First Edition: April 27, 2023

KFF Health News: Expectant Mom Needed $15,000 Overnight To Save Her Twins 
It was Labor Day weekend 2021 when Sara Walsh, who was 24 weeks pregnant with twins, began to experience severe lower-back pain. On Wednesday, a few days later, a maternal-fetal specialist near her home in Winter Haven, Florida, diagnosed Walsh with twin-to-twin transfusion syndrome, a rare complication that occurs when fetuses share blood unevenly through the same placenta. The doctor told her that the fetuses were experiencing cardiac issues and that she should prepare for treatment the following day, Walsh said. (Rayasam, 4/27)

KFF Health News: How One Patient’s Textured Hair Nearly Kept Her From A Needed EEG 
Sadé Lewis of Queens, New York, has suffered migraines since she was a kid, and as she started college, they got worse. A recent change in her insurance left the 27-year-old looking for a new neurologist. That’s when she found West 14 Street MedicalArts in New York. MedicalArts recommended that she get an electroencephalogram (EEG) and an MRI to make sure her brain was functioning properly. (Lofton, 4/27)

KFF Health News: As US Life Expectancy Falls, Experts Cite The Health Impacts Of Incarceration 
After spending 38 years in the Alabama prison system, one of the most violent and crowded in the nation, Larry Jordan felt lucky to live long enough to regain his freedom. The decorated Vietnam War veteran had survived prostate cancer and hepatitis C behind bars when a judge granted him early release late last year. “I never gave up hope,” said Jordan, 74, who lives in Alabama. “I know a lot of people in prison who did.” At least 6,182 people died in state and federal prisons in 2020, a 46% jump from the previous year, according to data recently released by researchers from the UCLA Law Behind Bars Data Project. (Clasen-Kelly, 4/27)

The Washington Post: House Passes GOP Debt Ceiling Bill, As U.S. Inches Toward Fiscal Crisis 
House Republicans on Wednesday approved a bill that would raise the debt ceiling, slash federal spending and repeal President Biden’s programs to combat climate change and reduce student debt, defying Democratic objections in a move that inched the United States closer to a fiscal crisis. Ignoring repeated warnings that the GOP’s brinkmanship could unleash vast economic turmoil, Speaker Kevin McCarthy (R-Calif.) muscled his narrow, quarrelsome majority toward a 217-215 vote, accelerating a high-stakes clash with the White House with as few as six weeks remaining before the government could default. (Romm, Sotomayor and Caldwell, 4/26)

Politico: Why The Senate Isn't Jumping At The Opportunity To End The Debt Crisis
The Senate still isn’t ready to save the day on the debt ceiling. As the House GOP scrambles to pass its ultimately doomed bid to raise the nation’s borrowing limit, across the Capitol almost no one is working to devise legislation that can overcome a Senate filibuster, win a House majority and get President Joe Biden’s signature. And time is ticking: Financial analysts are increasingly worried that the nation could default on its debt by early June if the limit isn’t raised. (Everett, 4/26)

Politico: Biden: I'll Meet With McCarthy — But Not On Debt Limit 
President Joe Biden said Wednesday that he is open to meeting again with House Speaker Kevin McCarthy — but would not give in to the Republican’s demand for negotiations on the debt limit. “Happy to meet with McCarthy,” Biden said at the end of a brief press conference at the White House. “But not on whether or not the debt limit gets extended. That’s not negotiable.” (Cancryn and Haberkorn, 4/26)

CNN: Work Requirements: Republicans Use Debt Ceiling Bill To Push Rules For Millions Receiving Medicaid And Food Stamps
House Republicans are using the debt ceiling standoff to advocate for one of their longstanding goals – requiring more low-income Americans to work in order to receive government benefits, particularly food stamps and Medicaid. They see work requirements as a twofer, allowing them to reduce government spending, while bolstering the nation’s labor force at a time when many businesses are still struggling to staff up. (Luhby, 4/26)

Axios: "Dramatic Disparities" Among Nation's Hungriest
Hunger rates were highest among Black and Latino households, women and adults with disabilities in a snapshot of the COVID-19 pandemic, according to new Centers for Disease Control and Prevention data. The detailed look at who is most vulnerable to food insecurity comes at a time when a long-standing congressional fight over food stamps has become a central issue in the debt limit debate. (Horn-Muller, 4/26)

Stat: Pharma Executives Flood Bill Cassidy With Campaign Cash
Sen. Bill Cassidy’s new perch as the top Republican on the Senate health committee has attracted some attention — and some campaign cash — from the executives of pharmaceutical companies, federal disclosures show. (Cohrs and Owermohle, 4/27)

Stat: Another Powerful Committee In Congress Is Ready To Take On PBMs
House Oversight Committee Chairman James Comer plans to hold a hearing on the results of an investigation into the business practices of drug middlemen, he said Wednesday. Comer is not a fan of pharmacy benefit managers. The Kentucky Republican represents a rural part of the state, and independent pharmacists in rural areas tend to be vehemently opposed to some PBM business practices. (Wilkerson, 4/26)

AP: US Adult Cigarette Smoking Rate Hits New All-Time Low
U.S. cigarette smoking dropped to another all-time low last year, with 1 in 9 adults saying they were current smokers, according to government survey data released Thursday. Meanwhile, electronic cigarette use rose, to about 1 in 17 adults. The preliminary findings from the Centers for Disease Control and Prevention are based on survey responses from more than 27,000 adults. Cigarette smoking is a risk factor for lung cancer, heart disease and stroke, and it’s long been considered the leading cause of preventable death. (Stobbe, 4/27)

CIDRAP: Novavax COVID-19 Vaccine 80% Effective Among US Teens 
The vaccine effectiveness (VE) of the Novavax COVID-19 vaccine was 79.5% among US adolescents before the SARS-CoV-2 Omicron variant emerged, but the monoclonal antibody combo tixagevimab and cilgavimab showed little benefit for nonhospitalized COVID patients, according to two randomized, controlled trials published today in JAMA Network Open. (Van Beusekom, 4/26)

The New York Times: Century-Old TB Vaccine Fails To Protect Against Covid 
An old tuberculosis vaccine known to bolster the immune system did not prevent Covid infections among health care workers, scientists reported on Thursday. But the trial was shorter and smaller than originally designed, and the investigators said that the results did not rule out other potential benefits associated with the vaccine, known as B.C.G. for bacille Calmette-Guerin. (Rabin, 4/26)

Reuters: Second Judge Says US Not Liable In Moderna COVID-19 Vaccine Patent Case 
Moderna Inc failed to persuade a Delaware federal judge on Wednesday to shift liability from the company to the U.S. government for alleged patent infringement by Moderna's COVID-19 vaccine. (Brittain, 4/26)

AP: Ban On COVID Vaccine Mandates Clears North Carolina House 
State agencies and local governments in North Carolina would not be allowed to deny employment to someone who refuses to get vaccinated against COVID-19 or prove they’ve been vaccinated, under legislation passed Wednesday by the state House. The bill passed the House 73-41, with three Democrats and all present Republicans voting in favor, and was sent to the Senate. (4/26)

Chicago Tribune: Illinois’ Blue Cross Will Stop Covering At-Home COVID-19 Tests When Public Health Emergency Ends Next Month 
Many Illinois residents will soon have to pay for over-the-counter COVID-19 tests, with the state’s largest insurer saying it will no longer cover them once the federal emergencies for COVID-19 end next month. (Schencker, 4/26)

CIDRAP: Increased Physical Activity Associated With Lower Risk Of Severe COVID-19
A South Korean study shows a complex relationship between moderate to vigorous physical activity (MVPA) and COVID-19, with a regular exercise habit linked to COVID-19 infection early in the pandemic but also associated with a significantly lower risk of developing severe symptoms. The study was published yesterday in JAMA Network Open. (Soucheray, 4/26)

Politico: More Adults Think Access To Abortion Should Be Easier, Pew Report Finds 
The number of adults living in states where abortion is banned or restricted who believe that access to abortion should be easier has grown since 2019, according to a new report from the Pew Research Center. In states that implemented bans on nearly all abortions after the Dobbs decision last year, 43 percent of adults said they believe it should be easier to get an abortion where they live, compared to 31 percent in 2019. In states that have seen new restrictions, either implemented or tied up in legal disputes, 38 percent believe access should be easier, up from 27 percent in 2019. The numbers are also up in states without any new abortion restrictions, now at 27 percent compared to 24 percent in 2019. (Garrity, 4/26)

Houston Chronicle: Texas Woman Denied Emergency Abortion Blames Cruz, Cornyn In Hearing
In testimony before the Senate Judiciary Committee on Wednesday, one of the five women suing Texas for abortion access blamed the state’s Republican senators for her near-death experience when she was denied reproductive care in the state. (Wermund, 4/26)

AP: Judge Puts Missouri Rule Limiting Transgender Care On Hold 
A Missouri judge on Wednesday temporarily halted enforcement of a first-of-its-kind rule that restricts access to gender-affirming health care for transgender kids and adults, just hours before it was set to take effect. The rule enstated by Republican Attorney General Andrew Bailey places requirements on both minors and adults before they would be allowed to receive gender-affirming treatments, such as puberty blockers or hormones. It was set to take effect Thursday, but transgender Missourians and health care providers sued to stop it from being enforced. (Salter and Ballentine, 4/27)

The Wall Street Journal: Justice Department Sues To Block Tennessee Restrictions On Transgender Healthcare 
The Justice Department filed a lawsuit Wednesday challenging Tennessee’s recent ban on certain healthcare for transgender minors, arguing the law violates the constitutional guarantee of equal protection. The suit targets a law signed last month by Tennessee’s Republican Gov. Bill Lee. Under the measure, doctors are prohibited from providing certain treatments to anyone under 18 even with parental consent if the procedure is used as part of transgender healthcare. (Timms, 4/26)

The New York Times: Efforts To Restrict Transgender Health Care Face Pushback In Three States 
Republican efforts to restrict gender-transitioning treatment hit roadblocks in three states on Wednesday. Kansas lawmakers failed to override the Democratic governor’s veto of a bill that would have banned the care for minors, the Justice Department sued Tennessee over its new ban and a Missouri judge temporarily blocked the enforcement of an emergency rule that would have restricted treatment for transgender children and adults. Across the country, transgender rights have emerged this year as a defining legislative issue, with Republicans enacting sweeping new restrictions in states they control. At least 11 states have passed laws or policies in recent months that ban or significantly limit the use of puberty blockers, cross-sex hormones and transition surgery for people under 18. (Smith, 4/26)

CNN: Montana House Republicans Ban Rep. Zooey Zephyr From House Chamber For Remainder Of Legislative Session 
Montana’s Republican-dominated House voted Wednesday to ban Rep. Zooey Zephyr, who had said GOP lawmakers would have “blood” on their hands for passing bills restricting transgender rights and rallied protesters Monday after Speaker Matt Regier blocked her from being recognized to speak, from the House chamber for the remainder of this year’s legislative session. Under the disciplinary measure approved on a 68-32 vote Wednesday, Zephyr – the 34-year-old Democrat from Missoula who last year became the first openly transgender woman elected to Montana’s legislature – will be allowed to retain her seat and cast votes remotely. But she will not be able to participate in debates. The session is scheduled to end next week. (Bradner, 4/26)

AP: First Pill For Fecal Transplants Wins FDA Approval 
U.S. health officials on Wednesday approved the first pill made from healthy bacteria found in human waste to fight dangerous gut infections — an easier way of performing so-called fecal transplants. The new treatment from Seres Therapeutics provides a simpler, rigorously tested version of stool-based procedures that some medical specialists have used for more than a decade to help patients. The Food and Drug Administration cleared the capsules for adults 18 and older who face risks from repeat infections with Clostridium difficile, a bacteria that can cause severe nausea, cramping and diarrhea. (Perrone, 4/27)

Stat: Early Look At Gene Therapy Death Suggests CRISPR Wasn't Cause
In February, four months after the first patient in the trial of a designer CRISPR therapy suddenly died, around 100 researchers gathered in a Tucson, Ariz., conference hall to hear investigators in the study walk through the results of an autopsy. (Mast, 4/26)

Bloomberg: Penicillin Shortage In US As Syphilis, Strep Cases Rise 
A common type of penicillin used to treat syphilis is in short supply in the US as cases of the sexually transmitted disease continue to rise. Penicillin G benzathine, an antibiotic sold in the US by Pfizer Inc., was added to the Food and Drug Administration’s shortage list on Wednesday. Pfizer has limited supply of the drug because of increased demand, according to the agency, and the situation may persist into September. (Swetlitz, 4/26)

CIDRAP: Some Critical Drugs Have Been In Shortage For More Than 8 Years 
At least 20 critical drugs have been intermittently in shortage since 2015, according to the American Society of Health-System Pharmacists (ASHP) database. All but three of these drugs are also on the Resilient Drug Supply Project's (RDSP's) Critical Acute and COVID-19 Drug List. The US Food and Drug Administration's (FDA's) drug shortage database includes some, but not all, of the drugs as being in shortage. (Van Beusekom, 4/26)

Modern Healthcare: Kaiser Foundation, Geisinger Health Launch Nonprofit To Buy Hospitals
Kaiser Foundation Hospitals and Geisinger Health are launching a nonprofit entity to acquire health systems and create a national network for value-based care. The entity, named Risant Health and headquartered in Washington, D.C., will become an affiliate of Oakland, California-based Kaiser but will operate as a separate organization from Kaiser's core integrated operations. (Hudson, 4/26)

Modern Healthcare: Walmart Health Expands Into Oklahoma 
Walmart Health plans to add four health centers in Oklahoma City in 2024, adding another state to its growing footprint. The new centers will be about 5,800 square feet each and located next to Walmart Supercenters, the mega-retailer said Wednesday. They will offer primary care, lab, X-ray, behavioral health, dental and hearing services, among others, although the offerings may vary by location. (Hudson, 4/26)

Modern Healthcare: Universal Health Services Considers Expansion As Staff Shortage Eases
Patient volumes rebounded and staff shortages began to moderate in the first quarter at Universal Health Services, signaling what CEO Marc Miller on Wednesday called a "year of continued transition into a post-pandemic world." Universal Health, a King of Prussia, Pennsylvania-based for-profit system, reported more patients in acute care and behavioral health during the first quarter. Same-facility admissions in behavioral health grew 7.5% from a year ago, while acute care admissions jumped 7.2%. (Hudson, 4/26) 

Stat: Health Insurance CEOs Set Another Record For Pay In 2022
Business has never been better for the largest health insurers in the country, which led to another record-setting windfall last year for their chief executives. (Herman, 4/27)

North Carolina Health News: Contentious Blue Cross NC Bill Sails Through Legislature
A bill that would allow the state’s largest health insurer to restructure its corporate model has progressed quickly through North Carolina House of Representatives committees over the past two days, and it appears to be sailing toward becoming law. House Bill 346 would give Blue Cross Blue Shield of North Carolina the leeway to create a nonprofit holding company that would become a parent to the 90-year-old insurance company and to any of Blue Cross NC’s current and future subsidiaries. (Hoban, 4/27)

Modern Healthcare: CMS Hospital Price Transparency Enforcement Toughened
The Centers for Medicare and Medicaid Services is strengthening enforcement of its hospital transparency rule by imposing stricter timelines and levying fines more quickly, the agency announced Wednesday. (Turner, 4/26)

AP: Feds Wrote $128M In Duplicate Checks To Docs, Report Finds
The federal government wrote duplicate checks to doctors who provided care for veterans, costing taxpayers as much as $128 million in extra payments, according to a new watchdog report out this week. In nearly 300,000 cases, private doctors were paid twice — once by the Veterans Health Administration and another time by Medicare — for the same care provided to veterans from 2017 to 2021, the Health and Human Services Office of Inspector General found in its report. There’s been a spike in those duplicate payments since 2020, when the program that allows veterans to seek care from private doctors was expanded. (Seitz, 4/27)

Stat: A Research Team Airs The Messy Truth About AI In Medicine
In public, hospitals rave about artificial intelligence. They trumpet the technology in press releases, plaster its use on billboards, and sprinkle AI into speeches touting its ability to detect diseases earlier and make health care faster, better, and cheaper. But on the front lines, the hype is smashing into a starkly different reality. (Ross, 4/27)

USA Today: 4 Dead In Klebsiella Pneumoniae Outbreak At Seattle Hospital
Four patients at a downtown Seattle hospital are dead in connection to an outbreak of a bacteria often found in health care settings that has developed resistance to some antibiotics. The infected patients, who contracted Klebsiella, were hospitalized in various departments, including inpatient medical beds, an ICU, and an operating room at Virginia Mason Medical Center, the hospital said in a statement released Wednesday. (Neysa Alund, 4/26)

The New York Times: California Reconsiders Its Boycotts Of States Over Their L.G.B.T.Q. Laws 
On Tuesday, San Francisco — a bastion of gay and transgender inclusion — repealed its boycott, which had expanded to encompass 30 states that had passed laws targeting L.G.B.T.Q. rights or that had passed abortion restrictions or laws deemed to suppress voters. Unlike California’s ban, the city ordinance had gone beyond travel and prohibited business dealings with identified states. (Cowan, 4/26)

The Washington Post: Jogging And Weight Training Can Help Addiction Recovery, Study Shows
At a moment when substance-use disorders and overdoses are on the rise, new research offers hope for the addicted: People who exercised as part of their addiction treatment programs were substantially more likely to reduce their substance use than those who didn’t. The study, published Wednesday in PLOS One, found that incorporating simple workouts such as jogging or weight training into treatment improved the likelihood of recovery from a variety of substance-use disorders, including to cocaine, opioids, cannabis and alcohol. (Reynolds, 4/26)

USA Today: Uterine Cancer Rapidly Rising In Young, Hispanic Women In The US
For six years, Martha Dejulian Ronquillo suffered severe anemia and depression. The mother of two in her late 30s often called out of work as a housekeeper because of fatigue and pain. During those years, Ronquillo bled daily and heavily outside of her periods. The blood loss led to chronic depression and so much iron deficiency that she needed three iron transfusions. (Hassanein, 4/26)

CNBC: No Prison Yet For Elizabeth Holmes Following Last-Ditch Appeal
Disgraced Theranos founder Elizabeth Holmes will not go to prison this week, despite a judge’s order that she begin serving her 11-year sentence on Thursday. Late Tuesday, Holmes’ attorneys appealed that ruling to the U.S. 9th Circuit Court of Appeals in San Francisco. Under the court’s rules, that means Holmes will remain free on bail for now. (Cohn, 4/26)