First Edition: August 15, 2018

Kaiser Health News: States Leverage Federal Funds To Help Insurers Lower Premiums
When Tracy Deis decided in 2016 to transition from a full-time job to part-time contract work, the loss of her employer’s health insurance was not a major worry because she knew she could get coverage through the marketplace set up by the Affordable Care Act. But price was a big concern.“The ACA made it possible to make the switch in my life,” said Deis, 48, who lives in Minneapolis. But she quickly added, “I was really worried about the cost.” (Findlay, 8/15)

Kaiser Health News: Listen: Why Young Doctors Appear To Be Embracing Single-Payer
Kaiser Health News correspondent Shefali Luthra talks with Susan Rinkunas, news editor for Tonic, about how a new generation of doctors within the American Medical Association hope to change the organization’s long-held opposition to such ideas as universal health care or single-payer systems. Luthra notes that some of the demographic and political shifts taking place within the profession mirror changes in the population at large. (8/15)

California Healthline: Battle Lines Drawn As Abortion-Rights Activists Leave Their Mark Outside Clinics 
Haley Pollock carries a box of chalk in her car, ready for action. In her spare time, she and fellow community activists convert the sidewalks outside of crisis pregnancy centers into political canvases, scrawling phrases such as “Fake Women’s Clinic Ahead” and “End the Lies.” Her team soon plans to carry out nighttime sorties — guerrilla-style — so people living near these centers find the pink, blue and yellow messages first thing in the morning. (Ibarra, 8/14)

Reuters: Trump Administration Sued Over Arkansas' Medicaid Work Requirements
Advocacy groups on Tuesday filed a lawsuit challenging the decision by President Donald Trump's administration to allow Arkansas to impose work requirements on Medicaid recipients in the state. The lawsuit, filed against the U.S. Department of Health and Human Services in federal court in Washington on behalf of three Medicaid recipients in the state, claims that the federal Medicaid law does not allow the administration to approve work requirements. (Pierson, 8/14)

The Washington Post: New Lawsuit Challenges Trump Administration’s Support For Medicaid Work Requirements
It contends that the administration’s approval of the state’s plan is unconstitutional, violates Congress’s power and undermines the basic purpose of the safety-net program created in the 1960s as part of President Lyndon B. Johnson’s War on Poverty. In language echoing the challenge in Kentucky, the suit accuses the administration of “overturning a half century of administrative practice, and threatening irreparable harm to the health and welfare of the poorest and most vulnerable in our country.” (Goldstein, 8/14)

Modern Healthcare: Trump's Immigrant Healthcare Rule Could Hurt Low-Income Populations
Healthcare leaders warn that a pending Trump administration rule penalizing legal immigrants for using government benefits like Medicaid would hurt public health efforts and reduce their ability to serve millions of low-income children and families. According to a revised draft of the 223-page rule leaked in March, the Trump administration will allow immigration officials to consider legal immigrants' use of public health insurance, nutrition and other programs as a strongly negative factor in their applications for legal permanent residency. The change also applies to citizens' and legal residents' requests to bring family members into the U.S., as well as to young people who have legal status under the Deferred Action for Childhood Arrivals program, known as Dreamers. (Meyer, 8/14)

Politico: Oral Arguments In Texas Obamacare Suit Set For Sept. 10
Oral arguments have been scheduled for Sept. 10 in a Texas lawsuit seeking to strike down Obamacare as unconstitutional. The case was filed in February by 20 Republican state attorneys general. They’re seeking a preliminary injunction halting enforcement of the federal health care law. (Demko, 8/14)

The Hill: Google Parent Invests $375M In ObamaCare Startup Oscar
Google’s parent company, Alphabet, is investing $375 million in Oscar Health, a startup health insurance company seeking to redefine the industry by using technology and data. The infusion of funding from the parent of a major technology giant is a vote of confidence in Oscar Health, which has been closely watched for how well it will be able to shake up the health insurance industry. (Sullivan, 8/14)

Stat: National Governors Association Promotes Ideas To Lower Drug Costs
As cash-strapped states across America struggle with their drug spending, the National Governors Association has suggested several ways to address the problem, from bulk purchasing and alternative payment plans to the use of metrics for assessing the value of medicines. The ideas were released in a long-awaited report by the group, which has sought ideas from economists and public health officials for containing rising prescription drug expenses. The initiative was triggered, in particular, by two events over the past few years: revolutionary but pricey new medicines for combating hepatitis C, and the rising costs of coping with the ongoing opioid crisis. (Silverman, 8/14)

The Hill: CVS Launches Program Targeting Expensive New Drugs 
CVS Caremark will allow its clients to exclude coverage of drugs with extremely high launch prices under a new program the company said is aimed at pressuring manufacturers to lower drug costs. According to CVS, launch prices have been steadily rising for years, and are completely up to the discretion of the manufacturer. The high prices put an unsustainable burden on the country’s health system, CVS said.  (Weixel, 8/14)

Stat: CVS Sets A Cost-Effectiveness Bar For Health Plan Coverage Of New Drugs
Specifically, the pharmacy benefit manager set a threshold of $100,000 per QALY, or quality-of-life years, a benchmark that measures both the quantity and quality of life generated by providing a treatment or some other health care intervention. In the U.S., anywhere from $50,000 to $150,000 is used for gauging value, although $100,000 is commonly used as a threshold. The pharmacy benefit manager will be looking to the Institute for Clinical and Economic Review, a nonprofit that runs cost-effective analyses, for guidance. Unlike other countries, the U.S. does not have a government entity that conducts official analyses and over the past few years, ICER has increasingly filled this role, sometimes irking drug makers in the process. (Silverman, 8/14)

Stat: Ohio Medicaid Cancels Contracts With Two Big PBMs Over 'Spread' Pricing 
In an unexpected move, Ohio officials are immediately ending contracts with two of the largest pharmacy benefit managers over pricing practices that cost the state tens of millions of dollars. The decision comes amid controversy over the fees that PBMs pay pharmacies for medicines and what they bill back to the Ohio Medicaid program, a practice known as spread pricing. A report commissioned by state officials found that two PBMs — CVS Caremark (CVS) and OptumRx — reaped more than $223 million by working on behalf of state Medicaid plans during a recent 12-month period. (Silverman, 8/14)

Stat: Oregon Medicaid Program Could Cut Off Chronic Pain Patients From Opioids 
These days, [Laura] Dolph has another concern on her mind. State officials are considering a first-in-the-nation proposal that would end coverage of opioids for many chronic pain patients who, like her, are enrolled in Oregon’s Medicaid program. Over just 12 months, beginning in 2020, they would see their opioid doses tapered to zero. The state declined to provide an estimate of how many pain patients the policy could affect. But nearly 1 million Oregonians are enrolled in Medicaid. More than 10 percent of adults nationwide have experienced pain every day for the previous three months. (Facher, 8/15)

Reuters: New York Sues OxyContin Maker Purdue Pharma Over Opioids
New York state on Tuesday sued Purdue Pharma LP, accusing the OxyContin maker of widespread fraud and deception in the marketing of opioids, and contributing to a nationwide epidemic that has killed thousands. The state blamed Purdue for running what it called a reckless, decades-long scheme to mislead doctors and patients by overstating the ability of opioids to improve bodily function, while downplaying the risk of addiction. (8/14)

The Wall Street Journal: New York Becomes Latest To Sue Purdue Over Opioid Crisis
With the suit, New York becomes the latest of 27 states to sue the manufacturer for its alleged role in the opioid crisis. While other states such as Florida and Ohio have targeted drug manufacturers and distributors, Purdue is the only defendant listed in the lawsuit spearheaded by Gov. Andrew Cuomo’s administration and New York Attorney General Barbara Underwood. (Porter, 8/14)

The New York Times: Fentanyl Used To Execute Nebraska Inmate, In A First For U.S.
Prison officials in Nebraska used the powerful opioid fentanyl to help execute a convicted murderer on Tuesday, the first such use of the drug in the United States and the first execution in the state since voters overturned a death penalty ban in 2016. The use of fentanyl, an opioid at the heart of the nation’s overdose crisis, as part of a previously untested four-drug cocktail drew concern from death penalty experts who questioned how the execution unfolded. And here in Nebraska, a state that last killed a prisoner in 1997, the lethal injection represented a stark political turnabout from when legislators outlawed capital punishment three years ago. (Smith, 8/14)

Stat: As Alzheimer's Drug Makers Abandon Today's Patients, Where Is The Outrage? 
When virologists and drug developers were too slow in finding ways to save the lives of people with HIV/AIDS and refused to give patients access to experimental drugs 30 years ago, activists chained themselves to a balcony on the New York Stock Exchange, held demonstrations where scores were arrested, and effectively shut down the Food and Drug Administration for a day. The lack of progress against Alzheimer’s disease has brought somewhat less outrage. Although the latest analysis of experimental Alzheimer’s drugs finds that literally zero are being tested in late-stage clinical trials to treat moderate to severe Alzheimer’s, no patient advocacy groups uttered a peep in protest. (Begley, 8/15)

The New York Times: The ‘Zombie Gene’ That May Protect Elephants From Cancer
Elephants ought to get a lot of cancer. They’re huge animals, weighing as much as eight tons. It takes a lot of cells to make up that much elephant. All of those cells arose from a single fertilized egg, and each time a cell divides, there’s a chance that it will gain a mutation — one that may lead to cancer. Strangely, however, elephants aren’t more prone to cancer than smaller animals. Some research even suggests they get less cancer than humans do. (Zimmer, 8/14)

The Washington Post: A Traumatic Brain Injury May Increase The Risk Of Suicide, Study Says
Traumatic brain injury is the leading cause of death and disability in young adults in the developed world. Suicide is the second leading cause of death for young people ages 15 to 24. Though the reasons for any particular suicide are often inscrutable, research published Tuesday in the Journal of the American Medical Association suggests that at least a fraction of the blame could be placed on traumatic brain injuries. (Nutt, 8/14)

The New York Times: Should You Choose A Female Doctor?
Does gender matter when choosing a doctor? Whether your doctor is male or female could be a matter of life or death, a new study suggests. The study, of more than 580,000 heart patients admitted over two decades to emergency rooms in Florida, found that mortality rates for both women and men were lower when the treating physician was female. And women who were treated by male doctors were the least likely to survive. (Parker-Pope, 8/14)

The Washington Post: The FDA Approved An App To Prevent Pregnancy. Can An App Do That?
Contraception? Yes, there’s an app for that. And an FDA-approved app at that. Last week, Natural Cycles became the first app approved by the government to prevent pregnancy. The Swedish-based company had been cleared in Europe in 2017 and is an emerging name within the “Femtech” industry — a catchall for “female health technology” that has reaped an estimated $1 billion of investment worldwide in the past three years. (Siegel, 8/14)

The New York Times: Black Boys Feel Less Safe In White Neighborhoods, Study Shows
Many black boys have been racially profiled, arrested or even killed in white neighborhoods because the residents were afraid of them. A new study suggests the boys are afraid, too. The study, which was released on Monday, found that “African-American boys experience a decreased sense of safety” when in neighborhoods with a larger white population than areas they normally frequent. Black boys “will expect increased scrutiny, surveillance and even direct targeting as they traverse whiter spaces,” the study found. Black girls did not report feeling significantly less safe in such areas. (Garcia, 8/14)

The Wall Street Journal: Ebola Outbreak Spreads To Conflict Zone In Democratic Republic Of Congo
A deadly outbreak of Ebola in the Democratic Republic of Congo has spread outside the province of North Kivu, the country’s health ministry said Tuesday, entering for the first time an active conflict zone and raising the threat of a wider outbreak. Forty-one people have died in Congo’s current epidemic, which started last month in the gold- and tin-mining heartlands of North Kivu. An earlier Ebola outbreak in Congo’s northwest had been declared over just a week earlier. (Bariyo, 8/14)

Reuters: Monsanto Roundup Appeal Has Uphill Climb On 'Junk Science' Grounds: Legal Experts
Bayer AG unit Monsanto faces long odds on an appeal blaming an "inflamed" jury and "junk science" for a verdict of $289 million in damages to a man who said the company's Roundup weed killer caused his cancer, according to some legal experts. Last week's verdict ended the first trial over whether glyphosate, the main ingredient in Roundup, causes cancer. Monsanto, which says decades of scientific studies have shown Roundup and glyphosate are safe, is facing about 5,000 similar lawsuits nationwide. (8/14)

The Washington Post: Lawsuit Alleges D.C. Has Failed Hundreds Of Emotionally Disturbed Children
Attorneys at several disability rights organizations have filed a class-action lawsuit against the D.C. government, alleging that District officials have failed to provide adequate mental-health services for hundreds of severely troubled children. The suit, filed in federal court Tuesday on behalf of two unnamed minors, states that the District did not give the children access to intensive outpatient counseling and mentoring programs. (Jamison, 8/14)

The Associated Press: Maryland Takes Responsibility For Mistakes In Player Death
The University of Maryland acknowledged Tuesday that the football player who collapsed during practice and subsequently died did not receive proper medical care and the school must accept “legal and moral responsibility for the mistakes.” Maryland also parted ways with strength and conditioning coach Rick Court, who resigned in the wake of the death of offensive lineman Jordan McNair. (Ginsburg, 8/14)

The Associated Press: Medical Device Maker Settles Suit Over Psychologist’s Death
A medical device maker has settled a lawsuit over the death of a prominent Yale University psychologist who died in 2013 when a machine part detached and caused her blood to be pumped onto a hospital room floor. Germany-based Maquet Cardiopulmonary and its U.S. sales division based in Wayne, New Jersey, settled the lawsuit in Connecticut with the husband of Susan Nolen-Hoeksema, according to documents filed Friday at Waterbury Superior Court. Terms of the deal were not disclosed. (Collins, 8/14)

The Associated Press: California May Redo Law To Treat, Free Suspects
California Gov. Jerry Brown wants to tighten a law he signed weeks ago that critics say could have freed rapists and murderers who completed two years of mental health treatment. The proposal obtained by The Associated Press on Tuesday specifically bans those charged with murder, rape and other sex crimes from participating and allows judges to bar a much broader range of dangerous suspects. (Thompson, 8/14)

The Associated Press: North Dakota Recreational Pot Measure Approved For Ballot
Supporters of legalizing recreational marijuana in North Dakota have succeeded in bringing the matter to a public vote later this year. Proponents submitted more than the required 13,452 valid petition signatures to get a measure on the November general election ballot, Secretary of State Al Jaeger announced Monday. Supporters submitted 17,695 signatures last month, and 14,637 were deemed valid, he said. (Nicholson, 8/14)