First Edition: August 13, 2019

Kaiser Health News: Hepatitis A Races Across The Country
Just before the Fourth of July, Trenton Burrell began feeling run-down and achy. Soon he could barely muster the energy to walk from one room to another. A friend shared an alarming observation: “You’re turning yellow.” Within days, the 40-year-old landed in the hospital, diagnosed with the highly contagious liver virus hepatitis A, which in Ohio has infected more than 3,220 people and killed at least 15. Since 2016, the virus has spawned outbreaks in at least 29 states, starting with Michigan and California. It has sickened more than 23,600 people, sent the majority to the hospital and killed more than 230. All but California’s and Utah’s outbreaks are ongoing, and experts expect to eventually see the virus seep into every state. (Ungar, 8/13)

California Healthline: Strong Effort By Lawmakers To Stabilize Covered California Draws More Insurers
Felicia Morrison, a solo lawyer in Stockton, Calif., buys coverage for herself and her twin sons through Covered California, the state’s Affordable Care Act insurance marketplace. Morrison, 57, gets a federal subsidy to help pay for her coverage and she said that her monthly premium of $167 is manageable. But she spends thousands of dollars a year on deductibles, copayments and care not covered by her plan.“I would just like to have health insurance for a change that feels like it’s worth it and covers your costs,” she said. Her chances are looking up after lawmakers in Sacramento acted to enhance Covered California for 2020: They added state-funded tax credits to the federal ones that help people pay for coverage. And they reinstated a requirement for residents to have coverage or pay a penalty — an effort to ensure that enough healthy people stay in the insurance pools to offset the financial burden of customers with expensive medical problems. (Findlay, 8/13)

The Associated Press: New Rules To Deny Green Cards To Many Legal Immigrants
The Trump administration announced Monday it is moving forward with one of its most aggressive steps yet to restrict legal immigration: Denying green cards to many migrants who use Medicaid, food stamps, housing vouchers or other forms of public assistance. Federal law already requires those seeking to become permanent residents or gain legal status to prove they will not be a burden to the U.S. — a “public charge,” in government speak —but the new rules detail a broader range of programs that could disqualify them. (Long and Colvin, 8/12)

The Wall Street Journal: Trump Administration To Deny Green Cards To Legal Immigrants Who Draw From Social Programs
The use or potential use of a benefits program such as Medicaid, some types of housing assistance or food stamps could disqualify an applicant. ... The use of several other benefits—including school lunch programs, homeless shelters, food pantries and the Children’s Health Insurance Program—won’t disqualify applicants. Pregnant women and children who rely on Medicaid are also exempt from the rule. The rule doesn’t affect humanitarian-based programs for refugees and asylum seekers. (Restuccia and Radnofsky, 8/12)

The New York Times: Trump Policy Favors Wealthier Immigrants For Green Cards
Mr. Trump has long insisted that the United States should welcome immigrants based only on the “merit” they demonstrate. And he has disparaged the idea of letting immigrants into the United States from poor and underdeveloped nations, which he once described in the most vulgar of terms. Monday’s rule is an attempt to enact Mr. Trump’s priorities. It embraces people who have financial means while shunning immigrants who are struggling. (Shear and Sullivan, 8/12)

NPR: Trump Administration Rule Would Penalize Immigrants For Needing Benefits
A preliminary draft published last year drew more than 260,000 comments. Many of the comments expressed outrage that the administration would penalize immigrants for using benefits that they are legally entitled to receive. The change is seen as part of a broader administration effort to limit both immigration and the overall use of public benefits. Immigrant advocates immediately denounced the final rule, which they say could hurt millions of immigrants already living in the U.S. as well as their citizen children. They say it could also sharply curtail legal immigration, especially when coupled with tough new State Department standards that take the likelihood of an immigrant's use of public benefits into account when granting visas. (Fessler and Rose, 8/12)

The Washington Post: Trump Officials Move To Deny Green Cards, Path To Citizenship For Poor Immigrants
The 837-page rule, whose length [Ken Cuccinelli, the acting director of U.S. Citizenship and Immigration Services] compared to “War and Peace,” focuses on the obscure definition of what it means to be a “public charge,” or someone dependent on U.S. government benefits, and who is likely to become one. (Hauslohner, Miroff, Sacchetti and Jan, 8/12)

Los Angeles Times: New Trump Rules Could Deny Green Cards To Immigrants On Public Assistance
President Trump has kept his effort to crack down on illegal immigration in the spotlight and central to his reelection campaign in 2020. But the new rules represent a significant escalation of a quieter but farther-reaching effort to reduce legal immigration, with Cuccinelli and others led by immigration hard-liner Stephen Miller. (O'Toole and Nieto Del Rio, 8/12)

Los Angeles Times: Trump Crackdown On Legal Immigrants Could Damage California Economy, Experts Say
The Trump administration’s new immigration crackdown — which could deny green cards to immigrants who use Medicaid, food stamps, housing vouchers or other forms of public assistance — would have major ramifications on the California economy, experts and advocates said Monday. Laurel Lucia, director of the healthcare program at the UC Berkeley Labor Center, says the policy could have a damaging effect on California and the country’s overall economy. Many in California who already have a green card or have become citizens may dis-enroll from public benefits such as Medi-Cal or CalFresh out of fear for what the policy may mean for themselves and for their family members, causing a chilling effect on the economy, she said. (Nieto Del Rio, 8/12)

The Washington Post: A Glimpse Inside The Central Processing Center, At The Heart Of The Border Crisis 
“We want to give folks a sense of what is going on down here,” said Border Patrol agent Marcelino “Alex” Medina. Inside the cavernous pair of warehouses in Southwestern McAllen, migrants are medically screened for common ailments and contagious diseases such as scabies, lice or chickenpox. Those needing medical help beyond basic services are sent to local hospitals, agents said. Workers have access to face masks and gloves when entering one of two large containment areas, although the center is not immune from contagious diseases; the processing center had an outbreak of an influenza-like illness in late May that led Border Patrol to stop admitting people until the infections died down. Once medically cleared, migrants are sent into holding pens. The center has seen tens of thousands of children and families since 2014. (Hernandez, 8/12)

The Hill: Data Shows Drop In Coverage Among People Ineligible For ObamaCare Subsidies 
Health insurance enrollment declined among people who do not qualify for financial help under ObamaCare as premiums rose to make coverage less affordable, new federal data shows. The data released by the Centers for Medicare and Medicaid Services (CMS) on Monday shows that enrollment declined by 1.2 million people, or 24 percent, between 2017 and 2018 among people with incomes too high to qualify for ObamaCare subsidies. (Sullivan, 8/12)

The Washington Post: Bernie Sanders Is Making Health Care His Defining Issue. Will It Work?
Sen. Bernie Sanders (I-Vt.) is seeking to break through a congested Democratic presidential race by campaigning more aggressively on Medicare-for-all, a risky strategy his advisers hope will shift the contest in his favor amid signs he has lost ground in recent months. On the campaign trail, Sanders increasingly touts his plan for a government program to insure all Americans, reminding voters that rivals followed his lead. And aides and allies have grown more hostile toward competing ideas, while Sanders’s team has planned more frequent events and initiatives focused on health care. (Sullivan, 8/12)

Reuters: U.S. Budget Deficit Widens; Spending Up On Health, Military
The U.S. government’s deficit widened to $120 billion in July, fueled by increases in spending on health care and the military, according to data released on Monday by the Treasury Department. ... The fiscal-year-to-date deficit was $867 billion, compared with $684 billion in the comparable year-earlier period. The U.S. government’s fiscal position has deteriorated since 2016, hit by an aging of the population that has led to more people drawing on Medicare, a federal health insurance program for the elderly. Increased spending on the military has also fueled the deficit under President Donald Trump, who took office in January 2017 promising to strengthen the military. (Lange, 8/12)

Modern Healthcare: Trump's Drug-Pricing Czar To Leave HHS
John O'Brien, chief adviser to HHS Secretary Alex Azar on drug-pricing reform, is leaving the Trump administration as the congressional debate over legislation is poised to intensify. O'Brien stepped up to the post last December, not long after his predecessor Dan Best died last year. He had already served with Azar as an adviser and helped with the Trump administration's drug-pricing strategy. His last day is Aug. 22. (Luthi, 8/12)

The Hill: Study: 4 In 10 Patients Faced Surprise Bills In 2016 After Visiting In-Network Hospitals
Four in 10 privately insured patients faced surprise medical bills after visiting emergency rooms or getting admitted to hospitals in 2016, according to a new study published Monday in the American Medical Association's internal medicine journal. The average price tag for a surprise bill related to care at an emergency department was $628 in 2016, up from $220 in 2010, according to the study. The average surprise bill for inpatient admissions increased from $804 in 2010 to $2,040 in 2016. (Hellmann, 8/12)

The New York Times: On Gun Control, 2020 Democrats Agree: No Reason To Hold Back
Democrats running for president have engaged in bitter disputes this year over topics like health care, immigration and criminal justice. But after mass shootings in El Paso and Dayton, Ohio, jolted the nation earlier this month, the field of 2020 contenders seemed to move in lock step toward more aggressive gun control positions without resistance from the party’s moderate voices. (Epstein and Kaplan, 8/12)

The New York Times: Democrats Want To Revive A Ban On Assault Weapons
Twenty-five years ago, Democratic support for an assault weapons ban was a major reason the party lost control of the House. Now top Democrats want to revive the fight. On both the presidential campaign trail and Capitol Hill, leading Democrats are either calling to reinstate the ban or are pressing for a new one. The 1994 ban barred Americans from buying certain military-style firearms and high-capacity magazines for a decade, until Republicans let it expire in 2004. (Stolberg, 8/12)

The Associated Press: Tennessee Lawmakers Mull Passing Strict Abortion Ban
Tennessee lawmakers said Monday they are considering whether to seek one of the nation’s strictest abortion bans even as such laws continue to be struck down in court. At issue is a proposal to prohibit abortion once a pregnancy is detected. While a similar bill stalled in the Republican-controlled Statehouse earlier this year, backers are renewing efforts now to collect enough support ahead of the 2020 legislative session. (Kruesi, 8/12)

The Washington Post: Tennessee Abortion Bill Is Probably Unconstitutional. A Republican Lawmaker Says That’s The Point.
Tennessee’s state lawmakers this week will discuss a bill that essentially bans abortion as soon as a woman knows she’s pregnant — and that at least one Republican legislator hopes could escalate into a Supreme Court challenge. The legislation, Senate Bill 1236, and its counterpart in the Tennessee House, H.B. 77, have been stalled during this session, but supporters hope to vote on its passage in January. States such as Alabama and Georgia have instituted “heartbeat” laws, named because they restrict abortion after a fetal heartbeat is detected. This can occur as early as six weeks into a pregnancy, before a woman may know she is pregnant. Other states, such as Ohio and Mississippi, have enacted such measures only to have them blocked or challenged in court. (Epstein, 8/12)

The Wall Street Journal: Newark Distributes Bottled Water After Lead Contamination Found
The city of Newark with help from the state, began distributing bottled water to some residents Monday after officials warned that certain city-issued water filters aren’t sufficiently reducing lead levels. In the past week, two of three Newark homes tested were found to be contaminated with lead above what is considered safe, even when a filter was used, according to the city. On Monday, the city notified residents that some filters may not be working as expected and advised those living in the Pequannock water-service area who have lead-service lines to only use bottled water for drinking, cooking and preparing baby formula. (Coronado, 8/12)

The Washington Post: Newark Begins Giving Residents Bottled Water Amid Ongoing Lead Problems
“I understand people’s frustration,” Newark Mayor Ras Baraka (D) said in an interview, adding that he also has a lead line at his home, and that he and his pregnant wife have been using one of the tens of thousands of water filters the city began distributing in the fall. “This is a very serious matter to me. We don’t take this lightly at all," he said, adding, “Am I worried? Yeah, I am worried. And we are going to do what we can to get to the bottom of this.” (Fieseler and Dennis, 8/12)

Los Angeles Times: Kaiser Permanente Workers In California Vote To Approve Strike
A swath of Kaiser Permanente workers in California has voted overwhelmingly to approve a strike that could draw in more than 80,000 employees of the healthcare giant across the nation, according to the coalition of unions representing them. The employees — who include most staff aside from doctors, mental health workers or certain nurses — have been working under an expired national contract since September, though their local contracts are still current. (Cutchin, 8/12)

The Associated Press: Sex Misconduct Complaints Against Calif. Doctors Up Sharply
The number of complaints against California physicians for sexual misconduct has risen 62% since fall of 2017 — a jump that coincides with the beginning of the #MeToo movement, according to a newspaper investigation published Monday. A Los Angeles Times analysis of California medical board data found complaints of sexual misconduct, though small in number, are among the fastest growing type of allegation. During the fiscal year that ended in June, the board got 11,406 complaints against physicians and surgeons, the most it has ever received. (8/12)

The Associated Press: Michigan State Agrees To Protect Patients In Deal With Feds
Michigan State University has agreed to better protect patients from sexual assaults, including following a chaperone requirement for sensitive medical exams, to resolve a federal civil-rights investigation into Larry Nassar’s abuse of young gymnasts and other athletes under the guise of medical treatment. The three-year agreement announced Monday is the first one struck under a section of the Affordable Care Act that prohibits discrimination in certain health care programs or activities, said Roger Severino, director of the U.S. Department of Health and Human Services’ Office for Civil Rights. The deal covers not only students under Title IX but also patients who are not students. (Eggert, 8/12)

The Wall Street Journal: The Unlikely Survival Of USA Gymnastics
USA Gymnastics last year was given the death penalty by U.S. Olympic officials for its handling of decadeslong sexual abuse by women’s team physician Larry Nassar. Yet as it crowned Simone Biles with her sixth all-around national title here this weekend, the disgraced gymnastics federation acted like an organization confident its sentence would be commuted. (Radnofsky, 8/12)

NPR: To Find The Next Antibiotic, Scientists Give Old Drugs A New Purpose
With antibiotic-resistant bacteria on the rise, scientists are urgently trying to find drugs that will work against persistent infections. But coming up with new ones does not have to be the only strategy. A recent study published in Proceedings of the National Academy of Sciences found that they can repurpose bithionol — a drug formerly used to treat parasitic infections in horses — to kill antibiotic-resistant bacteria, including MRSA, a common hospital-acquired infection. (Torres, 8/12)

The New York Times: A Cure For Ebola? Two New Treatments Prove Highly Effective In Congo
In a development that transforms the fight against Ebola, two experimental treatments are working so well that they will now be offered to all patients in the Democratic Republic of Congo, scientists announced on Monday. The antibody-based treatments are quite powerful — “Now we can say that 90 percent can come out of treatment cured,” one scientist said — that they raise hopes that the disastrous epidemic in eastern Congo can soon be stopped and future outbreaks more easily contained. (McNeil Jr., 8/12)

NPR: 2 Experimental Ebola Drugs Saved Lives In Congo Outbreak
Researchers say they have identified the first clearly effective treatments for Ebola, a deadly disease that continues to spread in central Africa. The experimental drugs will be made widely available in the centers that have already treated thousands of patients. This achievement is particularly notable given the extraordinary circumstances: Scientists in the Democratic Republic of Congo have been running a study in the midst of a deadly epidemic and in the face of armed assaults on doctors. (Harris, 8/12)

The Washington Post: Ebola No Longer ‘Incurable,’ Scientists Say, After Discovery Of Two Highly Effective Drugs
“It’s the first example that a therapeutic intervention can have a dramatic effect on decreasing the mortality of the Ebola virus disease,” Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said in an interview. Jean-Jacques Muyembe Tamfum, a Congolese doctor who has spent his career researching Ebola treatments and oversaw the trial on the ground, said in a conference call Monday that he “could not have imagined” that such a day would come. (Parker, 8/12)

The Wall Street Journal: Two Experimental Ebola Drugs Reduce Mortality Rate
Of the 2,831 people who have been infected with Ebola in eastern Congo since Aug. 1, 2018, two-thirds—or 1,888—have died, according to the World Health Organization. But patients who received a cocktail of antibodies developed by U.S. drugmaker Regeneron Pharmaceuticals Inc. only faced a 29% mortality rate, said Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, or NIAID. (Steinhauser, 8/12)

The Wall Street Journal: DNA Data Shared In Ways Patients May Find Surprising
Deals between drugmakers and hospital systems to mine the genetic profiles of hospital patients are triggering concerns over the control of valuable genetic data. Drugmakers have been spending hundreds of millions of dollars for access to patient information because of the data’s potential to help unlock disease insights and discover new drugs. They are striking deals to sequence patients’ genetic code, including with hospital systems like Geisinger in Pennsylvania, Mount Sinai Health System in New York and Mayo Clinic in Minnesota. (Evans, 8/12)

Stateline: Where Doctors Can Recommend Marijuana To Replace Opioids
New Mexico, New Jersey, New York and Pennsylvania allow people with an opioid addiction to qualify for a medical marijuana card. But many physicians and medical experts strongly oppose such policies, pointing out that science hasn’t yet shown that dispensary-bought marijuana can deliver the same pain-killing punch as a prescription drug, nor that it can help people kick an opioid addiction. (Quinton, 8/13)

NPR: It's The Go-To Drug To Treat Opioid Addiction. Why Won't More Pharmacies Stock It?
Louis Morano knows what he needs, and he knows where to get it. Morano, 29, has done seven stints in rehab for opioid addiction in the past 15 years. So, he has come to a mobile medical clinic parked on a corner of Philadelphia's Kensington neighborhood, in the geographical heart of the city's overdose crisis. People call the mobile clinic the "bupe bus." Buprenorphine is a drug, also known by its brand name, Suboxone, that curbs cravings and treats the symptoms of withdrawal from opioid addiction. Combined with cognitive behavioral therapy, it is one of the three FDA-approved medicines considered the gold standard for opioid-addiction treatment. (Feldman, 8/13)

The New York Times: Ads For CBD As Cure-All Are Everywhere, But Regulation Is Scant
The efforts of cannabis companies to go mainstream could be hampered by CBD advertising that depends on misleading or unproven claims, entrepreneurs and researchers said. [Forensic toxicologist Michelle R.] Peace compared the marketing efforts of some companies to snake-oil scams in the 1800s, “when guys in wagons were selling sham tinctures in glass bottles.”“People are taking these products in good faith, because they believe somebody is overseeing the quality of these products,” Ms. Peace said. “But there’s basically nobody.” (Hsu, 8/13)

The New York Times: As Phoenix Heats Up, The Night Comes Alive
Phoenix, which had 128 days at or above 100 degrees Fahrenheit last year, is one of the hottest and fastest-warming cities in the United States. Although it is on the leading edge, it is not alone: Most American cities are expected to drastically heat up in the next decades. Many may have summers with heat waves and triple-digit days — summers that resemble Phoenix today. Here in the Valley of the Sun, that means work and play shift into the cooler hours. Neighborhoods thrum with activity at dawn and dusk when residents hike, jog and paddleboard. In the hottest months, the zoo opens at 6 a.m., for the benefit of both animals and visitors. And across the city, certain construction work starts in the middle of the night — not only for the safety of workers, but also because even some building materials can be affected by intense heat. (Holloway, 8/12)

The New York Times: How To Reduce Exposure To Air Pollution
Hot summer days can bring spikes in air pollution, as traffic exhaust and other emissions bake in the sun. Scientists have linked dirty air to a long list of health problems, and the danger can seem all the more frightening because, unlike with many other risks, we have no choice about breathing. But ... there are some things individuals can do to protect themselves. Steps like changing travel and exercise routes, buying an air purifier and choosing not to light a fire at home can reduce your exposure to air pollution in any season, experts say. (Gardiner, 8/13)

USA Today & Westchester Journal News: Woman Wins $55.9M Malpractice Verdict After Botched Spinal Surgery
A jury awarded $55.9 million to a Pomona woman and her husband after a medical malpractice trial over allegations that a botched spinal surgery left her a quadriplegic. The woman, Patricia Jones, was 56 when she underwent surgery in 2009, at Good Samaritan Hospital in Suffern, after complaining of pain and tingling in her arms, hands and neck, said her lawyer, Evan Torgan. (Brum, 8/12)