First Edition: April 15, 2019

Kaiser Health News: Watchdogs Cite Lax Medical And Mental Health Treatment Of ICE Detainees
It’s Saturday morning and the women of the Contreras family are busy in Montclair, Calif., making pupusas, tamales and tacos. They’re working to replace the income of José Contreras, who has been held since last June at Southern California’s Adelanto ICE Processing Center, a privately run immigration detention center. José’s daughter, Giselle, drives around in an aging minivan collecting food orders. First a hospital, then a car wash, then a local bank. Giselle’s father crossed illegally from Guatemala more than two decades ago. He worked in construction until agents picked him up and brought him to Adelanto. (Varney, 4/15)

The Hill: Democratic Proposals To Overhaul Health Care: A 2020 Primer 
About 20 million Americans have gained coverage under ObamaCare since it was passed in 2010, but nearly 9 percent — 30 million people — still don’t have health insurance. All Democrats running for president say they want to provide universal health care coverage to Americans. But they have different ideas about how to get there. (Hellmann, 4/14)

Politico: Trump’s Health Care Blundering Soothes Democratic Infighting
House Democrats disagree sharply over where to take the nation’s health care system, but the infighting has eased — and for that they can thank President Donald Trump. The Trump administration’s renewed assault on Obamacare has quelled for the moment the simmering tensions over "Medicare for All" between Democrats’ vocal progressive wing and more moderate members and leaders. (Ollstein and Cancryn, 4/12)

The Washington Post: Resilient Health-Care Law More Popular Despite Trump’s Repeated Assaults
President Trump has begun a fresh assault on the Affordable Care Act, declaring his intent to come up with a new health-care plan and backing a state-led lawsuit to eliminate the entire law. But Trump and Republicans face a major problem: The 2010 law known as Obamacare has become more popular and enmeshed in the country’s health-care system over time. Thirty-six states and the District of Columbia have expanded Medicaid — including more than a dozen run by Republicans — and 25 million more Americans are insured, with millions more enjoying coverage that is more comprehensive because of the law. (Winfield Cunningham, 4/13)

Stat: Democrats Feud Over Drug Pricing Policy, As Progressives Push To Be Bolder
Democratic leadership and the party’s progressive flank are feuding over how best to lower drug prices. In recent weeks, tensions between the two camps have escalated, and some fights have even spilled into public view. In a high-profile tug of war, lawmakers hoping to strike an accord with the Trump administration have been forced to confront a faction pressing Democrats to instead pursue a bolder progressive agenda — albeit one that the GOP-controlled Senate would surely ignore. (Facher and Florko, 4/15)

Stat: Peter Bach's Crazy Idea: Give Up On Biosimilars. Regulate Prices Instead
[Oeter] Bach, the director for the center for health policy and outcomes at Memorial Sloan Kettering Cancer Center, thinks that biosimilars, the would-be cheaper alternatives to the biologic drugs that are among the industry’s most expensive, are a lost cause. The government has been developing policies to foster a biosimilars market, one that would work like the generics market and ultimately drive down the price of versions of drugs like Epogen, Avastin, and Humira. But Bach and his frequent co-author, Mark Trusheim of the MIT Sloan School of Management, argue in two new blog posts in Health Affairs that it’s time to abandon that approach. (Herper and Silverman, 4/15)

The New York Times: V.A. Officials, And The Nation, Battle An Unrelenting Tide Of Veteran Suicides
Three veterans killed themselves last week on Department of Veterans Affairs health care properties, barely a month after President Trump announced an aggressive task force to address the unremitting problem of veteran suicide. Mr. Trump’s executive order was a tacit acknowledgment of what the deaths rendered obvious: The department has not made a dent in stemming the approximately 20 suicide deaths every day among veterans, about one and a half times more often than those who have not served in the military, according to the most recent statistics available from the department. (Steinhauer, 4/14)

The New York Times: Medicare Aims To Expand Coverage Of Cancer Care. But Is It Enough?
In a major test case, Medicare is poised to cover a promising but expensive new type of cancer treatment, with significant restrictions meant to hold down the cost. Cancer patients, doctors and drug companies are urging the Trump administration to remove the restrictions and broaden coverage so more patients can benefit from the treatment, known as CAR T cell therapy, or CAR-T. But insurance companies are pushing for the restrictions. (Pear, 4/13)

The New York Times: Justice Dept. Declines To Defend Law Against Female Circumcision, Citing Flaws
The Justice Department told a lawmaker this week that it had stopped defending a federal prohibition on female genital mutilation because of flaws in the law, two weeks after it also began fighting the Affordable Care Act in court rather than defend it. The department “reluctantly determined” that it could not appeal a federal judge’s decision to throw out a female circumcision case because the statute outlawing the practice needed to be rewritten, the solicitor general, Noel J. Francisco, wrote in a letter to Senator Dianne Feinstein of California, the top Democrat on the Senate Judiciary Committee. (Benner, 4/12)

The Washington Post: Ohio Heartbeat Bill: U.S. Republicans Hope To Take Advantage Of New Supreme Court
North Dakota state lawmakers passed the first “heartbeat” bill in 2013 — a law that banned abortions after the detection of a fetal heartbeat, which can happen as early as six weeks, before a woman even knows she is pregnant. Lower courts ruled it unconstitutional, based on the landmark U.S. Supreme Court ruling in Roe v. Wade, and the high court refused to hear the appeal. Iowa passed a similar bill last year, and a state judge declared it unconstitutional, too. (Mettler, 4/12)

NPR: State Abortion Foes Split Over How Best To Test Roe V. Wade
The new anti-abortion tilt of the U.S. Supreme Court has inspired some states to further restrict the procedure during the first trimester of pregnancy and move to outlaw abortion entirely if Roe v. Wade ever falls. But the rush to regulate has exposed division among groups and lawmakers who consider themselves staunch abortion opponents. On Thursday, Ohio became the latest state to ban abortions after a fetal heartbeat can be detected. For a long time, Ohio Right to Life supported a more gradual approach to restrict the procedure and deemed what's come to be called a "heartbeat bill" too radical — until this year. (Farmer and Fortier, 4/12)

The Associated Press: Unsuccessful Abortions Focus Of Bill In N. Carolina Senate
The abortion debate is intensifying in North Carolina over a Republican measure supporters say will ensure doctors care properly for live babies delivered in unsuccessful abortions. Abortion-rights activists argue the proposal slated for state Senate floor debate late Monday is unnecessary for a non-existent problem and is designed to intimidate physicians and women who need medically necessary later-term abortions. (4/15)

Modern Healthcare: Patrick Kennedy Pressuring Insurers To Boost Mental Healthcare
Patrick Kennedy, son of the late Sen. Ted Kennedy, co-sponsored the 2008 Mental Health Parity and Addiction Equity Act while serving as a Democratic congressman from Rhode Island. In 2013, he founded the not-for-profit Kennedy Forum to support parity in health insurance coverage for behavioral and addiction treatment and advance evidence-based practices. Kennedy, who wrote a 2015 memoir about his and his family’s struggles with mental illness and addiction, currently is pushing regulators and large employers to crack down on insurers that discriminate against people who need behavioral care. Kennedy recently spoke with Modern Healthcare senior reporter Harris Meyer. The following is an edited transcript. (Meyer, 4/13)

The New York Times: Measles Outbreak Illustrates De Blasio’s Complex Relationship With Ultra-Orthodox Jews
Mayor Bill de Blasio has fostered a close relationship with the city’s ultra-Orthodox Jewish community during his political rise in New York. He represented the Orthodox neighborhood of Borough Park, Brooklyn, when he sat on the City Council, and that community coalesced behind Mr. de Blasio when he ran for public advocate and then mayor. Mr. de Blasio has courted donors from the Orthodox community and gave at least two of them, Jona S. Rechnitz and Jeremiah Reichberg, spots on his first inauguration committee. (Mays, 4/15)

The Wall Street Journal: The Struggle To Fight Measles In Close-Knit Communities
In 2017 it was a Somali community in Minnesota. In 2014 it was the Amish in Ohio. This year, it is Orthodox Jewish communities in New York and Eastern Europeans in Washington state. Insular and close-knit religious or cultural groups have seen some of the worst measles outbreaks in the U.S. in recent years. About 75% of measles outbreaks over the past five years—defined as three or more linked cases—took place in such tightknit communities, says Nancy Messonnier, acting director of the CDC’s Center for Preparedness and Response, and an expert on immunization and respiratory diseases. (Reddy, 4/15)

The Wall Street Journal: As Measles Spreads, Schools Turn Away Unvaccinated Students
Some school districts in the U.S. are booting unvaccinated students from campuses where infectious-disease cases have been confirmed, as the spread of measles accelerates in some states. Birmingham Public Schools in Michigan recently told families with students at Derby Middle School that students who are unvaccinated against measles have to stay out of school for 21 days after one child was diagnosed with the disease. (Hobbs, 4/13)

The Associated Press: Migrants Dropped Off In New Mexico; City Asks For Donations
Border Patrol agents dropped off asylum-seeking migrants in New Mexico's second most populous city for the second day in a row Saturday, prompting Las Cruces city officials to appeal for donations of food and personal hygiene items and a state medical program to seek volunteers to provide health assessments of migrants. The migrants were being temporarily housed at a homeless shelter in Las Cruces, a city recreation center and a campus of social service agencies, city officials said in a statement. (4/13)

Stateline: Southern States Slowly Embracing Harm Reduction To Curb Opioid Epidemic 
Since the 1990s, activists in cities such as Chicago, San Francisco and New York have led the nation in practicing harm reduction, a set of tools such as needle exchanges and naloxone distribution designed to help people addicted to drugs make incremental improvements to their health. But in the Bible Belt, many Southerners who held conservative views often criticized harm reduction as something that encouraged — not ended — the use of drugs. Those practices, in many states, were banned outright. But attitudes have shifted, given the sheer scale of the epidemic, proof that some harm reduction efforts save lives as well as taxpayer dollars, and the changing cultural view of drug users. (Blau, 4/15)

The Associated Press: Insider Q&A: American Addiction Centers CEO Talks Treatment
The tools for treating drug addiction are there — they just aren't reaching most of the people who need them. That's the conclusion reached by the National Academies in a report last month on the opioid epidemic: only a fraction of the estimated 2 million Americans addicted to opioids — including heroin, fetanyl and prescription painkillers — receive medications proven to help manage their condition. It's a predicament long recognized by addiction specialists. Just 38 percent of U.S. counties have a clinic for treating addiction to drugs, alcohol and other substances, according to federal figures. (4/14)

NPR: Legal Battle Over Philadelphia's Proposed Safe Injection Site Heats Up
A nonprofit group in Philadelphia is fighting in court to be allowed to open the first facility in the country for people to use illegal opioids under medical supervision. The group, called Safehouse, has the backing of local government, yet faces a legal challenge from federal prosecutors. The idea of supervised injection sites is to offer people a space where they can use drugs under the supervision of trained medical staff, who are prepared with the overdose-reversal drug naloxone. (Allyn, 4/13)

The Washington Post: New Campaign Seeks To Help Pregnant Opioid Users
A new campaign has launched in Virginia to help pregnant mothers who abuse opioids or other drugs. The Roanoke Times reports that several groups have partnered to launch an effort to connect women with recovery programs. The program is called “Mother-up” and its website is mother-up.org. Participating groups include the Children’s Trust, Carilion Clinic and the Virginia Department of Social Services. (4/15)

NPR: FDA AI Challenge: How To Assess Safety And Effectiveness
When Merdis Wells visited the diabetes clinic at the University Medical Center in New Orleans about a year ago, a nurse practitioner checked her eyes to look for signs of diabetic retinopathy, the most common cause of blindness. At her next visit, in February of this year, artificial intelligence software made the call. The clinic had just installed a system that's designed to identify patients who need follow-up attention. (Harris, 4/14)

Reuters: FDA Pulls Up Walmart, Kroger, Others For Selling Tobacco To Minors
The U.S. Food and Drug Administration (FDA) said on Friday it has sent letters to Walmart Inc, Kroger Co and 10 other convenience store chains for selling tobacco products to minors. In the letters, dated April 5, the FDA asked the companies to submit a plan of action within 30 days, describing how they will address and mitigate illegal sales to minors. (4/13)

The Washington Post: CDC Blames Ground Beef For Mystery E. Coli Outbreak That Sickened More Than 100 People In 6 States
The Centers for Disease Control and Prevention said Friday that E. coli-contaminated ground beef was the suspected culprit in an outbreak that infected at least 109 people in six states. Investigators are a step closer to tracking down the source of contamination that has perplexed them since health officials in Kentucky and Georgia notified them on March 28. The CDC said 17 people have been hospitalized, though no deaths have been reported. (Horton, Brice-Saddler and Sun, 4/12)

The New York Times: Gene-Edited Babies: What A Chinese Scientist Told An American Mentor
“Success!” read the subject line of the email. The text, in imperfect English, began: “Good News! The women is pregnant, the genome editing success!” The sender was He Jiankui, an ambitious, young Chinese scientist. The recipient was his former academic adviser, Stephen Quake, a star Stanford bioengineer and inventor. “Wow, that’s quite an achievement!” Dr. Quake wrote back. “Hopefully she will carry to term...” (Belluck, 4/14)

The Associated Press: Study Finds Diabetes Drug May Prevent, Slow Kidney Disease
A drug that's used to help control blood sugar in people with diabetes has now been shown to help prevent or slow kidney disease, which causes millions of deaths each year and requires hundreds of thousands of people to use dialysis to stay alive. Doctors say it's hard to overstate the importance of this study, and what it means for curbing this problem, which is growing because of the obesity epidemic. (Marchione, 4/14)

The Wall Street Journal: Fisher-Price Rock ‘N Play Sleepers Recalled Over Deaths
Fisher-Price’s Rock ‘n Play sleepers are being pulled off the market following more than 30 reports of infant deaths, a consumer-safety watchdog said Friday. The recall covers all models—4.7 million products in all—and follows the American Academy of Pediatrics’ call for an immediate recall, citing an investigation from influential product reviewer Consumer Reports that linked 36 deaths to the inclined sleepers. (Armental, 4/12)

The New York Times: You Need Vitamin D To Live. How Could This Woman Survive With None In Her Blood?
In 1992, a 33-year-old Lebanese woman had just immigrated to Canada and went to see a doctor. She was hunched over, and had limited mobility in her lower back, neck, shoulders and hips. Her doctor, Raymond Lewkonia at the University of Calgary, diagnosed her with ankylosing spondylitis, a medical condition that causes vertebrae in her spine to fuse, and thought that was it. Then, about eight years later, the woman had a series of fractures in her ribs, feet, left arm and right hip. Her doctor had her take vitamin D supplements, but they had no effect: Lab tests revealed that she didn’t have any vitamin D circulating around in her blood. (Yan, 4/13)

The New York Times: Doctors Use Electrical Implant To Aid Brain-Damaged Woman
More than 3 million Americans live with disabling brain injuries. The vast majority of these individuals are lost to the medical system soon after their initial treatment, to be cared for by family or to fend for themselves, managing fatigue, attention and concentration problems with little hope of improvement. On Saturday, a team of scientists reported a glimmer of hope. Using an implant that stimulates activity in key areas of the brain, they restored near-normal levels of brain function to a middle-aged woman who was severely injured in a car accident 18 years ago. (Carey, 4/13)

The New York Times: After A Hip Fracture, Reducing The Risk Of A Recurrence
Just as lightning can strike the same target more than once in a given storm, hip fractures can and do happen again to the same person. Yet, more often than not, people who fracture a hip do not get follow-up treatment that could prevent another fracture. Studies have shown that after a hip fracture is repaired, patients often fall through the cracks, leaving them at risk of a recurrence. The surgeon’s job ends with fixing or, more likely, replacing the broken hip. It’s then up to the patient’s personal physician to recommend and prescribe measures to help prevent a second fracture. (Brody, 4/15)

The Washington Post: Tracking A Sensitive Topic: Menstrual Health In Women
Menstruation may be commonplace, but it presents ­extraordinary challenges to ­people living in lower-income countries. According to UNICEF, at least 500 million women and girls worldwide lack adequate facilities for managing menstruation. And comfortable, effective menstrual supplies aren’t available to everyone with a period. People who care about ­menstrual health management want to change that. And the International Menstrual Health Entrepreneurship Roundup ­(IMHER) is tracking their efforts. (Blakemore, 4/13)

NPR: High Stress Can Lead To Heart Attacks, Sibling Study Finds. Here's How To Relax
Work Stress. Home Stress. Financial Stress. The toll of chronic stress isn't limited to emotional suffering. High stress can set the stage for heart disease. If fact, research shows that those of us who perceive a lot of stress in our lives are at higher risk of heart attacks and other cardiovascular problems over the long term. (Aubrey, 4/14)

The New York Times: Healing Your Feet, And Finding A Balance In Following Doctor’s Orders
People rarely follow a doctor’s orders to the letter. We often seek treatments that meet our preferences, and adapt them to our personal routines and responsibilities. This isn’t necessarily a problem. A treatment you don’t (or can’t) follow won’t help you, so the odds are better if you pick one you can. (Frakt, 4/15)

NPR: For Anxious Kids, Parents May Need To Learn To Let Them Face Their Fears
The first time Jessica Calise can remember her 9-year-old son Joseph's anxiety spiking was about a year ago, when he had to perform at a school concert. He said his stomach hurt and he might throw up. "We spent the whole performance in the bathroom," she recalls. After that, Joseph struggled whenever he had to do something alone, like showering or sleeping in his bedroom. He would beg his parents to sit outside the bathroom door or let him sleep in their bed. (Chen, 4/15)

The Associated Press: Mainstream Retailers Embrace CBD Despite Murky Status
Mainstream retailers are leaping into the world of products like skin creams and oils that tout such benefits as reducing anxiety and helping you sleep. The key ingredient? CBD, or cannabidiol, a compound derived from hemp and marijuana that doesn't cause a high. Retailers are taking advantage of the booming industry even as its legal status and health benefits remain murky. (4/15)

The Washington Post: Obesity Becoming No. 1 Preventable Cancer Cause
Smoking has been the No. 1 preventable cause of cancer for decades and still kills more than 500,000 people a year in the United States. But obesity is poised to take the top spot, as Americans’ waistlines continue to expand while tobacco use plummets. The switch could occur in five or 10 years, said Otis Brawley, a Johns Hopkins oncologist and former chief medical officer of the American Cancer Society. The rise in obesity rates could threaten the steady decline in cancer death rates since the early 1990s, he said. (McGinley, 4/14)

The Washington Post: Multiple Primary Cancers Can Afflict One Patient
Noelle Johnson, 42, was diagnosed with her first cancer — a soft tissue sarcoma under her right arm — in 1999 when she was 21. In 2013, her physicians found six different cancers in her breasts. In the years that followed, surgeons discovered and removed numerous masses they deemed “premalignant” from her ovary, her uterus, her leg, arm and chest wall, aiming to get them out before they turned cancerous. Each tumor was distinct, that is, none resulted from the spread of any of the others. For Johnson, having multiple primary tumors diagnosed at an unusually young age was both scary and baffling. “It was crazy,” recalls Johnson, who lives in Windsor, Col., where she operates a day-care center in her home. “My world started to spin. It was a huge red flag.” (Cimons, 4/14)

The Washington Post: Breast Implants And The Link To A Rare Type Of Lymphoma
In 2016, Jennifer Cook, a California schoolteacher who had breast implants in 2010, noticed a change in one of her breasts. So when a school play she attended with her class had a line in it about breast cancer and implants, she got nervous. After a quick online search turned up some scary stories, she got scanned and soon learned she had four masses around the implant — two of which were behind the implant, and therefore not palpable and not visible on a regular mammogram or ultrasound. She was diagnosed with something called breast implant-associated anaplastic large cell lymphoma, or BIA-ALCL. (Berger, 4/13)

The Washington Post: New Cancer Therapies Offer Great Hope, But Have Complications
When thinking about cancer therapy in recent years, Dorothy’s famous line from “The Wizard of Oz” comes to my mind: “We’re not in Kansas anymore.” Most fellows in oncology — including myself — begin their training by caring for patients with leukemia because they need a lot of monitoring. Patients with leukemia often are diagnosed with severe bleeds or infections and need treatment urgently. For decades, treatment for acute leukemia had been largely the same: seven days of a constant drip of drugs through an IV, followed by weeks in the hospital to monitor for complications — kidney problems, infections and other life-threatening side effects. (Parikh, 4/14)

The Washington Post: Cancer Patients Are Helped By Survivors
Families come in all varieties. Some we’re born into; others we get to choose; still others are accidental. Thirty-five years ago, I unwittingly (and unwillingly) joined the Memorial Sloan Kettering Cancer Center family when I became a patient there. On that evening, when I was alone and afraid hours before surgery for metastatic testicular cancer, a young man entered my room in that famous New York hospital wearing a pale blue coat. Alan explained that he was a hospital volunteer, a member of what was then called the “patient-to-patient” program; it took me 30 minutes to realize that meant he was a testicular cancer survivor who had been matched to me. (Petrow, 4/13)

The Washington Post: HPV Vaccine For Older Women Raises Complicated Questions
"Is Gardasil 9 right for me?" my patient asked during a recent office visit. She is 45, recently divorced from her husband of 20 years and crafting her online dating profile. She’s also wondering whether she is a candidate for the vaccine that protects against nine strains of the human papilloma virus (HPV) — a virus that causes most cervical, oral and anal cancer. Ten years ago, L — I’m referring to her by her first initial to protect her privacy — brought her then preteen daughter to a pediatrician to get her immunized against HPV. (Miller, 4/13)

ProPublica: After Baby’s Death, Rhode Island 911 Operators May Receive Enhanced Training
Rhode Island’s state police superintendent is recommending that all of the state’s 911 call takers be trained to provide emergency medical instructions over the phone before first responders arrive. Col. James M. Manni on Friday confirmed that he is asking Gov. Gina Raimondo to have all 34 telecommunicators and eight supervisors in the 911 emergency center certified in emergency medical dispatch, or EMD. EMD certification is required for people who answer emergency medical calls in every other New England state. (Arditi, 4/12)

The Wall Street Journal: California Governor Proposes Fixes To State’s Wildfire Crisis
California Gov. Gavin Newsom on Friday released a suite of proposals for how to confront the soaring wildfire liability costs that pushed PG&E Corp. into bankruptcy and threaten the financial health of the state’s other utilities. The ideas include creating a California wildfire fund to spread costs from fire-related lawsuits, and modifying a state liability standard that makes utilities responsible for damages arising from fires sparked by their equipment, even if they aren’t found negligent in maintaining it. (Blunt, 4/12)

The Associated Press: Strong Storms In US South Kill At Least 8 And Injure Dozens
Powerful storms swept across the South on Sunday after unleashing suspected tornadoes and flooding that killed at least eight people, injured dozens and flattened much of a Texas town. Three children were among the dead. Nearly 90,000 customers were without electricity in Texas, Mississippi, Louisiana, Arkansas, and Georgia as of midday Sunday, according to www.poweroutage.us as the severe weather left a trail of destruction. Two children were killed on a back road in East Texas when a pine tree fell onto the car in which they were riding in a severe thunderstorm Saturday near Pollok, about 150 miles (241 kilometers) southeast of Dallas. (4/14)