First Edition: October 17, 2017

Kaiser Health News: On Back Roads Of Appalachia’s Coal Country, Mental Health Services Are As Rare As Jobs
Every other month, Tanya Nelson travels 32 miles from the heart of Appalachia’s coal country for an appointment with the nearest psychiatrist for therapy and to renew prescriptions. But the commute, which should take less than an hour through the winding mountain roads of southern West Virginia, consumes her entire day. Nelson, 29, needs treatment for bipolar disorder, depression and anxiety. But she does not drive, so she must use a van service to keep her appointments. It makes numerous stops along the highway, picking up other travelers, and usually doesn’t return to her home in New Richmond, W.Va., until day’s end. (Connor, 10/17)

Kaiser Health News: Cascade Of Costs Could Push New Gene Therapy Above $1 Million Per Patient
Outrage over the high cost of cancer care has focused on skyrocketing drug prices, including the $475,000 price tag for the country’s first gene therapy, Novartis’ Kymriah, a leukemia treatment approved in August. But the total costs of Kymriah and the 21 similar drugs in development — known as CAR T-cell therapies — will be far higher than many have imagined, reaching $1 million or more per patient, according to leading cancer experts. The next CAR T-cell drug could be approved as soon as November. (Szabo, 10/17)

Kaiser Health News: Want An IUD? Take Note Of Trump’s New Birth Control Policy.
The Trump administration’s recently announced changes to health insurance rules have raised concerns among people wondering how they’ll be affected. This week, I address some of the questions likely on people’s minds. (Andrews, 10/17)

California Healthline: Governor Inks Support For Some Key Health Bills, Nixes Others
Wielding his pen, Gov. Jerry Brown has reinforced the Affordable Care Act, stood up to pharmaceutical companies and boosted testing for childhood lead poisoning. Facing a Sunday deadline to approve or reject measures passed by the legislature this year, Brown weighed in on some key health care bills, including measures to protect Californians who buy insurance for themselves. (Bartolone and Ibarra, 10/16)

Reuters: Trump Declares Obamacare 'Dead,' Urges Democratic Help For Short-Term Fix
U.S. President Donald Trump on Monday declared Obamacare "dead" and "gone," but urged Republicans and Democrats in Congress to craft a short-term fix of healthcare markets under the 7-year-old law that critics say he has effectively sabotaged. "It’s dead. It’s gone. It’s no longer - you shouldn’t even mention. It’s gone," Trump said of former Democratic President Barack Obama's signature 2010 healthcare law that Republicans have repeatedly tried and failed to repeal. (Rampton and Cowan, 10/16)

Los Angeles Times: Trump Calls For Short-Term Obamacare Fix And Reaches Out To Republican Leaders
President Trump threw his weight Monday behind a measure to fix parts of Obamacare, the first time he has voiced approval of a specific legislative approach to do so and an abrupt turnaround on a bipartisan effort to preserve key elements of the healthcare system that he has sought to repeal. Trump’s backing of what he repeatedly referred to as a “short-term fix” to ensure “good healthcare” came during freewheeling remarks in which he sought to mend relations with GOP leaders, even as he kicks a growing list of complicated issues to Congress, including immigration and the Iran nuclear deal. (Mascaro and Bierman, 10/16)

Politico: Trump Said To Want Bipartisan Senate Obamacare Deal
President Donald Trump urged Republican Sen. Lamar Alexander to seek out an Obamacare deal with Democrats — encouragement that might help sway Republicans who are skeptical of a bipartisan agreement. Alexander said Trump told him by phone Oct. 14 he’d like to see a bill that funds the Obamacare cost-sharing subsidies that he abruptly cut off last week. In return, he wants to see “meaningful flexibility for the states in providing more choices,” Alexander (R-Tenn.) said. (Haberkorn, 10/16)

The Washington Post: Two Swing-State Democrats Offer Middle Ground On Health Care
A pair of swing-state Democrats are offering new legislation that would create Medicare-style options for non-elderly workers, with a heavy focus on rural areas that have few insurers offering coverage under the Affordable Care Act. The proposal, from Sens. Michael F. Bennet (Colo.) and Tim Kaine (Va.), is politically significant because it tries to build on the existing law rather than the tear-it-all-down proposal of a national health-care system that is being offered by Sen. Bernie Sanders (I-Vt.). (Kane, 10/16)

The Hill: Tough Decisions Loom For Dems On ObamaCare 
Congressional Democrats have to decide how badly they want an ObamaCare deal. Senate Republicans are open to renewing the insurer payments that President Trump canceled last week, but, in return, they want to expand a program that allows states to waive Affordable Care Act regulations. That asking price could be hard for Democrats to swallow. (Sullivan, 10/17)

The New York Times: Deep In Trump Country, A Big Stake In Health Care
Marjorie Swanson was the first in the family to get a job at Baxter Regional Medical Center after moving to this rural Ozark town from Chicago’s South Side in 1995. A year later, her husband was hired by the maintenance department. Six months ago, their daughter snagged a job as a pharmacy technician and shares the night shift with her fiancé, who works in housekeeping. Their son started in 2013 as a biomedical technician, repairing medical equipment. He was introduced to his wife by two nurses there: one who is now his mother-in-law and Beverly Green, an aunt through marriage. (Cohen, 10/16)

The Wall Street Journal: In Maine, Medicaid Expansion Goes Before The Voters
As the Trump administration takes steps to weaken provisions of the Affordable Care Act, voters in Maine are being asked whether the state should embrace a central plank of the 2010 law. The November statewide ballot measure proposes the state accept enhanced federal funding available under the health law to extend Medicaid health benefits to low-income adults, over the strong opposition of the state’s Republican governor, Paul LePage. Mr. LePage argues that the expansion would deplete state coffers. (Levitz and Hackman, 10/16)

The Associated Press: Trump Raises Possibility Of Withdrawing Drug Czar Nominee
President Donald Trump on Monday raised the possibility of withdrawing his nomination of Republican Rep. Tom Marino to be the nation's drug czar following reports that the lawmaker played a key role in passing a bill weakening federal authority to stop companies from distributing opioids. (Daly, 10/16)

The Washington Post: Trump Declines To Express Confidence In Drug Czar Nominee In Wake Of Post/‘60 Minutes’ Probe
President Trump said Monday that he will declare a national emergency next week to address the opioid epidemic and declined to express confidence in Rep. Tom Marino (R-Pa.), his nominee for drug czar, in the wake of revelations that the lawmaker helped steer legislation making it harder to act against giant drug companies. Trump’s remarks came amid widespread reaction across the political spectrum to a Washington Post/“60 Minutes” investigation that explained how Marino helped guide the legislation, which sailed through Congress last year with virtually no opposition. (O'Keefe, Higham and Bernstein, 10/16)

Politico: Trump: 'Looking Into' Marino's Nomination As Drug Czar After Report On Opioid Legislation
“As far as Tom Marino, so he was a very early supporter of mine, the great state of Pennsylvania. He's a great guy,” Trump said during a Rose Garden news conference Monday afternoon. “I did see the report. We’re going to look into the report. We’re going to take it very seriously because we’re going to have a major announcement probably next week on the drug crisis and on the opioid massive problem, and I want to get that absolutely right … We're going to be looking into Tom.” (Nelson, 10/16)

The Hill: Manchin Calls On Trump To Withdraw Drug Czar Pick 
Sen. Joe Manchin (D-W.Va.) is calling for the White House to withdraw the nomination of Rep. Tom Marino (R-Pa.) to serve as the nation’s drug czar, after a Washington Post-60 Minutes investigation suggested he led a bid to weaken enforcement of the nation's drug policing laws. In in-depth reports released Sunday, the news organizations detailed Marino’s involvement in helping pass legislation reportedly weakening the Drug Enforcement Administration’s (DEA) authority to halt drug distributors. This reportedly undermined the DEA’s effort to stop the flow of prescription painkillers, drugs that have contributed to rising overdose death rates. (Roubein, 10/16)

Stat: McCaskill Seeks To Repeal Law That Hampered DEA Enforcement
Sen. Claire McCaskill (D-Mo.) on Monday said she would introduce legislation to repeal a 2016 law that hampered the Drug Enforcement Administration’s ability to regulate opioid distributors it suspects of misconduct. The new bill would rescind a little-noticed law championed last year by Rep. Tom Marino (R-Pa.), who President Trump has since nominated to serve as “drug czar” and director of the Office of National Drug Control Policy. (Facher, 10/16)

The Hill: No Progress On Negotiations To Fund Children's Health Insurance Program
Negotiations on a bipartisan bill to fund the popular Children's Health Insurance Program (CHIP) have made little progress, a top House Republican said Monday. Energy and Commerce Committee Chairman Greg Walden (R-Ore.) said Democrats have not made a counteroffer on paying for an extension of the program. (Hellmann, 10/16)

Politico: Undocumented Pregnant Girl In Texas Tests Trump Policy To Stop Abortions
The Trump administration is preventing an undocumented, pregnant teenager detained in a Brownsville refugee shelter from getting an abortion in a policy shift with big implications for hundreds of other pregnant, unaccompanied minors held in such shelters. She is not the first to be stopped, according to advocates who work with undocumented teenagers. (Rayasam, 10/16)

The Hill: McConnell: 20-Week Abortion Ban Will Get Senate Vote 
Senate Majority Leader Mitch McConnell (R-Ky.) said on Monday that the Senate will vote on a 20-week abortion ban, though he didn't specify when the legislation will come up. "It's supported by virtually all of my members, and we expect to have a vote on it at some point," McConnell told reporters during a press conference in the Rose Garden with President Trump. (Carney, 10/16)

The Hill: Trump Promises Action On Drug Prices
President Trump on Monday attacked prescription drug companies and hinted at taking action to bring down rising drug prices. “We are going to get prescription drug prices way down because the world is taking advantage of us,” Trump said during a wide-ranging press conference. (Weixel, 10/16)

The New York Times: Patents For Restasis Are Invalidated, Opening Door To Generics
A federal judge in Texas invalidated four key patents for the dry-eye treatment Restasis on Monday, dealing a blow to its manufacturer, Allergan, which had sought to protect its patents by transferring them to a Native American tribe. The ruling, by United States Circuit Judge William C. Bryson of the Eastern District of Texas, does not mean that generic versions of the drug will be available soon, however. Allergan said that it would appeal the decision, and the Food and Drug Administration has not yet approved copycat versions of the drug. (Thomas, 10/16)

The New York Times: 7 Million American Men Carry Cancer-Causing HPV Virus
The incidence of mouth and throat cancers caused by the human papilloma virus in men has now surpassed the incidence of HPV-related cervical cancers in women, researchers report. The study, in the Annals of Internal Medicine, found that 11 million men and 3.2 million women in the United States had oral HPV infections. Among them, 7 million men and 1.4 million women had strains that can cause cancers of the throat, tongue and other areas of the head and neck. (Bakalar, 10/16)

The New York Times: Raising Concerns About A Widely Used Test To Measure Fertility
Michele K. Bourquin, an account executive from Atlanta, was 36 and divorced when she first looked into freezing her eggs. “I knew I wasn’t getting any younger, and my eggs were aging,” Ms. Bourquin said. So she visited a doctor who gave her a blood test that’s often used to check a woman’s egg supply. It works by looking for anti-Müllerian hormone, or AMH, which is secreted by growing follicles, the sacs that house each egg. (Caron, 10/16)

Los Angeles Times: Doctors Urged To Make A Public Commitment To Talk To Their Patients About Guns And Gun Safety
As guardians of health and gatekeepers to the world of medicine, primary care doctors are expected to plunge dauntlessly into the most delicate topics with their patients. Now, in the wake of the worst mass shooting in recent U.S. history, a new campaign is challenging these physicians to talk to their patients about guns. As doctor questions go, it’s right up there with inquiring about risky sexual behavior and a notch stickier than drug or excess alcohol use and obesity. Asking about a patient’s guns strays into prickly political territory. It risks backlash from hard-line gun rights advocates. And in small or rural communities, where guns are often plentiful and medical care is scarce, it may scare a few patients off. (Healy, 10/16)

The New York Times: 750 Gun Deaths A Year Are Prevented By Waiting Periods, Study Finds
State waiting periods for handgun purchases prevent about 750 gun deaths each year in the United States, new research has found. An estimated 910 gun deaths could also be avoided if those policies were adopted nationwide, according to the study, published Monday in the Proceedings of the National Academy of Sciences. (Chokshi, 10/16)

Bloomberg: Drugmakers Are Planning To Start A Phase 2 Trial To Cure Peanut Allergy
Aimmune Therapeutics Inc. is teaming with Regeneron Pharmaceuticals Inc. in hopes of developing a cure for peanut allergies. Aimmune, based in Brisbane, California, specializes in food allergy treatments and has been developing a desensitizing therapy, AR101, to protect peanut allergy sufferers against reactions from accidental exposures. By combining AR101 with Regeneron’s inflammation-inhibiting drug Dupixent, the companies are seeking to increase protection enough so patients stop reacting to peanuts even after treatment ends. (Chen, 10/16)

NPR: What Does A Normal Brain Look Like?
Brain imaging studies have a diversity problem. That's what researchers concluded after they re-analyzed data from a large study that used MRI to measure brain development in children from 3 to 18. Like most brain imaging studies of children, this one included a disproportionate number of kids who have highly educated parents with relatively high household incomes, the team reported Thursday in the journal Nature Communications. (Hamilton, 10/16)

NPR: How To Fall Asleep And Why We Need More
The National Sleep Foundation recommends an average of eight hours of sleep per night for adults, but sleep scientist Matthew Walker says that too many people are falling short of the mark. "Human beings are the only species that deliberately deprive themselves of sleep for no apparent gain," Walker says. "Many people walk through their lives in an underslept state, not realizing it." (Gross, 10/16)

The Washington Post: Puerto Rican Families Draw Water From Superfund Site
Every 10 minutes or so, a truck or a van pulled up to the exposed spigot of an overgrown well, known as Maguayo #4, that sits not far from a bustling expressway and around the corner from a Krispy Kreme doughnut shop. Fencing around the area had been torn open, and a red and white “Peligro” sign, warning of danger, lay hidden beneath debris and dense vegetation. One after another, people attached a hose to draw water for bathing, washing dishes and, in some cases, drinking. They filled buckets, jugs, soda bottles. (Hernandez and Dennis, 10/16)

Reuters: U.S. Nursing Home Chain Faces Landlord Showdown Over Default
The fate of one of the largest U.S. nursing home operators, HCR ManorCare, will reach a critical court deadline on Thursday in a battle over months of unpaid rent, a growing problem in an industry where eviction would put thousands of elderly out on the street. Many nursing home chains spun off their properties to real estate companies over the last decade to unlock value. Now those landlords need to deal with operators behind on their rent without harming thousands of elderly residents. (Rucinski, 10/16)

The New York Times: On Health, De Blasio Focuses On Crises And Inequality
Four years ago, Bill de Blasio, then the city’s public advocate and a mere mayoral hopeful, took part in a rally in Midtown Manhattan to protest the imminent closing of Long Island College Hospital. Surrounded by dozens of singing and cheering hospital workers, he chanted “No Hospital, No Peace,” and helped block the entrance to the offices of the chancellor of the State University of New York. The police arrested Mr. de Blasio and charged him with disorderly conduct. (Santora, 10/16)

The Washington Post: A 2-Year-Old’s Kidney Transplant Was Put On Hold — After His Donor Father’s Probation Violation
A father in Georgia who had prepared to donate a kidney to his 2-year-old son said last week that he is being forced to wait after a recent stint in county jail. Anthony Dickerson's son, A.J., was born without kidneys, and Dickerson, who is a perfect match, was ready to donate one of his, he told NBC affiliate WXIA in Atlanta. He was arrested days before the planned transplant but released from Gwinnett County Jail this month to undergo surgery. Now, he said, the transplant center at Emory University Hospital has put it on hold — in a case that one expert called befuddling. (Bever, 10/16)