First Edition: August 22, 2018

Kaiser Health News: Battle Lines Drawn As Abortion-Rights Activists Leave Their Mark Outside Clinics
Abortion-rights activists in California and beyond have launched or stepped up information campaigns in response to a June U.S. Supreme Court ruling that crisis pregnancy centers cannot be required to tell women about the availability of publicly funded family planning services, including contraception and abortion. Through sidewalk drawings, bus-shelter ads and pop-up messages on mobile devices, these activists seek to spread the word themselves about such services, especially to young, low-income women. They aim to warn them about what they see as incomplete or false information provided by the centers, which are typically affiliated with Christian organizations and seek to persuade women to continue their pregnancies. (Ibarra, 8/22)

Los Angeles Times: Once Their Rallying Cry, Obamacare Is Suddenly A Sticky Campaign Issue For Republicans
After failing to deliver on their years-long promise to repeal the Affordable Care Act and faced with the sudden popularity of Obamacare’s consumer protections, GOP candidates across the country are struggling to put together a cohesive message on healthcare. Die-hards still want to repeal the 2010 law, but a growing number of Republicans — particularly those facing tough elections — want to quietly admit defeat and move on to other issues. (Haberkorn, 8/21)

The Washington Post: Sen. Susan Collins Says Kavanaugh Sees Roe V. Wade As ‘Settled Law’
A Republican senator whose vote could ensure the confirmation of Supreme Court nominee Brett M. Kavanaugh offered an upbeat assessment of their meeting Tuesday, highlighting the judge’s statement that the Roe v. Wade decision legalizing abortion is “settled law.” Sen. Susan Collins (Maine), a centrist who supports abortion rights, appeared to be leaning toward backing President Trump’s nominee after a one-on-one session that lasted more than two hours. Collins said she would announce her decision after confirmation hearings next month. (Viebeck and Pogrund, 8/21)

The New York Times: Roe Is ‘Settled Law,’ Kavanaugh Tells Collins. Democrats Aren’t Moved.
Democrats immediately pounced on the “settled law” construction, saying it is a standard phrase employed to duck the real question: whether Roe was correctly decided. “Let’s be clear; this is not as simple as Judge Kavanaugh saying that Roe is settled law,” Senator Chuck Schumer of New York, the minority leader, told reporters. “Everything the Supreme Court decides is settled law until it unsettles it. Saying a case is settled law is not the same thing as saying a case was correctly decided.” (Stolberg, 8/21)

NPR: Collins Says Supreme Court Nominee Kavanaugh Called Roe V. Wade 'Settled Law'
That assurance, made during a Tuesday morning meeting in the Maine senator's office that lasted more than two hours, likely goes a long way toward securing a key vote for Kavanaugh's confirmation. Collins supports abortion rights and made sure to point out she viewed the 1973 decision as "settled law" in her initial reaction to the news that abortion rights swing vote Anthony Kennedy was retiring from the Supreme Court. (Detrow, 8/21)

Politico: Collins: Kavanaugh Sees Roe V. Wade As 'Settled Law'
Collins said she also spoke to Kavanaugh “at length” about Garza v. Hargan, the only abortion case Kavanaugh has rendered a decision on. “We talked about whether he considered Roe to be settled law,” Collins told reporters. ... Collins and Sen. Lisa Murkowski (R-Alaska), who will meet with Kavanaugh later this week, are viewed as possible swing votes on Kavanaugh’s confirmation. Both moderate Republicans are sympathetic to abortion rights. (McCaskill, 8/21)

The Wall Street Journal: Kavanaugh Says Roe V. Wade Is ‘Settled Law,’ GOP Senator Says
Judge Kavanaugh’s comments, as reported by Ms. Collins, echo how other Republican nominees have handled the issue of abortion during confirmation battles. Chief Justice John Roberts said at his 2005 confirmation hearing that Roe v. Wade was precedent and “it is not enough that you may think the prior decision was wrongly decided” to reopen a case. ... Judge Kavanaugh’s record on abortion has been under scrutiny on Capitol Hill. As a judge on the influential U.S. Court of Appeals for the District of Columbia Circuit, Judge Kavanaugh has had no choice but to follow law as settled by the Supreme Court, as lower courts are required to do. At times his opinions suggest that is the only reason he has done so. (Andrews and Tau, 8/21)

Reuters: FDA Extends EpiPen Expiry Date To Combat Shortage
The U.S. Food and Drug Administration on Tuesday extended the expiration date of specific lots of Mylan NV’s EpiPen allergy injectors by four months to mitigate the shortage of the life-saving treatment. The decision comes at a time when the shortage has come under focus at the start of back-to-school season, and applies to specific lots of 0.3 milligram EpiPen products, after the regulator reviewed data provided by Mylan. (8/21)

USA Today: VA Wrongly Denied Hundreds Of Veteran Claims Of Military Sexual Trauma
The Department of Veterans Affairs improperly denied hundreds of military sexual trauma claims in recent years, leaving potentially thousands of veterans suffering from post-traumatic stress disorder without benefits, a VA inspector general investigation found. Last year alone, the investigation found the agency mishandled as many as 1,300 sexual trauma claims. Some 12,000 veterans file for sexual trauma-related PTSD benefits each year.  (Slack, 8/21)

The Wall Street Journal: VA May Have Erred In Rejecting Sexual-Trauma Claims, Report Says
The VA declined to comment beyond its official response to the report. In that response, Paul Lawrence, the top VA official for benefits, concurred with the findings and said the department would review all denied military sexual-trauma claims stretching back to late 2016. He also said the VA would improve training for claims processors and make sure trauma claims are handled by case workers with specialized training. The VA doesn’t expect to complete these fixes until fall of 2019. (Kesling, 8/21)

The Associated Press: US Plan For Coal Power Deregulation Could Cause More Deaths
EPA officials said they could give no firm projections for the health effects of their plan because that will depend on how states regulate power plants within their borders. But models provided by the agency estimate that under the Trump plan, 300 to 1,500 more people would die prematurely each year by 2030, compared to the Obama plan. The models for the Trump plan also project tens of thousands of additional major asthma attacks and hundreds more heart attacks compared with the Obama plan. (Knickmeyer and Borenstein, 8/22)

The New York Times: Cost Of New E.P.A. Coal Rules: Up To 1,400 More Deaths A Year
The Trump administration has hailed its overhaul of federal pollution restrictions on coal-burning power plants as creating new jobs, eliminating burdensome government regulations and ending what President Trump has long described as a “war on coal.” The administration’s own analysis, however, revealed on Tuesday that the new rules could also lead to as many as 1,400 premature deaths annually by 2030 from heart and lung disease, up to 15,000 new cases of upper respiratory problems, a rise in the extremely fine particulate matter that can trigger bronchitis, and tens of thousands of missed school days because of to increased pollution. (Friedman, 8/21)

The Associated Press: States Blast Trump Administration Coal Plan, Mull Lawsuits
States with a history of fighting air pollution generated by coal-fired power plants on Tuesday criticized a move by President Donald Trump’s administration to scale back federal restrictions on emissions, with some threatening court challenges. Illinois Attorney General Lisa Madigan was among those who pledged to “take legal action to ensure the federal government does its job” to protect the environment and people’s health. ... New York Attorney General Barbara Underwood also vowed to sue the Environmental Protection Agency if the plan is approved. Both are Democrats. (Haigh, 8/21)

The Wall Street Journal: What Does Knee Surgery Cost? Few Know, And That’s A Problem
For nearly a decade, Gundersen Health System’s hospital in La Crosse, Wis., boosted the price of knee-replacement surgery an average of 3% a year. By 2016, the average list price was more than $50,000, including the surgeon and anesthesiologist. Yet even as administrators raised the price, they had no real idea what it cost to perform the surgery—the most common for hospitals in the U.S. outside of those related to childbirth. ... Prompted by rumblings from Medicare and private insurers over potential changes to payments, Gundersen decided to nail down the numbers. ... The actual cost? $10,550 at most, including the physicians. The list price was five times that amount. (Evans, 8/21)

NPR: Ohio Medicaid Expansion Cut Uninsured By Half, Report Finds
Four years after going out on a limb to get Medicaid expansion enacted in Ohio, outgoing Republican Gov. John Kasich is worried about the future of the program. So he is now defending it — through a study and through the stories of people who have benefited from the coverage expansion. (Kasler, 8/21)

The Associated Press: Delaware Officials Approve ACA Rate Request
Delaware regulators have approved a 3 percent rate increase for the lone insurer offering coverage under the Affordable Care Act in Delaware. Highmark Blue Cross Blue Shield of Delaware initially sought an average rate increase of 5.7 percent for individual plan coverage next year. The request was revised to 3.7 percent because the initial filing erroneously contained a risk adjustment factor. (8/22)

The Associated Press: Maryland Lawmakers Say Health Reinsurance Plan OK’d
Maryland lawmakers say a federal waiver has been approved to hold down consumer costs to Maryland’s individual market for insurance in the state’s health care exchange. Sen. Thomas Middleton and Del. Joseline Pena-Melnyk said Tuesday the federal government has approved Maryland’s plan to create a reinsurance plan. The lawmakers, both Democrats, sponsored legislation for the plan. (Witte, 8/21)

CNN: Suicide Rates In Rural America Are Soaring. One Family Is Working To Change That.
The suicide rate in rural America is 45% greater than in large urban areas, according to a study released last fall by the US Centers for Disease Control and Prevention. A more recent CDC report said Montana's suicide rate leads the nation, coming in at nearly twice the national average. A third long-touted CDC study, currently under review, listed farming in the occupational group, along with fishing and forestry, with the highest rate of suicide deaths. (Ravitz, 8/21)

NPR: Poll: Most Americans Know About Opioid Antidote And Are Willing To Use It
After the surgeon general called for more people to be prepared with naloxone, we decided to ask Americans about their knowledge about the opioid antidote's availability, attitudes toward using it and experience with the medicine in the latest NPR-IBM Watson Health Health Poll. The survey queried more than 3,000 households nationwide in May. We wondered how many people know about naloxone and the fact that someone doesn't have to be a medical professional to administer it. Fifty-nine percent of respondents said they were aware of the antidote and that it could be given by laypeople; 41 percent said they weren't. (Hensley, 8/21)

The Associated Press: AG Jeff Sessions To Address US Opioid Epidemic In Cleveland
U.S. Attorney General Jeff Sessions is expected to discuss the country’s opioid epidemic in Cleveland. Sessions is scheduled to address the crisis Wednesday at the federal courthouse. A news release says Sessions will talk about the Justice Department’s efforts to combat the epidemic. Ohio has been one of the states hardest hit. (8/22)

Stat: The Trump Administration Can't Decide Whether To Boost PBMs Or Rein Them In
Some days, President Trump vows to eliminate them. But then, there are days when his top health lieutenants promise to empower them. There are even days when they do both. The mixed and muddled signals from the administration are over the increasingly contentious role of the pharmacy benefit managers, or PBMs. Those discordant signals reflect a lack of clarity from Trump and his lieutenants over how best to address one of their top priorities: how to lower prescription drug prices. (Swetlitz, 8/22)

Stat: China's First Cancer Immunotherapy Will Cost Half Of What It Costs In The U.S.
The blockbuster cancer drug Opdivo will be sold for about $84,000 per year in the Chinese market, before discounts — meaning that China’s first cancer immunotherapy will come at about half the price it costs in the U.S. The price tag for the Bristol-Myers Squibb drug, which is in line with analysts’ expectations, will be an early test of whether the Chinese market can support a coming wave of innovative but pricey medicines. (Robbins, 8/21)

The Wall Street Journal: Biotech Instrument Maker Bionano Genomics Bucks Trend In $20.6 Million IPO
Bionano Genomics Inc. has gone public in an unusual move for a venture-backed biotech research instrument company, making its Nasdaq debut Tuesday. Drug developers capture the bulk of medical venture-capital dollars, and among health-care startups, they are the most likely to go public. Drug makers also made up the majority of the 29 venture-backed health-care companies that staged initial public offerings in the first half of the year, according to Dow Jones VentureSource. (Gormley, 8/21)

Los Angeles Times: Maternal Mortality Rates In The U.S. Have Risen Steadily. Sen. Kamala Harris Has A Plan To Change That
Sen. Kamala Harris says she wants to force the medical community to address an uncomfortable reality: Black women in the United States are three to four times more likely than white women to die immediately before or after child birth. The California Democrat plans to introduce a bill Wednesday to provide $30 million in annual grants to train against racial bias and to incentivize healthcare professionals to address the disparity in maternal health outcomes. (Haberkorn, 8/22)

NPR: West Coast Smoke: Scientists Warn Of Longer And Harsher Season
Across California and the West, where dozens of large wildfires are burning, public health agencies are urging people to seal off their windows and doors, change filters in air conditioning units and in some places wear masks if they have to go outside for any extended period. Just as the wildfire season is getting longer and more destructive in the West due to climate change and prior forest management, scientists are warning of a lengthening — and worsening — smoke season. The fires themselves have burned hundreds of homes and forced thousands to evacuate. But the smoke, and the unhealthy toxins blowing in with it, will directly affect hundreds of thousands more people. (Siegler, 8/21)

USA Today: Las Vegas Shooting: Doctor Faces Discipline Over Drug Records
A Nevada state licensing board has accused a doctor and his staff of accessing the private prescription drug records of Las Vegas shooter Stephen Paddock before similar details were published by a media outlet. The doctor, Ivan Goldsmith, an internal medicine and weight-loss specialist who owns the Trimcare clinic in Las Vegas, is scheduled to appear before the Nevada State Board of Pharmacy on Sept. 5 to face possible discipline over the disclosure of Paddock's prescription drug records, according to pharmacy board officials.  (Alltucker, 8/21)

NPR: For Cervical Cancer Screening, Women Over 30 Can Now Choose The HPV Test Only
Federal health advisors say women can now consider three options when it's time for their cervical cancer screening tests. The influential group, the U.S. Preventive Services Task Force (USPSTF), has expanded its recommendations for this potentially life-saving exam. The new recommendations are published in the latest issue of JAMA. (Harris, 8/21)

The New York Times: A Candidate Backed Medical Marijuana. Wells Fargo Closed Her Bank Account.
Wells Fargo isn’t the first bank to close a customer’s account over money that could be related to the sale of marijuana, which is legal in some form in states including Florida but still prohibited by federal law. That conflict has had banks large and small walking a line for more than a decade, since the first states began changing their cannabis laws. Marijuana growers have struggled to open and maintain bank accounts, and dispensaries have relied on cash to do business instead of credit cards. Businesses like construction companies and electricians that provide services to the growers and distributors have also had problems. (Flitter, 8/20)

The Associated Press: Herbalife Distributors Claim In $1B Suit Events Were A Sham
Patricia and Jeff Rodgers figured they did everything right to get rich beyond their wildest dreams selling Herbalife health and personal care products. They attended all of the “Circle of Success” events, brought in new recruits, met their quotas on buying Herbalife goods to sell and even set up a storefront shop. But they didn’t get rich. Instead, Patricia Rodgers estimates the couple lost over $100,000, including about $20,000 spent on attending Herbalife events. Now, the couple and others are suing the multi-level marketing company that sells its products through a network of distributors who recruit more distributors. The potential class-action case could involve more than 100,000 plaintiffs and might mean as much as $1 billion in damages. (Anderson, 8/21)