First Edition: May 11, 2017

Kaiser Health News: CMS Gives States Until 2022 To Meet Medicaid Standards On Home And Community-Based Care
The Trump administration has given states three extra years to carry out plans for helping elderly and disabled people receive Medicaid services without being forced to go into nursing homes. Federal standards requiring states find ways of delivering care to Medicaid enrollees in home and community-based settings will take effect in 2022 instead of 2019, the Centers for Medicare & Medicaid Services announced this week. (Galewitz, 5/11)

Kaiser Health News: For Knee Pain, Experts Say Don’t Think About Scoping It
A panel of international health experts and patients Wednesday challenged the effectiveness of one of the most common orthopedic procedures and recommended strongly against the use of arthroscopic surgery for patients with degenerative knee problems. The guidelines, published in the journal BMJ, relied on 13 studies involving nearly 1,700 patients that found the surgery did not provide lasting pain relief or improve function. Those studies compared the surgery with a variety of options, including physical therapy, exercise and even placebo surgery. (Heredia Rodriguez, 5/10)

Politico: 52 Ways To Repeal Obamacare
Senate Republicans want to do their own Obamacare repeal plan — but nearly all 52 Republicans have their own ideas about how it should look. With his razor-thin majority, Majority Leader Mitch McConnell can afford to lose only two GOP votes. That turns each senator into a de facto powerbroker with the ability to shape — or kill — legislation simply by aligning with two other members. (Haberkorn, 5/11)

The Washington Post: CBO To Issue Cost Estimate Of House Health-Care Bill Within Two Weeks
The Congressional Budget Office is planning to release the week of May 22 an assessment of how the health-care legislation that the House just passed will impact federal spending. In a blog post on Wednesday, the CBO said that its staff and Congress’s nonpartisan Joint Committee on Taxation expect to issue the cost estimates early that week. The notice did not say whether the analysis of the Republicans’ Affordable Health Care Act will include a forecast of how the bill would affect the number of Americans with health insurance, and a spokeswoman for the office said she did not have that information. (Goldstein, 5/10)

Politico: CBO Score Of Obamacare Repeal Bill Expected Week Of May 22
The Senate parliamentarian can't review the legislation and the GOP cannot really start writing its bill in the upper chamber until the CBO scoring is complete. That’s because the Senate version has to save at least as much money as the House bill — otherwise the measure would violate the budget resolution and the GOP repeal effort would come to a swift end. (Haberkorn, 5/10)

Politico: Republicans Flub Defense Of Health Care Vote
House Republicans celebrated passing legislation to repeal Obamacare last week — but apparently forgot to figure out how to talk about the feat back home. The result has been a messaging mess, as lawmakers returned to their districts for a weeklong recess to face furious Obamacare defenders. (Cheney, 5/11)

The New York Times: In New Jersey, Democrats Hope No Good Health Care Compromise Goes Unpunished
It took a moderate Republican from New Jersey to wrestle a compromise out of his party’s hard-right naysayers and resuscitate the House health care plan. And for that, he may pay dearly. Less than a week after Representative Tom MacArthur helped legislation that would repeal the Affordable Care Act clear a gridlocked House, he faced hundreds of outraged constituents and protesters on Wednesday in his district’s Democratic stronghold. He has to defend the measure bearing his name that would undermine protections for patients with pre-existing conditions. (Huetteman, 5/10)

The Associated Press: Republican Who Revived Health Bill Faces Onslaught Of Anger
Rep. Tom MacArthur faced hundreds of angry voters for nearly than five hours, seeking to both sell and defend the health plan that has drawn widespread outrage and fears among those worried they may be at risk of not being able to afford coverage. (5/10)

The Washington Post: ‘I Didn’t Come Here To Defend The President Tonight.’ Republican Who Rescued Health-Care Bill Faces Voters.
The mood was toxic from the start. Protesters lined up outside the town’s Kennedy Center event hall for hours before the 6:30 p.m. start time: an assemblage of local activist groups, including chapters of Indivisible, New Jersey Citizen Action and Our Revolution. Tax March, a group that grew out of protests demanding the president’s tax returns, inflated a balloon that approximated a chicken with golden, Trump-like hair; nearby, dozens of protesters lied down in a “die-in,” as a man wearing a Trump puppet head pretended to tee off on them. In the sky, a plane flew by, trailing letters that spelled out “MacArthur Tax Cut for 1% No Care.” MacArthur’s town hall was designed to weed out interlopers. District residents stood in line — at start time, it stretched as long as a football field — for one of the scarce seats inside. MacArthur entered the room through a curtain, with a sound system playing Coldplay’s anthem “A Sky Full of Stars.” Despite some of the trappings of a rally, there was little applause. (Weigel, 5/10)

Politico: MacArthur Endures Town Hall Trial-By-Fire
It was a prime example of the anger, confusion and raw emotion surrounding the GOP’s replacement health care plan, and a glimpse at why the party’s House majority suddenly seems in jeopardy in 2018. (Hutchins and Jennings, 5/11)

Politico: Democratic Group Argues Elusive GOP House Targets Are Vulnerable On Health Care
A new polling memo from a Democratic outside group argues that three Republican House members who have been targeted in past elections and represent districts President Donald Trump carried — Reps. Rod Blum (IA-01), Bruce Poliquin (ME-02) and Fred Upton (MI-06) — are newly vulnerable after the passage of the House GOP Obamacare repeal. (Bland, 5/10)

The Wall Street Journal: Health-Care Bill’s Tax Cuts Aren’t A Done Deal
Don’t count on a retroactive tax cut just yet. Republican senators aren’t sold on a piece of the House-passed health-care bill that makes this past Jan. 1 the effective date for tax cuts on capital gains, health-insurance companies and pharmaceutical companies. (Rubin, 5/10)

The Washington Post: Aetna Exiting All ACA Insurance Marketplaces In 2018
Aetna will complete its withdrawal from Affordable Care Act insurance exchanges for 2018, announcing on Wednesday that lingering financial losses and uncertainty about the marketplaces’ future was prompting it to exit two final states. According to an Aetna spokesman, the insurer will not sell individual health plans next year in Delaware or Nebraska. Its announcement came a week after the company said it would stop offering ACA health plans in Virginia in 2018 and a month after it said it would leave Iowa. (Goldstein, 5/10)

The Wall Street Journal: Aetna To Pull Out Of Current Affordable Care Act Exchanges
Aetna said its individual plans are projected to lose more than $200 million this year, and “those losses are the result of marketplace structural issues that have led to co-op failures and carrier exits, and subsequent risk pool deterioration.” The insurer said that “at this time [we] have completely exited the exchanges.” (Wilde Mathews, 5/10)

Reuters: Aetna Fully Exits Obamacare Exchanges With Pull-Out In Two States
"This decision is not a surprise given continued uncertainty about market stability and whether cost-sharing subsidies will continue to flow," Evercore ISI analyst Michael Newshel said in an investor research note. He noted that only one health plan remains in both Delaware, where Highmark Blue Cross Blue Shield sells Obamacare coverage, and Nebraska, where Medica still offers coverage but has warned it may exit the program. (Beasley, 5/10)

Los Angeles Times: Four Things Americans Should Know About Dr. Scott Gottlieb, The New Head Of The FDA
America, you have a new commissioner at the Food and Drug Administration. Dr. Scott Gottlieb, a 44-year-old physician, was confirmed by the Senate this week in a 57-42 vote. Many Democrats expressed concern about Gottlieb’s financial ties to the pharmaceutical industry. Sen. Lamar Alexander (R-Tenn.), who chaired the panel that forwarded the nomination to the Senate floor, countered that Gottlieb’s extensive experience in the drug industry would be an asset in his regulatory role. Here are four things you’ll want to know about Gottlieb. (Healy, 5/10)

The Associated Press: Lawmakers Reach Agreement On Stalled VA Accountability Bill
Congressional Republicans and Democrats have reached agreement on a bill to make it easier for the Department of Veterans Affairs to fire its employees, part of an accountability effort touted by President Donald Trump. The deal being announced early Thursday could smooth the way for final passage on an issue that had been largely stalled since the 2014 wait-time scandal at the Phoenix VA medical center. As many as 40 veterans died while waiting months for appointments as VA employees created secret waiting lists and other falsehoods to cover up delays. (Yen, 5/11)

The Associated Press: Herring Asks Feds To Change Policy On Medicaid Cases
Virginia’s attorney general is calling on federal officials to let the states use federal funds to target more cases of abuse and neglect committed against Medicaid beneficiaries. Attorney General Mark Herring was among more than three dozen attorneys general who requested the policy change in a letter to U.S. Department of Health and Human Services Secretary Tom Price. (5/11)

Reuters: Mylan Disagrees With FDA Over Generic Advair Delay
Generic drug maker Mylan NV on Wednesday said it disagrees with the reasoning behind the U.S. Food and Drug Administration's decision not to approve its generic for GlaxoSmithKline Plc's blockbuster Advair in March. Mylan President Rajiv Malik said the FDA was asking it to comply with standards set out in draft guidance the agency issued, but that it believes it is not required to do so. An FDA spokeswoman declined to comment, saying she was prohibited by law from discussing a pending application. (Erman, Grover and Clarke, 5/10)

The Associated Press: Head Of Ring That Dealt Heroin On Reservations Gets 25 Years
The leader of a drug trafficking ring that brought heroin to Minnesota and North Dakota Indian reservations was sentenced Wednesday to 25 years in prison. Omar Sharif Beasley, 39, was among 41 people charged in the drug trafficking case in which he and others brought heroin from Midwest cities like Detroit, Chicago and Minneapolis to the Red Lake and White Earth reservations in Minnesota and to Native American communities in North Dakota, prosecutors said. (5/10)

The Associated Press: Illinois Senate Approves Abortion Safeguards; Veto Likely
The Democratic-controlled Illinois Senate voted Wednesday to expand public financing for abortions and ensure legal access to the procedure across the state, although the measure likely awaits a veto by Republican Gov. Bruce Rauner. Senators voted along party lines, 33-22, in favor of the plan, which would permit abortion coverage by state employee health insurance and Medicaid funds. It would also strike statutory language expressing the state's intent to criminalize the procedure if the 1973 U.S. Supreme Court ruling that legalized it is ever overturned. (Sepeda-Miller, 5/10)

The Associated Press: Alaska Lawmaker Censured Over Abortion Comment
The Alaska House voted Wednesday to censure a Republican member over comments he made suggesting there are women in Alaska who try to get pregnant to get a "free trip to the city" for abortions. The House voted 25-14 to take the highly unusual step of censure after hours of debate, during which Rep. David Eastman of Wasilla — who referred to himself as the "least politically correct legislator in our state" — said he was sorry he made the comments. (5/10)

NPR: Lead Dust At Firearms Ranges Poses A Health Risk
Firearms safety is key for people who use weapons at work or for recreational shooting. But one risk has been little acknowledged: Lead dust exposure. In a standard bullet, a solid lead core wrapped in a copper jacket sits atop a stack of gunpowder and lead primer. When the gun fires, the primer ignites, the gunpowder lights, and some of the lead on the bullet boils. When the casing snaps out of the ejection port, lead particles trail behind it. As the bullet hurtles down the barrel of the gun, a shower of lead particles follows. (Chen, 5/10)

The New York Times: Vape Shops Want To Do Good, But Fear F.D.A. Won’t Let Them Do Well
Like so many entrepreneurs who have opened vaping shops lately, Stephen D’Angelo was a heavy smoker who finally kicked nicotine after switching to electronic cigarettes, which he viewed as a healthier — and less smelly — alternative. Mr. D’Angelo runs a 500-square-foot store on a suburban corner in Hartsdale, N.Y., and, after seven months in business, has just started to turn a profit. But now his future — and those of thousands of other vaping entrepreneurs who have gotten into the business recently — is cloudy, since new Food and Drug Administration regulations seem poised to clamp down on e-cigarettes for health reasons. (Kelly, 5/10)

The New York Times: A Baffling Brain Defect Is Linked To Gut Bacteria, Scientists Say
Researchers have traced the cause of a baffling brain disorder to a surprising source: a particular type of bacteria living in the gut. Scientists increasingly suspect that the body’s vast community of bacteria — the microbiome — may play a role in the development of a wide variety of diseases, from obesity to perhaps even autism. (Kolata, 5/10)

USA Today: Medication Error: Woman's Skin 'Melts Off'
Three years ago, a Georgia woman went to the doctor because she was depressed. The medication worked at first, but then blisters broke out all over her body. For the first two weeks, "everything was OK," said Khaliah Shaw, 26. But then, "I was in excruciating pain. It felt like I was on fire," she said. Her skin was burning from the inside out. Her sweat glands melted. The doctor had prescribed lamotrigine in 2014. (Pierrotti and Wolfe, 5/10)

Los Angeles Times: L.A. City Attorney Accuses Home Healthcare Firm Of Stealing Workers' Wages
The Los Angeles city attorney filed suit Wednesday against a home healthcare business operator, accusing her companies of bilking hundreds of mostly immigrant workers out of their pay while violating minimum wage and overtime laws. "Stealing wages from hardworking men and women is reprehensible,” Mike Feuer said. “No worker should be forced into poverty because an employer denies them their basic rights to a minimum wage and overtime. My office will aggressively combat wage theft and fight to ensure all workers are paid what the law demands.” (Winton, 5/10)