First Edition: Dec. 7, 2022

KHN: Paxlovid Has Been Free So Far. Next Year, Sticker Shock Awaits.
Nearly 6 million Americans have taken Paxlovid for free, courtesy of the federal government. The Pfizer pill has helped prevent many people infected with covid-19 from being hospitalized or dying, and it may even reduce the risk of developing long covid. But the government plans to stop footing the bill within months, and millions of people who are at the highest risk of severe illness and are least able to afford the drug — the uninsured and seniors — may have to pay the full price. And that means fewer people will get the potentially lifesaving treatments, experts said. (Recht, 12/7)

KHN: Colorado Option’s Big Test: Open Enrollment
Critics declared Colorado’s new quasi-public option a failure this fall, before it was even available for purchase on the state’s Affordable Care Act health insurance marketplace. They seized on an October announcement from the state that premiums for individual coverage were rising by an average of 10% in 2023 despite the arrival of the much-anticipated Colorado Option, which was meant to drive down costs. What’s more, people in most counties had access to traditional plans that were cheaper than the new option. Supporters warned against calling the Colorado Option a bust just yet. With open enrollment underway, consumers on the ACA marketplace can choose Colorado Option plans for the first time since the 2021 law that created them took effect. State officials are betting that people will look beyond the cost of the premiums. (Hawryluk, 12/7)

KHN: Watch: Big Medicaid Changes In California Leave Millions Of Patients Behind
KHN senior correspondent Angela Hart appeared on Spectrum News 1’s “Los Angeles Times Today” on Nov. 29 to discuss her reporting on California’s pricey and ambitious experiment to transform its Medicaid program, called Medi-Cal. The initiative, known as CalAIM, will provide some of Medi-Cal’s sickest and costliest patients with social services such as home-delivered healthy meals, help with housing move-in costs, and home repairs to make living environments safer for people with asthma. (12/7)

Politico: Defense Bill Rolls Back Pentagon’s Covid Vaccine Mandate 
A compromise defense policy bill released Tuesday night would end the Pentagon’s policy requiring troops to receive the Covid vaccine — and kicking out those troops who refuse it — delivering a win to Republicans who railed against the policy. A final version of the National Defense Authorization Act included the measure after conservatives threatened to hold up the bill to curtail the vaccine mandate. The policy became a point of contention in talks in recent days between Democratic and Republican leaders over the bill. (O'Brien, 12/6)

The Hill: Democrats Make Major Concession On Vaccine Mandate 
In a compromise with Republicans, House Democrats are allowing language into the National Defense Authorization Act (NDAA) that repeals the coronavirus vaccine mandate for U.S. service members a year after it was enacted, House Armed Services Committee ranking member Mike Rogers (R-Ala.) confirmed to The Hill Tuesday. The bill, which lays out how an $847 billion Defense Department top line will be allocated in fiscal 2023, is tentatively set to be released as early as Tuesday evening and voted on by the House Thursday, Rogers said. Asked if he believes the language will stick amid all the last-minute jostling over the bill, Rogers replied: “Yes.” (Mitchell, Frazin and Lillis, 12/6)

The Wall Street Journal: Lawmakers Agree To Rescind Military’s Covid-19 Mandate In Defense Deal 
House Minority Leader Kevin McCarthy (R., Calif.) hailed the revocation of the vaccine mandate as a victory for the military and common sense. But the policy change doesn’t reinstate troops discharged for refusing the vaccine, as Mr. McCarthy and other Republicans had wanted. (Wise and Ferek, 12/6)

The New York Times: Georgia Win Gives 51-49 Senate Majority To Democrats 
Senator Raphael Warnock’s victory in Georgia’s runoff election on Tuesday delivered Democrats just one additional seat, but that single layer of padding for their majority will hand them exponentially more leeway to control the chamber than they have now. ... With an additional vote, Democrats can take much more operational control of the Senate, easing the confirmation of contentious nominees, clearing the way for investigations and in general availing themselves of breathing room on a variety of matters. (Hulse, 12/6)

The Washington Post: Scathing Report Urges Major Changes At FDA, Including Possibly Breaking Up Agency
An outside group that was asked to examine problems at the Food and Drug Administration in the wake of an infant formula crisis this year offered a scathing indictment of the agency’s structure and culture and recommended major restructuring, including possibly breaking up the agency so that oversight of the food system gets more attention. The FDA has long been accused of giving its food program short shrift, and it came under fire from members of Congress and others for not heading off a formula shortage that left many parents scrambling to feed their infants. (Reiley, 12/6)

The New York Times: FDA Report Faults Agency’s Food Unit For Leaderless Dysfunction
The Food and Drug Administration’s food division has no clear leadership, avoids bold policy or enforcement actions, and fosters a culture that doesn’t adequately protect public health, according to a report issued on Tuesday by an agency-related group. Experts with the group, the Reagan-Udall Foundation, which was asked to examine the food division after widespread criticism stemming from the infant formula crisis, concluded in the report that the division’s management structure and mission should be overhauled. (Jewett, 12/6)

Politico: ‘Constant Turmoil’ At FDA’s Food Regulatory Agency, Report Says 
In response to the report, the FDA said in a statement that it plans to release a public update on the “new vision” in January 2023 and any changes to leadership as well as internal process and procedures by February 2023. The “new vision and structure” will be based on the RUF report, the internal review of the FDA’s response to the infant formula crisis as well as new advances in food science. (Brown, 12/6)

AP: Speedier Drug Approvals Hit Slowdown As FDA Faces Scrutiny 
Expedited drug approvals slowed this year as the Food and Drug Administration’s controversial accelerated pathway came under new scrutiny from Congress, government watchdogs and some of the agency’s own leaders. With less than a month remaining in the year, the FDA’s drug center has granted 10 accelerated approvals — fewer than the tally in each of the last five years, when use of the program reached all-time highs. (Perrone, 12/7)

Axios: FDA Fast-Tracks Review Of Over-The-Counter Opioid Drug
A nasal spray for reversing opioid overdoses could become available over-the-counter as early as next March after the Food and Drug Administration gave it priority review. Advocacy groups, medical associations and federal agencies have said expanding the availability of naloxone is critical to addressing the addiction epidemic that killed more than 100,000 Americans last year. (Moreno, 12/7)

CBS News: Narcan Maker Says Anti-Opioid Nasal Spray Will Soon Be Available Over The Counter
Emergent BioSolutions on Tuesday said the Food and Drug Administration has fast-tracked its application for an over-the-counter version of Narcan, a nasal-spray form of naloxone. Approved in 2015, Narcan and its somewhat less expensive generic competitors are widely used by first responders and laypeople to treat known or suspected opioid overdoses that kill tens of thousands of Americans in the U.S. each year. (Gibson, 12/6)

Modern Healthcare: Health Insurance Prior Authorization Rules Proposed By CMS
The regulation would require Medicare Advantage, Medicaid and health insurance exchange carriers to ease their prior authorization processes and respond to “urgent” requests within 72 hours and standard requests within seven days. This would halve the amount of time Medicare Advantage plans currently have to respond to clinicians’ prior authorization requests, according to CMS. (Tepper, 12/6)

The Boston Globe: Pfizer Partners With Tiny Cambridge Startup To Develop New COVID Pills
The coronavirus hasn’t seen the last of Pfizer yet. The pharmaceutical giant has tapped Clear Creek Bio, a tiny Cambridge startup, for help in developing new antiviral pills that treat COVID-19, the companies said Tuesday. (Cross, 12/6)

Reuters: Pandemic Lockdowns Linked To Decline In U.S. Twin Births, Study Suggests
Reduced access to infertility treatments early in the pandemic may have contributed to a drop in twin births, data from the U.S. Centers for Disease Control and Prevention suggest. The number of twin births fell 7% between 2019 and 2020 - from 120,291 to 112,437 - compared to an average 2%-per-year decline from 2014 to 2019, researchers reported on Wednesday in the CDC's National Vital Statistics Reports, based on data from 50 states and the District of Columbia. (Alleyne-Morris, 12/7)

Los Angeles Times: L.A. County Coronavirus Cases Spike; Deaths Rise
Los Angeles County appears in the midst of another full-blown coronavirus surge, with cases doubling since Thanksgiving. The spike — which partially captures but likely does not fully reflect exposures over the Thanksgiving holiday — is prompting increasingly urgent calls for residents to get up to date on their vaccines and consider taking other preventive steps to stymie viral transmission and severe illness. (Money and Lin II, 12/6)

The Washington Post: Strep A: What To Know About The Usually Mild Infection Leading To Children’s Deaths
Strep A is highly contagious and commonly carried by many of us in our nose and throats and on our skin without resulting in serious illness, medical officials and experts say. While most cases are not life-threatening, it can develop into an infection known as invasive Group A strep (iGAS), which can be fatal, with the risk greatest among children and the elderly. (Hassan and Suliman, 12/6)

CIDRAP: COVID-19 Rebound Found Uncommon After Antiviral Treatment 
Early reports suggested a link between nirmatrelvir-ritonavir (Paxlovid) and viral rebound, but more recent studies have concluded that rebound may be simply part of the natural course of some COVID-19 cases. (Van Beusekom, 12/6)

CIDRAP: Meta-Analysis Estimates 29% Vaccine Effectiveness Against Long COVID 
A meta-analysis of six studies estimates that one dose or more of COVID-19 vaccine is 29% effective against symptoms persisting for at least 3 weeks after infection, or long COVID. (Van Beusekom, 12/6)

Reuters: China Loosens Anti-COVID Rules In Major Policy Shift
China announced on Wednesday the most sweeping changes to its tough anti-COVID regime since the pandemic began three years ago, loosening rules that curbed the spread of the virus but had hobbled the world's second largest economy and sparked protests. The relaxation of rules, which include allowing infected people with mild or no symptoms to quarantine at home and dropping testing for people travelling within the country, are the strongest sign yet that Beijing is preparing its people to live with the disease. (Pollard and Goh, 12/7)

Las Vegas Review-Journal: Pagan Nurse Files Religious Discrimination Lawsuit Against UMC
A Las Vegas nurse and self-described pagan has sued the hospital that fired her after it rejected her request for a religious exemption to its COVID-19 vaccination requirement. (Hynes, 12/6)

AP: New Zealand Court Rules Against Anti-Vax Parents Of Ill Baby 
A New Zealand court temporarily took away medical custody of a baby from his parents on Wednesday after they refused blood transfusions for him unless the blood came from donors who were unvaccinated against COVID-19. The court’s ruling in favor of health authorities places the 4-month-old boy into the guardianship of authorities until after he undergoes an urgently needed heart operation and recovers. The parents remain in charge of decisions about their boy that don’t relate to the operation. (Perry, 12/7)

CIDRAP: Shortage Of ADHD Drug Adderall Likely To Last Into 2023
Americans with attention-deficit hyperactivity disorder (ADHD) are struggling to find good alternatives to the stimulant Adderall, which has been in short supply this fall and will likely not be back in stock until early next year. (Van Beusekom, 12/6)

CBS News: Young Man's Death Leads To Questions About An Adderall Prescription Obtained Online
Elijah Hanson struggled with his mental health for years. The 21-year-old from Tacoma, Washington, had been diagnosed with antisocial personality disorder and was receiving treatment from a local behavioral health clinic. According to years of therapy notes, he was desperate to better understand himself and his emotions. (Werner and Kegu, 12/6)

Stat: Eli Lilly Tightens Access To Diabetes Drug, Frustrating Obesity Patients
Touted by celebrities, raved about by TikTok users and advertised by med spas, a new class of drugs for treating diabetes and obesity has exploded in popularity for its weight-loss effects, leading to rippling shortages across several of the medications. Amid the surge in demand, Eli Lilly and pharmacies have started to tighten access to the latest of this type of drug, tirzepatide, focusing on giving it to people with type 2 diabetes, the only population it’s authorized for so far. (Chen, 12/7)

Modern Healthcare: IHI, AMA Launch National Coalition Targeting Health Equity
The Institute for Healthcare Improvement and American Medical Association are launching a coalition to bring together hundreds of health systems, companies and organizations with the goal of developing a cohesive approach to more equitable patient care and remove areas of inequity and bias. (Devereaux, 12/6)

CBS News: Hospital Shutdown In Pennsylvania Spurs Questions About Private Equity In Health Care
After a car accident last month, Latifa Dixon, a mother of two, arrived at the emergency room at Delaware County Memorial Hospital in suburban Philadelphia only to learn the ER had just shut down. Twenty-eight-year-old Cecilia Vizuete, who was having trouble feeding her one-year-old daughter because of a breast infection, said she was told by a security guard to search Google Maps for another hospital. Shirley Posey arrived there suffering from shortness of breath and tightness in her chest. (Lapook and Kaplan, 12/6)

AP: Minnesota Nurses Reach Tentative Contract, Averting Strike
The union representing Minnesota nurses announced Tuesday that it has reached tentative contract agreements with 15 hospitals in the Twin Cities and Duluth areas, averting a strike that was scheduled to begin Sunday. (12/6)

AP: Foundations, Major Donors Tackle Nation’s Nursing Shortage 
As more nurses leave their jobs in hospitals and health-care centers, foundations are pouring millions of dollars into efforts to ensure that more stay in the profession and get more out of the job than just the applause and pats on the back they got during the bleakest days of the pandemic. (Daniels, 12/6)

Stat: Limits Of ‘Fauci Effect’: Infectious Disease Applicants Plummet
The lack of doctors entering ID fellowships — and the ensuing shortage of these specialists — has been a concern for years, with experts pointing to the comparatively low earnings these physicians make as a major disincentive for doctors considering which field to enter. But this year’s numbers marked a backslide. Fully a quarter of available positions went unfilled. Among the fellowship programs, 44% didn’t fill their slots, according to data from the National Resident Matching Program. (Joseph, 12/7)

CBS News: End Of Blanket Restriction On Gay Blood Donors To Face Key Federal Vote Next Year 
A panel of federal advisers could vote early next year on new recommendations about the nation's blood supply, the Biden administration says, in one of the key final hurdles to ending a sweeping federal ban on blood donations from sexually active gay men. (Tin, 12/6)

NBC News: Drug Deaths Among Pregnant Women Hit A Record High
The number of pregnant women and new mothers dying from drug overdoses grew dramatically as the pandemic took hold, reaching a record high in 2020, a new study finds. The research, published Tuesday in JAMA, provides a stark look at how substance use disorder is harming pregnant people who are less likely than others to seek or receive help for a dependency on opioids and other drugs. (Edwards, 12/6)

Reuters: Alabama Case Over Mistaken Pregnancy Highlights Risks In A Post-Roe World
Etowah County officials are facing what appears to be the first lawsuit in the state alleging false imprisonment because a woman who was jailed for exposing her unborn child to drugs wasn’t pregnant — although it isn’t the first time such dystopian injustice has played out in Alabama. Stacey Freeman, who is seeking compensatory and punitive damages, was under investigation by a family services agency for substance abuse when her daughter incorrectly told social workers that Freeman was pregnant, according to her Nov. 7 complaint. Freeman said she offered to take a pregnancy test, but it wasn’t administered. (Kanu, 12/6)

San Francisco Chronicle: San Francisco’s Plan To Open 12 Supervised Drug Consumption Sites Stalled By Legal Issues
San Francisco’s plan to open a dozen so-called wellness hubs where people can use drugs under the supervision of trained staff, including a couple by next June, has stalled because of legal and logistical issues. (Moench, 12/6)

Houston Chronicle: Texas' Maternal Death Report Was Ready. So Why Was It Shelved?
State health officials had completed a long-awaited report on maternal deaths and were preparing talking points about the findings just days before it was shelved until after the November midterms, according to emails obtained by Hearst Newspapers. (Blackman and Gill, 12/6)

ABC News: Firearm Deaths Among Black Men At 28-Year High, Doctors Are Taking Steps To Reframe Gun Violence As One Of America's Major Health Crisis
"Gun violence is an incredible scourge in our country. Gun violence affects everybody, and that's an important thing to recognize. However, it affects certain groups far more than others. Black men speak to one of the greatest disparities, if not the greatest disparity," co-author Eric Fleegler, associate professor of pediatrics and emergency physician at Harvard Medical School, said in a statement. (Crittenden, 12/6)

Columbus Dispatch: Adult Changing Tables: More Sought In Ohio's Public Restrooms
Kim Boulter has used bathroom floors, angled the back of her van away from onlookers in various parking lots and cleared off conference room tables in order to change her 9-year-old son. (King, 12/6)

AP: New Mexico Governor Wants Free Lunch For All Students K-12
Gov. Michelle Lujan Grisham wants New Mexico to help provide school lunches without charge to all K-12 students across the state. Lujan Grisham spokeswoman Nora Meyers Sackett confirmed Tuesday that the governor will pursue legislation when lawmakers meet in January 2023 to ensure that every student has access to free and nutritious school meals by covering the cost of breakfast and lunch for students that don’t already qualify for free or reduced-price meals. (12/7)

AP: Dozens On Hunger Strike At Nevada Prison Over Food, Health 
At least two dozen people are on hunger strike over conditions at a maximum-security prison in rural eastern Nevada, prison officials and an advocacy organization said Tuesday. The strike was launched Thursday by people incarcerated at Ely State Prison who are fed up over what they say are inadequate food portions and shortages in the prison commissary, among other grievances, said Jodi Hocking, executive director of the prisoners’ rights group Return Strong. She said they’re also protesting longstanding problems at correctional facilities across the state. (Stern, 12/7)

Stateline: More States Offer Health Coverage To Immigrant Children
Come January, Connecticut and New Jersey will join the nine states plus Washington, D.C., that already allow children without permanent legal status to enroll in either Medicaid, the public health plan for residents with lower incomes, or in its sister program, the Children’s Health Insurance Program, known as CHIP. (Ollove, 12/6)

CBS News: Frozen Raspberries Recalled Due To Potential Hepatitis A Contamination 
Frozen raspberries are being recalled because of potential hepatitis A contamination. Exportadora Copramar, a company that exports fruit, is voluntarily recalling 1,260 cases of frozen raspberries sold under the James Farm brand. (O'Kane, 12/6)

CIDRAP: CDC Reports Cholera In A Few Travelers, Urges Travel History In Diarrhea Workup 
Amid an unprecedented increase in global cholera activity, eight infections in travelers returning from affected areas have been reported in the United States, the Centers for Disease Control and Prevention (CDC) said in an email to clinicians yesterday. (Schnirring, 12/6)

The Washington Post: Weighted Blankets May Boost Melatonin, A Sleep Hormone, Study Shows
The use of a weighted blanket may result in more melatonin — a sleep-promoting hormone produced by the brain — being released, the research reveals. ... While the study observed an increase in melatonin, it observed no difference in participants’ sleep duration or feeling of sleepiness with use of a weighted blanket. The researchers also measured oxytocin, a hormone released in response to physical touch that is known to induce feelings of well-being and calm, but saw no increase for the weighted blanket condition. (Kim, 12/6)

The Washington Post: Why You Don't Need To Drink Eight Cups Of Water A Day 
We’ve all heard the age-old advice to drink eight cups of water a day. But if you fall short, don’t worry: That advice is probably wrong anyway. That’s according to new research, published in the journal Science, which found that for most healthy adults, drinking eight cups of water a day is completely unnecessary. The advice is misguided in part because it doesn’t take into account all the water that we get from our food and from other beverages like coffee and tea. The research found that our water needs vary from one person to next and depend on factors like your age, sex, size, physical activity levels and the climate that you live in. (O'Connor, 12/6)

NBC News: Kirstie Alley Died Of Colon Cancer. These Are The Disease's Early Signs
Following the news that actor Kirstie Alley died of colon cancer at age 71, several doctors and cancer specialists urged people to get the recommended screenings for the disease. Alley's manager confirmed to NBC News on Tuesday that the actor died of colon cancer. Alley’s family said in a statement on Monday night that the cancer had only recently been discovered. (Bendix, 12/6)