First Edition: December 17, 2019

Kaiser Health News: Despite Quick Fixes, Kaiser Permanente Mental Health Care Still Lags
After years of state sanctions and fines, Kaiser Permanente claims it has gone a long way toward improving its mental health care. The national managed-care giant — California’s largest insurer with 9 million members — touts more than 1,200 therapist hires since 2016, improved patient access to appointments and an expanded training program for mental health professionals. Regulators at California’s Department of Managed Health Care report that Kaiser is meeting the benchmarks laid out in a 2017 settlement agreement that resulted from two years of negotiations. (Gold, 12/17)

Kaiser Health News: Surprising Swings In Momentum For Legislation On Surprise Medical Bills
After months of hearings and negotiations, millions of dollars in attack ads, full-court press lobbying efforts and countless rounds of negotiations, Congress appeared to be moving toward a solution to the nation’s surprise medical bill problem. Sort of. Surprise bills, the often-exorbitant medical bills that come when a patient doesn’t realize they’ve been seen by a provider outside their insurance network, have in recent months been viewed as public enemy No. 1 on Capitol Hill. (Bluth, 12/17)

California Healthline: Valley Fever Cases Climb In California’s Central Valley — And Beyond
Valley fever cases are on the rise in California and across the arid Southwest, and scientists point to climate change and population shifts as possible reasons. California public health officials documented 7,768 reports of confirmed, suspected and probable new cases of the fungal disease as of Nov. 30, 2019, up 12% from 6,929 in the first 11 months of 2018. (Feder Ostrov and Rowan, 12/16)

Reuters: U.S. Government Extends Deadline To Sign Up For Obamacare Insurance Plans
The U.S. government said on Monday the deadline for signing-up for 2020 insurance plans under the Affordable Care Act has been extended by three days to Dec. 18 to accommodate those who experienced issues while attempting to enroll. There were website glitches and call center delays reported on Sunday, the earlier deadline for the 2020 open enrollment, and the extension should help the final enrollment tally, said Evercore ISI analyst Michael Newshel. (12/16)

The Wall Street Journal: Trump Administration Extends Deadline For Affordable Care Act Enrollment
Federal officials said some consumers who logged in or created an account were routed to a waiting system but that it only impacted a portion of consumers for a few minutes. People who contacted the call center were instructed to leave their contact information and would be allowed to enroll in a plan after the Dec. 15 deadline, according to a spokeswoman with the Centers for Medicare and Medicaid Services. “This additional time will give consumers the opportunity to come back and complete their enrollment for January 1 coverage,” CMS officials said Monday, referring to the deadline extension. (Armour, 12/16)

The Associated Press: 'Obamacare' Sign-Up Deadline Is Extended Following Glitches
On Monday afternoon, the HealthCare.gov website displayed an alert telling people about the deadline extension. But it was in a small font, and a much larger banner directly below still said open enrollment was over, potentially creating confusion. The problems started Sunday, which was the original sign-up deadline. The last day of open enrollment is always the busiest, with hundreds of thousands of people going online or trying to reach the call center. (Alonso-Zaldivar, 12/16)

NPR: Government Extends Open Enrollment For ACA Health Plans, But Only For 36 Hours
Charles Gaba, an analyst who tracks enrollment in Affordable Care Act exchanges, has a guess as to how many people may have had problems signing up on Sunday. "I'd estimate that it'll be somewhere in the range of around 100,000 people," he says. He notes 36 hours is not a lot of time to let those people know they still have a chance to sign up for coverage in 2020. But "it's better than nothing," he says. (Simmons-Duffin, 12/16)

The New York Times: Spending Deal To Avert Shutdown Carries Key Priorities For Both Parties
Lawmakers on Monday unveiled a dozen bills that would allocate $1.4 trillion in federal spending for the remainder of the fiscal year to prevent the government from shutting down at midnight on Friday. The legislation, divided into two packages, provides funding for all federal agencies and departments and for extending a number of community and health programs. The measures drew bipartisan support after months of gridlock, and gave members of each party something to brag about. (Cochrane, 12/16)

Reuters: U.S. Spending Deal Would Raise Tobacco Age, Deny Some Trump Border Wall Money
Congress would raise the U.S. tobacco purchasing age to 21 and permanently repeal several of the Affordable Care Act's taxes under a massive government spending bill unveiled on Monday. ... The crackdown on youth smoking, by changing the minimum age for cigarette and other tobacco purchases to 21 from the current 18, would give the U.S. Food and Drug Administration six months to develop regulations. The agency would then have three years to work with states on implementing the change. (Cowan and Cornwell, 12/16)

The Washington Post: Congress Set To Prohibit Sales Of Tobacco To Anyone Under 21
Public health advocates praised the move, saying it would help reduce kids’ access to vaping products. But they stressed much more action is needed to reverse the youth vaping surge. And several expressed concern that the White House will use the “Tobacco 21” measure, as it is called, to avoid imposing the ban on flavored e-cigarettes that Trump announced in September but subsequently backed away from. (McGinley and Abutaleb, 12/16)

The Associated Press: Budget Deal Puts Access To Health Care Above Curbing Costs
The deal would repeal a cost-control measure in “Obamacare” known as the Cadillac Tax, an unpopular levy on benefit-rich health insurance plans scheduled to take effect in 2022. That means Congress is upsetting the balance between expanding access and controlling costs that former President Barack Obama tried to strike in his signature law, said Kathleen Sebelius, who served as his health secretary. “President Obama thought it was very important to have additional access paid for,” said Sebelius. “This just takes a big step backwards.” (Alonso-Zaldivar, 12/16)

The Wall Street Journal: Federal Spending Agreement Adds Up To Nearly $1.4 Trillion
The repeal of the health-care taxes would be a windfall for the industry. Absent from the agreement is an effort to protect consumers from surprise, out-of-network medical bills despite a monthslong congressional effort to craft a workable, bipartisan proposal. (Duehren and Rubin, 12/16)

Politico: Congress To Repeal 3 Major Health Taxes, Fund Gun Violence Research In Year-End Spending Deal
It is also expected to extend expiring health care programs through May 22, and notably, it doesn’t include a last-ditch effort from key committee leaders to pass legislation protecting consumers from getting slapped with “surprise” medical bills. The short-term extension could give surprise billing a vehicle to ride on next year, according to a senior House Democratic aide. And Congress is also aiming to ban the sale of tobacco products to people under 21. (Luthi and Emma, 12/16)

The Associated Press: Spending Deal Would End Two-Decade Freeze On Gun Research
A bipartisan deal on a government spending bill would for the first time in two decades provide money for federal research on gun safety. A law adopted in the 1990's has effectively blocked such research and prohibits federal agencies from engaging in advocacy on gun-related issues. The spending bill, set for a House vote as soon as Tuesday, would provide $25 million for gun violence research, divided evenly between the National Institutes of Health and the Centers for Disease Control and Prevention. (12/16)

The Washington Post: Congressional Deal Could Fund Gun Violence Research For First Time Since 1990s
While gun violence is one of the country’s leading causes of death, it receives little research funding. As many people die because of gun violence, for example, as of sepsis infection, yet funding for gun research is less than 1 percent of that for sepsis, a 2017 analysis found. “This is a deal of historic proportions,” said Mark Rosenberg, who was heading the CDC’s research on firearm violence in the 1990s when Congress abruptly cut off funding for the work. “It ends the horrendous position we’re in, where we don’t even know what works.” (Wan, 12/16)

Politico: Congress Debuts $1.37T Spending Deal That Sidesteps Border Fight
The legislation would also provide $41.7 billion for medical research at the NIH, a nearly 7 percent increase over current funding. Republican leaders are touting the fact that the deal does not include new funding or directives for international efforts to aid family planning and reproductive health. They are proud that the legislation would deliver a $22 billion increase in defense spending, as well as a 3.1 percent military pay increase — the largest bump in a decade. (Scholtes and Emma, 12/16)

Reuters: 'Havana Syndrome' U.S. Diplomats Get Benefits In Spending Bill
U.S. diplomats who mysteriously fell ill in Cuba and China would get long-term emergency health and other benefits under a $1.4 trillion spending bill lawmakers unveiled on Monday. Over 40 U.S. government employees were affected by the incidents, which started in 2017 and have not been explained. They helped lead President Donald Trump to reduce staffing at the country's mission in Havana. (12/16)

The New York Times: Supreme Court Won’t Revive Law Barring Homeless People From Sleeping Outdoors
The Supreme Court said on Monday that it would not hear a closely watched case on whether cities can make it a crime for homeless people to sleep outdoors. The case was brought by six people in Boise, Idaho, who said a pair of local laws violated the Eighth Amendment’s prohibition of cruel and unusual punishment. One prohibited “camping” in streets, parks and other public property. The other prohibited “lodging or sleeping” in any place, whether public or private, without the owner’s permission. (Liptak, 12/16)

The Associated Press: Supreme Court Won't Revive Homeless Camping Ban In Idaho
The justices on Monday did not comment as they left in place a ruling that struck down a Boise, Idaho, ordinance. The ruling by the 9th U.S. Circuit Court of Appeals applies across several Western states where cities are struggling with homelessness brought on by rising housing costs and income inequality. Many have similar restrictions that aim to keep homeless people from sleeping on their streets. The appeals court held that Boise could not make it a crime for homeless people to sleep on the streets when no alternative shelter is available. The decision the justices refused to review found that the Boise ordinance violated the constitutional ban on “cruel and unusual punishment.” (12/16)

The New York Times: Purdue Pharma Payments To Sackler Family Soared Amid Opioid Crisis
As scrutiny of Purdue Pharma’s role in the opioid epidemic intensified during the past dozen years, its owners, members of the Sackler family, withdrew more than $10 billion from the company, distributing it among trusts and overseas holding companies, according to a new audit commissioned by Purdue. The amount is more than eight times what the family took out of the company in the 13 years after OxyContin, its signature product, was approved in 1995. The audit is likely to renew questions about how much the Sacklers should pay to resolve more than 2,800 lawsuits that seek to hold Purdue accountable for the opioid crisis. (Hoffman and Hakim, 12/16)

The Wall Street Journal: Purdue Paid Out $10.4 Billion To Sacklers As Opioid Crisis Grew, Report Finds
While the audit offers new insight into Purdue’s operations and profitability, the report doesn’t shed light on how wealthy the Sacklers are today, or the location of family members’ assets. The Sacklers have offered to return $3 billion in cash and surrender ownership of Purdue to resolve lawsuits by states, counties, cities and Native American tribes that accuse the company of hiding OxyContin’s addictive risks and contributing to the opioid epidemic. (Scurria, 12/16)

Stat: Purdue, Maker Of OxyContin, Quietly Splits Ways With PhRMA 
Purdue Pharma, the embattled opioid maker, has quietly split ways with PhRMA, the powerful lobbying organization charged with representing the drug industry in Washington. The break is the latest demonstration that the drug maker, which has filed for bankruptcy and is inundated by lawsuits across the country for its role in marketing OxyContin, is retreating from attempts to influence federal drug policy or restore its reputation. (Florko, 12/17)

The Associated Press: Kentucky Governor Rescinds Planned Medicaid Work Requirement
Kentucky Gov. Andy Beshear on Monday halted his Republican predecessor's efforts to impose work requirements as a condition for some able-bodied adults to receive Medicaid health coverage, calling his action the “moral, faith-driven thing to do." The new Democratic governor signed an executive order rescinding former Gov. Matt Bevin's plan to require that the affected recipients either work, study, volunteer or perform other “community engagement" activities to qualify for Medicaid coverage. A federal judge blocked the requirements before they took effect, but Bevin's administration had appealed. (Schreiner, 12/16)

The Wall Street Journal: Kentucky’s New Governor Ends Medicaid Work Requirement
Under Democratic Gov. Steve Beshear—Mr. Beshear’s father, who held office from 2007 to 2015—Kentucky expanded Medicaid, the federal-state health program for the poor, and created a health exchange. But Republican Gov. Matt Bevin dismantled the exchange after taking office in 2015 and proposed changes to Medicaid that he said were necessary to keep costs down. Among the policies he pursued was a requirement that recipients perform a minimum number of hours of work or other activities like volunteering. CMS, which has supported work requirements under President Trump, approved the plan in 2018, triggering a lawsuit challenging it. (Campo-Flores, 12/16)

Reveal/The Associated Press: Probe: Medicaid Funds Still Go To Suspect Senior Care Homes
Medicaid funding has continued to flow to dozens of senior care-home operators in four states cited for stealing workers’ wages or breaking other labor laws, an investigation by Reveal from The Center for Investigative Reporting has found. Earlier this fall, Medicaid funding went to at least 45 care homes previously cited for labor violations in California, Florida, Oregon and Wisconsin. (Gollan, 12/16)

Reuters: U.S. Approves Roche's $4.3 Billion Purchase Of Spark Therapeutics
Swiss drugmaker Roche has won U.S. antitrust approval for its $4.3 billion deal to buy gene therapy specialist Spark Therapeutics clearing the way for Roche's push into treating rare diseases including hemophilia A. The Federal Trade Commission said on Monday it had approved the deal, which was originally announced in February, without requiring any asset sales to ensure the planned merger complies with antitrust law. (12/16)

The Washington Post: A Tweet Gave A Journalist A Seizure. His Case Brings New Meaning To The Idea Of ‘Online Assault.’
Kurt Eichenwald sat down at the desk in his Dallas home office and logged onto Twitter. The prominent journalist and author was used to Internet invective — especially then, in the weeks after he posted a particularly inflammatory tweet about President Trump. More than 170 notifications awaited him when he signed on that evening, Dec. 15, 2016. But he didn’t make it past the first one: A GIF that strobed violently across his computer screen, flashing a red, yellow and blue geometric pattern behind the words “YOU DESERVE A SEIZURE FOR YOUR POSTS.” (Thebault, 12/16)

NPR: Is Tasigna (Or Nilotinib) Worth Testing For Parkinson's?
A leukemia drug may have cleared another hurdle as a potential treatment for Parkinson's disease. But critics say it's still not clear whether the drug, nilotinib (brand name Tasigna), is truly safe or effective for this use. In a study of 75 people with Parkinson's, nilotinib appeared to improve quality of life and boost the chemical dopamine, a team from Georgetown University Medical Center reported Monday in JAMA Neurology. (Hamilton, 12/16)

Los Angeles Times: After Fatal School Shootings, Antidepressant Use Spikes Among Student Survivors
The children who experience a school shooting but live to see their parents and friends again are often called survivors. But by at least one measure of mental health, they too are among a gunman’s victims, new research finds. In the two years after a fatal school shooting, the rate at which antidepressants were prescribed to children and teens rose by 21% within a tight ring around the affected school. The increase in antidepressants prescribed to kids grew more — to nearly 25% — three years after a school shooting, suggesting that survivors’ depression lingers long after the incident has begun to fade from a community’s memory. (Healy, 12/16)

The Associated Press: EPA Watchdog: Health Monitoring After Harvey Was Lacking
A federal watchdog released a report Monday that cast doubt on the public health assurances made after Hurricane Harvey unleashed an environmental assault on the country’s largest petrochemical corridor, saying officials relied on limited data to offer residents peace of mind and that Houston’s air quality monitors had been offline to prevent storm damage. The report by the U.S. Environmental Protection Agency’s Office of Inspector General paints a picture of state and federal regulators telling those who live in and around the nation’s fourth-largest city — which was inundated with more than 50 inches of rainfall — that there were no public health risks even though it lacked a full range of data to make such a determination. (Weber, 12/16)

The Associated Press: Dozens Potentially Exposed To Toxic Mercury In Houston Spill
Dozens of people in Houston potentially were exposed to the toxic metal mercury after it was spilled outside a Walmart, a Sonic Drive-In and a gas station, officials said. Federal and local investigators were trying to determine if the spills were intentional. Fire Chief Sam Pena said up to 60 people were asked to take decontamination showers and a pregnant woman was taken to a hospital as a precaution. (12/16)

NPR: Vaping Nicotine Tied To Long-Term Lung Damage In Nonsmokers And Smokers
The extreme cases of lung injury caused by vaping have raised awareness of the potential harms of electronic cigarettes. Since the Centers for Disease Control and Prevention began tracking the problem last March, there have been 52 confirmed deaths and about 2,400 hospitalizations. Many of these acute illnesses are linked to black market THC products, but a growing body of evidence points to the risks associated with vaping nicotine. (Aubrey, 12/16)

The Wall Street Journal: To Fight Vaping, New York City Bans Nearly All Flavored E-Cigarettes
New York City Mayor Bill de Blasio on Monday signed into law a bill that bans the retail sale of nearly all flavored e-cigarette products, which health officials have said are popular among young people. New York joins some 230 municipalities and states across the country that have enacted restrictions on the sale of the products. The New York City Council passed the ban in late November. Mint and wintergreen flavors are included in the ban, but not tobacco-flavored products. (West, 12/16)

The Associated Press: NJ Assembly Passes Bill To Bar Religious Exemption For Shots
New Jersey's Assembly on Monday passed a measure to eliminate religious exemptions for vaccines for schoolchildren, but the bill stalled in the state Senate as opponents shouted so loudly they drowned out the session. The Democrat-led Assembly passed the bill 45-25, with six abstentions, but the Democrat-controlled state Senate postponed a vote because there weren't enough yes votes, according to the bill's sponsor and Senate President Steve Sweeney. (Catalini, 12/16)

The New York Times: Strict Vaccine Law Stumbles In N.J. Legislature
“They can cheer all they want. We’re not walking away from it,” Senate President Stephen M. Sweeney said about the jubilant roar in the chamber after the Senate adjourned without voting on the bill. He added, “It’s just remarkable how people are looking at this and not trusting the science on it at all. They’re trusting the internet.” Sue Collins, co-founder of the New Jersey Coalition for Vaccine Choice, which rallied against the bill, was triumphant. “The parents of New Jersey had a victory today,” she said. “The Legislature stood with us.” (Otterman and Tully, 12/16)

Politico: Senate Cancels Vote On Controversial Vaccination Bill After Hours Of Protests
Around 94 percent of New Jersey children meet all of the state’s necessary vaccine requirements. That includes for measles, which requires between 93 percent to 95 percent of the population to be vaccinated to generate the necessary herd immunity. The number of children who have been able to obtain exemptions has risen slowly over time, particularly over the last decade as anti-vaccination propaganda spouted by religious leaders and political activists like Robert F. Kennedy Jr. developed a following. (Sutton, 12/16)

The Associated Press: Sexual Arousal Study Investigated At Iowa Home For Disabled
Few details are being released about an investigation conducted by civil rights officials from the U.S. Department of Justice into possible human experiments focused on sexual arousal at a state-run Iowa institution for disabled residents, but Gov. Kim Reynolds recently acknowledged that the state’s response to long-term issues at Glenwood Resource Center was inadequate. (12/16)

The Washington Post: Three People Infected With Measles Traveled Through LAX Last Week, Officials Confirm
Three people with measles passed through Los Angeles International Airport last week, Los Angeles County health officials said Monday — and it is unclear how many people were exposed to one of the most contagious viruses in the world. The infected people, who were not Los Angeles County residents, were at the airport and could have exposed other travelers on Wednesday within Terminals 4 and 5 between 6:50 a.m. and noon. (Brice-Saddler, 12/16)

Los Angeles Times: Health Officials Warn Of Another Measles Exposure At LAX
Anyone who was in those terminals during that time may be at risk of developing measles within the next 21 days, according to public health officials. They advised that people check if they are immunized against measles and to monitor themselves for symptoms. There is no known risk of contracting measles at LAX currently, officials said. (Karlamangla, 12/16)