First Edition: August 20, 2019

Kaiser Health News: The Collapse Of A Hospital Empire — And Towns Left In The Wreckage
The money was so good in the beginning, and it seemed it might gush forever, right through tiny country hospitals in Missouri, Oklahoma, Tennessee and into the coffers of companies controlled by Jorge A. Perez, his family and business partners. It was his “secret sauce,” the rotund Miami entrepreneur would smilingly tell people in their no-stoplight towns. The money-making ventures he proposed sounded complicated, sure, but he said they would bring in enough cash to save their hospital and dozens, even hundreds, of good jobs in rural towns where gainful employment is hard to come by. (Ostrov and Weber, 8/20)

Kaiser Health News: A Brush With A Notorious Cat, My Rabies Education And The Big Bill That Followed
I was just petting an orange tabby cat in my Falls Church, Va., neighborhood, a cat I’d never met before. He was very cute. And he was purring and butting his head against my hand. Until he wasn’t. He sunk his teeth into my wrist, hissed at me and ran off. So began my personal episode of Law & Order: Feline Victims Unit, complete with cat mug shots and weekly check-ins from local animal control and public health officials. And rabies shots. Multiple rabies shots in the emergency room. And more than $26,000 in health care costs, an alarming amount considering I was perfectly healthy throughout the whole ordeal. (Hillyard, 8/20)

The New York Times: Planned Parenthood Refuses Federal Funds Over Abortion Restrictions
Planned Parenthood said Monday that it would withdraw from the federal family planning program that provides birth control and other health services to poor women rather than comply with a new Trump administration rule that forbids referrals to doctors who can perform abortions. Planned Parenthood receives about $60 million annually through the federal program, known as Title X. The funds have enabled the group to provide more than 1.5 million low-income women each year with services like birth control and pregnancy tests, as well as screenings for sexually transmitted diseases and breast and cervical cancer. In some rural communities, Planned Parenthood is the only provider of such services. (Belluck, 8/19)

The Associated Press: Planned Parenthood Leaves Federal Family Planning Program
Alexis McGill Johnson, Planned Parenthood's acting president and CEO, said the organization's nationwide network of health centers would remain open and strive to make up for the loss of federal money. But she predicted that many low-income women who rely on Planned Parenthood services would "delay or go without" care. "We will not be bullied into withholding abortion information from our patients," said McGill Johnson. "Our patients deserve to make their own health care decisions, not to be forced to have Donald Trump or Mike Pence make those decisions for them." (Crary and Alonso-Zaldivar, 8/19)

Reuters: Planned Parenthood Opts Out Of U.S. Subsidies In Fight Over Abortion Referrals
Planned Parenthood, the largest abortion provider in the United States, said its move was spurred by a federal appeals court decision last month clearing the administration's way to restrict Title X grants under a new policy critics have branded a "gag rule." In addition to barring recipients from making abortion referrals, the policy requires financial and physical separation between facilities funded by Title X and those where actual abortions are performed. (O'Brien, 8/20)

The Wall Street Journal: Planned Parenthood To Withdraw From Title X Funding Program Over Abortion Restrictions
Planned Parenthood has called the new rules a direct attack against the largest provider of federal family-planning services by a Republican administration that believes in using any legal and policy tools at its disposal to curb access to abortion and some forms of contraception. A spokeswoman for the Department of Health and Human Services said Planned Parenthood rejected the federal funds at the expense of its patients. “Some [Title X] grantees are now blaming the government for their own actions…and they are abandoning their obligations to serve their patients under the program,” said Mia Palmieri Heck, a spokeswoman for the HHS office running Title X. (Hackman, 8/19)

Los Angeles Times: Planned Parenthood Leaves Title X Over Abortion 'Gag Rule'
Several states have pledged to try to come up with new funding to replace the federal dollars. The impact is likely to vary state by state. In some parts of the country, Planned Parenthood is the only Title X grantee, and in some regions, the state acts as a grantee, with several subgrantees, including Planned Parenthood facilities and other healthcare providers. The decision by Planned Parenthood — which gets about $60 million in funding and is the program’s largest grantee — is the latest in a years-long battle between abortion-rights supporters and Republicans, who have advocated the elimination all federal funding for abortion providers and the “defunding” of Planned Parenthood. (Haberkorn, 8/19)

Politico: Planned Parenthood Pulls Out Of Family Planning Program Over Trump Abortion Rule
Vermont's health department also gave notice Monday that it is quitting Title X. The agency relied entirely on Planned Parenthood clinics to provide services under the program. And Maine Family Planning, the sole Title X provider in the state, informed HHS that it is withdrawing over the rule. “It’s important that we maintain women’s rights and access to health care," said Vermont GOP Gov. Phil Scott. (Ollstein, 8/19)

The New York Times: Chicago Man Charged With Making Online Death Threat Against Abortion Clinic
A Chicago man is accused of promising to “slaughter and murder” doctors, patients and visitors at an abortion clinic, a threat that the authorities said Monday he issued on iFunny.co, an online forum where he followed an Ohio man charged last week over similar threats, court records show. The man in Chicago, Farhan Sheikh, 19, has been charged with transmitting a threat in interstate commerce, a crime punishable by up to five years in prison, the United States Attorney’s Office for the Northern District of Illinois said on Monday in a news release. (Chokshi, 8/19)

The New York Times: After Lobbying By Gun Rights Advocates, Trump Sounds A Familiar Retreat
Days after a pair of deadly mass shootings in Texas and Ohio, President Trump said he was prepared to endorse what he described as “very meaningful background checks” that would be possible because of his “greater influence now over the Senate and over the House.” But after discussions with gun rights advocates during his two-week working vacation in Bedminster, N.J. — including talks with Wayne LaPierre, the chief executive of the National Rifle Association — Mr. Trump’s resolve appears to have substantially softened, and he has reverted to reiterating the conservative positions on the gun issue he has espoused since the 2016 campaign. (Karni and Haberman, 8/19)

The Washington Post: Trump Again Appears To Back Away From Gun Background Checks
Immediately after the carnage in El Paso and Dayton, Ohio, Trump said “there is a great appetite” for tightening background checks on people who buy firearms. But in recent days, Trump has focused in public remarks on the need to keep guns out of the hands of the mentally ill while emphasizing that the nation already has “very strong background checks right now” — positions that hew more closely to the views of the National Rifle Association. Behind the scenes, Trump’s communication with key lawmakers, including Sen. Joe Manchin III, a moderate Democrat from West Virginia who has sought to develop bipartisan gun-control measures, has gone mostly cold, according to Capitol Hill aides, in part because Congress has left town for its summer recess. (Dawsey and Nakamura, 8/19)

The Hill: Pelosi, Schumer Press For Gun Screenings As Trump Inches Away 
Democratic leaders on Capitol Hill pressed President Trump on Monday to support tougher gun laws, a move that comes as the president attempts to shift the focus of gun-violence prevention from firearms to mental illness. Speaker Nancy Pelosi (D-Calif.) and Senate Minority Leader Charles Schumer (D-N.Y.) contend that the most effective prescription for reining in shooting deaths is to expand background checks prior to the sale of firearms. A pair of House-passed measures, they argued, would do just that. (Lillis, 8/19)

The Washington Post: ‘Red Flag’ Laws May Play Role In Preventing Mass Shootings, Study Finds
State laws that allow the removal of guns from people who present a threat to themselves or others may play a role in preventing mass shootings, according to a new study, a finding that could buttress support for “red flag” legislation being debated in Congress. The study by a team at the nonpartisan Violence Prevention Research Program at the University of California at Davis identified more than 20 cases in which California’s red-flag law was used in an effort to prevent a mass shooting. (Jamison, 8/19)

Los Angeles Times: Study: California's 'Red Flag' Law May Cut Mass Shooting Risk
The initial findings by the school’s Violence Prevention Research Program were made public just hours after Gov. Gavin Newsom said Monday that he is interested in receiving a group of pending bills that would significantly expand the use of so-called “extreme risk protection” orders. At the same time, recent mass shootings in Gilroy, Calif., as well as El Paso and Dayton, Ohio, have renewed the conversation in Congress about possibly adopting national red flag laws. (McGreevy, 8/19)

The Associated Press: Governor Brings Big Tech To The Table After El Paso Attack
Texas Gov. Greg Abbott called Monday for the help of big tech platforms in the wake of an El Paso mass shooting that authorities say was carried out by a gunman who posted a racist screed online before killing 22 people at a Walmart. It’s unclear what the invited companies, which include Google, Facebook and Twitter, will offer or say in the aftermath of the tragedy. None addressed questions about their role after Abbott announced the tech giants will join the FBI and state lawmakers this week in Austin to discuss the El Paso shooting and how to prevent future attacks. (Weber, 8/19)

USA Today: Obamacare: As 2019 Open Enrollment Nears, Signs Of Trouble, Progress
The latest health insurance data gives new ammunition to the Trump administration as it touts the latest bad news on Obamacare, but supporters of the law say there are positive signs for the state and federal marketplaces as 2019 open enrollment nears. A study out Thursday showed the number of uninsured people increased in 2017 for the first time since the Affordable Care Act exchanges opened in 2013. Last week, the Centers for Medicare and Medicaid Services reported 2.5 million people left the Obamacare health insurance exchanges between 2016 and 2018. (O'Donnell, 8/19)

The Associated Press: Detained Immigrants Sue Over Conditions, Medical Care
Immigrants held in U.S. detention facilities filed a lawsuit Monday decrying what they called shoddy medical care and a failure by authorities to provide accommodations for disabilities. In the suit filed by disability and civil rights advocates in U.S. District Court, immigrants said they’re placed in isolation as punishment and denied recommended medical treatment and surgery. Some said they’ve been denied wheelchairs and a deaf detainee who communicates in American Sign Language said he has not been provided an interpreter. (Taxin, 8/19)

Politico: Trump Administration Sued Over Poor Medical Care In Immigration Centers
Detainees with medical and mental health conditions and those with disabilities face settings so brutal, including delays and denials of medical care, overuse of solitary confinement and lack of disability accommodations, they have led to permanent harm and 24 deaths in the last two years, according to a portion of the 200-page complaint shared with POLITICO. (Rayasam, 8/19)

ProPublica: 'No Comment': Emails Show The VA Took No Action To Spare Veterans From A Harsh Trump Immigration Policy
Top officials of the Department of Veterans Affairs declined to step in to try to exempt veterans and their families from a new immigration rule that would make it far easier to deny green cards to low-income immigrants, according to documents obtained by ProPublica under a Freedom of Information Act request. The Department of Defense, on the other hand, worked throughout 2018 to minimize the new policy’s impact on military families. (Torbati, Arnsdorf and Lind, 8/19)

The Wall Street Journal: Two Drugmakers Closing In On Opioid Settlements
Drugmakers Endo International PLC and Allergan PLC are in talks to avoid going to a landmark trial set to begin in October over the opioid crisis, according to people familiar with the matter. Endo is close to finalizing a $10 million deal, and Allergan is in negotiations for a potential $5 million deal that would settle claims over its branded drugs but may not entirely eliminate it from the trial, the people said. The settlements, if finalized, would bring the companies in accord with two Ohio counties whose claims have been chosen to serve as bellwethers in sprawling litigation over the opioid epidemic. (Randazzo, 8/19)

The Associated Press: US Attorney Seeks To Block Plan For Supervised Drug Center
Loved ones propped photos of more than a dozen young people lost to the opioid crisis against the outside of the federal courthouse in Philadelphia on Monday as a judge inside heard arguments on whether the city could become the nation's first to open a supervised injection center. U.S. Attorney William McSwain, an appointee of President Donald Trump, believes the plan normalizes the use of heroin and fentanyl and violates federal drug laws. He has sued to block the site, supported by several leading Democrats in the city, including the mayor and district attorney, and at least seven state attorneys general. (Dale, 8/19)

Stat: Scientist Denies Wrongdoing In Novartis Data Manipulation Scandal
The Novartis (NVS) scientist who was ousted by the drug maker in connection with a scandal over data manipulation broke his silence late Monday, saying through a lawyer that he categorically denied any wrongdoing and was “prepared to assert his rights and defend his conduct accordingly.” The researcher, Brian Kaspar, was dismissed from the company, along with his brother, Allan. Both were leading scientists at AveXis, which developed the gene therapy Zolgensma and which was later acquired by Novartis. The Food and Drug Administration earlier this month accused the drug maker of falsifying preclinical data related to its application for approval of the treatment. (Herper, 8/19)

Bloomberg: Juul, Philip Morris Sued Under Racketeer Act For Targeting Kids 
E-cigarette maker Juul Labs Inc. and Philip Morris USA Inc. were sued for illegally marketing nicotine-delivery devices to minors and deceiving consumers about the risks of vaping. The lawsuit was filed on behalf of a 19-year-old, Christian Foss, who says he became addicted to nicotine and suffered worsening asthma symptoms after he began using Juul’s device at 16, and seeks to represent all Illinois minors who used it. It alleges that Juul and Philip Morris violated the Racketeer Influenced and Corrupt Organizations Act, adopting the tobacco industry’s past use of catchy ad campaigns aimed at children. The Justice Department invoked RICO to sue the industry two decades ago. (Hanna, 8/19)

The New York Times: ‘Tasting Funny For Years’: Lead In The Water And A City In Crisis
Donnette Goodluck tried all day to pick up the free bottled water the city was distributing as officials addressed a growing lead contamination crisis. When she first arrived at Boylan Street Recreation Center last Tuesday at 10:30 a.m., the line wrapped around the block; Ms. Goodluck and others were told to come back at 1 p.m. At 1 p.m., she was instructed to come back two hours later. Uncertain she could find a neighbor to watch the six children she babysits, she gave up. (Goldbaum, 8/20)

NPR: Study: Fluoride Consumption During Pregnancy May Affect Child's IQ
A study published Monday suggests that fluoride consumed by pregnant women can decrease the IQ of their children. No single study provides definitive answers, but the latest research on this controversial topic will no doubt stir debate. Fluoride protects teeth from decay, so public health officials celebrate what has been accomplished by putting it in many water supplies. But Christine Till, an associate professor of psychology at York University in Toronto, also wondered about potential downsides. (Harris, 8/19)

The Wall Street Journal: Can Dancing Prevent Dementia?
Elvis Presley croons in the background as dance teacher Stine Moen gently calls out dance steps. “Right, left, rock step,” says Ms. Moen, demonstrating the Lindy hop to six seniors. “Sloooooow, sloooow, quick, quick.” The seniors follow: some in step, others more tentative. “Stop right there,” she says, and turns the music off. The seniors sit down and a woman comes to take their blood pressure. This is no routine dance class. The participants are part of a study at Albert Einstein College of Medicine looking at whether group dancing might be a useful tool in helping to prevent dementia. (Reddy, 8/19)

ProPublica: The Car Seat Industry Helped Delay A Child Safety Regulation — Again
A long-awaited federal safety standard to test child car seats for their effectiveness in side-impact car crashes has been delayed to March 2020 — more than six years since the regulation was first proposed and nearly two decades since Congress urged the Department of Transportation to address the issue. Attempts to improve car seat safety have bogged down because of a lack of good data on accidents involving children, antiquated technology and industry lobbying. The car seat industry has sought to delay the side-impact rule, arguing that the government should not act without also updating its other safety standards for car seats. (Porat, 8/20)

Reuters: U.S. Records 21 New Measles Cases As Of Last Week
The United States recorded 21 new measles cases last week, raising the total number of cases for the year to 1,203 across 30 states in the worst outbreak of the virus since 1992, federal health officials said on Monday. The U.S. Centers for Disease Control and Prevention said there had been a 1.8% increase in the number of cases of the highly contagious and sometimes deadly disease between Aug. 8 and Aug. 15. (8/19)

The New York Times: Premature Babies Lag In Vaccinations
Many premature babies, who are at increased risk for vaccine-preventable diseases, are not getting their vaccinations on time. Researchers in Washington State retrospectively studied vaccination rates among 10,367 infants born between 2008 and 2018 at academic medical centers or affiliated health care settings. About 20 percent were born prematurely. (Bakalar, 8/19)

The Wall Street Journal: Vaping Moves From The Bathroom To The Classroom
Kids used to duck into the school bathroom to sneak a drag on a cigarette. But with the electronic kind, they are becoming increasingly daring, often vaping right under their teachers’ noses. I spoke to more than two dozen teachers, students and administrators across the country about the creative ways high-school and even middle-school kids have found to hide vape pens and take hits of nicotine—and sometimes marijuana—in class. Students conceal them in highlighter pens, pencil cases and long-sleeve shirts. (Jargon, 8/20)

The New York Times: The Keto Diet Is Popular, But Is It Good For You?
Low-carbohydrate diets have fallen in and out of favor since before the days of Atkins. But now an even stricter version of low-carb eating called the ketogenic diet is gaining popular attention, igniting a fierce scientific debate about its potential risks and benefits. Both the Atkins and ketogenic diets encourage followers to cut carbs from their diets. But while the Atkins diet gradually increases carbs over time, keto places firm limits on carbs and protein. (O'Connor, 8/20)

Reuters: Alaska Governor Reverses Course On Controversial Budget Cuts
Alaska's governor signed a budget bill on Monday rolling back most of the deep, highly controversial spending cuts he imposed weeks ago on the University of Alaska but rebuffed a renewed bid by lawmakers to restore funding he slashed from health programs. The partial funding restoration marked the latest in a pitched budget battle between Governor Mike Dunleavy, a Republican serving his first year in office, and a bipartisan coalition in the Republican-dominated state legislature. (8/19)

The Associated Press: Nebraska Moves All Girls Out Of Facility For Troubled Youth
Nebraska officials are moving 24 teenage girls out of a state-run facility for female juvenile offenders after learning that many were confined to buildings with fire hazards, holes in the wall and mold and water damage. The Department of Health and Human Services announced the move Monday after some state lawmakers voiced concerns about the conditions and a lack of staff and programming at the Youth Rehabilitation and Treatment Center in Geneva. (Schulte, 8/19)

The Wall Street Journal: New York City Union Uses Its Size To Leverage Improved Maternity Care
In a bid to provide better health outcomes for pregnant women and reduce health care costs, one of New York City’s largest unions is pushing local hospital systems to create specialty maternity-care networks. This week, the health fund of Local 32BJ of the Service Employees International Union will request that area hospital systems provide information on rates of maternal harm and apply to a newly created program promising higher quality, higher value care. (West, 8/19)

ProPublica: Inside The Prison Where Inmates Set Each Other On Fire And Gangs Have More Power Than Guards
Jeffery Wilemon clutched his gut, throbbing in pain as he lay on his bed inside the South Mississippi Correctional Institution in April. But there was no way for him to cry out — not unless he wanted another beating. Hours earlier, inmates had slugged the 54-year-old and declared that he needed to “follow the rules” their gang had set for prison life, he later wrote in a handwritten pleading filed in Itawamba County Circuit Court. (Mitchell, 8/19)

The Associated Press: SC Elementary Reopening Despite Toxic 'Trash Mountain' Fire
A South Carolina elementary is reopening for the first day of school despite a smoldering, toxic fire in a 50-foot trash pile at a nearby recycling center. News outlets report Beaufort County School District decided to open Okatie Elementary as scheduled on Monday. It says a sensor at the school shows the air is safe, despite the ongoing blaze less than a mile away at the site known locally as Trash Mountain. (8/19)

The Associated Press: Wildfire Acreage Way Down In California This Year — So Far
California is not burning. At least not as much as it has in recent years. Acreage burned through Sunday is down 90% compared to the average over the past five years and down 95% from last year, according to statistics from the Department of Forestry and Fire Protection. The stats are good news for a state that has seen terrifyingly destructive and deadly blazes the past two years, but the worst of those fires occurred in the fall. (8/19)