First Edition: December 5, 2019

Kaiser Health News: As His Wife’s Caregiver, A Doctor Discovers What’s Missing At Health Care’s Core
Caring for someone with a serious illness stretches people spiritually and emotionally, often beyond what they might have thought possible. Dr. Arthur Kleinman, a professor of psychiatry and anthropology at Harvard University, calls this “enduring the unendurable” in his recently published book, “The Soul of Care: The Moral Education of a Husband and a Doctor.” (Graham, 12/5)

Kaiser Health News: Pharma’s Take On The Pelosi Drug-Pricing Bill: Fair Warning Or Fearmongering?
House Speaker Nancy Pelosi’s flagship proposal to curb prescription drug prices, the “Lower Drug Costs Now Act” ― H.R. 3 ― could come up for a vote in the chamber this month. The measure would allow Medicare to negotiate prices for a limited number of drugs, cap what seniors pay out-of-pocket at $2,000 and force companies that have raised prices beyond inflation since 2016 to either reverse the price or rebate the amount of the increase to the federal government. And drug manufacturers are in full attack mode. (Luthra, 12/5)

California Healthline: California Surprise-Billing Law Protects Patients But Aggravates Many Doctors
More than two years after California’s surprise-billing law took effect, there’s one thing on which consumer advocates, doctors and insurers all agree: The law has been effective at protecting many people from bills they might have been saddled with from doctors who aren’t in their insurance network. But the consensus stops there. (Andrews, 12/4)

Kaiser Health News: ‘An Arm And A Leg’: How Much For Stitches In The ER? Hard To Gauge Upfront
Sarah Macsalka had heard the stories about how expensive an emergency room visit can be, even for a minor complaint. So when her 7-year-old son, Cameron, tripped and gashed his knee in the backyard, the ER was not where her family headed first. In fact, Macsalka did just about everything she could to avoid paying a big, fat bill to get Cameron’s knee stitched up.Ultimately, she failed. (Weissmann, 12/5)

The Associated Press: 668,000 Will Lose Food Stamp Benefits Under New Work Rules
Hundreds of thousands of Americans who rely on the federal food stamp program will lose their benefits under a new Trump administration rule that will tighten work requirements for recipients. The move by the administration is the latest in its attempt to scale back the social safety net for low-income Americans. It is the first of three proposed rules targeting the Supplemental Nutrition Program, known as SNAP, to be finalized. The program feeds more than 36 million people. (Linderman, 12/4)

The New York Times: Hundreds Of Thousands Are Losing Access To Food Stamps
The rule, which was proposed by the Agriculture Department in February, would press states to carry out work requirements for able-bodied adults without children that governors have routinely been allowed to waive, especially for areas in economic distress. The economy has improved under the Trump administration, the department argued, and assistance to unemployed, able-bodied adults was no longer necessary in a strong job market. The change is expected to shave nearly $5.5 billion from food stamp spending over five years. “Government can be a powerful force for good, but government dependency has never been the American dream,” said Sonny Perdue, the agriculture secretary. “We need to encourage people by giving them a helping hand but not allowing it to become an indefinitely giving hand.” (Fadulu, 12/4)

NPR: Nearly 700,000 SNAP Recipients Could Lose Benefits Under New Trump Rule
SNAP statutes already limit adults to three months of benefits in a three-year period unless they meet the 20 hours per week requirement, but many states currently waive that requirement in high unemployment areas. This change would make those waivers harder to get. "The rule restores the system to what Congress intended: assistance through difficult times, not a way of life," Perdue said. As NPR reported last year, though, Congress passed the farm bill without changes like these to SNAP. (Fessler and Treisman, 12/4)

Reuters: Trump Administration Moves To Remove 700,000 People From Food Stamps
Critics say the moves will hurt poor Americans. “This is an unacceptable escalation of the administration’s war on working families, and it comes during a time when too many are forced to stretch already-thin budgets to make ends meet,” said U.S. Representative Marcia Fudge, an Ohio Democrat. (Polansek, 12/4)

NBC News: Nearly 700,000 Will Lose Food Stamps With USDA Work Requirement Change
Sen. Debbie Stabenow, D-Mich., the ranking member of the Senate Committee on Agriculture, Nutrition and Forestry, said this rule would do little to help anyone find work. All the rule change does is strip people from accessing the benefit, she said. "This Administration is out of touch with families who are struggling to make ends meet by working seasonal jobs or part time jobs with unreliable hours," Stabenow said. "Seasonal holiday workers, workers in Northern Michigan’s tourism industry, and workers with unreliable hours like waiters and waitresses are the kinds of workers hurt by this proposal." The senator also noted that an attempt to add work requirements to SNAP had failed in Congress when they had considered the Farm Bill last year. The House rejected it in a bipartisan vote of 330-83, and the Senate voted down a similar amendment 68-30. (McCausland, 12/4)

USA Today: Food Stamps: Americans In Cold Weathered States Could Get Less Aid
Americans who live in cold-weather states like Vermont, New York and South Dakota could be the next to feel the impact of the Trump administration’s efforts to tighten food-stamp eligibility. (Picchi, 12/5)

The Washington Post: Biden Releases $3.2 Trillion Tax Plan, Highlighting Divisions With Sanders And Warren
Former vice president Joe Biden released a plan Wednesday to raise $3.2 trillion in taxes over 10 years to pay for his domestic spending proposals, including on health care and climate, as he seeks to cast himself as the fiscal moderate in the Democratic presidential primary amid pressure from his liberal rivals. (Stein, 12/4)

The Wall Street Journal: Joe Biden Proposes $1 Trillion In New Corporate Taxes
Until now, Mr. Biden has largely confined his ideas to rolling back parts of the 2017 Republican tax cut and pursuing policies that the Democratic Obama administration, in which he served as vice president, couldn’t get through Congress. The new proposals come atop Mr. Biden’s previous calls for tax increases, which would push the corporate tax rate to 28% from 21%, tax unrealized capital gains at death and push the top rate on individuals to 39.6% from 37%. (Rubin, 12/4)

Politico: Biden Proposes $3.2T In Tax Increases, Less Than Democratic Rivals
Biden’s camp said he was leveling with voters about how he would pay for new policies aimed at combating climate change, and expanding access to higher education and health care, after he accused rivals of falling short in that area. “He believes that being forthright with voters about how plans would be financed is critical to building the public support necessary to beat Donald Trump, help more Democrats win up and down the ballot, and then pass legislation through Congress,” said Stef Feldman, Biden’s policy director. (Becker, 12/4)

The New York Times: What Is Voters’ Highest Priority? There’s A Way To Find Out
Republicans in Congress have tried to discredit the Democratic-led impeachment inquiry by arguing that it distracts Congress from its real duties. One Republican-aligned group recently released a poll of 1,600 voters in four congressional districts that suggested Americans “prioritize issues over impeachment.” But when we look at data on revealed priorities from people all over the country, we see something different. In reality, there are few things facing the nation that anyone, regardless of party, believes are a higher priority right now. Most people would give up their preferred outcomes on health care, the environment or taxes if it meant getting what they want on impeachment. (Vavreck, Sides and Tausanovitch, 12/5)

The New York Times: Hospitals Sue Trump To Keep Negotiated Prices Secret
The nation’s hospital groups sued the Trump administration on Wednesday over a new federal rule that would require them to disclose the discounted prices they give insurers for all sorts of procedures. The hospitals, including the American Hospital Association, argued in a lawsuit filed in United States District Court in Washington that the new rule “is unlawful, several times over.” They argued that the administration exceeded its legal authority in issuing the rule last month as part of its efforts to make the health care system much more transparent to patients. (Abelson, 12/4)

The Wall Street Journal: Hospital Groups Sue To Block Price-Transparency Rule
The lawsuit filed Wednesday says the rule compelling the hospitals to publish their negotiated rates with insurers violates the First Amendment and goes beyond the statutory intent of the Affordable Care Act. “The burden of compliance with the rule is enormous, and way out of line with any projected benefits associated with the rule,” according to the suit, which was filed by the American Hospital Association and other industry groups in U.S. District Court in Washington. (Armour, 12/4)

The Hill: Hospital Groups File Lawsuit To Stop Trump Price Transparency Rule 
The hospitals argue that the efforts and cost required to follow the rule are overreaching as they would be required to release massive spreadsheets with data on negotiated drugs, supplies, facility and physician care prices. The estimated cost to hospitals to follow the rule is between $38.7 million to $39.4 million. (Coleman, 12/4)

Reuters: Hospital Groups File Lawsuit To Block Trump's Price Transparency Rule
“The rule ... does not provide the information patients need. Mandating the public disclosure of negotiated charges would create confusion about patients’ out-of-pocket costs, not prevent it,” the plaintiffs said. The rule, seen as a violation of the First Amendment by the hospital groups, also demands confidential information on individually negotiated contract terms with all third-party payers, including private commercial health insurers. (12/4)

The Associated Press: Virginia Moves To Drop Work Requirement For Medicaid
Virginia is moving toward dropping work requirements for Medicaid enrollees after Democrats won full control of the state legislature for the first time in a generation. Democratic Gov. Ralph Northam said Wednesday that his administration is hitting “pause” on its request for federal approval to requires some Medicaid recipients to have a job or participate in some form of approved community engagement and pay part of the premiums. (Sunderman, 12/4)

The Washington Post: Virginia Gov. Ralph Northam Pauses Medicaid Work Requirement
A work requirement was just one of several strings attached by conservatives before Virginia’s Republican-controlled General Assembly would agree to expand the program in May 2018. Another would make certain recipients responsible for co-payments, deductibles and monthly premiums. The state has been seeking the federal government’s permission — a “waiver” from the Center for Medicaid and CHIP Services — to impose those conditions. But in a letter Tuesday to Washington, the Northam administration said it wanted to hold off “in light of recent changes in our state legislature, which have generated dynamic policy conversations with regard to the . . . waiver.” (Vozzella, 12/4)

The Hill: Virginia Moves To Suspend Medicaid Work Requirements
“Virginians made it clear they want more access to health care, not less," [Gov. Northam] said in the statement. "Given the changed make-up of the General Assembly and based on conversations with new leadership, it is unlikely Virginia will move forward with funding a program that could cause tens of thousands of Virginians to lose health care coverage." (Weixel, 12/4)

The New York Times: Barr Says Communities That Protest The Police Risk Losing Protection
Attorney General William P. Barr warned that communities and critics of policing must display more deference or risk losing protection, a stark admonition that underscored the Trump administration’s support for law enforcement amid an ongoing national conversation about police brutality against minorities. “They have to start showing, more than they do, the respect and support that law enforcement deserves,” Mr. Barr said on Tuesday afternoon in comments at an awards ceremony for policing. “And if communities don’t give that support and respect, they may find themselves without the police protection they need.” (Benner, 12/4)

Los Angeles Times: He Wanted To Ban Feeding Homeless People. Now He’s About To Lead A Federal Homeless Agency 
A consultant known for urging cities to stop “enabling” homeless people, in part by blocking charities from handing out food, has been tapped to lead the agency that coordinates the federal government’s response to homelessness. Robert Marbut, who has worked with several cities, including Fresno and several other California cities and counties, would succeed Matthew Doherty as executive director of the U.S. Interagency Council on Homelessness. (Oreskes, 12/4)

The Washington Post: Trump Nominee Who Is Anti-IVF And Surrogacy Was Deemed Unqualified. She Was Just Confirmed.
The latest of President Trump’s confirmed federal judges has been assailed by fellow lawyers for her lack of trial experience and has been lambasted by reproductive rights advocates for her vigorous opposition to abortion, surrogacy and in vitro fertilization. And in a near-party-line vote Tuesday, the Senate approved the nomination of Sarah Pitlyk, making the conservative lawyer the newest federal judge for the U.S. District Court in St. Louis. Sen. Susan Collins (R-Maine) joined the Democrats to oppose Pitlyk. Every other Republican present voted for her. (Thebault, 12/4)

Stat: Problems With Medicines May Be Vastly Underreported To The FDA 
It’s no secret that the many side effects caused by medicines do not get reported to the Food and Drug Administration, but a new report suggests the magnitude of underreporting is far greater than imagined. After examining side effects that were conveyed to the regulator for five widely used medicines — two different types of arthritis treatments, an antipsychotic, and a blood thinner — just 1% of an estimated 276,000 serious adverse events had been reported in 2017. (Silverman, 12/4)

Stat: Over 100 Small Biotech CEOs Blast Pelosi's Drug Pricing Bill
Nearly 150 CEOs of emerging biotech companies are sending a unified, stark message to Capitol Hill: Abandon the Democrats’ signature drug pricing policy. In a new letter, signed by buzzy biotech startups like Global Blood Therapeutics (GBT) and Alnylam Pharmaceuticals (ALNY), the executives lob a blistering critique of the signature drug pricing bill unveiled this fall by House Speaker Nancy Pelosi. The legislation would allow Medicare to negotiate the price of certain high cost drugs and wage huge fines for companies that don’t comply. (Florko, 12/5)

Stat: A Second Generic Drug Maker Admits To Price Fixing In Probe Into Generics
Asmall drug maker called Rising Pharmaceuticals agreed to pay more than $3 million to resolve criminal and civil charges related to a price-fixing scheme involving a high blood pressure pill, the second time a company has reached such a deal with federal authorities who are conducting a probe into the generic industry. From April 2015 until at least September 2015, Rising conspired with another unnamed generic drug maker and its executives to fix prices and allocate customers for Benazepril HCTZ, according to court documents. Effectively, the companies “engaged in a conspiracy to suppress and eliminate competition,” the Department of Justice wrote in a document outlining the charges. (Silverman, 12/4)

The Wall Street Journal: Judge Approves Millions In Bonuses For Purdue Pharma Employees
A bankruptcy judge approved millions of dollars in bonus and incentive payments for a group of employees of OxyContin maker Purdue Pharma LP. But Judge Robert Drain put off a decision to approve a $1.3 million bonus for Purdue Chief Executive Officer Craig Landau at a hearing Wednesday in U.S. Bankruptcy Court in White Plains, N.Y. (Biswas, 12/4)

The Wall Street Journal: Kaiser, Optum Back Addiction-Recovery Startup Groups
As the U.S. opioid addiction epidemic grinds on, startups offering treatment services are gaining popularity with health-care providers and investors. One company making headway in the crisis is Groups, which recently raised $27 million in new financing from major health organizations. Groups, which is based near Boston and officially called Recover Together Inc., said its backers were impressed by its above-average patient success rates. (Mack, 12/4)

The Wall Street Journal: Insys Creditors Can Begin Voting On Chapter 11 Plan
Defunct opioid maker Insys Therapeutics Inc. faced tough questioning from a bankruptcy judge Wednesday over its plan to bar shareholders from suing anyone involved in the company’s demise. (Brickley, 12/4)

The Washington Post: Forget Freer/Sackler. The Smithsonian Debuts The The National Museum Of Asian Art.
The Freer Gallery of Art and the Arthur M. Sackler Gallery have long described themselves as the Smithsonian’s Asian art museums. Now the two institutions want to be known as the National Museum of Asian Art. Don’t call it a name change, though. Museum officials say it is a rebranding that clarifies the missions of the joint institutions. And, they say, it has absolutely nothing to do with international protests over the Sackler family’s connection to the opioid crisis. (McGlone, 12/4)

The New York Times: Hair Dyes And Straighteners May Raise Breast Cancer Risk For Black Women
For decades, scientists have debated whether hair dyes frequently used by women might contribute to cancer. The research has been mixed and inconclusive, but now government investigators have turned up a disturbing new possibility. Black women who regularly used permanent dyes to color their hair were 60 percent more likely to develop breast cancer, compared to black women who did not report using dye, according to an analysis published this week in the International Journal of Cancer. (Rabin, 12/4)

NPR: Hair Dyes And Straighteners Linked To Higher Cancer Risk, Especially For Black Women
Researchers don't know which ingredients in the products might be of concern. The study did not look at the specific ingredients in the products women were using, only at whether they had used the product and whether they developed breast cancer. All women in the Sister Study were already at high risk for breast cancer since they had a sister who had breast cancer. (Neighmond, 12/4)

Los Angeles Times: Fearing CTE, A Former USC Star's Family Donates His Brain
The brains arrive at all hours in white cardboard boxes stamped “RUSH!” Inside each package is an inch-and-a-half-thick foam liner and a red bag protecting an ordinary white plastic bucket. When a courier service delivered Kevin Ellison’s brain to the Bedford VA Medical Center near Boston just after 2 p.m. on Jan. 22, Dr. Victor Alvarez performed the routine he has done so many times that he’s stopped counting. (Fenno, 12/3)

The Wall Street Journal: DexCom’s Blood-Sugar-Monitor Data Sharing Returns After Outage
DexCom Inc. said Wednesday a data-sharing feature for its diabetes devices is now operating at “full service levels” after a technology problem caused the service to crash over the weekend. The lapse, which began early Saturday, blocked many parents’ and caregivers’ smartphones from remotely receiving blood-sugar readings of diabetes patients who wear DexCom’s glucose monitors. (Loftus, 12/4)

The Associated Press: Drug Can Curb Dementia’s Delusions, Researchers Find
A drug that curbs delusions in Parkinson's patients did the same for people with Alzheimer's disease and other forms of dementia in a study that was stopped early because the benefit seemed clear. If regulators agree, the drug could become the first treatment specifically for dementia-related psychosis and the first new medicine for Alzheimer's in nearly two decades. It targets some of the most troubling symptoms that patients and caregivers face — hallucinations that often lead to anxiety, aggression, and physical and verbal abuse. (Marchione, 12/4)

The Associated Press: Once-A-Month Birth Control Pill? Experiment Works In Animals
Birth control pills work great if women remember to take them every day but missing doses can mean a surprise pregnancy. Now scientists have figured out how to pack a month’s supply into one capsule. The trick: A tiny star-shaped gadget that unfolds in the stomach and gradually releases the drug. (12/4)

USA Today: Pearl Harbor Shooting: Sailor Shot Three People, Base Says
A U.S. Navy sailor shot three people, then killed himself at Pearl Harbor on Wednesday, military officials said, three days before the anniversary of the attack that prompted the United States to enter World War II.  Two victims are dead and one is hospitalized in stable condition, officials at Joint Base Pearl Harbor-Hickam said. The shooting at the naval shipyard happened at about 2:30 p.m. local time. Military forces responded to the scene and put the roughly 66,000 people who live at the base on lockdown for about an hour. (Lam, 12/4)

The New York Times: He Waited 6 Hours For Medical Help. Then He Tried To Hang Himself.
The guards brought the 18-year-old detainee with a gashed lip into a special holding cell on Friday night. He had been injured after a fight with seven other inmates and was being transferred to an urgent care facility on Rikers Island. What happened over the next six hours would plunge the jail and the city’s correction department into a crisis on Wednesday over the supervision of inmates, especially those at risk of suicide, at a time when the city is seeking to close Rikers. (Ransom, 12/4)

The Associated Press: At Notorious Jail, Guards Feel Heat For Teen’s Near Suicide
Mayor Bill de Blasio tweeted the allegations that officers failed to immediately intervene in Feliciano’s suicide attempt are “deeply troubling.” “The people in our jails are human beings,” de Blasio wrote. “Their well-being is our responsibility.” Correction Commissioner Cynthia Brann said in a statement the allegations were “extremely troubling and we are taking them seriously.” (12/4)

The Associated Press: Minnesota Sues E-Cigarette Maker Juul Over Youth Vaping Rise
Minnesota Attorney General Keith Ellison sued Juul Labs on Wednesday, accusing the e-cigarette maker of unlawfully targeting young people with its products to get a new generation addicted to nicotine. The lawsuit filed in Hennepin County District Court in Minneapolis seeks to force Juul to stop marketing to young people; fund a corrective public education campaign in Minnesota on the dangers of youth vaping; fund vaping cessation programs; disclose all its research on vaping and health; and surrender all profits from its allegedly unlawful conduct. (Karnowski, 12/4)

The Associated Press: Rapper T.I.’s Remarks Spark NY Bill To End Virginity Tests
New York could bar doctors from performing so-called virginity tests under legislation prompted by the rapper T.I.'s controversial claim that he has a gynecologist check his daughter's hymen annually. Assemblywoman Michaelle Solages said Tuesday the bill she submitted last month would prohibit medical professionals from performing or supervising such examinations, though it's unclear how common they are in the U.S. New York would also consider it sexual assault when such tests are performed outside of a medical setting. (12/4)

Los Angeles Times: Flesh-Eating Bacteria Linked To Black Tar Heroin Kills 7 In San Diego County
A flesh-eating bacteria linked to the use of black tar heroin has killed at least seven San Diego County residents who injected the drug since early October, county health officials said Wednesday. Between Oct. 2 and Nov. 24, nine people who injected black tar heroin were hospitalized with severe myonecrosis, a soft-tissue infection that destroys muscle, health officials said. The patients ranged from 19 to 57 years old; of the seven who died, five were men. (Riggins, 12/4)

ProPublica/Chicago Tribune: Illinois Will Allow Prone, Supine Restraints On Children While Schools Learn To Phase Them Out
Amending emergency rules put in place two weeks ago, the Illinois State Board of Education says it will again allow schoolchildren to be physically restrained in positions it had banned, though only in crisis situations. The change comes after several schools said they could no longer serve some students with behavior issues because of the new restrictions, put in place after publication of a Chicago Tribune/ProPublica Illinois investigation that found overuse and misuse of “isolated timeouts” in public schools across the state. (Richards, Cohen and Chavis, 12/4)