First Edition: August 10, 2017

Kaiser Health News: Hospitals Slashed Use Of Two Heart Drugs After Huge Price Hikes
Even before media reports and a congressional hearing vilified Valeant Pharmaceuticals International for raising prices on a pair of lifesaving heart drugs, Dr. Umesh Khot knew something was very wrong. Khot is a cardiologist at the Cleveland Clinic, which prides itself on outstanding heart care. The health system’s pharmacists had alerted doctors about the skyrocketing cost of the drugs, nitroprusside and isoproterenol. But these two older drugs, frequently used in emergency and intensive care situations, have no direct alternatives. (Tribble, 8/9)

California Healthline: Medi-Cal Sued For Pushing Patients Into Managed Care Despite Judges’ Orders
Like Medicaid programs in many states that want more budgeting certainty or hope to save money, Medi-Cal is shifting many patients like [Alondra] Diaz, with complex conditions, into managed care plans. The plans agree to cover enrollees for a fixed amount per month. But in doing so, they often rely on narrow networks of physicians that do not include the patients’ doctors. ... Two health consumer advocacy groups, Neighborhood Legal Services of Los Angeles County and Western Center on Law and Poverty, sued DHCS Tuesday to help Diaz and the dozens of other Medi-Cal members who’ve had similar rulings [allowing them to stay in the traditional fee-for-service Medi-Cal] overturned by the state. (Bazar, 8/10)

Kaiser Health News: Asthma, More Deadly With Age, Takes Heavy Toll On Older Adults
In early June, Donna Bilgore Robins stood on a patio in Beaver Creek, Colo., under a crystal-clear blue sky and tried to catch her breath. She couldn’t. With mountain vistas around her, Robins felt as if she was drowning. She gasped for air hungrily again and again. (Graham, 8/10)

The Washington Post: Bipartisan Health Policy Coalition Urges Congress To Strengthen The ACA
An unlikely coalition of liberal and conservative health-policy leaders is calling on Congress to strengthen the existing health-care law in a variety of ways to help Americans get and keep insurance. The group is urging the government, in particular, to continuing paying all the federal subsidies provided under the Affordable Care Act and to help Americans enroll in coverage. In a five-point set of principles issued Wednesday, the coalition lays out a potential bipartisan path forward after a Republican strategy to tilt federal health policies in more conservative directions failed in the Senate last month. (Goldstein, 8/9)

The Wall Street Journal: Health Experts Push Fix For Insurance Markets Aimed At Both Parties
The plan makes five primary recommendations. It encourages lawmakers to formally authorize the ACA’s “cost-sharing reduction” payments, which help insurers subsidize costs for some low-income consumers. It recommends Congress ensure funding for the popular Children’s Health Insurance Program, which is favored by members of both parties but has been floated as a vehicle to pass more contentious health reforms. The authors also endorse two GOP-backed ideas—expanding the use of health savings accounts and broadening the ACA’s state innovation waivers, to give states additional flexibility in administering their insurance markets. In exchange, they nod to a core priority for Democrats to have a mechanism that will entice more people to sign up for health insurance. (Hackman, 8/9)

The Associated Press: Study: Trump Actions Trigger Health Premium Hikes For 2018
The Trump administration's own actions are triggering double-digit premium increases on individual health insurance policies purchased by many consumers, a nonpartisan study has found. The analysis released Thursday by the Kaiser Family Foundation found that mixed signals from President Donald Trump have created uncertainty "far outside the norm," leading insurers to seek higher premium increases for 2018 than would otherwise have been the case. (Alonso-Zaldivar, 8/10)

The Wall Street Journal: Health ‘Navigators’ Brace For Decision On Their Funding
The Trump administration must decide within weeks whether to continue funding organizations that help people enroll in health insurance through the Affordable Care Act, one of several imminent choices that could signal the administration’s larger approach to the law. The Centers for Medicare and Medicaid Services last year awarded $63 million in grants to nearly 100 community organizations that help people sign up for health plans under the 2010 law. The grants for these so-called “navigators” are set to run through September 2018, but the contracts specify that funding year-to-year would be contingent on their performance. (Hackman, 8/9)

Los Angeles Times: Trump Administration Shifts Tone On Obamacare, Signals Openness To Bipartisan 'Fix'
The Trump administration, thwarted in several attempts to repeal the Affordable Care Act, notably shifted tone Wednesday, opening the door for a bipartisan plan to "fix" the law. ... "Both folks in the House and the Senate, on both sides of the aisle frankly, have said that Obamacare doesn't work, and it needs to be either repealed or fixed," Health and Human Services Secretary Tom Price said on the Fox News program “Fox & Friends.” "So the onus is on Congress," he said.Talk of fixing the law is new for most Republicans. Price and President Trump have long focused only on repealing or replacing it. (Bierman, 8/9)

The Associated Press: Trump Hits McConnell For Senate Crash Of Obama Health Repeal
President Donald Trump scolded his own party's Senate leader on Wednesday for the crash of the Republican drive to repeal and rewrite the Obama health care law, using Twitter to demand of Majority Leader Mitch McConnell, "Why not done?" Trump fired back at the Kentucky Republican for telling a home-state audience this week that the president had "not been in this line of work before, and I think had excessive expectations about how quickly things happen in the democratic process." (8/9)

USA Today: Donald Trump Responds To McConnell: I Don't Have Excessive Expectations
In an interview this week, McConnell had blamed Trump for setting "early timelines" and "excessive expectations" as one of the reasons that people believe Congress is getting nothing done. But Trump said he didn't think he had "excessive expectations." "After 7 years of hearing Repeal & Replace, why not done?" he said on Twitter. (Collins, 8/9)

The Wall Street Journal: Trump Criticizes McConnell For Failure To Advance Health-Law Reform
Separately, other Senate Republicans are increasingly becoming potential targets for Mr. Trump. The president wrote in a tweet last month that Alaska Republican Sen. Lisa Murkowski “really let the Republicans, and our country, down.” She was one of the three who voted against the health-care measure. (Tau, 8/9)

Politico: Trump Vs. McConnell
The tit-for-tat between Donald Trump and Senate Majority Leader Mitch McConnell over the chamber's failure to repeal Obamacare opens a politically perilous schism within a party already riven by tensions over its lack of accomplishments this year. (McCaskill and Schor, 8/9)

The Associated Press: GOP Senator Suggests Brain Tumor Affected McCain Vote
Sen. Ron Johnson suggested that fellow Republican Sen. John McCain's brain tumor and the after-midnight timing of the vote were factors in the Arizona lawmaker's decisive vote against the GOP health care bill. In a radio interview Tuesday with AM560 "Chicago's Morning Answer," Johnson answered questions about the collapse of the years-long Republican effort to repeal and replace Barack Obama's Affordable Care Act, his criticism of the process and McCain's dramatic vote. (8/9)

USA Today: Bernie Sanders Seeks 'Citizen Co-Sponsors' For Single-Payer Health Care Bill
Sen. Bernie Sanders is seeking "citizen co-sponsors" for a “Medicare-for-all” health care bill he plans to introduce in a few weeks. While pledging to fight GOP efforts to repeal Obamacare, the Vermont independent told supporters in a Wednesday email that the ultimate goal is a single-payer system, a federally administered program that would eliminate the role of private insurers in basic health care coverage. (Gaudiano, 8/9)

The New York Times: 5 Transgender Service Members Sue Trump Over Military Ban
Five transgender people serving in the United States military sued President Trump and top Pentagon officials on Wednesday, asking that transgender troops be allowed to stay in the military. The lawsuit was filed in response to Mr. Trump’s ban abruptly announced last month on Twitter. (Savage, 8/9)

The New York Times: For Transgender Women, An Extra Dose Of Fear
In an era in which protections allowing transgender students to use the restrooms they prefer have been rescinded and 14 transgender people have been murdered so far this year, according to the Human Rights Campaign, an L.G.B.T. rights advocacy group, many transgender people say they feel increasingly unsafe, and that “passing” is necessary for survival. So far, 19 states and the District of Columbia have put strong nondiscrimination policies in place for transgender people. But “now we’re seeing this pushback,” said Jaclyn White Hughto, a research fellow at the Yale School of Public Health who specializes in transgender health. “It’s the belief that the violence is a response to the more progressive agenda to protect transgender people.” (Ellin, 8/9)

The New York Times: V.A. Plans To Fire Its D.C. Medical Director — Again
The head of the Veterans Affairs Department told lawmakers he intends to try out a new law that makes it easier to fire — and keep fired — deficient department employees. The test case: the former director of the agency’s main medical center here. The center’s director, Brian Hawkins, oversaw an operation that the department’s inspector general said was plagued by the “highest levels of chaos.” After the inspector general findings were released in a rare interim report in April, the department immediately transferred Mr. Hawkins to a job at its nearby headquarters. It then fired him in late July, saying in a statement that he had “failed to provide effective leadership at the medical center” or live up to the department’s values. (Fandos, 8/9)

The Washington Post: Federal Panel Blocks Firing Of Head Of Troubled D.C. Veterans’ Hospital
A federal board has blocked the firing of the director of D.C.’s troubled hospital for veterans, setting up a showdown with the Trump administration as it pursues expanded authority to clean house at the U.S. Department of Veterans Affairs. Brian Hawkins, who until recently served as the head of the VA Medical Center in Washington, was removed from his post in April and fired two weeks ago for what VA officials said was a failure to “provide effective leadership.” (Jamison, 8/9)

The Washington Post: Big City Health Officials Decry Trump Administration’s Cuts To Teen Pregnancy Prevention Programs
The federal funding was curtailed last month without explanation and without warning: $214 million for teen pregnancy prevention programs across the country. The city of Baltimore lost $3.5 million, money that Health Commissioner Leana Wen said had supported classes in anatomy and physiology and counseling in social and emotional issues related to sex for 20,000 teens, plus training for 115 teachers. She worries what the loss of funds will mean for local teen pregnancy rates, which already are twice as high as the state's and much higher than the U.S. average. (Cha, 8/9)

The New York Times: Programs That Fight Teenage Pregnancy Are At Risk Of Being Cut
At age 14, Latavia Burton knows something about teenage pregnancy. Her mother gave birth to her at 18 and couldn’t attend college because of it. And Latavia’s former best friend became pregnant at 16. So a pregnancy prevention program in eighth grade and another in her neighborhood this summer hit home. Latavia hasn’t had sex yet, and said if she were asked to she’d say, “Let’s just wait a little longer.” But to be safe, she plans to get an intrauterine device at a clinic for teenagers the program introduced her to. And since she learned that it would not protect her from sexually transmitted diseases, but that condoms would, she said she would “just go to the teen clinic and get some for free” if a boyfriend claimed he couldn’t afford them. (Belluck, 8/10)

The Washington Post: Study: Doctors Received More Than $46 Million From Drug Companies Marketing Opioids
“The next step is to understand these links between payments,” said Scott Hadland, a pediatrician and author of the study, and “prescribing practices and overdose deaths.” (Zezima, 8/9)

The Washington Post: At Least 17 States Are Enacting Strict Limits On The Length Of Painkiller Prescriptions As Drug Overdoses Soar
States are enacting strict limits on the number of powerful prescription painkillers doctors can prescribe, a move that many believe will help fight the opioid crisis but has raised alarms among some physicians. At least 17 states have enacted rules to curb the number of painkillers doctors can prescribe. Some, including Arizona, Connecticut, Delaware, Massachusetts, New Jersey and Ohio, have passed laws limiting the duration of initial opioid prescriptions to five or seven days. Others are passing dosage limits. In Kentucky, a law went into effect last month capping opioid prescriptions for acute pain to three days. (Zezima, 8/9)

NPR: Arizona Fighting Opioid Crisis With Better Data, More Funding
Health officials awaiting news from President Trump's briefing on opioids Tuesday didn't, in the end, get much about what the White House plans to do about the growing crisis. While he acknowledged the severity of the problem and the threat opioids pose to all Americans, Trump did not talk about expanding addiction treatment or access to the overdose-reversal drug naloxone, two of the recommendations his commission on opioids made in its interim report last week. (Hsu, 8/9)

The Washington Post: Selling Opioids In This Rural Maryland County Could Get You A Murder Charge
A rural Maryland county is bringing murder charges against suspected opioid drug dealers as part of an aggressive campaign to combat the epidemic, becoming the first in the state to file some of the toughest charges against distributors who they say are responsible for carnage, officials said. St. Mary’s County law enforcement officials on Wednesday announced eight second-degree murder indictments so rare that they attracted a visit from Gov. Larry Hogan (R), who traveled to Southern Maryland to support the stepped-up effort to identify and arrest drug dealers. (Hernandez, 8/9)

The New York Times: Stroke Risk Declining In Men But Not Women
The incidence of stroke has declined in recent years, but only in men. Researchers studied stroke incidence in four periods from 1993 to 2010 in five counties in Ohio and Kentucky. There were 7,710 strokes all together, 57.2 percent of them in women. (Bakalar, 8/9)

The New York Times: Exercise As A Weight-Loss Strategy
Some types of exercise may be better than others at blunting appetite and potentially aiding in weight management, according to an interesting new study of workouts and hunger. It finds that pushing yourself during exercise affects appetite, sometimes in surprising ways. As anyone who has begun an exercise program knows, the relationships between exercise, appetite, weight control and hunger are complex and often counterintuitive. (Reynolds, 8/9)

Los Angeles Times: Can A Hormone Called Klotho Enhance Cognition And Hold Off Dementia? Yes, In Mice, At Least
If ever there were a hormone to spark intellectual excitement, it’s klotho. At the dawn of our lives, our blood brims with klotho. But as age and disease stiffen our joints and cloud our minds, klotho ebbs. People who exercise and remain spry into old age have more of the stuff. Those suffering chronic stress or degenerative brain diseases such Parkinson’s and Alzheimer’s see theirs depleted. (Healy, 8/9)

NPR: Action Video Games May Affect The Brain Differently
People who played action video games that involve first-person shooters, such as Call of Duty and Medal of Honor, experienced shrinkage in a brain region called the hippocampus, according to a study published Tuesday in Molecular Psychiatry. That part of the brain is associated with spatial navigation, stress regulation and memory. Playing Super Mario games, in which the noble plumber strives to rescue a princess, had the opposite effect on the hippocampus, causing growth in it. (Columbus, 8/9)

The Washington Post: Much-Lampooned Ultrasound Bill Revived In Race For Va. Lieutenant Governor
Democrat Justin Fairfax used an infamous Virginia antiabortion bill to go after Republican Jill Holtzman Vogel on Wednesday, when the two rivals for lieutenant governor faced off at a candidate forum. Vogel, a state senator from Fauquier County, sponsored a 2012 bill that would have required most women who get abortions to first undergo a vaginal ultrasound. (Vozzella, 8/9)

The Associated Press: Alabama Wants To Reinstate Hearings For Pregnant Girls
Alabama’s top prosecutor said the state is going to appeal a federal judge’s ruling that struck down a one-of-a-kind law in which minors seeking court permission for an abortion could be put through a hearing where the fetus could get a lawyer and a district attorney could question the pregnant girl’s maturity. (Chandler, 8/9)

The Washington Post: Md. Drug Company Sues Federal Government To Fend Off Competition From Generics
One of Maryland’s largest drug manufacturers is suing the federal government to fend off competition on one of its key drugs, saying its right to exclusively sell the medication should continue an additinoal three years. The suit comes as the company, United Therapeutics, faces new competition from other firms trying to sell similar treatments on the generic market. Silver Spring-based United Therapeutics filed suit Aug. 4 in U.S. District Court for the District of Columbia, alleging the firm is entitled to a seven-year period of exclusive sale of the drug’s oral formulation. (Gregg, 8/9)

Los Angeles Times: While Dialysis Clinic Battle Brews At State Capitol, Healthcare Workers Look To The Ballot
Cracking down on clinics treating Californians with chronic kidney disease has been a top legislative priority this year for unions representing healthcare workers. Now they’re opening a new front in their crusade against the dialysis industry: the ballot box. Service Employees International Union-United Healthcare Workers filed two initiatives with the state attorney general on Wednesday that, if they qualify, would appear on the November 2018 ballot. The union is seeking to impose stricter rules at dialysis centers for the staffing levels and how much they charge. (Mason, 8/9)

The Associated Press: Maggot Case Gives Rare Look At Neglect Probes
In his bed at a New York state group home for the severely disabled, Steven Wenger lay helpless against a silent invader. A slimy, wriggling clump was growing around the hole in his throat near his breathing tube. Nurses peered closer and made a discovery almost unheard of in modern American health care: maggots. For Wenger, unable to walk, speak, or breathe without a ventilator since a car accident 26 years ago, it was the first of two infestations of the larval flies in his throat over successive days last summer, resulting in repeated trips to an emergency room and a state investigation that found days of neglect by caretakers. (Klepper, 8/10)

The Associated Press: Arizona Dogged By Suit Over Quality Of Health Care In Prison
For more than five years, Arizona has been dogged by a federal lawsuit that alleges the state provides shoddy medical care for its prisoners. Now, the state is facing the prospect of millions of dollars in fines over its failure to carry out reforms of its medical system. (Billeaud, 8/9)

Reuters: Oregon Bans Tobacco Sales To Under 21s, Matching Rules On Marijuana
Oregon is raising the minimum age for buying tobacco and e-cigarettes in the state to 21, bringing its regulations into line with sales of marijuana products. The new law, signed by Governor Kate Brown on Wednesday and taking effect on Jan. 1, bans under-21s from buying tobacco products and vaping devices, and makes vendors liable for fines for under-age sales. (O'Brien, 8/10)

The Associated Press: Texas Doctor Gets 35 Years In Prison For $375M Medical Fraud
A 60-year-old Dallas-area doctor has been sentenced to 35 years in prison for helping defraud Medicare and Medicaid out of almost $375 million. A federal judge also ordered Dr. Jacques Roy on Wednesday to pay more than $268 million in restitution. A jury in April 2016 convicted the Rockwall physician of nine of 10 counts of defrauding a health care benefit program. (8/9)