First Edition: April 3, 2019

Kaiser Health News: Fixing Surprise Medical Bill Problem Shouldn’t Fall To Consumers, Panel Told
One point drew clear agreement Tuesday during a House subcommittee hearing: When it comes to the problem of surprise medical bills, the solution must protect patients — not demand that they be great negotiators. “It is the providers and insurers, not patients, who should bear the burden of settling on a fair payment,” said Frederick Isasi, the executive director of Families USA. He was one of the witnesses who testified before the House Health, Employment, Labor and Pensions subcommittee of the Education & Labor Committee. (Bluth, 4/2)

California Healthline: Finding Homeless Patients A Place To Heal
After they amputated the second toe on John Trumbla’s right foot last summer, doctors sent him to a nursing home because he still needed medical care — but not necessarily a hospital bed. The proud, burly Army veteran resisted at first, but he didn’t have a choice. Before his hospitalization at Santa Clara Valley Medical Center, Trumbla, 56, and his wife had been homeless, crashing in his boss’s construction shop or living out of their station wagon. (Ibarra, 4/2)

Kaiser Health News: Readers And Tweeters Chime In On Investigation Of Electronic Health Records
Empowered by the digital revolution, the U.S. government claimed that turning American medical charts into electronic records would make health care better, safer and cheaper. Ten years and $36 billion later, the system is an unholy mess. KHN partnered with Fortune magazine to investigate this botched operation. The resulting story, “Death By 1,000 Clicks: Where Electronic Health Records Went Wrong” (March 18), proved clicky on social media. Even Seema Verma, administrator of the Centers for Medicare & Medicaid Services, who was interviewed for the feature, tweeted it out. (4/3)

The New York Times: Trump Retreats On Health Care After McConnell Warns It Won’t Happen
President Trump backed off plans to introduce a Republican replacement for the Affordable Care Act after Senator Mitch McConnell privately warned him that the Senate would not revisit health care in a comprehensive way before the November 2020 elections. Reversing himself in the face of Republican consternation, Mr. Trump said his party would not produce a health care plan of its own, as he had promised, until after the elections, meaning he will only try to fulfill his first-term promise to repeal and replace his predecessor’s signature program if he wins a second term. (Pear and Haberman, 4/2)

The Associated Press: 'Obamacare' Repeal Off The Table For GOP Until After 2020
"Not any longer." And with that, a triumphant Senate Majority Leader Mitch McConnell appeared to close the book Tuesday on a divisive Republican debate, convincing President Donald Trump to shelve plans to replace the Affordable Care Act until after the 2020 election. "I made it clear to him that we were not going to be doing that in the Senate," McConnell told reporters. (Mascaro and Lucey, 4/3)

The Hill: McConnell To Trump: We're Not Repealing And Replacing ObamaCare
“We had a good conversation yesterday afternoon and I pointed out to him the Senate Republicans’ view on dealing with comprehensive health care reform with a Democratic House of Representatives,” McConnell told reporters Tuesday, describing his conversation with Trump. (Bolton, 4/2)

The Washington Post: Trump Leaves Washington Reeling With Policy Whiplash As He Struggles With Domestic Agenda
The battles illustrate the difficulties Trump and Republicans have had in adjusting to Democratic control of the House after two years of uncontested GOP power in Congress and the White House. But many Republicans say they have adapted to the pandemonium — learning to privately sway Trump by warning him of the consequences of his policy declarations, many of which are launched in late-night or early-morning tweets. GOP lawmakers, for instance, think they have successfully headed off any major health-care effort, which they fear would open them up to damaging Democratic attacks. Even so, a legal challenge targeting the Obama-era health law, and backed by the Trump administration, virtually ensures that the issue will remain at the forefront of the president’s reelection campaign. (Kim and Werner, 4/2)

The Wall Street Journal: GOP Puts Off Unveiling New Health Plan Until After 2020 Election
Heading into the campaign season, the GOP is now on track to pursue targeted measures aimed at lowering drug prices and out-of-pocket costs, as well as attacking such ideas as Medicare for All. Democrats are focused on driving down costs and defending the ACA against GOP-led legal attacks, with some in the party floating broader health-care proposals such as a government-run health system. (Armour and Peterson, 4/2)

The Associated Press: Trump Tells Republicans To Embrace Health Care In 2020 Race
President Donald Trump told House Republicans on Tuesday that they need to embrace health care reform and make it the first thing they vote on following the 2020 election. Speaking at an annual fundraiser for the National Republican Congressional Committee, Trump told GOP lawmakers and supporters they have the advantage on a variety of issues, but conceded that Democrats have the advantage on health care. "We have to take that away from them," Trump said. (4/2)

The Associated Press: Pivoting On Pledges, Trump Explores Art Of The Climb-Down
His border shutdown went from imminent to uncertain. A major health-care push was declared and then delayed. Funding cuts were inserted in his proposed budget and just as quickly taken out. President Donald Trump has been exploring the art of the climb-down. Trump pivoted on two big policy fronts this week, easing up on his threats to quickly close the southern border and deciding that a fresh effort to repeal and replace the Affordable Care Act should wait until after the 2020 election. (4/3)

ProPublica: Trump, All About Winning, Sees Losses In Court Pile Up
The drumbeat of defeats grew hard to ignore. A federal judge struck down the Donald Trump administration’s plan to require some people to work for their Medicaid benefits. Another judge halted Trump’s plan to open Arctic waters to drilling. Yet another ordered an end to what critics said was the administration’s efforts to encourage an end run around the Affordable Care Act. All in the span of about a week. (Sexton, 4/2)

The Hill: Judge Allows Wisconsin To Withdraw From Two Lawsuits Against ObamaCare
A federal court has allowed Wisconsin's Democratic attorney general to withdraw the state from a pair of lawsuits challenging the Affordable Care Act, also known as ObamaCare. Josh Kaul's office announced Tuesday that the U.S. District Court in Northern Texas granted Kaul's request to remove Wisconsin from two lawsuits the state is involved that challenge the health care law, according to the Wisconsin State Journal. (Burke, 4/2)

The Hill: Democrats Rally At Supreme Court Ahead Of ObamaCare Vote 
House and Senate Democrats rallied on the steps of the Supreme Court Tuesday ahead of a vote on a resolution asking the Department of Justice (DOJ) to reverse its decision to side with a lower court ruling ObamaCare unconstitutional. The symbolic resolution will likely pass the Democratic-controlled House Wednesday, but it won't get a vote in the Senate, where Republicans are in the majority. (Hellmann, 4/2)

The New York Times: Trump Lashes Out Again At Puerto Rico, Bewildering The Island
President Trump on Tuesday lashed out at Puerto Rico’s local lawmakers as “grossly incompetent” and singled out one of his favorite targets, Carmen Yulín Cruz, the mayor of San Juan, as “crazed and incompetent.” Mr. Trump’s latest invective toward the local leaders of an island devastated by a hurricane in September 2017 came in a torrent of tweets, which began on Monday night and spilled into Tuesday morning. Mr. Trump was reacting after the Senate on Monday blocked billions of dollars in disaster aid for Midwestern states, in part because Democrats said a proposed $600 million in nutritional assistance to Puerto Rico fell short of its needs. (Karni and Mazzei, 4/2)

The Wall Street Journal: Congress Looks To Tackle Surprise Medical Bills
A push to curb surprise medical bills has found support among both Democrats and Republicans on Capitol Hill but also ignited a fight within the health-care industry over how far the federal government should go in regulating prices. While President Trump and members of Congress are sharply divided over U.S. health-care policy more broadly, they have largely come together over the need to tackle surprise bills, which can leave patients with thousands of dollars in unexpected charges. The House Education and Labor Committee held a hearing Tuesday on protecting patients from surprise charges. (Armour, 4/2)

The Hill: Democratic Senators Unveil 'Medicare X' Bill To Expand Coverage
Two Democratic senators rolled out a proposal Tuesday that would allow anyone to buy Medicare plans, a proposal they say is a more realistic than proposals like Medicare for all that would eliminate private insurance companies and reshape the American health care system. The introduction of “Medicare X” comes as the Democratic Party debates its next steps on health care, with the left wing of the caucus pushing for a single-payer "Medicare for all" system and more moderate members supporting efforts to strengthen the Affordable Care Act (ACA). (Hellmann, 4/2)

Politico: Progressive Leader Confronts Pelosi Aide Over 'Medicare For All'
Congressional Progressive Caucus co-chair Pramila Jayapal (D-Wash.) on Tuesday confronted a top aide to Speaker Nancy Pelosi, expressing frustration over his private dismissals of "Medicare for All" legislation. Jayapal, a lead author of the plan, H.R. 1384, told Wendell Primus, who serves as Pelosi's senior health policy adviser, that she did not appreciate what she perceived as his efforts to undermine lawmakers’ bills. Jayapal pressed him to explain reports that he made disdainful remarks about the proposal in separate meetings with health policy researchers and insurance executives. (Cancryn, 4/2)

The Hill: Insulin Manufacturers To Testify As Part Of House Pricing Probe
The only three companies that manufacture insulin in the United States will testify in the House next week about their pricing practices. Rep. Diana DeGette (D-Colo.), chairwoman of the House Energy and Commerce oversight subcommittee, said the three companies— Eli Lilly, Novo Nordisk and Sanofi— will testify April 10. (Weixel, 4/2)

The Hill: Progressive House Dems Meet With Pelosi Staffer To Push For Tough Drug Pricing Bill
House Democratic members of the Progressive Caucus met with a top aide to Speaker Nancy Pelosi (D-Calif.) on Tuesday and pushed for a controversial, progressive bill to lower drug prices. The meeting with Wendell Primus, the health care adviser to Pelosi, comes as House Democrats craft legislation on lowering drug prices, one of their signature priorities. (Sullivan, 4/2)

Politico: GOP Makes Long-Shot Push To Force Anti-Abortion Vote
House Republicans on Tuesday launched a long-shot bid to force a vote on anti-abortion legislation — an issue they plan to hammer vulnerable Democrats on even if they can’t secure action on the floor. House Minority Whip Steve Scalise (R-La.), along with Rep. Ann Wagner (R-Mo.), filed a discharge petition to circumvent Democratic leadership and bring the “Born-Alive Abortion Survivors Protection Act” to the floor if it gets 218 signatures. The legislation would require infants who survive attempted abortions to receive medical care. (Zanona, 4/2)

The Hill: Top GOP Lawmaker Moves To Force Floor Vote On Abortion Bill
Scalise and Rep. Ann Wagner (R-Mo.) have been leading GOP efforts to advance the Born-Alive Abortion Survivors Protection Act, which was reintroduced earlier this year. The two lawmakers have expressed confidence in their ability to garner the 218 signatures needed to implement the discharge petition, a rarely successful procedural tool. (Brufke, 4/2)

The Associated Press: Kentucky Judge Rules Against Unvaccinated Student In Lawsuit
A Kentucky judge has ruled against a student who sued after he wasn’t allowed to play basketball because he wasn’t vaccinated for chickenpox. In the lawsuit against the Northern Kentucky Health Department, 18-year-old Jerome Kunkel claimed the vaccine is against his religious beliefs. WXIX-TV in Cincinnati reports Boone County Circuit Judge James R. Schrand on Tuesday denied Kunkel’s request to return to school activities. (4/2)

The Associated Press: Alyssa Milano Leads Protest Of Georgia Abortion Ban
Actress Alyssa Milano has joined several Georgia-based TV and film industry workers in protesting a “heartbeat” abortion ban awaiting Republican Gov. Brian Kemp’s signature. Milano delivered a letter signed by other prominent Hollywood actors to Kemp’s office Tuesday before speaking against the bill. Republican Rep. Dominic LaRiccia confronted Milano in a packed reception area in front of Kemp’s office and asked her which Georgia district she votes in. (4/2)

The Associated Press: Kansas Expansion Foes Signal Nervousness With Medicaid Move
Top Republican lawmakers in Kansas appear skittish about being able to block Medicaid expansion, offering political cover to moderate GOP colleagues if they back off their push for an expansion this year. State Senate President Susan Wagle told reporters Tuesday that GOP leaders plan to have a legislative committee study Medicaid expansion this summer and fall. She said the panel would review proposals that could generate broader support among Republicans, such as a work requirement or drug testing for people receiving the expanded coverage. (4/2)

The Associated Press: Arkansas Lawmakers Vote To Keep Medicaid Plan After Ruling
Arkansas lawmakers voted Tuesday to keep the state's Medicaid expansion another year, days after a court decision blocking the state from enforcing a work requirement put the program's future in limbo. The majority-Republican House voted 75-18 for the budget for Medicaid and the expansion program, sending the legislation to GOP Gov. Asa Hutchinson. The Senate-backed bill on Friday fell short nearly two dozen votes of the 75 needed in the 100-member House to win final approval. (4/2)

Helena (Mont.) Independent Record: Montana Governor Says Medicaid Expansion Bill Isn't Perfect, But Gets His Support
Montana Gov. Steve Bullock said Monday he can support the Medicaid expansion bill that cleared the state House over the weekend, with the inclusion of work requirements. "While it may not be perfect, perfect rarely comes out of this body, and we did a lot of work to try to make sure that we have something that will certainly work for Montana and work for Montanans," said Bullock, a Democrat. (Michels, 4/1)

The Associated Press: Migrant Teen Detention Camp In Florida Expands Once Again
Federal officials are once again expanding a detention camp for migrant children in a Miami suburb as the number of immigrants crossing into the U.S. rises. Florida Democratic Rep. Debbie Wasserman Schulz said in a Tuesday statement that the Trump administration notified members of Congress that its capacity was growing from 2,350 to 3,200. (4/2)

The Associated Press: US Expands 'Catch And Release' Amid Surge In Migrants
The surge of migrant families arriving at the southern border has led the Trump administration to dramatically expand a practice President Donald Trump has long mocked as "catch and release." With immigrant processing and holding centers overwhelmed, the administration is busing people hundreds of miles inland and releasing them at Greyhound stations and churches in cities like Albuquerque, San Antonio and Phoenix because towns close to the border already have more than they can handle. (Attanasio and Galvan, 4/2)

The Associated Press: US Aid Cuts Will Spur Central America Migration, Experts Say
Government officials, aid workers and activists in Central America are mystified by U.S. President Donald Trump's threat to cut off nearly $500 million in aid to Honduras, Guatemala and El Salvador in response to what he calls an immigration crisis. Over time, they say, it will only worsen the problem. At risk of falling on the chopping block are development programs that work to tackle the root causes driving migration: poverty, inequality, violence and corruption. (Aleman, 4/2)

The Associated Press: Family Behind OxyContin Calls Opioid Suit False, Misleading
Massachusetts authorities created a false picture of the Sackler family's role in promoting OxyContin, the Sacklers said Tuesday in their first court response to allegations that individual family members — not just their company, Purdue Pharma — helped fuel the deadly opioid epidemic. The Sackler family says a lawsuit filed by Massachusetts Attorney General Maura Healey that accuses Connecticut-based Purdue Pharma and the family of hiding the risks of opioids from doctors and patients is riddled with inaccurate and misleading statements. The Sacklers are accusing Healey of cherry picking from hundreds of internal documents in an attempt to wrongly vilify the family for the public health crisis. (4/2)

The Associated Press: Walgreens Lowers 2019 Expectations After 2Q Forecast Miss
Walgreens slashed its 2019 forecast and missed second-quarter expectations with a performance that sent its shares plunging Tuesday and helped knock down the Dow Jones Industrial Average. Company leaders told analysts that challenges they had been expecting like reimbursement cuts and lower price increases for branded drugs hit Walgreens much sooner than they anticipated. (4/2)

Reuters: Walgreens Cuts 2019 Profit Forecast, Hit By Lower Drug Prices
The drop in shares to a more than five-year low wiped off nearly $8 billion from the market capitalization of the worst performing stock in the Dow Jones Industrial Average this year, and weighed on shares of rival CVS Health Corp and drug wholesalers. Drug retailers like Walgreens and CVS Health have been squeezed by reimbursement pressure as their pharmacies receive less for filing prescriptions coupled with a steep decline in generic drug prices for several years. (4/2)

The Wall Street Journal: Generic-Drug Trends Squeeze Walgreens Profit
Smaller profit from the sale of generic drugs is squeezing the two biggest U.S. pharmacy chains, with Walgreens Boots Alliance Inc. joining rival CVS Health Corp. in lowering earnings goals for the year. Walgreens cut its forecast on Tuesday after experiencing what the company described as its most difficult quarter since the 2014 merger of Walgreens and Alliance Boots. Its shares fell 13% on Tuesday, while CVS lost 3.8%, extending a slump dating to late February when the drugstore chain lowered its 2019 profit target. (Terlep and Walker, 4/2)

Reuters: Bayer Board Says Pursuit Of Monsanto Was Done Diligently
Bayer's non-executive board reaffirmed its support for top management's decision to acquire seed maker Monsanto last year, after losing high-profile lawsuits to U.S. plaintiffs who claimed Monsanto's Roundup weedkiller caused their cancer. In documents posted on the company's website on Monday, the non-executive supervisory board said an expert opinion it commissioned from lawfirm Linklaters found that Bayer's management had complied with their duties when acquiring Monsanto for $63 billion last year. (4/2)

Reuters: To Save Time And Money, Companies Roll Out Caregiving Benefits
When Laura Hirsch of Keller Texas had to find a rehabilitation center to help her father recover from a difficult surgery in September, the caregiving service Cariloop saved her a whole day. A case manager at Cariloop, based in Richardson, Texas, sorted through more than a dozen rehab facility options, then armed Hirsch with the right questions to ask when choosing among the final contenders. (Pinsker, 4/2)

The New York Times: Drug Sites Upend Doctor-Patient Relations: ‘It’s Restaurant-Menu Medicine’
The sites promise easy and embarrassment-free access to erectile dysfunction and libido pills. “E.D. meds prescribed online, delivered to your door,” one said recently. “Starting at $2 per dose.” “Low sex drive? That can be optional,” another one said. “Try today — $99.” The sites, Roman and Hers, as well as others now make obtaining lifestyle drugs for sexual health, hair loss and anxiety nearly as easy as ordering dinner online. (Singer and Thomas, 4/2)

The Associated Press: US Experts Reviewing Low-Carb, Other Diets For Guidelines
With keto-friendly recipes sweeping social media, some followers of low-carb eating are hoping for a nod of approval in the upcoming U.S. dietary guidelines that advise Americans on what to eat. It may seem minor, but backers say low-carb's inclusion could influence nutrition advice that doctors give and help shape government food programs like school lunches. Currently, the guidelines cite the Mediterranean, vegetarian and other diets as examples of healthy eating. "The main point is to get away from a one-size-fits-all diet," said Nina Teicholz, who has written about low-carb diets. (Choi, 4/2)

The Associated Press: US Health Officials Alarmed By Paralyzing Illness In Kids
One morning last fall, 4-year-old Joey Wilcox woke up with the left side of his face drooping. It was the first sign of an unfolding nightmare. Three days later, Joey was in a hospital intensive care unit, unable to move his arms or legs or sit up. Spinal taps and other tests failed to find a cause. Doctors worried he was about to lose the ability to breathe. (4/2)

The Associated Press: CBD Is Getting Buzz, But Does It Work? And Is It Legal?
With CBD showing up everywhere, U.S. regulators announced Tuesday they are exploring ways the marijuana extract could be used legally in foods, dietary supplements and cosmetics. The U.S. Food and Drug Administration said it will hold a public hearing May 31 to gather more information on the science, manufacturing and sale of cannabis compounds such as CBD. (4/2)

The New York Times: The Heart Of A Swimmer Vs. The Heart Of A Runner
Do world-class swimmers’ hearts function differently than the hearts of elite runners? A new study finds that the answer may be yes, and the differences, although slight, could be telling and consequential, even for those of us who swim or run at a much less lofty level. (Reynolds, 4/3)

The Wall Street Journal: Why Videogames Trigger The Nightly Meltdown—And How To Help Your Child Cope
Every night, parents around the globe fight a battle of wills when they tell their kids to power down their game consoles to do homework, eat dinner or go to bed. The directive is usually met with some serious side-eye and whining. In some cases, children yell, throw tantrums or slam doors. No one likes to be forced to stop having fun, but something unique appears to be going on here—you don’t hear much about kids having epic meltdowns when they’re told to stop playing with Legos. (Jargon, 4/2)

The New York Times: How To Raise Vegetable Eaters
Cereal bars with spinach mixed in or veggie-infused tater tots are great at fooling children into eating greens or broccoli or carrots. But experts say that aside from the fact that these products often use only traces of vegetables, this strategy assumes the children can’t like kale or broccoli itself, and relying on such products makes it far more likely that they won’t. (Cernansky, 4/3)