First Edition: April 5, 2018

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Alive And Limping: ACA In The Age Of Trump
A lot has happened to the federal Affordable Care Act in the past year and a half. In this special episode of KHN’s “What the Health?” the panelists dissect the changes made to the health law, how it has affected the politics and policy around health care, and what to watch for going forward. (4/5)

Kaiser Health News: Timeline: Despite GOP’s Failure To Repeal Obamacare, The ACA Has Changed
Congress in 2017 failed to “repeal and replace” the Affordable Care Act. But the health law has been changed in many other ways over the past year and a half. Some changes were made by Congress, some by President Donald Trump and his administration and some by state officials. Here is a timeline of the most consequential events that have shaped the health law. (Rovner, 4/5)

The Washington Post: VA’s Acting Secretary Takes Over: ‘I Don’t Think He Has Any Idea What He’s Gotten Himself Into’
Amid reports of slumping morale following last week’s ousting of Veterans Affairs Secretary David Shulkin, the agency’s new acting head told employees Wednesday that he intends to refocus an organization beset by internal division. Robert Wilkie has been walking the halls of VA’s Washington headquarters, holding meetings with small groups of employees and inquiring about their duties, said a senior VA official who spoke on the condition of anonymity because the person is not authorized to speak with the media. In a three-minute video distributed to employees Wednesday, Wilkie, 55, emphasized the agency’s sacred mission of caring for those who have fought the nation’s wars. (Wax-Thibodeaux, 4/4)

The Hill: AMA: Mattis Memo Distorted Medical Evidence On Transgender Troops 
The country’s largest medical organization Wednesday told Defense Secretary James Mattis that it believes his recommendations on excluding most transgender people from military service “mischaracterized and rejected” evidence on treatment for gender dysphoria. “We believe there is no medically valid reason — including a diagnosis of gender dysphoria — to exclude transgender individuals from military service,” American Medical Association (AMA) CEO James Madara wrote in a letter to Mattis. “Transgender individuals have served, and continue to serve, our country with honor, and we believe they should be allowed to continue doing so.” (Kheel, 4/4)

Politico: ‘No Medically Valid Reason’ To Exclude Transgender Troops, AMA Chides Mattis
The letter from CEO James Madara, first obtained by POLITICO, also slams the suggestion that the cost of providing medical care to transgender troops should be a reason to keep them out of the military. “The financial cost is negligible and a rounding error in the defense budget,” Madara writes. “It should not be used as a reason to deny patriotic Americans an opportunity to serve their country. We should be honoring their service.” (Klimas, 4/4)

The Washington Post: FDA Commissioner Calls On Internet Providers To Help Police Opioid Offerings
The head of the Food and Drug Administration on Wednesday called on Internet providers to help rid the Web of illegal offers of prescription opioids and illicit drugs such as fentanyl that have contributed to the nation's drug crisis. And on Thursday, the surgeon general is scheduled to recommend that more people keep on hand an antidote for overdoses — the latest examples of public health officials scrambling to respond to the opioid crisis. (Bernstein and Dwoskin, 4/5)

The Hill: FDA Commissioner Urges Social Media Sites, Internet Providers To Curb Illegal Opioid Sales
“I’m concerned that social media companies, internet service providers (ISP) firms that host websites, and others in the internet ecosystem haven’t been proactive enough in rooting out these illegal offers to distribute opioids from their respective platforms,” Gottlieb will say Wednesday evening at the annual National Rx Drug Abuse and Heroin Summit in Atlanta, according to his prepared remarks. (Roubein, 4/4)

The Wall Street Journal: FDA Wants Better Control Of Online Opioid Sales
The push for internet companies to police opioid sales adds to political pressure tech companies are facing over concerns they aren’t protecting users’ privacy. Federal regulators are investigating Facebook’s social-media privacy policies and 37 state attorneys general are demanding explanations after the company’s disclosure that an outside firm improperly accessed and retained user information. The FDA commissioner said the agency’s investigators are pursuing inquiries related to internet drug sales and that “we’ve also had some notable take-downs stemming from this work. (Burton, 4/4)

Stat: Gottlieb: Facebook, Other Tech Firms Must Do More To Stop Illicit Opioid Sales
Gottlieb and other Trump administration officials have long made preventing the sale and importation of illicit fentanyl a focus of their efforts to address the opioid crisis. But the comments thrust Gottlieb into a broader fight that has lately consumed Washington — one that is much more squarely focused on scrutinizing major technology companies and their responsibility for what happens on their platforms. (Mershon and Facher, 4/4)

The Associated Press: Surgeon General Urges Americans To Carry Overdose Antidote
The nation's chief doctor wants more Americans to start carrying the overdose antidote naloxone in an effort to combat the nation's opioid crisis. U.S. Surgeon General Dr. Jerome Adams is expected to speak on the new public health advisory Thursday morning at the National Rx Drug Abuse & Heroin Summit in Atlanta. (Rico, 4/5)

Stat: Surgeon General Urges Public To Carry Overdose-Reversal Medication
The recommendation comes in the form of a surgeon general’s advisory, a tool used to draw attention to major public health issues. The last one, focused on drinking during pregnancy, was issued in 2005. “What makes this one of those rare moments is we’re facing an unprecedented drug epidemic,” Adams told STAT in a phone interview Wednesday. (Joseph, 4/5)

NPR: Surgeon General Urges More Americans To Carry Opioid Antidote
Police officers and EMTs often have naloxone at the ready. Access to the drug for the general public has been eased in the past few years, too. The medicine is now available at retail pharmacies in most states without a prescription. Between 2013 and 2015, researchers found a tenfold increase in naloxone sold by retail pharmacies in the U.S. But prices have increased along with demand. Naloxone-filled syringes that used to cost $6 a piece now cost $30 and up. A two-pack of naloxone nasal spray can cost $135 or more. And a two-pack of automatic naloxone injectors runs more than $3,700. (Martin and Wilhelm, 4/5)

The Hill: Senate Health Committee Releases Draft Of Bipartisan Opioid Bill 
Senate Health Committee leaders released Wednesday a bipartisan discussion draft of a bill aimed at combating the opioid epidemic, legislation that's the result of six hearings over the past six months. The panel will hold a hearing next week on the draft aimed at stemming the crisis killing thousands of people each year. It includes measures attempting to make it easier to prescribe smaller packs of opioids for limited durations, spur the development of nonaddictive painkillers and bolster the detection of illegal drugs at the border. (Roubein, 4/4)

CQ: Senate Finance Eyes Action On Opioid Epidemic
The Senate Finance Committee plans to focus on the opioid epidemic when Congress returns from a two-week hiatus next week. Committee leaders are currently soliciting proposals from members on solutions to address the ongoing crisis, with an eye to holding a hearing in the coming weeks, according to a Democratic aide. The proposals, due this week, address issues such as prescription drug monitoring programs, sharing data, access to health screenings and information for prescribers, according to a lobbyist familiar with the talks. (Clason, 4/4)

Stat: Is Drug Industry Friend Or Foe? In Addiction Policy Circles, Depends Who You Ask
Increased attention to the epidemic, however, has created an undeniable business opportunity for many drug companies. A spending bill passed earlier this year added $3 billion in funding for initiatives specific to the opioid crisis. Budget caps allow for many more billions to be spent in 2020 — a significant chunk of which is destined to fund medications used to treat opioid use disorder. The bills Nickel testified about before the Energy and Commerce Committee are likely to authorize much of this spending. (Facher, 4/5)

The Associated Press: Opioid Addiction Costs Employers $2.6B A Year For Care
A new report shows large employers spent $2.6 billion to treat opioid addiction and overdoses in 2016, an eightfold increase since 2004. More than half went to treat employees' children. The analysis released Thursday by the nonpartisan Kaiser Family Foundation finds such spending cost companies and workers about $26 per enrollee in 2016. Employers have been limiting insurance coverage of opioids because of concerns about addiction. The report finds spending on opioid prescriptions falling 27 percent from a peak in 2009. (4/5)

The Hill: Study: Cost Of Treating Opioid Addiction Soars 
Opioid use on employer-based health plans peaked in 2009 with about 17.3 percent of enrollees receiving at least one prescription that year. It has since fallen to its lowest level in more than a decade — 13.6 percent, the Kaiser report shows. (Roubein, 4/5)

The Associated Press: Puerto Rico Sues Purdue Pharma Over Opioid Crisis
Puerto Rico's Justice Department has filed a lawsuit against Purdue Pharma accusing the drugmaker of causing an opioid crisis in the U.S. territory. Officials said Wednesday that they are seeking to hold the company responsible for all government costs incurred as a result of the damage opioids have caused. The suit also accuses the company of misrepresenting the risk of abuse and addiction, among other things. (4/4)

Stat: Will The Trump Tariffs On China Raise Drug Prices For Americans? 
Now that the Trump administration has proposed 25 percent tariffs on thousands of Chinese-made products, including raw ingredients for a slew of medicines, there are concerns that prices for these products may rise, although experts caution the long-term impact remains unclear. Among the medicines that could be affected are insulin, epinephrine, heparin, antibiotics, antidepressants, tranquilizers, and vaccines, according to the list released by the U.S. trade representative. However, the agency cautioned that the list, which also includes numerous raw ingredients, is incomplete and not intended to “delimit, in any way, the scope of the proposed action.” (Silverman, 4/4)

The Hill: China Tariffs Could Raise Prices For Prescription Drugs In US, Groups Warn 
Advocates and drugmakers worry that the tariffs would make generic products more expensive as the nation continues to struggle with already high drug prices. "We are concerned that the proposed tariffs may lead to increased costs of manufacturing for generics and biosimilars and thus higher prescription drug prices for patients in the U.S.," said a statement from the Association for Accessible Medicines, an organization that represents prescription drug manufacturers. (Hellmann, 4/4)

Stat: Drug Makers Still Have A Bad Reputation Among Patient Groups 
Just 45 percent of patient groups thought the pharmaceutical industry had an “excellent” or “good” reputation last year. Despite the poor showing, however, this is still an improvement — albeit, a modest one — from the 38 percent of patient groups that offered the same assessment in 2016, according to PatientView, a research firm that canvassed more than 1,300 patient groups from 95 countries. (Silverman, 4/5)

Bloomberg: J&J Jury Set To Weigh Banker's Claims Baby Powder Caused Cancer 
Jurors are set to weigh an investment banker’s claims that using Johnson & Johnson’s baby powder for more than 30 years caused him to develop a deadly cancer linked to asbestos. A New Jersey jury will begin deciding Wednesday whether Stephen Lanzo III can legitimately blame J&J’s iconic product for his mesothelioma, an often-fatal cancer tied to asbestos exposure. Lanzo, a 46-year-old banker with U.S. Trust Corp., accuses the world’s largest health-care company of hiding that its talc-based products have contained asbestos for nearly a half century. (Feeley, 4/4)

The Associated Press: CVS Health Eyes Kidney Patients For Next Expansion Into Care
CVS Health is now planning to treat kidney failure patients, as the national drugstore chain continues to branch deeper into monitoring and providing care. The company said Wednesday it will offer home dialysis for patients through its Coram business, and it is working with another unspecified company to develop a new device for that. A CVS spokeswoman declined to name the company or disclose how much CVS is spending on the venture. (4/4)

The Washington Post: People Can’t Be Educated Into Vaccinations, But Behavioral Nudges Help, Study Finds
Vaccines were one of the great inventions of modern history. They helped stop America’s polio epidemic in the 1950s, when it was paralyzing thousands and killing at least 3,000 a year. They have prevented the deaths of millions worldwide from diseases such as diphtheria, smallpox, measles and tetanus. And yet many people are reluctant to get their shots or vaccinate their children. (Wan, 4/4)

The Wall Street Journal: In School Shootings, Most Guns Come From Home
A striking detail stands out in nearly three decades of American mass school shootings: The killers mostly use guns owned by a family member, not purchased on their own. As Congress, statehouses, school districts, retailers and various groups debate how to prevent a school shooting after a 19-year-old who legally bought guns left 17 dead in Parkland, Fla., much discussion centers on whether to raise the minimum age for gun purchases. But statistics suggest that a lack of gun safety at home also has played a big role in school shootings. (Hobbs, 4/5)

Stat: SARS-Like Outbreak Among Pigs Renews Concern Virus Could Strike Humans
When a disease swept through southern China last year, killing off nearly 25,000 piglets over a period of months, scientists initially thought a diarrheal virus was to blame. They later determined it was something else: a dangerous coronavirus, the same family of viruses that 15 years ago caused a human epidemic of SARS, or severe acute respiratory syndrome. Scientists who went looking for those viruses in bats in China’s Guangdong and Yunnan provinces had found dozens that are closely related to the SARS coronavirus. In some places, they found people living nearby who had antibodies to these viruses, suggesting they had been previously infected. (Branswell, 4/4)

The Associated Press: Getting Kids To A Good Weight By 13 May Help Avoid Diabetes
There may be a critical window for overweight kids to get to a healthy level. Those who shed their extra pounds by age 13 had the same risk of developing diabetes in adulthood as others who had never weighed too much, a large study of Danish men found. Diabetes can develop when the body can’t properly use insulin to turn food into energy. Being overweight at any age raises the chances of the most common form, Type 2. But it’s not known whether or how much that risk is reduced if people lose weight, and when. (Marchione, 4/4)

Los Angeles Times: This Retinal Implant May One Day Cure Blindness Caused By Macular Degeneration
For many of the 10 million Americans who are losing their vision to a thievish eye condition with no treatment, help may be on its way. In a very early clinical trial, researchers have implanted a stem cell "patch" to repair failing retinal cells in four patients with a condition called "dry" macular degeneration. Three of the four patients who got the bioengineered implant — all of whom had lost their central field of vision and were legally blind — reported some lightening in the previously dark center of their visual field, according to a study published Wednesday in the journal Science Translational Medicine. The three also saw some improvement in their ability to see shapes and focus on letters or other objects directly in front of them. (Healy, 4/4)

Stat: Monkey Study Suggests Zika Infection In Infancy Could Cause Brain Damage
A new study in primates raises the possibility that children infected with the Zika virus during infancy could be at risk of experiencing brain damage. Zika is known to destroy developing brain tissue when it infects a fetus in the womb. Scientists know less — next to nothing, essentially — about how the virus might affect the brain of an infant infected after birth. (Branswell, 4/4)

The New York Times: Bananas Vs. Sports Drinks? Bananas Win In Study
A banana might reasonably replace sports drinks for those of us who rely on carbohydrates to fuel exercise and speed recovery, according to a new study comparing the cellular effects of carbohydrates consumed during sports. It found that a banana, with its all-natural package, provides comparable or greater anti-inflammatory and other benefits for athletes than sports drinks. But there may be a downside, and it involves bloating. (Reynolds, 4/4)

The Associated Press: Maryland Lawmakers Vote To Ban 'Gay Conversion Therapy'
Maryland lawmakers voted Wednesday to prohibit health professionals from practicing "gay conversion therapy" on minors, after a legislator spoke of the pain she experienced when her parents sought it for her. Just days earlier, the woman's father, a state senator, voted against the bill. The House passed the bill 95-27, sending the measure to Gov. Larry Hogan. A spokeswoman for Hogan said the governor supports the bill. (4/4)

The Associated Press: Baltimore Seeks US Supreme Court Review Of Abortion Ruling
Attorneys in Baltimore are asking the U.S. Supreme Court to overturn a ruling that struck down as unconstitutional an ordinance requiring pregnancy centers notify patients if they don't offer abortion or birth control services. The 4th U.S. Circuit Court of Appeals ruled in January that the ordinance unconstitutionally compelled speech by Christian-based Greater Baltimore Center for Pregnancy Concerns Inc., which opposes abortion. (4/4)

The Associated Press: Court Weighs Hospital's Blame In Killing By Ex-Patient
In 2012, a judge ordered Tu Nguyen to be civilly committed for up to six months. Eleven days later, he was released from the hospital, and within weeks had stabbed his neighbor to death in front of her 8-year-old granddaughter. Mary Miller's family is now asking Massachusetts' highest court to decide whether the hospital can be held responsible in a case that's stirring complex questions about whether mental health providers should be liable when former patients commit crimes. (4/4)

The New York Times: California Family Gets $1.6 Million After 3-Year-Old Was Scarred By Bedbugs
A family in California whose son was permanently scarred by bedbug bites has been awarded nearly $1.6 million by a civil jury. It was the highest amount ever paid to a single family in a bedbug case in the United States, according to the family’s lawyer. (Caron, 4/4)

The Washington Post: After A Dramatic Failure, Effort To Diversify Maryland’s Medical Marijuana Industry Moves Closer To Passage
A bill to diversify Maryland’s medical marijuana industry received final approval in the state Senate on Wednesday — after a similar effort to bring in more minority-owned businesses faced a bitter defeat in the final minutes of last year’s session. About one-third of Maryland residents are African American, but none of the 14 companies that have lucrative licenses to grow medical marijuana are led by black executives. The bill would increase the number of licenses for growers and processors, and it specifies that those licenses will be awarded in a process that gives preference to minority-owned businesses. (Chason, 4/4)

The Associated Press: Maryland Senate Passes Medical Marijuana Bill
A measure passed by the Maryland Senate on Wednesday aims to create opportunities for minority business owners to become licensed medical marijuana growers and processors. The measure was approved 42-3. The House and Senate still have to reconcile some differences in the legislation before the session ends at midnight Monday to send the bill to Gov. Larry Hogan. (Columbus, 4/4)