money’’ helped persuade him to write unnecessary prescriptions for the highly addictive drug. Gavin Awerbuch told a Boston jury Wednesday he made more than $130,000 over 18 months just for showing up to sham educational sessions. Earlier this week, the jury heard that a former sales manager at Insys had been a stripper who once wooed a Chicago doctor with a lap dance. (Feeley and Lawrence, 1/31)

Reuters: Largest-Ever U.S. Border Seizure Of Fentanyl Made In Arizona: Officials
U.S. border agents have seized 254 pounds (115 kg) of fentanyl that was stashed in a truck crossing into Arizona from Mexico, marking the largest single bust of the powerful opioid ever made at an American border checkpoint, officials said on Thursday. The 26-year-old Mexican driver of a cucumber-toting tractor trailer was arrested after agents on Saturday at the border station in Nogales discovered the fentanyl in a secret compartment, U.S. Customs and Border Protection officials said. (1/31)

The Associated Press: Hospital, Doc Face 9th Suit Over Patient Deaths, Drug Doses
A new wrongful-death lawsuit alleges an Ohio hospital patient was given a lethal painkiller overdose weeks after concern was raised about the doctor who ordered the medication. It’s the ninth lawsuit against the Columbus-area Mount Carmel Health System, now-fired Dr. William Husel (HYOO’-suhl), and pharmacists and nurses accused of wrongly approving and administering the drugs. (1/31)

The Washington Post: ‘I’m Just Wondering If I’m Going To Have Enough’: Shutdown Creates Lasting Fallout For Food Stamp Recipients
The call came Jan. 19, just after Quatashia Cuff got back from grocery shopping, a task that had taken several hours because she’d made the trip out of Boston to shop in the suburb of Quincy. It was a long way to haul groceries, especially for someone seven months pregnant, but she’d learned long ago that getting by meant stretching her money as far as possible, and milk was often $2 cheaper out there. A recorded message on the phone confirmed what she’d been bracing for: February’s Supplemental Nutrition Assistance Program benefits, or food stamps, had been paid out early because of the government shutdown, so she had a little more money than usual for this time of the month. (Telford, 1/31)

The New York Times: ICE Says It Is Force-Feeding Detainees Who Are On Hunger Strike
Immigration officials have been force-feeding a half dozen detainees who began a hunger strike to protest conditions at a processing center in Texas where they are being held, the authorities said Thursday. In a statement, Immigration and Customs Enforcement said that as of Wednesday night, 11 detainees in El Paso had refused to eat; four other individuals at different ICE detention centers across the country were also on hunger strike, officials said. (Stevens, 1/31)

The Associated Press: Kentucky Delays Start Time For Some New Medicaid Rules
State officials in Kentucky have delayed the start of some new eligibility rules for a portion of its Medicaid population. Kentucky is one of 36 states to expand its Medicaid program under former President Barack Obama’s health care law to cover more people. President Donald Trump’s administration gave Kentucky permission to require those people to do things like get a job, go to school or do community service work to maintain their coverage. The Bevin administration calls these rules the “community engagement” requirements. (1/31)

The New York Times: If You Do Medicare Sign-Up Wrong, It Will Cost You
Tony Farrell turned 65 four years ago — the age when most people shift their health coverage to Medicare. But he was still employed and covered by his company’s group insurance. When his birthday came around, he began researching whether he needed to move to Medicare, and determined he could stick with his employer’s plan, said Mr. Farrell, a marketing and merchandising executive for specialty retailers. At the time, he was working for a company that makes infomercials in San Francisco. (Miller, 1/31)

Stat: No Products Yet, But Gawande Health Venture To Begin ‘Deploying Tests’ This Year
Atul Gawande’s new Boston-based health care venture has yet to design any products, but it could be changing the way some employees of Amazon, Berkshire Hathaway, and JPMorgan Chase receive their health care within the year, the venture’s chief operating officer told a federal judge on Thursday. The venture’s COO, Jack Stoddard, testified for an hour on Thursday at a Boston federal courthouse during a contentious, technical, and unusually long hearing. The hearing was intended to determine the fate of David Smith, a former midlevel executive at Optum. Smith began a new job at Gawande’s venture, referred to in court documents as ABC, earlier in January. Optum is suing to prevent Smith from continuing to work for the new company. (Sheridan, 1/31)

Reuters: Altria Says Juul Sales Skyrocket To $1 Billion In 2018
Marlboro maker Altria Group Inc said on Thursday e-cigarette maker Juul Labs Inc posted more than $1 billion in revenue in 2018, up from about $200 million a year earlier, the first official growth figures for the controversial vaping product. Altria paid $12.8 billion to acquire a 35 percent stake in Juul in December 2018, getting a foothold in a segment that is quickly becoming an attractive alternative for smokers. (1/31)

Stat: To Improve Mental Health Treatments, Scientists Try To Dissect Why They Work
Successful mental health treatments can function like a conversation: The brain hears some kind of message — whether it’s from a drug or another other approach — and the brain responds in a way that alleviates some symptoms. Some scientists are listening in on those conversations — and trying to “back translate” them to figure out how successful treatments actually work. And that effort is about to get a big boost: The nonprofit Wellcome Trust recently announced a $200 million commitment to support more mental health research, including scientists studying the underpinnings of existing treatments. (Thielking, 2/1)

The New York Times: Shortage Of Anxiety Drug Leaves Patients Scrambling
A sudden shortage of one of the safest anti-anxiety drugs on the market has spread alarm among people who rely on the medication, buspirone, to get through the day without debilitating anxiety and panic attacks. Physicians are also expressing concern, because there is no information about when the supply will resume, making it difficult to manage patients. Shelby Vittek, a 27-year-old writer in New Jersey, fruitlessly called dozens of drugstores in New Jersey and Pennsylvania in an attempt to locate the medication after her pharmacist told her the drug was on back-order with no end in sight. (Rabin, 2/1)

Los Angeles Times: Hate Crimes In L.A. Highest In 10 Years, With LGBTQ And African Americans Most Targeted
Los Angeles recorded its highest level of reports of hate crimes in a decade, with a nearly 13% increase in 2018 over the year before. Last year, L.A. tallied 289 hate crimes, compared with 256 in 2017, according to LAPD statistics gathered by researchers at Cal State San Bernardino. Members of the LGBTQ community, African Americans and those of Jewish faith were the most frequently targeted, according to the newly released report by the Center for the Study of Hate and Extremism. (Winton, 1/31)

The New York Times: Polar Vortex Updates: Extreme Cold Weather Spreads East
Midwesterners trudged ahead Thursday into a familiar, grim reality: temperatures well below zero, schools and businesses closed, stern warnings to wear extra layers or, better yet, just stay indoors. The polar vortex that arrived earlier this week has for days disrupted life across an entire region. Deaths and injuries were reported. Decades-old records fell. And, for one more day, even stepping outside remained a painful, risky experience. (Smith, Bosman and Davey, 1/31)

Stat: The Modern Tragedy Of Fake Cancer Cures 
To start, no. There won’t be “a complete cure for cancer” in a year’s time, as the chairman of a small Israeli biotechnology firm predicted to the Jerusalem Post. The claim, absurd on its face, was particularly frustrating to those who work in medicine and drug development because it seemed so obvious there was not enough evidence to make it. It doesn’t take a lot of complicated biology to understand why. You simply need the information contained in the Jerusalem Post’s article: that the data available so far are from a single study in mice and that they have not been published in a scientific journal. (Herper, 2/1)

NPR: CRISPR And Human Embryo Experiments Underway In The U.S.
A scientist in New York is conducting experiments designed to modify DNA in human embryos as a step toward someday preventing inherited diseases, NPR has learned. For now, the work is confined to a laboratory. But the research, if successful, would mark another step toward turning CRISPR, a powerful form of gene editing, into a tool for medical treatment. (Stein, 2/1)

CNN: A New Study Finds Americans Take The Pain Of Girls Less Seriously Than That Of Boys
Our long-held notions of boys as being more stoic and girls as being more expressive may lead Americans to overrate the severity of male physical pain. A recent study by psychologists at Yale University found that adults, when presented with imagery of a child’s finger being pricked, considered the child to be in less pain when they thought it was a girl. The study, published in The Journal of Pediatric Psychology, involved showing 264 adult participants a video of a child whose gender appeared ambiguous. (Prior, 1/31)

The Associated Press: Study: Many Small Kids In US Are Using Too Much Toothpaste
Too many young kids are using too much toothpaste, increasing their risk of streaky or splotchy teeth when they get older, according to a government survey released Thursday. About 40 percent of kids ages 3 to 6 used a brush that was full or half-full of toothpaste, even though experts recommend no more than a pea-sized amount, the study found. (1/31)

NPR: A Single Protein Induces Sleep And Boosts Immune Response In Fruit Flies
It’s cold outside, you’re sick and all you want to do is curl up under the covers until you feel better. In fact, the need for sleep can be so strong when we’re sick that this may be all we can do. Scientists don’t fully understand how this excessive sleepiness is different from your normal, everyday tiredness. (Lambert, 1/31)

CNN: Food Tastes Better, And Other Side Effects When Your Team Is Winning The Game
Super fans could have more to look forward to during Sunday’s Super Bowl than an exciting game of football. For those whose team takes home the trophy, several side effects could make the day even better, including how your food tastes and how you think about yourself. The more you care about a team, the more you could feel these effects. (Thomas, 1/30)

The Associated Press: Federal Court Again Blocks San Francisco Warning On Soda Ads
A federal appeals court on Thursday blocked for a second time a San Francisco law requiring health warnings on advertisements for soda and other sugary drinks in a victory for beverage and retail groups that sued to block the ordinance. The law violates constitutionally protected commercial speech, the 9th U.S. Circuit Court of Appeals said in a unanimous ruling. (1/31)

The Wall Street Journal: San Francisco’s Soda Health Warning Found Unconstitutional
The unanimous ruling by a full court of 11 judges on the Ninth U.S. Circuit Court of Appeals on Thursday affirms a decision by a three-judge panel of the court in 2017, which the city of San Francisco appealed. The court also determined the city’s warning that consumption of sugary drinks can lead to obesity and other diseases wasn’t based on established fact—citing statements by the Food and Drug Administration that sugars are “generally recognized as safe” when not consumed to excess. (Carlton, 1/31)

The Associated Press: Deal Announced To Fix NYC Public Housing Under Monitor’s Eye
New York City and U.S. housing officials announced a deal Thursday that will keep the city’s massive public housing system out of federal receivership, but require the city to spend $2.2 billion over the next few years fixing chronic problems with lousy living conditions, lead paint and lack of heat. The settlement, announced by U.S. Housing Secretary Ben Carson and Mayor Bill de Blasio, resolves a lawsuit in which federal authorities filed on behalf of the system’s 400,000 tenants. (1/31)

Los Angeles Times: Travel Agents Charged With Bringing Pregnant Chinese Women To Give Birth On U.S. Soil
When pregnant Chinese women called You Win USA Vacation Services, they didn’t receive information on visiting Disneyland or the Grand Canyon. Instead, they sought coveted advice on how to make a very different type of trip — one aimed at giving birth on U.S. soil so their children would be American citizens. You Win USA employees allegedly coached the women on the lies they should write on bogus applications for tourist visas and made sure the women traveled before their bellies swelled too much to conceal. (Mejia and Rubin, 1/31)

Los Angeles Times: D.A. To Review Video Evidence In Case Of O.C. Surgeon Charged With Rapes
The Orange County district attorney has ordered an examination of all evidence, including numerous videos, in the case of a Newport Beach surgeon and his girlfriend charged with sexually assaulting seven women. Dist. Atty. Todd Spitzer said that after the review, he will determine how to proceed in the case against Dr. Grant Robicheaux and his girlfriend, Cerissa Riley, whose high-profile prosecutions were launched by Spitzer’s predecessor, Tony Rackauckas. (Winton, 1/31)

Los Angeles Times: Climate Change Should Tamp Down California’s Wildfire-Fanning Santa Ana Winds, Study Finds
Scientists have warned that California should brace for more wildfire as global warming drives longer bouts of hot and dry weather.Now researchers at UC San Diego’s Scripps Institution of Oceanography have found a positive trend when it comes to Southern California’s battle against destructive blazes. Santa Ana winds — which routinely whip up walls of flame through brush-covered hillsides — are likely to be tempered in coming decades as a result of climate change, according to a paper published Wednesday in the journal Geophysical Research Letters. (Smith, 1/31)