First Edition: April 12, 2019

Kaiser Health News: How To Fight ‘Scary’ Superbugs? Cooperation — And A Special Soap
Hospitals and nursing homes in California and Illinois are testing a surprisingly simple strategy against the dangerous, antibiotic-resistant superbugs that kill thousands of people each year: washing patients with a special soap. The efforts — funded with roughly $8 million from the federal government’s Centers for Disease Control and Prevention — are taking place at 50 facilities in those two states. (Gorman, 4/12)

Kaiser Health News: Heavy Rains, End Of Drought Could Help Keep West Nile Virus Subdued — For Now
The end of California’s drought, announced last month amid one of the rainiest winters in memory, could offer a surprising benefit: reduced transmission of the mosquito-borne West Nile virus. Longer term, however, more severe droughts associated with climate change could contribute to an increase in the number of infections in the state and nationally. (Rowan, 4/12)

The Washington Post: ‘We’ve Done A Lot More Than You Would Think’: How The Health-Insurance Industry Is Working To Pull Democrats Away From Medicare-For-All
At a company town hall meeting in late February, a UnitedHealthcare executive assured employees that the private health insurance giant was indeed working to undercut support for Democratic lawmakers’ push for Medicare-for-all. But the company, he said, is trying to tread lightly. “One of the things you said: ‘We’re really quiet’ or ‘It seems like we’re quiet.’ Um, we’ve done a lot more than you would think,” chief executive Steve Nelson said in response to an employee’s question about the company’s role in the Medicare-for-all debate, according to a video of his remarks obtained by The Washington Post. “You want to be kind of thoughtful about how you show up and have these kind of conversations, because the last thing you want to do is become the poster child during the presidential campaign." (Stein, 4/12)

The Associated Press: Top Senate Dem Stops Short Of Embracing 'Medicare For All'
The Senate’s top Democrat stopped short of throwing his weight behind Sen. Bernie Sanders’ “Medicare for All” plan Thursday, calling it one of several proposals his party is advancing to strengthen health care. Senate Minority Leader Chuck Schumer, D-N.Y., made the comments to reporters a day after Sanders, a Democratic presidential candidate, rolled out his latest version of the measure. The Vermont independent’s package is supported by many liberals and several other presidential contenders, but many moderates fear it’s an easy target for Republicans to characterize as socialist and a pathway to huge tax increases. Health care seems likely to be a major issue in next year’s presidential and congressional elections. (Fram, 4/11)

The Washington Post: Far-Left Policies Will Drive A 2020 Defeat, Centrist Democrats Fear. So They’re Floating Alternatives.
After ceding the policy debate to the left for months, Democratic centrists have begun to fight back with new proposals and a stark warning: The latest wave of far-left ideas, though popular with many in the Democratic Party, could lead to electoral disaster in 2020. Environmentalists are drafting alternatives to the Green New Deal. Candidates who have endorsed Medicare-for-all are open to backing more incremental plans. And the economic strategist who helped steer the last two Democratic presidents is warning that liberal tax proposals could backfire. (Scherer and Viser, 4/11)

The Wall Street Journal: At Party Retreat, Pelosi Tries To Focus Democrats On ‘Kitchen Table’ Issues
House Democrats are hoping to use their retreat this week and the two-week recess that follows to refocus on policy topics that helped them win the chamber in 2018. ... In a letter sent to House Democrats Wednesday, House Speaker Nancy Pelosi and members of the Democratic Policy and Communications Committee wrote about the importance of “fighting for kitchen table issues,” listing reducing health-care costs and raising wages among them. Health care was the signature issue in the 2018 midterm election. (Duehren, 4/11)

The Hill: GOP Senator Issues Stark Warning To Republicans On Health Care
GOP Sen. Mike Braun (Ind.) has a stark warning for Republicans: Come up with a viable alternative to ObamaCare or face another rout in the 2020 election. Speaking with The Hill at his office in the Senate Russell Building, Braun described the GOP’s push to repeal ObamaCare without a plan of their own as one of the primary reasons for the Democratic wave election in 2018. (Easley, 4/12)

The Hill: Sanders Campaign To Trump: 'We Welcome This Fight' On 'Medicare For All' 
Sen. Bernie Sanders’s (I-Vt.) campaign on Thursday hit back at President Trump, a day after the White House attacked Sanders’s “Medicare for all” bill. “This campaign's message to Trump is simple: we welcome this fight because we are going to defeat you in the election and guarantee health care as a right to all people,” Sanders campaign manager Faiz Shakir said in a statement. (Sullivan, 4/11)

The Associated Press: Sanders Starts Campaign Swing With Wisconsin Rally
U.S. Sen. Bernie Sanders returns to the friendly terrain of Wisconsin on Friday to kick off a swing through pivotal states that are part of the Democratic "blue wall" strategy for 2020. ... The Sanders campaign said his message on trade, unions, working families and health care resonates in Wisconsin and throughout the Midwest. Earlier this week, Sanders unveiled his latest "Medicare for All" proposal, an idea that has influenced Democratic state lawmakers in Wisconsin who are advocating for similar statewide health insurance coverage. (4/11)

NPR: The Issue Of Medicare For All Is Dominating The 2020 Democratic Field
Several 2020 Democratic candidates support Medicare for All, but what would that proposal look like in action? (Kodjak, 4/11)

Los Angeles Times: Kamala Harris And Other Democrats Point To Racial Gap In Care Of Pregnant Black Women
It was a harrowing brush with a baffling problem: the high risk of dying as an expectant mother in America, a danger that is especially acute for black women like [Tamara] King. The nation’s maternal health crisis has captured increasing attention in the media, in the medical community and in Congress. Now it has hit the 2020 presidential campaign, with multiple Democrats touting plans to expand healthcare access and address the racism that leads to disparate treatment of white and black patients. (Mason, 4/11)

Stat: Lawmakers Ask The Trump Administration To Investigate PBM Pricing 
As pharmacy benefit managers undergo increasing scrutiny, two lawmakers have asked the Health and Human Services inspector general to investigate so-called spread pricing practices by these pharmaceutical middlemen as part of a larger inquiry into rising drug costs. In an April 8 letter released on Wednesday night, the heads of the Senate Finance Committee pointed to instances where PBMs have purportedly used this practice to make millions of dollars in excess profits at the expense of state Medicaid programs. Spread pricing is a crucial but little-known part of the opaque pharmaceutical pricing system and refers to fees PBMs pay pharmacies and bill back to Medicaid. (Silverman, 4/11)

Stat: Many Employers Would Like To Drop Controversial Rebates On Drugs 
As Washington lawmakers struggle to find ways to lower drug costs, a new survey finds that a sizable proportion of employers support proposals to eliminate the rebates paid by drug makers to win favorable insurance coverage. Specifically, 42% of nearly 600 employers support eliminating rebates for both public and private payers, and another 5% were in favor of eliminating them only for government healthcare plans.  Just 17% opposed any change to the current rebating system, but 36% have no opinion or want more information, according to the survey conducted last month by the Mercer benefits consulting firm. (Silverman, 4/11)

The Associated Press: Medical Association Blasts Military's Transgender Policy
A Trump administration regulation set to go into effect Friday bars transgender people from the military unless they “correct those deficiencies,” a description the American Medical Association said Thursday is unfair and defies science. The AMA told The Associated Press on Thursday the policy and its wording mischaracterizes transgender people as having a “deficiency.” It said it also objects to the Defense Department classifying the need to transition to another gender among “administratively disqualifying conditions” that include those the Pentagon has labeled as “congenital or developmental defects.” (Watson and Crary, 4/11)

NPR: How The Trump Administration's Transgender Troop Ban Is Affecting One Military Family
Lt. Col. Bree "B" Fram left a doctor's office on April 2. Presenting that day as Bryan, the name given to them at birth, B should have been relieved. "Overall, it's a good thing," said B. "It just didn't feel great to have to do it on someone else's timeline other than my own." "It" was an official diagnosis of gender dysphoria. As a transgender member of the military, B had to secure the diagnosis by April 12 in order to continue serving openly. That's when the Trump administration's new policy on transgender military service takes effect. It effectively bans transgender people from joining the military. The more than 14,000 already serving will be allowed to do so openly, so long as they have that formal diagnosis of gender dysphoria filed by the deadline. If not, they must serve under the gender assigned them at birth - or leave the armed forces. (Hodges and Chang, 4/11)

The Associated Press: Tennessee House Advances Bill Seeking To Overhaul Medicaid
Tennessee would dramatically overhaul how it provides health care to its lower-income and disabled residents under a proposal the House advanced Thursday. The bill cleared the GOP-dominated chamber on party lines, with 68 Republicans in favor and 21 Democrats against. It’s a proposal considered one of the top policy debates of the sessions, yet many in the minority party were visibly upset after being cut off from the debate and forced to cast a vote before all members had a chance to speak. (Kruesi, 4/11)

The New York Times: Opioid Sales Reps Swarmed New York At Height Of Crisis
Purdue Pharma’s sales force swept through New York State, visiting doctors and pharmacies nearly half a million times between 2006 and 2017 to promote OxyContin and other opioid painkillers. That is roughly 160 sales stops in the state each weekday during the height of the nation’s addiction crisis. The company’s flood-the-zone sales strategy was among the new disclosures contained in court papers filed on Thursday by Attorney General Letitia James of New York as part of the office’s lawsuit against opioid manufacturers, distributors and eight members of the Sackler family, who control Purdue. (Rashbaum, Rabin and Hakim, 4/11)

The Associated Press: Oklahoma Judge, Not Jury, To Decide Case Against Drugmakers
An Oklahoma judge has ruled that he, not a jury, will decide the state's case against several drug manufacturers for their alleged role in the nation's deadly opioid crisis. The attorney general's office says Cleveland County District Judge Thad Balkman made the decision at Thursday's hearing that a jury won't hear the case. At least one of the defendants, Johnson & Johnson, had sought a jury trial. (4/11)

The Associated Press: Herbal Supplement Kratom Is Tied To More US Deaths
U.S. health officials say overdose deaths involving the herbal supplement kratom are more common than previously reported. A government report released Thursday said kratom was a cause in 91 overdose deaths in 27 states. Officials previously said they knew of 44 nationally. Most who died had also taken heroin, fentanyl or other drugs. But kratom was the only substance detected in seven of the deaths. (Stobbe, 4/11)

USA Today: Kratom, Herbal Drug, Linked To More Overdose Deaths, CDC Says
Kratom – a plant grown naturally in Southeast Asia and often sold in powder capsules – was a cause of death in 91 overdoses in the United States from July 2016 to December 2017, according to a report released Thursday by the U.S. Centers for Disease Control and Prevention. In seven of the overdoses, kratom was the only substance to test positive in a toxicology report, though the CDC says other substances couldn't be ruled out. (Miller, 4/11)

The Associated Press: Senator: Marijuana Is 'The Elephant In The Room' As Lawmakers Work To Restrict Initiatives Process
When Idaho senators debated a bill that would make it harder to qualify a voter initiative or referendum for the ballot, one senator pointed to “the elephant in the room”: marijuana. “I’m not as fearful of things that may be coming in the future as others are — certainly a big concern has been marijuana,” said Sen. Jim Guthrie, R-Inkom. “Certainly the speculation has been that’s part of the reason.” (Cardon, 4/11)

The Associated Press: Ohio Governor Signs Ban On Abortion After 1st Heartbeat
A bill imposing one of the most stringent abortion restrictions in the nation was signed into law in Ohio on Thursday, banning abortions after a detectable heartbeat in a long-sought victory for abortion opponents that drew an immediate constitutional challenge. In signing the heartbeat bill, Republican Gov. Mike DeWine broke with his predecessor, Republican John Kasich, who had vetoed the measure twice on grounds that it was unconstitutional. (4/12)

NPR: Ohio's 6-Week Abortion Ban Becomes Law; Opponents Will Sue
Now known as the "Human Rights Protection Act," SB 23 outlaws abortions as early as five or six weeks into a pregnancy, before many women know they're pregnant. It is one of the most restrictive abortion laws in the country. The bill does include an exception to save the life of the woman, but no exceptions for cases of rape or incest. (Rosenberg, 4/11)

The Associated Press: Planned Parenthood Sues Over Arizona Abortion Laws
Abortion rights groups filed a lawsuit Thursday challenging Arizona laws they say unnecessarily restrict access to the procedures and leave most rural areas without clinics. The legal action by Planned Parenthood Arizona targets laws that prohibit anyone other than a physician from performing abortions; require patients to visit clinics twice over a 24-hour period for counseling; and bar the use of telemedicine in providing abortion services. (Billeaud, 4/11)

The Associated Press: Police Again Step In As Texas Lawmaker Halts Abortion Bill
A Texas sheriff’s department said Thursday it had “security concerns” over social media posts targeting a Republican lawmaker, who has come under fire by some conservative activists after blocking a bill that could lead to a woman being charged with homicide if she has an abortion. It marks the second time this month that Texas law enforcement has taken protective measures involving Republican lawmakers, who in both cases have been blamed by frustrated groups for torpedoing divisive measures, first over guns and now abortion. (Silber, 4/11)

Reuters: More U.S. States Push Ahead With Near-Bans On Abortion For Supreme Court Challenge
Activists on both sides of the issue say such laws, which are commonly blocked by court injunctions, are aimed at getting a case sent to the U.S. Supreme Court, where conservatives hold a 5-4 majority, to challenge Roe v. Wade, the landmark 1973 decision that established a constitutional right to abortion. (4/11)

The Associated Press: Arizona Governor Signs Repeal Of HIV/AIDS Instruction Law
Arizona's Republican governor quickly signed a bill Thursday repealing a 1991 state law that had barred HIV and AIDS instruction that "promotes a homosexual lifestyle." The move was intended to end a discrimination lawsuit filed by LGBTQ groups. Gov. Doug Ducey's signature came less than an hour after the state Senate approved the repeal. One of the 10 Republicans who opposed the measure said she opposed sex education. Another noted that gay men are most at risk from the HIV virus. (Christie, 4/11)

The Associated Press: Kentucky County To Pay $253K Over Claims Of False Billing
A Kentucky county has agreed to pay nearly $254,000 to the federal government to settle a lawsuit alleging its ambulance service submitted more than 1,000 fake reimbursement claims to Medicare and Medicaid. The Lexington Herald-Leader reported Thursday that the federal government sued the county and related agencies last year. It said the county-owned ambulance service forged reports to make patients seem sicker than they were so ambulance runs would qualify for federal reimbursement. (4/11)

The Wall Street Journal: Rite Aid To Stop Sale Of E-Cigarettes
Rite Aid Corp. is halting the sale of e-cigarettes in its drugstores, even as it continues to sell traditional cigarettes, taking a different stance on tobacco products than its two main pharmacy rivals. The company will remove all e-cigarette and vaping products, including startup Juul Labs Inc.’s popular nicotine-packed vaporizers, over the next 90 days, Bryan Everett, Rite Aid operating chief, said on a conference call Thursday. Executives said the change was in response to use of the products by children and teens. (Thomas, 4/11)

The Wall Street Journal: Novartis Doesn’t Rule Out Further Deals In NASH Treatments
Novartis AG can’t rule out striking more collaboration deals or acquisitions to develop effective treatments against a complex liver disease known as NASH, a company executive said Thursday, as drug giants race for dominion in an untapped disease area that could rake in billions of dollars in revenue. There are currently no approved drugs for NASH, or nonalcoholic steatohepatitis, a progressive liver disease that affects about 5 percent of the global population. The disease is expected to become the leading cause of liver transplants in the U.S. by 2020. The market is expected to balloon to $18.3 billion in 2026 from $138.4 million in 2016, according to analytics company GlobalData. And that’s only for the world’s seven major markets, or the U.S. Germany, France, Italy, Spain, the U.K. and Japan. (Mancini, 4/11)

The Wall Street Journal: One Teenager Killed Himself. Six More Followed. 
The country’s rising suicide rate, part of an increase in what has been dubbed “deaths of despair,” is hitting the youngest Americans hard. The overall suicide rate rose 26% between 2007 and 2017, the most recent year for government data, according to the federal Centers for Disease Control and Prevention. For children ages 10 to 17, over the same period, the rate more than doubled. The most painful and perplexing cases sometimes happen in the same town, at the same school, on the same block. (Lovett, 4/12)

The New York Times: Measles Outbreak: Tensions Rise As New York City Steps Up Response
Vaccine skeptics were planning a lawsuit against New York City. A Hasidic woman was heckled when she boarded a public bus. Family members were avoiding weddings for fear of encountering unvaccinated relatives. When Mayor Bill de Blasio announced on Tuesday an emergency health order requiring measles vaccinations, he said the step was necessary to curtail the large measles outbreak in the ultra-Orthodox Jewish community. But as health officials plunged into Brooklyn’s Williamsburg neighborhood to enforce the mandate, tensions only escalated. (Pager, 4/11)

The Washington Post: New York City Vaccination Order Shines Spotlight On Insular Jewish Community
Even among New York’s Hasidic Jews, members of the ultra-Orthodox Satmar sect are known for their strict religious and cultural traditions. They speak mainly Yiddish. They shun the secular world. They are skeptical, if not suspicious, of anyone from outside their insular community in Brooklyn’s Williamsburg neighborhood. Now the refusal of some parents to vaccinate their children — a decision not based on any religious proscription — and a resulting measles outbreak have brought public health authorities to their doorsteps in a collision of cultures that could turn messy. (Bernstein, Sun and Paluch, 4/11)

The Washington Post: How Does Measles Spread? Do I Need Another MMR Vaccine Shot? How Dangerous Is Measles? FAQ On The Outbreaks.
The United States is experiencing its second-highest number of measles cases in nearly two decades. The Centers for Disease Control and Prevention said the diagnosed cases have climbed to 465. At least 19 states have reported cases of the highly contagious virus. New York City officials have ordered mandatory measles vaccinations to halt an outbreak. The outbreaks are linked to people who traveled from countries such as Israel, Ukraine and the Philippines, where large measles outbreaks are occurring. The disease is spreading in U.S. communities that have relatively high numbers of people who have not been vaccinated against measles. Here are some answers to commonly asked questions about measles, which can cause serious complications among all age groups, especially young children, adults with weakened immune systems, and the very elderly. (Sun, 4/11)

The Washington Post: Measles Outbreak Has Not Spread To D.C. Area So Far, Officials Say
A case of measles confirmed in Maryland last week appears not to have spread into the greater Washington area, officials said Thursday, but government health agencies are preparing and watching for any additional signs of the highly infectious disease. From Jan. 1 to April 4, 465 measles cases were confirmed in 19 U.S. states, the federal Centers for Disease Control and Prevention reported. One of those was a child in Pikes­ville, Md., northwest of Baltimore. (Sullivan, 4/11)

The New York Times: Scott Kelly Spent A Year In Orbit. His Body Is Not Quite The Same.
For 340 days, Scott Kelly circled the Earth aboard the International Space Station, gathering data about himself. He drew blood from his arms. He saved his urine. He played computer games to test his memory and reaction speed. He measured the shape of his eyes. Two hundred and forty miles below, Mr. Kelly’s twin brother, Mark, who also served as an astronaut, carried out identical tests. Now, a comparison of these two men has provided a unique opportunity to learn what happens to the human body in space — down to the molecular level. (Zimmer, 4/11)

The Washington Post: NASA Kelly Twin Astronauts Study Shows Health Risks Of Space Travel
The researchers, echoing what NASA has suggested previously, said the twins study turned up no showstoppers — no shocking health consequences that would surely prevent a human mission to Mars or similar long-duration mission. But the report shows anew that the human body is adapted for life on the surface of Earth and goes haywire in zero gravity. One of the most dramatic findings concerned epigenetics — how genes are turned on or off to produce proteins. (Contrary to some breathless headlines, Scott Kelly didn’t undergo a space-induced change in his genetic code.) Gene expression changed in both Kellys during the study but in significantly different ways. The study found that more than 90 percent of Scott Kelly’s gene expression changes reverted to normal when he returned to the surface. (Achenbach, 4/11)

The Wall Street Journal: Astronauts Can Withstand Longer Space Trips, New Study Of Twins Finds
Astronauts may be better able to withstand long missions to the Moon and even Mars than previously realized, lifting what had loomed as a barrier to space exploration, a unique study of twin astronauts revealed. The longer people stay in space the more their vital signs change in small but significant ways, but there aren’t long-term health consequences, the study found. (Hotz, 4/11)

The Associated Press: Lawsuit: Georgia Jail Conditions Bad For Mentally Ill Women
Prolonged solitary confinement and harrowing conditions at a Georgia jail result in a substantial risk of serious psychological harm for mentally ill women held there, a federal lawsuit says. Urine and toilet water pool on the floor of cells and meals of moldy sandwich meat are not uncommon at the South Fulton Municipal Regional Jail in Union City, the lawsuit filed Wednesday says. Lawyers have observed women in psychological distress lying on the floor, their bodies and the walls of their cells smeared with feces or food. (Brumback, 4/11)

The New York Times: Living Near A Major Highway Tied To Developmental Delays In Children
Living near a major highway may be associated with developmental delays in children. Researchers studied 5,825 children living in New York state outside of New York City. Parents periodically filled out a well-validated questionnaire that tracks developmental milestones in children from age 8 months to 3 years. Milestones encompassed physical, verbal and social domains. (Bakalar, 4/11)

The New York Times: ‘Extreme Pollen’ Blankets North Carolina In A Sneeze-Inducing Yellow Haze
Spring can feel like the end of the world for allergy sufferers, but in North Carolina this week, it looked that way, too. And it has a name to match: “Pollenpocalypse.” Massive clouds of sneeze-inducing pollen overtook North Carolina this week, tinting the skies yellow and covering cars, streets and ponds in a fine powder that left footprints on the carpets of unsuspecting residents and made allergy sufferers want to hibernate in a panic room until summer. (Levin, 4/11)