First Edition: April 10, 2023

KHN: Special Medicaid Funds Help Most States, But Prompt Oversight Concerns 
The extra federal money comes through an obscure, complicated mechanism called “directed payments” — available only for states that hire health insurers to deliver services for Medicaid. It’s not Medicaid expansion, which Georgia Republican leaders have rejected. Instead, the state Department of Community Health is using an under-the-radar Medicaid funding opportunity that has been rapidly taken up by more than 35 states — including most of the states that have expanded the government insurance program. (Miller, 4/10)

KHN: Abortion Clinics In Conservative-Led States Face Increasing Legal Threats
Thirty years ago, Blue Mountain Clinic Director Willa Craig stood in front of the sagging roof and broken windows of an abortion clinic that an arsonist had burned down early that morning in Missoula, Montana. “This morning, Missoula, Montana, learned that there is no place in America that is safe from hateful, misguided groups,” she told the crowd of reporters and onlookers. (Bolton, 4/10)

KHN: Journalists Explain Impact Of Texas Judge’s ACA Decision And Cuts In Federal Food Benefits 
KHN chief Washington correspondent Julie Rovner discussed the aftermath of a federal judge’s decision in Texas that blocks the Affordable Care Act’s provision on preventive care benefits on Slate’s “What Next” on April 5. (4/8)

AP: Access To Abortion Pill In Limbo After Competing Rulings
Access to the most commonly used method of abortion in the U.S. plunged into uncertainty Friday following conflicting court rulings over the legality of the abortion medication mifepristone that has been widely available for more than 20 years. For now, the drug the Food and Drug Administration approved in 2000 appeared to remain at least immediately available in the wake of two separate rulings that were issued in quick succession by federal judges in Texas and Washington. (Weber, Perrone and Whitehurst, 4/8)

The 19th: Federal Judges Issue Conflicting Rulings On Medication Abortion Pill Mifepristone
Federal judges have issued contradicting orders about whether mifepristone — one of two drugs used to induce a medication abortion — can be legally distributed. A judge in Texas ruled Friday in a much watched case, saying that the federal government’s approval of the drug must be blocked; his decision, he wrote, takes effect in one week, giving the Department of Justice time to appeal the decision. But another federal judge, in Washington state, found the opposite in a separate case concerning the drug’s approval. That judge, who also ruled Friday, held that a nationwide injunction blocking mifepristone’s distribution would be “inappropriate.” (Luthra, 4/7)

AP: What Does 1870s Comstock Act Have To Do With Abortion Pills? 
A 19th century “anti-vice” law is at the center of a new court ruling that threatens access to the leading abortion drug in the U.S. Dormant for a half-century, the Comstock Act has been revived by anti-abortion groups and conservative states seeking to block the mailing of mifepristone, the pill used in more than half of U.S. abortions. (Perrone, 4/8)

The Hill: Biden Slams Texas Abortion Pill Ruling As ‘Political, Ideological’ Attack
President Biden slammed the ruling by a federal judge in Texas rejecting the Food and Drug Administration’s (FDA) approval of an abortion pill as a “political, ideological” attack. Biden said in a statement on Friday that the court has substituted its judgment for that of the FDA, which he called the “expert agency” on approving drugs. He said mifepristone, the pill, has been available for more than 22 years and safely and effectively used by millions of women in the United States and throughout the world. “If this ruling were to stand, then there will be virtually no prescription, approved by the FDA, that would be safe from these kinds of political, ideological attacks,” he said. (Gans, 4/8)

The Hill: Biden’s Health Chief Says ‘Everything Is On The Table’ To Fight Abortion Pill Ruling
President Biden’s health chief said “everything is on the table” to fight the Texas abortion pill ruling last week that blocked the prescribing and distribution of mifepristone, including ignoring the ruling as some Democrats have suggested. (Sforza, 4/9)

The New York Times: Abortion Ruling Could Undermine The F.D.A.’s Drug-Approval Authority 
A federal judge’s ruling to revoke the Food and Drug Administration’s longstanding approval of the abortion pill mifepristone poses threats to the U.S. government’s regulatory authority that could go far beyond one drug, legal experts say. The decision by a Texas judge appears to be the first time a court has moved toward ordering removal of an approved drug from the market over the objection of the F.D.A. (Jewett and Belluck, 4/10)

The Hill: Texas Abortion Pill Ruling Could Impact Other FDA-Approved Drugs, Vaccinations: HHS Secretary 
“When you turn upside down the entire FDA approval process, you’re not talking about just mifepristone,” Xavier Becerra said on CNN’s “State of the Union” on Sunday. “You’re talking about every kind of drug. You’re talking about our vaccines. You’re talking about insulin. You’re talking about the new Alzheimer’s drugs that may come on.” (Neukam, 4/9)

The Hill: House Republican Suggests Defunding FDA If Texas Abortion Pill Ruling Not Followed 
Rep. Tony Gonzales (R-Texas) warned that Republicans should consider defunding the Food and Drug Administration (FDA) if the Biden administration does not adhere to a ruling from a federal judge last week that blocked the long-standing approval of an abortion medication. ... “It’s very dangerous when you have the administration, the Biden administration, coming out and saying they may not uphold a ruling,” Gonzales said on CNN’s “State of the Union” on Sunday. “The House Republicans have the power of the purse. And if the administration wants to not live up to this ruling, then we’re going to have a problem… it may come to a point where House Republicans on the appropriation side have to defund FDA programs that don’t make sense.” (Neukam, 4/9)

The Washington Post: Can I Still Get A Medication Abortion?
Access to the two-drug regimen will likely vary across the country. In states where abortion is legal, clinics could limit their offerings to surgical abortions, which require far more time and resources than pills. But many providers say they will continue to offer medication abortions — using only misoprostol if need be. Others say they have been stockpiling mifepristone while it is still FDA-approved, and will continue using that supply of the drug. (Kitchener, Marimow, McGinley, Roubein and Sellers, 4/7)

San Francisco Chronicle: Medication Abortions Will Be More Painful Without Mifepristone
By suspending a drug used in medicated abortions Friday, a conservative federal judge in Texas did more than make it harder for people to obtain abortions. U.S. District Judge Matthew Kacsmaryk also made it more painful. And that may be the point, abortion rights advocates say. (Garofoli, 4/7)

AP: Abortion Pill Plan Clears Kansas Legislature; Veto Expected 
Abortion opponents pushed a bill through the Kansas Legislature early Friday to require providers to tell patients that a medication abortion can be “reversed” once it’s started — a measure that could face a state court challenge if its supporters can overcome the governor’s expected veto. Republican lawmakers pursued the bill even though experts dispute abortion opponents’ claims about medication abortions. Democrats argue the measure defies a decisive statewide vote in August affirming abortion rights. Democratic Gov. Laura Kelly vetoed a similar measure in 2019. (Hanna, 4/7)

AP: California To Keep Paying Walgreens Despite Abortion Dispute 
California’s Medicaid program will continue to pay Walgreens about $1.5 billion each year despite Democratic Gov. Gavin Newsom declaring last month the state was done doing business with the pharmacy giant after it indicated it would not sell abortion pills by mail in some states. “California won’t be doing business with @Walgreens -- or any company that cowers to the extremists and puts women’s lives at risk. We’re done,” Newsom tweeted March 6. (4/7)

Stateline: First State Law To Criminalize Abortion ‘Trafficking’ May Inspire Others
“Abortion opponents are testing the waters around abortion bans with this Idaho law, because state lawmakers realize they’re facing a real uphill climb in courts because of the federal right to travel,” said Elizabeth Nash, principal policy associate at the Guttmacher Institute, which supports abortion rights. “Other states will be watching closely to see how this plays out.” Idaho’s travel ban is based on wording in a model abortion law proposed by the National Right to Life Committee for lawmakers to introduce in their states. (Vestal, 4/7)

AP: Iowa Won't Pay For Rape Victims' Abortions Or Contraceptives
The Iowa Attorney General’s Office has paused its practice of paying for emergency contraception — and in rare cases, abortions — for victims of sexual assault, a move that drew criticism from some victim advocates. Federal regulations and state law require Iowa to pay many of the expenses for sexual assault victims who seek medical help, such as the costs of forensic exams and treatment for sexually transmitted infections. Under the previous attorney general, Democrat Tom Miller, Iowa’s victim compensation fund also paid for Plan B, the so-called morning after pill, as well as other treatments to prevent pregnancy. (4/9)

AP: Report: Florida Officials Cut Key Data From Vaccine Study 
An analysis that was the basis of a highly criticized recommendation from Florida’s surgeon general cautioning young men against getting the COVID-19 vaccine omitted information that showed catching the virus could increase the risk of a cardiac-related death much more than getting the mRNA shot, according to drafts of the analysis obtained by the Tampa Bay Times. The nonbinding recommendation made by Florida Surgeon General Joseph Ladapo last fall ran counter to the advice provided by the federal Centers for Disease Control and Prevention. Ladapo, a Harvard-trained medical doctor who was appointed by Florida Gov. Ron DeSantis in 2021 to head the Florida Department of Health, has drawn intense scrutiny over his shared resistance with the Republican governor to COVID-19 mandates for vaccines and masks and other health policies endorsed by the federal government. (4/8)

AP: China Health Officials Lash Out At WHO, Defend Virus Search
Chinese health officials defended their search for the source of the COVID-19 virus and lashed out Saturday at the World Health Organization after its leader said Beijing should have shared genetic information earlier. The WHO comments were “offensive and disrespectful,” said the director of the China Center for Disease Control and Prevention, Shen Hongbing. He accused the WHO of “attempting to smear China” and said it should avoid helping others “politicize COVID-19.” (McDonald, 4/8)

The Atlantic: A Radical Change To The Flu Vaccine May Be Coming
In March 2020, Yamagata’s trail went cold. The pathogen, one of the four main groups of flu viruses targeted by seasonal vaccines, had spent the first part of the year flitting across the Northern Hemisphere, as it typically did. As the seasons turned, scientists were preparing, as they typically did, for the virus to make its annual trek across the equator and seed new outbreaks in the globe’s southern half. That migration never came to pass. ... (Wu, 4/7)

NPR: Strep Circulates While Antibiotic Shortage Continues In The U.S.
Downing a spoonful of bubblegum pink amoxicillin is a regular part of being a kid, but a nationwide shortage of the antibiotic is making a particularly bad season of strep throat tougher. That hit home for Caitlin Rivers recently when both of her kids had strep. (Lupkin, 4/10)

Stat: FDA: Some Philips Respirators May Not Deliver The Right Treatment
On Friday, the Food and Drug Administration issued a Class I recall for certain Philips CPAP and BiPAP respirators that were refurbished in an earlier recall, the latest in a string of troubles for the medical device giant. The machines were incorrectly programmed with the wrong serial numbers, leaving some users without the right prescription settings and running the risk that the machines “fail to deliver any therapy at all.” (Trang, 4/8)

Modern Healthcare: Recent Layoffs Raise Questions On Industry's Job Outlook
Employment in the healthcare sector was up 3.8% year-over-year in the first quarter, according to preliminary data released Friday by the Labor Department's Bureau of Labor Statistics. In ambulatory care, employment increased 3.8%, and the number of people working in home health jumped 4.8%. Employment at  hospitals increased by 3.3%, according to the data, which may be revised in the coming months. (Hudson, 4/7)

Crain's Detroit Business: 40% Of Michigan Hospital Nurses Want To Quit: Survey
While Michigan hospitals had problems retaining nurses even before the COVID-19 pandemic, the situation grew much worse in the first two years of the public health crisis. That’s according to newly published survey data showing that from just prior to the pandemic to March 2022, the rate at which nurses planned to leave the profession rose sharply across Michigan. (Sanchez, 4/7)

CBS News: Doctor Shortages Distress Rural America, Where Few Residency Programs Exist
Anger, devastation, and concern for her patients washed over Bridget Martinez as she learned that her residency training program in rural northeastern Nevada would be shuttered. The doctor in training remembered telling one of her patients that, come July of this year, she would no longer be her physician. Martinez had been treating the patient for months at a local health care center for a variety of physical and psychiatric health issues. (Orozco and Rodriguez, 4/10)

Stat: 5 Tech Startups Trying To Solve Health Care's Staffing Crisis To Watch
Three years after the pandemic upended the health care workforce, hospital staffing is still a top concern for hospital administrators. Hospitals and nursing homes are competing for nurses after strikes across the country showed an empowered cadre of nurses fed up with high provider-to-patient ratios and stagnant wages. Meanwhile, health systems are navigating a dramatically altered workforce, as many nurses left behind full-time hospital roles for short-term contract and remote positions. (Castillo, 4/10)

Stat: UnitedHealth Acquires Another New York Physician Group
UnitedHealth Group has acquired Crystal Run Healthcare, a prominent physician group in New York. The deal for Crystal Run, a network of almost 400 doctors, nurse practitioners, and other clinicians, closed in late February. There was no fanfare. Neither company issued a press release. The deal only came to light from an email obtained by the Mid-Hudson News. (Herman, 4/10)

AP: Ex-Theranos Executive Headed To Prison After Losing Appeal
Former Theranos executive Ramesh “Sunny” Balwani will be heading to prison later this month after an appeals court rejected his bid to remain free while he contests his conviction for carrying out a blood-testing hoax with his former boss and lover, Elizabeth Holmes. After the Ninth Circuit Court of Appeals issued a decision refusing Balwani’s request, U.S District Judge Edward Davila on Friday ordered him to start his nearly 13-year prison sentence on April 20. ... The April 20 reporting date means Balwani will be heading to prison a week before Holmes, Theranos’ founder and CEO, is scheduled to begin a more than 11-year prison sentence after being convicted on four counts of fraud and conspiracy last year. (Liedtke, 4/7)

The New York Times: Will North Carolina Be The ‘Beginning Of The End’ Of The Medicaid Expansion Fight? 
Thirteen years after the adoption of the Affordable Care Act under President Barack Obama, Republicans are abandoning their opposition to Medicaid expansion. Lingering reservations about the welfare state and the cost of expansion are giving way to arguments about Medicaid as an engine for economic growth and a lifeline for struggling hospitals. (Stolberg, 4/9)

AP: US Judge Issues Order In Arizona Prison Health Care Case
A U.S. District Court judge has made permanent an order that aims to improve the way Arizona delivers health care to incarcerated people in state-run prisons. The injunction issued Friday by Judge Roslyn Silver is the latest effort to ensure Arizona prisons meet constitutional standards. She initially ruled last year that Arizona had been violating the rights of incarcerated people by providing them with inadequate medical and mental health care, saying the state knew about the problem for years but refused to correct its failures. (4/8)

AP: US States Consider Ban On Cosmetics With 'Forever Chemicals'
A growing number of state legislatures are considering bans on cosmetics and other consumer products that contain a group of synthetic, potentially harmful chemicals known as PFAS. In Vermont, the state Senate gave final approval this week to legislation that would prohibit manufacturers and suppliers from selling or distributing any cosmetics or menstrual products in the state that have perfluoroalkyl and polyfluoroalkyl substances, as well as a number of other chemicals. (Rathke, 4/7)

AP: Nebraska Church Raises $520K To Erase Medical Bills
A Nebraska church has raised more than $520,000 to pay off the medical bills of residents in its neighborhood, ending the 14-month-campaign on Easter Sunday. An estimated 10,000 people contributed to the First-Plymouth Congregational Church effort, The Lincoln Journal Star reports. (4/9)

CIDRAP: Wyoming Reports High-Path Avian Flu In Cat 
The Wyoming State Veterinary Lab (WSVL) said it has diagnosed highly pathogenic avian influenza in a barn cat, the state's first detection of the virus in a domestic cat. In a brief statement on its website, the WSVL said the cat is located near Thermopolis, in the central part of the state. It said that the cat probably contracted the virus from eating meat from wild waterfowl. In recent months, the lab has also detected the virus in other carnivores, including mountain lions and a red fox. (Schnirring, 4/7)

Science: From Bad To Worse: How Avian Flu Must Change To Trigger A Human Pandemic 
The victims are varied, from thousands of sea lions off the coast of Peru to mink farmed for fur in Spain to grizzly bears in Montana and harbor seals in Maine. For months, the avian influenza virus that has been decimating birds across the world has also sickened and killed a menagerie of mammals, raising fears it might evolve to spread more efficiently between these animals, and ultimately between people. For that nightmare to unfold, however, the virus, a subtype known as H5N1, would have to undergo a major transformation, changing from a pathogen efficient at infecting cells in the guts of birds and spreading through feces-contaminated water into one adept at infecting human lung tissue and spreading through the air. So far, that has not happened. None of the few people who have caught the virus currently wiping out birds, called clade 2.3.4.4b, seems to have passed it on to other people. (Kupferschmidt, 4/6)