First Edition: Feb. 13, 2023

KHN: Doctors Are Disappearing From Emergency Rooms As Hospitals Look To Cut Costs 
Pregnant and scared, Natasha Valle went to a Tennova Healthcare hospital in Clarksville, Tennessee, in January 2021 because she was bleeding. She didn’t know much about miscarriage, but this seemed like one. In the emergency room, she was examined then sent home, she said. She went back when her cramping became excruciating. Then home again. It ultimately took three trips to the ER on three consecutive days, generating three separate bills, before she saw a doctor who looked at her bloodwork and confirmed her fears. (Kelman and Farmer, 2/13)

KHN: Montana’s Tax-Exempt Hospitals Oppose Increased Oversight By State Officials 
Nonprofit hospitals are fighting Montana’s attempt to boost oversight of the ways they claim they provide benefits to their communities in exchange for millions of dollars in tax breaks. It’s the latest clash in a national struggle between policymakers and the industry over whether hospitals’ charitable giving is enough to justify their tax-exempt status. (Houghton, 2/13)

The Wall Street Journal: U.S. Begins Allowing Medicaid Money To Be Spent On Food 
The Biden administration has started approving state requests to use Medicaid to pay for groceries and nutritional counseling as policy makers explore whether “food as medicine” programs can lead to broad health benefits and trim costs. A growing body of research suggests that addressing food insecurity can improve health as well as deliver savings by reducing medical visits, the need for medication, or by helping control serious illness. The programs have also appealed to some GOP lawmakers who believe states should have more control over their Medicaid programs. (Armour and Peterson, 2/12)

USA Today: 'That’s Not A Republican Plan': McConnell Distances GOP From Scott On Social Security, Medicare Sunset Plan
Senate Republican Leader Mitch McConnell said any idea on sunsetting Social Security and Medicare belongs to Sen. Rick Scott—not the GOP. “Unfortunately, that was the Scott plan, that’s not a Republican plan,” McConnell said on a Kentucky radio program. (Bailey, 2/10)

Politico: GOP Senator: ‘Vast Majority’ Want ‘A Different Direction’ Than Rick Scott On Social Security 
Most Republicans don’t agree with Sen. Rick Scott‘s plan to sunset programs including Medicare and Social Security, Sen. Mike Rounds said Sunday on CNN’s “State of the Union,” even as he left the door open to other changes. “The vast majority of us would say that we prefer to look at it in a different direction, one of managing it, as opposed to a discussion about having everything start over again,” Rounds said. (Olander, 2/12)

The Hill: Can These Lawmaker Proposals Save Social Security?
Capitol Hill is talking more about Social Security, which estimates show is on track to becoming insolvent in little more than a decade, as both sides feud over how to address the rising national debt. A recent report from the Congressional Budget Office (CBO) found that spending for Social Security benefits increased by 10 percent, or $37 billion, in the four-month stretch ending in January, compared to the same period the year before. (Folley, 2/12)

Axios: Workplace Plans Paid More Than Medicare For Physician-Administered Drugs, Study Finds
Employer-sponsored health plans pay significantly more than Medicare for costly physician-administered drugs, threatening access to lifesaving treatments, according to a newly published analysis of claims data and Medicare files. (Dreher, 2/13)

NBC News: Texas Lawsuit Seeking To Reverse FDA Approval Of Abortion Pills
On Friday, New York Attorney General Letitia James led a coalition of 22 attorneys general in filing a brief that argued that if the FDA were ordered to rescind its approval of mifepristone, that would have “devastating consequences” for women across the U.S., regardless of their state’s abortion policy. Mississippi Attorney General Lynn Fitch, meanwhile, led a group of 22 Republican attorneys general who filed a brief calling the FDA’s approval of abortion pills “deeply flawed.” (Atkins, 2/11)

Bloomberg: Abortion Providers Gear Up For Judge’s Ruling Over Pill Approval 
Health providers are bracing for massive disruptions as they await a federal judge’s decision on whether to halt national access to an abortion pill approved decades ago by the Food and Drug Administration. Trump-appointed Judge Matthew Kacsmaryk is expected to rule soon on the Alliance Defending Freedom’s request for a preliminary injunction stopping the sale and distribution of mifepristone, a drug used as part of a regimen to end a pregnancy within the first 10 weeks. (Castronuovo and Lopez, 2/10)

Axios: 40 Million Would Lose Abortion Access If Court Blocks Pill, Study Shows
40 million more women would lose access to abortion care if a federal court revokes the use of a key drug in medication abortions, data from the abortion rights group NARAL shows. (Gonzalez, 2/10)

Axios: Dissatisfaction With Abortion Policy Highest Since 2001
People in America are more dissatisfied with the U.S.'s abortion policy than they have ever been in the 23 years, according to a new Gallup poll released Friday. Democrats' dissatisfaction with laws have jumped after the fall of Roe last June and nationwide GOP-led efforts to enforce abortion restrictions. For over 20 years, Republicans were more likely than Democrats to express dissatisfaction, per Gallup. (Chen, 2/10)

Politico: Republicans Clash With Prosecutors Over Enforcement Of Abortion Bans 
GOP lawmakers see a major flaw in their states’ near-total abortion bans: Some local prosecutors won’t enforce them. Republicans in Georgia, Indiana, South Carolina and Texas — frustrated by progressive district attorneys who have publicly pledged not to bring charges under their state’s abortion laws — have introduced bills that would allow state officials to either bypass the local prosecutors or kick them out of office if their abortion-related enforcement is deemed too lenient. (Ollstein and Messerly, 2/12)

The Wall Street Journal: Women Encounter Abortion Delays As Clinics Draw Patients From Out Of State 
Seven months after the Supreme Court overturned Roe v. Wade, some abortion clinics say new state bans on the procedure are pushing abortions later into pregnancy. Since the high court’s decision to remove constitutional protections for abortion, the procedure has become largely inaccessible in nearly one-third of the states, either because a ban is in place or because clinics have shut down owing to legal uncertainty. (Kusisto and Owens, 2/12)

The New York Times: Childbirth Is Deadlier For Black Families Even When They’re Rich, Expansive Study Finds 
In the United States, the richest mothers and their newborns are the most likely to survive the year after childbirth — except when the family is Black, according to a groundbreaking new study of two million California births. The richest Black mothers and their babies are twice as likely to die as the richest white mothers and their babies. Research has repeatedly shown that Black mothers and babies have the worst childbirth outcomes in the United States. But this study is novel because it’s the first of its size to show how the risks of childbirth vary by both race and parental income, and how Black families, regardless of their socioeconomic status, are disproportionately affected. (Miller, Kliff and Buchanan, 2/12)

NBC News: Wildfire Smoke Exposure In Pregnancy Raises Risk Of Preterm Birth
A study of more than 2.5 million pregnant people in California found that those exposed to wildfire smoke for at least one day faced a higher risk of giving birth prematurely. The findings were presented Saturday at the Society for Maternal-Fetal Medicine’s annual meeting and are currently undergoing peer review. They're set to be published in the American Journal of Obstetrics and Gynecology. (Bendix, 2/11)

NBC News: Mississippi Hit By 900% Spike In Babies Treated For Congenital Syphilis
The number of babies in Mississippi being treated for congenital syphilis has jumped by more than 900% over five years, uprooting the progress the nation’s poorest state had made in nearly quashing what experts say is an avoidable public health crisis. The rise in cases has placed newborns at further risk of life-threatening harm in a state that’s already home to the nation’s worst infant mortality rate. (Harris, 2/11)

AP: New York Lets COVID-19 Health Care Mask Requirements Lapse 
New York state officials said they will allow COVID-19-related masking requirements for staff and visitors in hospitals and other health care facilities to lapse on Sunday. Acting Health Commissioner Dr. James McDonald said that while the pandemic is not over, “we are moving to a transition.” “As we do, and with safe and effective vaccines, treatments, and more, we are able to lift the state’s masking requirement in health care settings,” McDonald said in a statement. (2/10)

Boston Globe: Fauci's Longtime Deputy, Hugh Auchincloss, Takes His Role
Dr. Anthony Fauci was the face of the fight against Covid-19, an omnipresent figure featured on T-shirts, bobbleheads, and yard signs. He was lionized by his fans as a scientific hero and villainized by his opponents as a denier of their freedoms. But there are no tchotchkes with the likeness of the person who has replaced him at the helm of National Institute for Allergy and Infectious Diseases. In fact, finding more than one photo of Dr. Hugh Auchincloss on the Internet is a challenge. (Puzzanghera, 2/11)

CIDRAP: Omicron XBB.1.5 Variant Expands US Dominance 
In updated variant projections today, the CDC said the more transmissible XBB.15 subvariant makes up an estimated 74.7% of cases, up from 66.4% last week. The only area where the subvariant isn't dominant is in the far northwestern region, which includes Alaska, Idaho, Oregon, and Washington. (Schnirring, 2/10)

CIDRAP: COVID Deaths 5-Fold Lower After Bivalent Vs Monovalent Booster 
Recipients of the bivalent (two-strain) COVID-19 vaccine booster were 14 times less likely to die of Omicron BA.4/BA.5 infections than their unvaccinated peers and 5 times less likely to die than recipients of the monovalent (single-strain) booster, particularly among older people, finds a study today in Morbidity and Mortality Weekly Report. (Van Beusekom, 2/10)

The New York Times: For Older Americans, The Pandemic Is Not Over
For older Americans, the pandemic still poses significant dangers. About three-quarters of Covid deaths have occurred in people over 65, with the greatest losses concentrated among those over 75.In January, the number of Covid-related deaths fell after a holiday spike but nevertheless numbered about 2,100 among those ages 65 to 74, more than 3,500 among 75- to 84-year-olds and nearly 5,000 among those over 85. Those three groups accounted for about 90 percent of the nation’s Covid deaths last month. (Span, 2/11)

NPR: Since COVID, Concern Grows Over Race-Based Skin Bias In Pulse Oximeters
"There's no doubt in my mind that this has led to people not getting care, not getting timely care, or even being sent home or staying home to die from COVID-19," says Noha Aboelata, a family practice physician at the Roots Community Health Center. Aboelata is a co-author on one of several studies that have shown inaccuracies in the device have led to patients of color not getting timely care. (Oza, Kwong, Lu and Spitzer, 2/10)

CIDRAP: US Flu Activity Remain Low, But Kids' Deaths Pass 100
After an early surge, flu activity remained low nationally, the US Centers for Disease Control and Prevention (CDC) said today in its weekly update. But the addition of 9 more flu-related pediatric deaths put the country over the 100 mark for the current influenza season. (Schnirring, 2/10)

Modern Healthcare: Kaiser Permanente Posted $4.47B Net Loss In 2022 As Costs Rose
Kaiser Permanente is the latest health system showing signs of struggle amid rising costs. Kaiser, an Oakland, California-based integrated nonprofit, on Friday reported a $4.47 billion net loss in 2022, compared with a $8.08 billion gain in 2021. (Hudson, 2/10)

Modern Healthcare: Mass General Brigham Records Nearly $1.5M In Q1 Operating Loss
Mass General Brigham continues to struggle with cost increases, staffing problems and capacity issues. The system on Friday reported net income of $480 million in its first quarter ended Dec. 31, a dramatic improvement from the $104.96 million reported in the year-ago period. However, that jump was largely supported by nonoperating factors, including more than $400 million in investment-related gains. Revenue increased 8.4% to $4.46 billion. (Hudson, 2/10)

Modern Healthcare: Oscar Health's Net Loss Grew In 2022
The insurtech's medical loss ratio improved from 88.9% in 2021 to 85.3% last year and its administrative expense ratio declined from 21.8% to 20.6%, the company reported Thursday. Oscar Health recorded a $226.6 million net loss during the fourth quarter, which beat analyst expectations of $261.3 million in net losses. (Turner, 2/10)

Crain's Detroit Business: Why New Hospitals Are Being Built During Tough Financial Times
The rise of medically complex patients is presenting an opportunity for Michigan health systems willing to bet on the future of hospitals even as they struggle through tough financial times now. Henry Ford Health announced this week a planned $2.2 billion investment in the city of Detroit, including a new hospital tower and a research and innovation center with Michigan State University. (Walsh, 2/10)

Stat: Patients Still Face Surprise Ambulance Bills. There's No Fix In Sight
One night in November 2021, 11 weeks into her pregnancy, Carolyn Provine started bleeding — a lot. When she passed out, her wife and mother-in-law called an ambulance and drove 21 miles to the hospital for an emergency surgery. But the hemorrhaging, and miscarriage, no longer were Provine’s only concerns. “My first thought was, ‘Wait, is there some way for me not to take an ambulance?’” said Provine, 26, a reading specialist in Vermont. (Herman, 2/13)

CNN: Almost Half Of Children Who Go To ER With Mental Health Crisis Don't Get The Follow-Up Care They Need, Study Finds
Every night that Dr. Jennifer Hoffmann works as an attending physician in the pediatric ER, she says, at least one child comes in with a mental or behavioral health emergency. Over the span of her career, she’s seen the number of young people needing help grow enormously. “The most common problems that I see are children with suicidal thoughts or children with severe behavior problems, where they may be a risk of harm to themselves or others,” said Hoffmann, who works at Ann & Robert H. Lurie Children’s Hospital of Chicago. (Christensen, 2/13)

The Wall Street Journal: With Therapists In Short Supply, College Students Counsel Each Other 
Hamilton College has found one answer to the growing number of students seeking mental-health care on campus: Send them to other students. The school trains about a dozen undergrads a year to serve as peer counselors, a role that entails being a good listener to other students. The counselors go through about three days of training per year and attend weekly meetings to review peer conversations with the school counseling center’s professional therapists. (Petersen, 2/12)

The Washington Post: Can Family Medicine Improve America’s Mental Health? 
Primary care providers are at the forefront of the nation’s deepening behavioral health crisis because when patients walk into a doctor’s office, they bring all their needs with them. Asthma. Anxiety. Diabetes. Depression. Sniffles. Stress. “We artificially separate ‘this is a mental health issue’ and ‘this is a physical health issue,’” said Lisa Barkley, a doctor and director of the family medicine residency program at Charles R. Drew University of Medicine and Science, where James is training. “But really, people are just coming in for their issues.” (Johnson, 2/10)

Tampa Bay Times: Florida Nursing Homes See Spike In Serious Violations
A man in a wheelchair was left outside a St. Petersburg nursing home on a 95-degree summer day. When the nursing home’s staff discovered him two hours later, he was unresponsive. His body temperature had climbed to 106. (Chritchfield, 2/10)

The Boston Globe: A 15-Year-Old Stayed In A Hospital For 40 Days. The Reason? The State Child Welfare Agency Had No Place To Put Him
For 40 days last fall, James’s entire life fit within the four walls of an emergency department room in Leominster. The 15-year-old lived in a windowless room, ate hospital meals, wore thin papery scrubs, and was allowed to leave only to use the bathroom or shower down the hall. (Koh, 2/11)

AP: Nebraska Considers Medical Conscientious Objection Bill
Nebraska lawmakers are following the path of other conservative states in considering a bill that would allow medical providers, facilities and insurers to cite their religious, ethical or moral beliefs in denying some medical treatments. Critics say it’s simply another way to target abortion rights and the LGBTQ community. The bill, introduced by Sen. Dave Murman, of Glenvil, casts a wide net. The term “medical providers” covers everyone from doctors, nurses and pharmacists to mental health counselors and nursing home staffers — all of whom could refuse to perform nonemergency procedures, from abortions and gender-affirming hormone treatments to prescribing birth control — if the provider has a moral objection to it. (Beck, 2/10)

AP: Florida Doctors' Board Tightens Ban On Gender-Affirming Care
A prohibition against puberty blocking hormones and gender-affirming surgeries for minors in Florida was tightened further after a board overseeing doctors eliminated an exception for clinical trials Friday at the request of Florida Gov. Ron DeSantis’ administration. Some members of the public attending the meeting in Tallahassee shouted expletives, and law enforcement officers positioned themselves in the front of the room after the vote by the Florida Board of Osteopathic Medicine. (Schneider, 2/10)

AP: Transgender Advocates Sue South Dakota Gov. Kristi Noem 
A transgender advocacy group in South Dakota sued Republican Gov. Kristi Noem and the head of the state’s Department of Health on Friday over the state’s decision to terminate a contract with the group last December. The Transformation Project filed a lawsuit Friday that alleges that the decision to terminate the contract — which resulted in the group losing a nearly $136,000 grant from the U.S. Centers for Disease Control and Prevention — was discrimination. (Biraben, 2/10)

The Texas Tribune: Greg Abbott Says He Backs Legislation Banning Transgender College Athletes 
Gov. Greg Abbott said Saturday that he would back legislation banning transgender student athletes from competing on a collegiate level on teams that match their gender. “This next session, we will pass a law prohibiting biological men to compete against women in college sports,” Abbott said at the Young America’s Foundation Freedom conference in Dallas. (Dey, 2/12)

AP: Tests Negative, Sen. John Fetterman Leaves Hospital 
Pennsylvania Democratic Sen. John Fetterman left a hospital in Washington after a two-day stay, his office said Friday, following a spell of lightheadedness that prompted the visit as he recovers from a stroke he suffered last year on the campaign trail. In a statement, Fetterman’s office said he was discharged from George Washington University Hospital after tests found no evidence of a new stroke or a seizure. (2/10)

AP: Lawsuit Seeks Medical Testing After Toxic Train Derailment 
Residents who filed a federal lawsuit in the fiery derailment of a train carrying toxic chemicals along the Ohio-Pennsylvania line are seeking to force Norfolk Southern to set up health monitoring for residents in both states. The lawsuit filed Thursday by two Pennsylvania residents calls for the rail operator to pay for medical screenings and related care for anyone living within a 30-mile (48-kilometer) radius of the derailment to determine who was affected by toxic substances released after the derailment. The lawsuit also is seeking undetermined damages. (2/10)

AP: Suburban Detroit School Closed Due To Norovirus Outbreak
Classes at a suburban Detroit school have been cancelled due to an outbreak of the norovirus among students and staff. St. Michael the Archangel Catholic School in Livonia shut down Wednesday, WXYZ-TV reported Friday. Norovirus is contagious and causes inflammation of the stomach and intestines. Symptoms include vomiting, diarrhea and fever. (2/10)

Politico: Governors Find Common Cause In Fighting Addiction 
A bipartisan panel of governors from Maryland, New Hampshire, New Mexico and North Dakota said they agreed on elements of each other’s ideas to address addiction and the fentanyl crisis, speaking Sunday on CBS’ “Face the Nation.” “That is probably going to be the nexus of real bipartisan work,” Democratic New Mexico Gov. Michelle Lujan Grisham said to North Dakota Gov. Doug Burgum, a Republican, after he described treating addiction as a disease. The governors were in Washington, D.C., for the National Governors Association conference, and dealing with fentanyl was one area where they clearly found common cause. (Olander, 2/12)

San Francisco Chronicle: Fentanyl-Fueled Overdose Deaths Spiked In These Bay Area ZIP Codes
In San Francisco, it’s well documented that the Tenderloin and South of Market neighborhoods are experiencing the brunt of the opioid epidemic. But state data shows other Bay Area counties have their own hotspots. Most of the nine counties had a few ZIP codes with a fatal opioid overdose rate several times the county figure, according to the California Overdose Surveillance Dashboard’s 2021 data, the latest year with finalized numbers. (Leonard, 2/10)

NBC News: Lawsuit Filed Against The Maker Of Eyedrops Linked To Infections
A woman in Florida filed a lawsuit late Thursday against the maker of EzriCare artificial tears and Walmart after suffering a bacterial infection that she said was caused by the eyedrops. Houston-based Lange Law Firm, which is representing the woman, Teresa Phillips, 60, of Bradford County, said the lawsuit is the first nationwide over injuries related to eyedrops linked to a drug-resistant bacterial infection called Pseudomonas aeruginosa. (Lovelace Jr., 2/10)

Reuters: Martin Shkreli: I'm Not In Contempt Over Drug Industry Ban 
Martin Shkreli on Friday urged a U.S. judge not to hold him in civil contempt for failing to provide federal and state regulators with information to determine whether he is violating a lifetime ban from working in the pharmaceutical industry. In a filing in Manhattan federal court, Shkreli said he has complied with the February 2022 ban "as extensively as possible and in good faith," and has provided the materials sought by the Federal Trade Commission (FTC) and seven states. (Stempel, 2/10)

The Washington Post: Study Links Traffic Noise And Common, Vexing Hearing Problem 
Tinnitus — a ringing or whistling sound in the ears — plagues millions worldwide. Though the estimates of those bothered by the condition vary, a new study suggests they may have something in common: exposure to road traffic noise at home. The paper, published in Environmental Health Perspectives, looked to Denmark to find a potential link between road noise and tinnitus levels. The nationwide study included data on 3.5 million Danish residents who were 30 and older between 2000 and 2017. Over that time, 40,692 were diagnosed with tinnitus. (Blakemore, 2/11)