First Edition: December 11, 2019

Kaiser Health News: When Teens Abuse Parents, Shame And Secrecy Make It Hard To Seek Help
Nothing Jenn and Jason learned in parenting class prepared them for the challenges they’ve faced raising a child prone to violent outbursts. The couple are parents to two siblings. They first fostered the children as toddlers and later adopted them. (KHN has agreed not to use the children’s names or the couple’s last names because of the sensitive nature of the family’s story.) In some ways, the family seems like many others. Jenn and Jason’s 12-year-old daughter is into pop star Taylor Swift and loves playing outside with her older brother. (Herman, 12/11)

Kaiser Health News: Supreme Court Seems Sympathetic To Insurers In Obamacare Case
No clear split between conservative and liberal Supreme Court justices emerged Tuesday as justices heard arguments over whether the federal government could renege on Congress’ promise to pay health insurance companies billions to motivate them to participate in the Obamacare marketplaces. (Galewitz, 12/10)

Kaiser Health News: Among U.S. States, New York’s Suicide Rate Is The Lowest. How’s That?
“I just snapped” is how Jessica Lioy describes her attempt in April to kill herself. After a tough year in which she’d moved back to her parents’ Syracuse, N.Y., home and changed colleges, the crumbling of her relationship with her boyfriend pushed the 22-year-old over the edge. She impulsively swallowed a handful of sleeping pills. Her mom happened to walk into her bedroom, saw the pills scattered on the floor and called 911. (Andrews, 12/11)

California Healthline: Books, Binders, Bleed-Control Kits: How School Shootings Are Changing Classroom Basics
When a student recently opened fire at a California high school, staff members did what they were trained to do. They shepherded students to safe spaces, barricaded doors, pulled shades — and, when gunfire struck, used techniques adapted from the battlefield to save lives. The staffers used two bleeding-control kits in the Nov. 14 shooting in Santa Clarita, in which two students were killed and three injured before the gunman fatally shot himself, said Dave Caldwell, spokesman for the William S. Hart Union High School District. The kits, a recent addition to the district northwest of Los Angeles, are equipped with tourniquets, compression bandages and blood-clotting hemostatic gauze to prevent excessive blood loss. (West, 12/10)

Reuters: U.S. Supreme Court Justices Lean Toward Insurers On $12 Billion Obamacare Claims
U.S. Supreme Court justices on Tuesday appeared sympathetic to claims made by health insurers seeking $12 billion from the federal government under a program set up by the Obamacare law aimed at encouraging them to offer medical coverage to previously uninsured Americans. The justices considered a challenge by a group of insurers of a lower court's ruling that Congress had suspended the government's obligation to make such payments. (Hurley, 12/10)

The New York Times: Supreme Court May Back Insurers In $12 Billion Obamacare Case
Paul D. Clement, a lawyer for the insurance companies, said his clients had been the victims of “a massive government bait-and-switch.” But Edwin S. Kneedler, a lawyer for the federal government, said a statutory promise to cover the companies’ losses was ineffective without a separate congressional appropriation of money. “The appropriations clause of the Constitution is central to this case,” he said, referring to a provision that says, “No money shall be drawn from the Treasury, but in consequence of appropriations made by law.” Requiring the government to pay the insurers, Mr. Kneedler said, “would impose unprecedented liability on the United States of billions of dollars.” (Liptak, 12/10)

The Wall Street Journal: Supreme Court Questions Government Bid To Avoid Paying Insurers Under Affordable Care Act
During an hourlong oral argument Tuesday, most of the justices seemed skeptical about the Justice Department’s arguments that the government didn’t have to pay roughly $12 billion. The money wasn’t owed, the department said, because lawmakers made changes to a program under the ACA called the “risk corridors” program. The three-year program aimed to keep premiums low and limit financial risks for insurers that offered coverage on the exchanges, a critical feature of the Obama-era health law. But after the ACA was enacted, Congress in later budget years attached appropriations provisions that effectively prohibited the government from making payments under the program. (Kendall, 12/10)

The New York Times: The I.R.S. Sent A Letter To 3.9 Million People. It Saved Some Of Their Lives.
Three years ago, 3.9 million Americans received a plain-looking envelope from the Internal Revenue Service. Inside was a letter stating that they had recently paid a fine for not carrying health insurance and suggesting possible ways to enroll in coverage. New research concludes that the bureaucratic mailing saved lives. Three Treasury Department economists have published a working paper finding that these notices increased health insurance sign-ups. Obtaining insurance, they say, reduced premature deaths by an amount that exceeded any of their expectations. (Kliff, 12/10)

The Associated Press: Buttigieg Discloses Ex-Clients As Fundraising Swing Begins
Facing intense pressure to answer questions about his work in the private sector, Democratic presidential contender Pete Buttigieg on Tuesday disclosed a roster of former consulting clients that include a major health insurance provider, a nationwide electronics retailer, the U.S. Department of Energy and the Department of Defense. (Peoples and Smith, 12/10)

The New York Times: How Pete Buttigieg Spent His McKinsey Days: Blue Cross, Best Buy, U.S. Agencies
The most politically troubling element of his client list might be his tenure working for Blue Cross Blue Shield of Michigan, a health care firm that at the time was in the process of reducing its work force. Last week Mr. Buttigieg’s campaign said his time in Michigan included “analytical work as part of a team identifying savings in administration and overhead costs.” While it was not yet clear exactly what Mr. Buttigieg did at Blue Cross, his work appeared to come at about the same time the insurer announced that it would cut up to 1,000 jobs — or nearly 10 percent of its work force — and request rate increases. (Epstein and Saul, 12/10)

The Atlantic: What Pete Buttigieg Says He Did At McKinsey
He said that while working with Blue Cross Blue Shield of Michigan, he remembered going along with his manager to a few meetings with people on staff, but he couldn’t remember any meeting he’d been able to attend on his own. “Mostly I was with fellow consultants in a room working on a spreadsheet,” he said, explaining that the analysis had focused on rent, travel costs, mail, and printing, but nothing having to do with policy or premium costs. He insisted that none of his work could have led to people’s insurance changing, or being taken away. (Dovere, 12/10)

Politico: Buttigieg Releases Names Of Consulting Clients
In 2007, Buttigieg analyzed Blue Cross Blue Shield of Michigan’s “overhead expenditures,” like rent, utilities and company travel, according to a memo from Buttigieg’s campaign. ... The insurance company was running into trouble, and two years later, in January 2009, Blue Cross and Blue Shield of Michigan cut nearly 10 percent of its workforce, after the company reported a loss of $140 million on health care plans. It had been a target for Michigan’s then-attorney general, who sued Blue Cross Blue Shield of Michigan multiple times and, in 2007, published a presentation titled, “Profits Over People: The Drive to Privatize and Destroy the Social Mission of Blue Cross and Blue Shield.” (Schneider, 12/10)

The Washington Post: Under Pressure, Buttigieg Releases Names Of Former McKinsey Clients
Buttigieg was 25 years old at the time he joined McKinsey, working his first job after graduating from Oxford University, and reported $73,557 in income on his 2007 federal tax return. Buttigieg also filed a state return in Michigan that year, in which he reported that just more than $22,000 of that income came from the work he did for Blue Cross Blue Shield there. Buttigieg has received about $26,000 in contributions from individuals associated with the national health conglomerate, according to OpenSecrets.org — more than any of his rivals, though Biden and Sanders have received nearly as much. (Janes and Wang, 12/10)

Los Angeles Times: Buttigieg's Clients At McKinsey Included The Pentagon
To Warren and other Buttigieg rivals, the secrecy surrounding his work at McKinsey has offered a tempting target. McKinsey’s image has been battered in recent years as news stories revealed its work for authoritarian regimes, opioid manufacturers and U.S. Immigration and Customs Enforcement. (Finnegan, 12/10)

The Hill: 'Medicare For All' Backers Notch Win With High-Profile Hearing 
"Medicare for All" supporters scored a victory Tuesday with a long-awaited hearing in one of the House's most powerful committees, putting more focus on the health care proposal that has divided the field of 2020 Democratic presidential candidates. The Energy and Commerce Committee discussed the single-payer health plan backed by White House hopefuls Sens. Elizabeth Warren (D-Mass.) and Bernie Sanders (I-Vt.) after a sustained campaign led by Rep. Pramila Jayapal (D-Wash.), a co-chairwoman of the Congressional Progressive Caucus, and other members of the party's liberal wing. (Hellmann, 12/10)

Politico: ‘A F—Ing Soap Opera’: The Health Care Drama Riveting The White House
They’re not obsessing about the impeachment imbroglio consuming the rest of the Washington. At the West Wing’s Navy mess, in hallway asides and at staff meetings, many White House aides just want to chatter about an increasingly vicious public spat between two of President Donald Trump’s top health officials. Among top Trump aides, it’s now an open question as to whether Secretary of Health and Human Services Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma can survive the scale of bickering that has appalled and horrified people internally, a White House official said. (Cook, 12/11)

The New York Times: White House Summons Feuding Health Officials For Counseling Session
The acting White House chief of staff has summoned President Trump’s top two health policy officials to the White House on Thursday to assess whether the president’s health secretary and his Medicare chief can continue to work together, a senior administration official confirmed on Tuesday. White House aides said President Trump is still standing by his embattled administrator of the Centers for Medicare and Medicaid Services, Seema Verma, amid reports that she had requested that taxpayers reimburse her $47,000 for property stolen on a trip, including jewelry priced at more than $40,000. (Rogers, Abelson and Goodnough, 12/10)

The Wall Street Journal: White House Calls Top Health Officials For Meeting To Resolve Tensions
People familiar with the matter said distrust between Ms. Verma and Mr. Azar has arisen in part because some people at HHS suspect Ms. Verma leaked information to the media about former HHS Secretary Tom Price’s use of private and military planes for work travel. Reports about that travel led Mr. Price to resign last year. These people also said the tension is partly fueled by a belief that Ms. Verma wants the HHS secretary position. Allies of Ms. Verma have said she played no role in providing leaks to the press about Mr. Price’s travel and that she wasn’t aware he was doing it. (Armour, 12/10)

Politico: Medicare Chief Sought To Bring Complaints Against Previous Boss, As Well
Medicare chief Seema Verma allegedly retained a lawyer to discuss a claim that President Donald Trump’s first Health and Human Services secretary, Tom Price, was creating a hostile work environment, according to an internal 2017 memo prepared by a HHS appointee. A spokesperson for Verma denied that she hired a lawyer. (Pradhan, Diamond and Cancryn, 12/10)

Modern Healthcare: Political Complaint Against Seema Verma Dropped For 'Insufficient Evidence'
The U.S. Office of Special Counsel said it found insufficient evidence to conclude that CMS Administrator Seema Verma violated the law barring federal employees from engaging in political activities while on the job. The nonpartisan Center for Responsibility and Ethics in Washington filed a complaint in November 2018 alleging that Verma used her official Twitter account and blog post to advocate against Democratic Medicare for All proposals, in violation of the Hatch Act. The group claimed Verma did so as part of a White House-coordinated effort to defeat Democratic party candidates in the 2018 midterm elections. (Meyer, 12/10)

The New York Times: Trump Aides And Democrats Agree On Trade Pact With Mexico And Canada
The White House and House Democrats reached an agreement to strengthen labor, environmental, pharmaceutical and enforcement provisions in President Trump’s North American trade pact, a significant development that made it all but certain that the signature trade deal would become law. ... One of the most significant revisions will roll back protections for new pharmaceutical products, in particular an advanced class of drugs called biologics, which were initially given 10 years of patent protection from cheaper alternatives. It also removed language that would ensure patent protections when drug companies find new uses for their existing products, a process known as “evergreening.” (Cochrane and Swanson, 12/10)

Politico: ‘We Ate Their Lunch’: How Pelosi Got To ‘Yes’ On Trump’s Trade Deal
Some issues were worked out quickly: An agreement to strip out protections for biologic drugs, which opponents say would allow drug companies to keep prices high, was struck in those first few weeks, said Rep. Earl Blumenauer (D-Ore.), who focused on the issue for the working group. It was deliberately kept under a proverbial lock-and-key to help prevent a propaganda campaign from the powerful pharmaceutical lobby, which could have derailed the handshake deal. The early win for Democrats boosted members’ confidence and showed the administration was willing to make concessions. But compromises on other areas — specifically, labor and enforcement provisions — remained elusive. The caucus began to splinter over summer recess as moderate Democrats grew increasingly anxious to hold a vote on the agreement. (Cassella, 12/10)

The Washington Post: With USMCA And Parental Leave, Democrats Say They Won Big Concessions From Trump
Democrats have emphasized that they won inclusion of new protections for workers’ rights and scrapped part of the initial agreement that would have raised prescription drug prices. “The same Republicans who are complaining they are not included are also too scared to vote against [Trump]. So why would he bother negotiating with them?” said an aide to a GOP senator, speaking on the condition of anonymity to discuss caucus dynamics. (Kim and Stein, 12/10)

Politico: Pelosi Brokers Deal With Liberals On Drug Pricing Bill
House Democratic leadership on Tuesday clinched a deal to win progressive leaders’ support for a sweeping drug pricing bill that could clear its path for passage in the full House on Thursday. The pact between Speaker Nancy Pelosi and progressive leaders includes an agreement to expand the government’s authority to directly negotiate drug prices under the legislation, ultimately requiring federal officials to hammer out the cost of at least 50 medicines a year, from the original 35. (Cancryn and Ferris, 12/10)

The Hill: Pelosi Drug Pricing Plan Would Save $456 Billion Over Ten Years: Analysis
House Speaker Nancy Pelosi's bill that would let Medicare negotiate prices with drug companies would save the government $456 billion over ten years, according to an analysis released Tuesday. The bill, which will get a vote on the House floor this week, would require that federal health officials negotiate the prices of at least 35 brand-name drugs per year. (Hellmann, 12/10)

The Wall Street Journal: Six CEOs And No Operating Room: The Impossible Job Of Fixing The Indian Health Service
Three years ago, the U.S. Indian Health Service needed a savior for its hospital in Rosebud, S.D. The federal health-care agency was forced to shut down the emergency department under pressure from federal regulators. Capt. Michael Weahkee seemed the man for the job, having run the IHS’s flagship hospital in Phoenix. He launched quality-improvement efforts and got the hospital’s emergency department running again, before departing later that year to resume his Phoenix post. He signed off with a laudatory email to the Rosebud hospital staff: “For those of you who have weathered this storm, I salute you.” (Wilde Mathews and Weaver, 12/10)

The New York Times: 3 Crime Scenes And 6 Dead: Rampage Stuns Jersey City
The shooting began outside a cemetery in Jersey City, N.J., on Tuesday when a 40-year-old detective tried to intercept two people who were suspects in a homicide. They opened fire and fled, speeding off in a rented truck that had been reported stolen and leaving the detective dead on the ground. They drove about a mile, stopping in a Hasidic neighborhood where dozens of young ultra-Orthodox families have relocated to in recent years. With traffic at a standstill as the police rushed to answer 911 calls about the shooting at the cemetery, the pair invaded a kosher market. (Barron and Gold, 12/10)

The Washington Post: Jersey City Shooting: Six Dead, Including One Police Officer And Two Suspects
Authorities initially said there was “no indication” of terrorism and suggested that the shooters stormed the Jewish market at random. But hours after he addressed reporters on Tuesday, Fulop said on Twitter that an “initial investigation,” which remains ongoing, has led them to believe “the active shooters targeted the location they attacked.” He did not elaborate, but said police have no indication of additional threats. (Thebault, 12/10)

Politico: Murphy, Booker Go To Jersey City After Deadly Shootout; Trump Briefed On Incident
U.S. Sen. Cory Booker (D-N.J.) and Gov. Phil Murphy, who canceled a trip to a fundraiser in Washington, both arrived in Jersey City on Tuesday evening to speak to police and local officials. In brief remarks, the governor acknowledged “the selfless work of all members of law enforcement who responded to this incident not knowing what they were entering or even if they would make it out.” (Hutchins, 12/10)

The Washington Post: Facebook Ads Pushed Misinformation About HIV Prevention, PrEP, LGBT Activists Say
Facebook users have been bombarded with misleading ads about medication meant to prevent the transmission of HIV, according to lesbian, gay, bisexual and transgender advocates, who say the tech giant’s refusal to remove the content has created a public-health crisis. The ads have been viewed millions of times in recent months, Facebook’s archive reveals, and LGBT organizations argue they’ve had a dire effect: They’ve scared patients, potentially those who may be most at risk of contracting HIV, out of taking preventative drugs, known as PrEP, even though health officials and federal regulators have said they are safe. (Romm, 12/9)

The Washington Post: FDA Can Regulate E-Cigarettes Just Like Conventional Cigarettes, Appeals Court Says
The Food and Drug Administration can regulate e-cigarettes like it does conventional cigarettes, an appeals court said Tuesday, finding that the products are “indisputably highly addictive and pose health risks, especially to youth, that are not well understood.” The case before the U.S. Court of Appeals for the District of Columbia Circuit, brought by an e-cigarette manufacturer, was not about banning the sale of the devices and did not pose the question of whether e-cigarettes are more or less safe than traditional cigarettes. (Marimow, 12/10)

The Wall Street Journal: Tiny Tax Moves Can Save You Big On Medicare Premiums
Now is a good time for higher-earning Medicare recipients to check whether a small reduction in this year’s income could make a big difference in future premiums. Here’s why. Medicare premiums are based on income, and the formulas have “cliffs” that can raise premiums steeply if income rises by even one dollar. In addition, there’s a new inflation adjustment for 2020 that complicates the situation. (Saunders, 12/10)

The Wall Street Journal: New York Life In Talks To Buy Cigna Unit For Up To $6 Billion
New York Life Insurance Co. is negotiating with Cigna Corp. to acquire a unit that sells nonmedical insurance products to employers, a deal that could be valued at as much as $6 billion, according to people familiar with the matter. Cigna in recent months has been seeking a buyer for a business that sells life, accident and disability-income insurance to employers for their workers, in a move that would help the health giant focus on its core business, according to the people. (Scism, Cimilluca and Wilde Mathews, 12/10)

The New York Times: Marathon Running May Be Good For Your Knees
Could it be that marathon training and racing are actually good for our knees? A myth-toppling new study of novice, middle-aged runners suggests that the answer is a qualified yes. The study finds that taking up distance running rebuilds the health of certain essential components of middle-aged knees, even if the joints start off somewhat tattered and worn. (Reynolds, 12/11)

The Washington Post: GWU Sues Corporate Hospital Partner, Leaving Fate Of Southeast Project Uncertain
George Washington University is suing its corporate partner in one of the Washington region’s foremost hospitals, crossing a new threshold in a dispute that could affect plans to build a new medical center east of the Anacostia River. The lawsuit, filed last week in D.C. Superior Court, alleges that Universal Health Services (UHS) — a Pennsylvania-based health-care corporation that owns hospitals across the country — has improperly diverted more than $100 million from George Washington University Hospital. (Jamison, 12/10)

The Associated Press: Report: Medicaid Recipients Often Use ER For Dental Issues
A new state report found that many Virginians on Medicaid often go to emergency rooms for dental issues that could have been prevented or treated at a dentist’s office. A recently released report by the Department of Medical Assistance Services found that about 16,000 Medicaid recipients visited emergency rooms about 19,000 times in 2018. More than half of those 16,000 were treated for “non-traumatic dental conditions” like tooth aches and loose teeth. (12/11)

The Washington Post: With Dozens Of Kids Orphaned By The Opioid Crisis, This Md. County Has A New Outlook On Trauma Services
Growing up in a Cecil County trailer park, Ray Lynn has been shaped by tragedy. He went from seeing drug addiction firsthand in his neighborhood as a child to tackling the problem as a police officer decades later. “I can name you friends that are dead because of it,” he said. (Davis, 12/10)

The Associated Press: New Judge To Decide On Removing Life Support For Texas Baby
A new judge will consider if a Texas hospital can take a 10-month-old girl off life support despite her family's opposition after the impartiality of the previous judge was questioned. A temporary restraining order stopping Cook Children's Medical Center in Fort Worth from removing life-sustaining treatment for Tinslee Lewis was set to expire Tuesday. But after the removal last week of Tarrant County Juvenile Court Judge Alex Kim, a new hearing on the family's request for a temporary injunction will now be held Thursday in Fort Worth. (12/10)

The Associated Press: Lab Owner To Plead Guilty In Medicare Kickback Scheme
A Pennsylvania business owner has agreed to plead guilty in a $127 million kickback scheme involving his genetic testing labs. Ravitej Reddy is scheduled to plead guilty to federal charges that he conspired with out-of-state marketing companies to pay kickbacks for lucrative lab tests at his two testing facilities, the Pittsburgh Post-Gazette reported Tuesday. A plea hearing is scheduled for Jan. 10. (12/10)

The Wall Street Journal: Frontier Airlines Is Sued For Pregnancy Discrimination
When Renee Schwartzkopf, a flight attendant with Frontier Airlines, gave birth in 2017, she didn’t tell her employer that she planned to breast-feed her son after returning to work. Ms. Schwartzkopf said she knew of another flight attendant who had asked to pump milk during flights and was told no. As the primary breadwinner in her family at the time, she couldn’t afford to lose her income if she requested permission and was denied, then forced to choose whether to quit or take unpaid leave. (Weber, 12/10)