First Edition: December 14, 2017

Kaiser Health News: Good Friends Might Be Your Best Brain Booster As You Age
Ask Edith Smith, a proud 103-year-old, about her friends, and she’ll give you an earful. There’s Johnetta, 101, whom she’s known for 70 years and who has Alzheimer’s disease. “I call her every day and just say ‘Hi, how are you doing?’ She never knows, but she says hi back, and I tease her,” Smith said. There’s Katie, 93, whom Smith met during a long teaching career with the Chicago Public Schools. “Every day we have a good conversation. She’s still driving and lives in her own house, and she tells me what’s going on.” (Graham, 12/14)

California Healthline: Pharmacy Costs Continue To Soar For California’s Public Employee Health System
Spending on prescription drugs by the California Public Employees’ Retirement System (CalPERS) continues to climb, putting pressure on administrators to deploy more cost-cutting measures at the nation’s largest public pension system. The agency’s health benefits committee will discuss the challenge of rising drug costs at its regular meeting on Tuesday, and it will convene a special panel in January to discuss ways to address the problem. (Bartolone, 12/14)

Kaiser Health News: Telemedicine For Addiction Treatment? Picture Remains Fuzzy
When President Donald Trump declared the opioid epidemic a public health emergency, it came with a regulatory change intended to make it easier for people to get care. The declaration allows for doctors to prescribe addiction medicine virtually, without ever seeing the patient in person. In Indiana, this kind of virtual visit has been legal since early 2017. But among a dozen addiction specialists in Indiana contacted by a reporter, just one had heard of doctors using telemedicine for opioid addiction treatment: Dr. Jay Joshi. (Forman, 12/14)

Kaiser Health News: Fear Compromises The Health, Well-Being Of Immigrant Families, Report Finds
Luis Ramirez has lived in the U.S. without immigration papers for two decades, but he is more worried about deportation now than ever before. Ramirez said he and his wife, Luz Cadeo, who is also here illegally, have already made plans in case they are arrested by immigration police: The couple, who live in Lakewood, Calif., would try to find work in their native Mexico while their youngest U.S.-born children, ages 15 and 18, stayed in the U.S. with a relative. (Gorman, 12/13)

The New York Times: Republican Tax Bill In Final Sprint Across Finish Line
The day after suffering a political blow in the Alabama special Senate election, congressional Republicans sped forward with the most sweeping tax rewrite in decades, announcing an agreement on a final bill that would cut taxes for businesses and individuals and signal the party’s first major legislative achievement since assuming political control this year. ... In a break from the House bill, the agreement would allow taxpayers to continue to deduct high out-of-pocket medical expenses, and it would retain a provision allowing graduate students who receive tuition stipends to avoid paying taxes on that benefit. Also included in the consensus bill is the Senate’s repeal of the Affordable Care Act requirement that most Americans have health insurance or pay a penalty and a provision that opens the Arctic National Wildlife Refuge in Alaska to energy exploration. (Tankersley, Kaplan and Rappeport, 12/13)

Bloomberg: GOP Tax Compromise Would Repeal Obamacare’s Individual Mandate
Republican lawmakers will overturn a key piece of the Affordable Care Act in their tax overhaul, a victory in a long GOP campaign against the health law. Senate Majority Leader Mitch McConnell said the compromise tax bill from House and Senate negotiators will end the health law’s requirement that all individuals buy insurance or pay a fine. Doing so could jeopardize Obamacare’s already-shaky marketplaces, by reducing the number of healthier people who sign up for insurance. (Tracer and Rausch, 12/13)

The New York Times: Last-Ditch Effort To Sway Senator On Tax Bill Involves Personal Pleas
As a group of progressive activists and constituents prepared for a 15-minute meeting on Wednesday with Senator Susan Collins, Republican of Maine, they sat in the lobby of her office and developed a last-ditch strategy to persuade her to vote against the $1.5 trillion tax bill barreling through Congress: tears. “If Senator Collins actually saw you as a human, saw me as a human, then she wouldn’t pass any of this,” said Ady Barkan, a member of the Center for Popular Democracy, who recently learned he had amyotrophic lateral sclerosis, or A.L.S., and uses a wheelchair. (Rappeport, 12/14)

The Hill: Collins Confident Health Subsidies Will Be In Spending Bill
Funding for key ObamaCare insurer subsidies is likely to be included in the upcoming government funding bill, Sen. Susan Collins (R-Maine) said Wednesday. Collins said she had received reassurances Tuesday from Vice President Pence that the subsidies, opposed by House conservatives, would be in the funding bill. (Weixel, 12/13)

The New York Times: Strong Demand For Health Insurance As Deadline Looms
More than one million people signed up last week for health insurance under the Affordable Care Act, pushing the total in the federal marketplace to nearly 4.7 million, the Trump administration said Wednesday, days before the annual enrollment period is scheduled to end. The number of sign-ups on HealthCare.gov from Nov. 1 through Saturday was about 17 percent higher than the same time last year. But the final tally is likely to fall short of the 9.2 million who were in plans at the end of the last open enrollment period, which was twice as long as the current one. (Pear, 12/13)

Reuters: Obamacare Sign-Ups Rise But Overall Enrollment Set To Fall
The number of consumers who signed up for 2018 Obamacare health insurance surpassed the 1 million mark in the second-to-last week of enrollment, the government said on Wednesday, but it did not appear to be enough to grow the program. The Trump administration has worked to undercut former President Barack Obama's national healthcare law by decreasing advertising and discussing ending the mandate that Americans have health insurance, which has weighed on 2018 enrollment. (Humer, 12/13)

The Washington Post: Enrollment In ACA Health Plans Up From Same Time Last Year, But Sign-Up Chance Dwindling
With three days remaining in most of the country to buy Affordable Care Act coverage for 2018, enrollment is ahead of the same time last year but is almost sure to fall short in the end because of a compressed enrollment season. During each of the six weeks of this sign-up period, the number of consumers choosing plans through the federal HealthCare.gov website has outmatched that of 2017, according to a federal enrollment snapshot released Wednesday. The overall sign-ups of nearly 4.7 million Americans through last Saturday was about 650,000 higher than through the parallel week a year ago. (Goldstein and Shaban, 12/13)

NPR: HealthCare.Gov's Sign-Up For 2018 Health Insurance Ends Friday For Most
Friday is the last day to enroll in a health insurance plan through the federal government's insurance exchange, HealthCare.gov. And in a little office park in Northern Virginia, Brima Bob Deen is dealing with the rush. He is the president of a church-sponsored job training center called Salvation Academy. But this time of year, he acts mostly as an enrollment counselor for Affordable Care Act health plans. And this week, his calendar is full. (Kodjak, 12/13)

The Hill: 4.7M Have Signed Up For ObamaCare Plans
The strong numbers so far come despite cuts the Trump administration made to ObamaCare's advertising and outreach budget. The initial surge has also put the administration, which has long claimed the health-care law is failing, in a difficult spot. But if the final enrollment numbers are significantly lower than in the past, which many analysts expect, it could bolster the GOP's argument that ObamaCare is failing and needs to be repealed. (Hellmann, 12/13)

The Hill: Maryland Extends ObamaCare Enrollment Deadline
Maryland is extending the deadline by one week for people to enroll in ObamaCare through its state exchange. The new deadline is Dec. 22. The previous deadline would have been Friday, the same date for states that use the healthcare.gov federal exchange. (Weixel, 12/13)

NPR: Health Insurance Bargains Still Available For Many, But Deadline Looms
Gene Kern, 63, retired early from Fujifilm, where he sold professional videotape. "When the product became obsolete, so did I," he says, "and that's why I retired." Kern lives in Frederick, Md., and has been an enthusiastic enrollee in Maryland's health exchange since it began in 2014. But this fall he received a letter from his insurer explaining that the cost of his policy's premium would jump from $800 a month to $1,300 in 2018. (Simmons-Duffin and Farmer, 12/14)

The Hill: Alabama Result Deals Heavy Blow To ObamaCare Repeal
The surprise election of a Democrat in Alabama has dealt a major blow to Republican hopes of reviving ObamaCare repeal next year. Republicans already failed multiple times this year to pass an ObamaCare replacement through the Senate with a 52-48 majority. Next year, thanks to the election of Democrat Doug Jones in Alabama, their margin for error will be even slimmer, at 51-49. (Sullivan, 12/14)

Los Angeles Times: Obamacare Is Helping Patients Get To The Doctor And Pay Their Medical Bills, New Report Finds
Fewer Americans are putting off doctor visits or struggling with medical bills, according to a new report examining the effect of the Affordable Care Act. The report – based on a state-by-state survey of data collected by the federal government – provides powerful new evidence that insurance gains made through the 2010 healthcare law are helping millions of patients get needed medical care. (Levey, 12/13)

Stat: Hospital And Pharma Lobbyists Spar Over Drug-Discount Program Before Time Runs Out
Hospital and pharmaceutical industry lobbyists are facing off as lawmakers scramble to finalize a year-end spending deal that could include changes to the controversial 340B program. Hospitals want Congress to use the package to reverse a $1.6 billion cut to the program that the Trump administration finalized this fall, and which is set to take effect Jan. 1. Drugmakers don’t. And if the package does end or delay the cut, they want hospitals to disclose far more information about the discounts they get under the program, according to a half dozen lobbyists from both industries and several congressional staffers. (Mershon, 12/14)

The Hill: Lawmakers Battle Trump, PhRMA On Discount Drug Rule
Lawmakers in both parties are seeking to block the Trump administration’s changes to a Medicare drug discount program, arguing it would have a negative impact on hospitals that serve low-income people. A rule from the Centers for Medicare and Medicaid Services (CMS) slated to go into effect on Jan. 1 would result in $1.6 billion in cuts to “safety net” hospitals that serve a significant number of low-income patients under the so-called 340B drug discount program. (Hellmann, 12/14)

Stat: ‘Big Black Box Called PBMs’ Draws Attention From Lawmakers Trying To Solve Drug Prices
As lawmakers are puzzling over the question of why so many patients are paying so much money for prescription drugs — and what to do about it — Republicans are focusing increasing scrutiny on the middlemen: pharmacy benefit managers. “What I’m seeing, and what the public sees, is that we’ve got this big black box called PBMs,” said Rep. Morgan Griffith, a Virginia Republican, at a Wednesday House subcommittee hearing. (Swetlitz, 12/13)

The Washington Post: Facing Senate Rejection, Controversial Pick To Head EPA Chemical Office Bows Out
Michael Dourson, whose nomination to become the Environmental Protection Agency’s top chemical safety official drew widespread criticism, withdrew from consideration Wednesday after it became clear the Senate probably would not confirm him. Dourson’s decision, which was confirmed by two senior administration officials who spoke on the condition of anonymity to discuss personnel matters, prevents him from likely becoming the first Trump nominee rejected by the Senate. (Dennis and Eilperin, 12/13)

The Associated Press: EPA Chemical Safety Nominee Drops Out Amid Strong Opposition
North Carolina’s two Republican senators, Richard Burr and Thom Tillis, said last month they would vote against Dourson’s nomination after The Associated Press and other media outlets detailed his past work as a toxicologist hired to defend major chemical companies. The Senate’s 48 Democrats were united in opposition, meaning only one more GOP defection would be needed to defeat Dourson’s nomination. In his letter asking the president to withdraw his name from consideration, which was obtained by the AP, Dourson said his stepping aside “avoids unnecessarily politicizing the important environmental protection goals of Administrator Pruitt.” (Biesecker and Colvin, 12/13)

The New York Times: Joe Biden Comforts Meghan McCain In Heartfelt Exchange On ‘The View'
It lasted only a short time, and it hardly eclipsed the bitterness of partisan politics that has consumed the country. But for nearly five minutes on Wednesday morning, Joe Biden and Meghan McCain shared an emotional exchange about the aggressive form of brain cancer that has affected both of their families. The clip from “The View,” on which Mr. Biden, the former United States vice president, was a guest, drew a powerful and heartfelt outpouring online from viewers. Ms. McCain, a Republican who co-hosts the morning talk show, told Mr. Biden, a Democrat, that she “couldn’t get through” his new book, “Promise Me, Dad,” about his son Beau’s battle with the disease. (Salam, 12/13)

The Associated Press: Biden Consoles Daughter Of Ailing Arizona Sen. John McCain
“I think about Beau almost every day and I was told that this doesn’t get easier but that you cultivate the tools to work with this and live with this,” Meghan McCain said, her voice breaking. “I know you and your family have been through tragedy I couldn’t conceive of.” Biden, who served with John McCain in the Senate, stood up and moved from his seat on the set to sit next to her and hold her hand. He told Meghan McCain not to lose hope and that a medical breakthrough is possible. “And it can happen tomorrow,” Biden said, adding that if anyone can beat brain cancer, it’s John McCain. (Lardner, 12/13)

Politico: Biden Consoles An Emotional Meghan McCain Over Father's Cancer
Biden added that while the glioblastoma diagnosis was "about as bad as it gets," medical advancements were ongoing in the battle against cancer. And that McCain, a renowned-war veteran and congressional leader, would persevere. "If anybody can make it, [it's] your dad," Biden said. "Her dad is one of my best friends." (Lima, 12/13)

The Wall Street Journal: In Opioid Fight, Should States Consider Involuntary Rehab?
When Julia Raposa overdosed on opioids last year, she was rushed to a hospital in Leominster, Mass., where her aunt says she was treated and released within 90 minutes. Days later, Ms. Raposa’s next overdose killed her. A big challenge in the opioid crisis is getting overdose patients from emergency rooms into treatment. Failed opportunities can be fatal. In an aggressive, new proposal, Massachusetts authorities want to allow hospital staff to send overdose patients to treatment centers against their will for up to three days. The goal is to buy more time for addicts facing imminent risks to accept longer-term treatment. (Kamp, 12/13)

Stat: Kellyanne Conway, Top White House Aide, Is Leading An 'Opioids Cabinet'
Kellyanne Conway, counselor to President Trump, has been leading weekly meetings at the White House with officials across a dozen federal departments to develop a plan to respond to the opioid crisis and to implement recommendations from a presidentially appointed commission, she and other officials told STAT. The “opioids cabinet,” as the group is known, is intended to help streamline efforts across the government and includes staffers from the Department of Health and Human Services and the Office of National Drug Control Policy, among other executive branch offices. (Facher, 12/14)

Stat: Precision Medicine Is Rapidly Advancing. Precision Public Health Could Be Next
Rapid advances in personalized medicine have sparked interest in another new idea: precision public health. Essentially, it’s the thought that if doctors could pinpoint populations with genetic vulnerabilities — like those prone to obesity, depression, or cancer — they might be able to treat those diseases sooner, slow their progression, or even prevent them altogether. It could be a more effective preventive medicine tactic than the blanket approaches used right now (Thielking, 12/13)

The New York Times: A ‘Game Changer’ For Patients With Irregular Heart Rhythm
The patients were gravely ill, their hearts scarred by infections or heart attacks. In each, the electrical system that maintains a regular heartbeat had been short-circuited. They suffered frequent bursts of rapid heartbeats, which can end in sudden death. The condition kills an estimated 325,000 Americans each year, the most common cause of death in this country. And these people had exhausted all conventional treatments. (Kolata, 12/13)

The New York Times: Exercise May Aid Parkinson’s Disease, But Make It Intense
Intense treadmill exercise can be safe for people who have recently been given diagnoses of Parkinson’s disease and may substantially slow the progression of their condition, according to an important new study of adults in the early stages of the disease. But the same study’s results also indicate that gentler exercise, while safe for people with Parkinson’s, does not seem to delay the disease’s advance. (Reynolds, 12/13)

The New York Times: Can The Weather Make Bones And Joints Ache?
Fact or old wives’ tale? A change in the weather can make bones and joints ache. A new study has an answer: old wives’ tale. Other studies have looked at whether an increase in humidity, rainfall or barometric pressure can bring on pain, but never with as much data as in this newest study, in BMJ. Researchers looked at medical records of 11,673,392 Medicare outpatient visits. Matching the dates of the visits to local weather reports, they found that 2,095,761 of them occurred on rainy days. (Bakalar, 12/13)

The Washington Post: A Baby Was Born With Her Heart Outside Her Body — And Survived
Immediately after Vanellope Hope Wilkins was born, she was put in sterile plastic to protect her heart — which was beating outside her tiny chest. It was a moment that her parents, Dean Wilkins and Naomi Findlay, had hoped for but were not certain would actually come — a moment in which their baby girl would come into the world, and live. The newborn, who was born Nov. 22 at Glenfield Hospital in Leicester, England, was delivered by Caesarean section several weeks premature with a rare and often fatal congenital condition called ectopia cordis, in which the heart is growing either completely or partially outside the chest cavity. (Bever, 12/13)

The Washington Post: Fracking Sites May Raise The Risk Of Underweight Babies, New Study Says
Living within half a mile of a hydraulic fracturing site carries a serious risk for pregnant women, a new study has found. The drilling technique, also known as fracking, injects high-pressure water laced with chemicals into underground rock to release natural gas. Women who lived within that distance to fracking operations in Pennsylvania were 25 percent more likely to give birth to low-weight infants than were mothers who lived more than two miles beyond the sites. (Fears, 12/13)

The Wall Street Journal: Study Links Lower Birth Weights To Living Near Fracking Sites
That research underscores a problem that has bedeviled the industry and regulators: While the benefits of hydraulic fracturing are widespread, the costs are very localized. The drilling and completion technologies commonly known as fracking have turned the U.S. into an energy superpower while lowering both energy prices and carbon dioxide emissions. To accommodate the industry’s rapid growth over the past decade, several regions of the country—including parts of Pennsylvania, Colorado, Texas and North Dakota—have been turned into industrialized zones, sometimes overlapping with communities. (Gold, 12/13)

Los Angeles Times: Babies Born To Moms Who Lived Near Fracking Wells Faced Host Of Health Risks, Study Suggests
Many of the toxic chemicals used in the hydraulic fracturing process are known carcinogens. Toxic gases, including benzene, are released from the rock by fracking. And the high-pressure pumping of a slurry of chemicals into the ground is widely thought to release toxins and irritants into nearby air and water. The noise and pollution emitted by trucks and heavy machinery also may affect the health of people living nearby. (Healy, 12/13)

The New York Times: Marijuana And Vaping Are More Popular Than Cigarettes Among Teenagers
Cigarette smoking has dropped so sharply among American teenagers that vaping and marijuana use are now more common, according to a national survey of adolescent drug use released Thursday. The report, sponsored by the federal government’s National Institute on Drug Abuse and administered by the University of Michigan, found that 22.9 percent of high school seniors said they had used marijuana within the previous 30 days and 16.6 percent had used a vaping device. Only 9.7 percent had smoked cigarettes. (Hoffman, 12/14)

Los Angeles Times: Smoking, Drinking And Drug Abuse Decline Among U.S. Teens, Who Prefer Pot And Vaping, Study Finds
About 1 in 3 middle and high school students surveyed in 2017 said they had used some kind of illicit drug sometime in their life. Two decades ago, that figure was 43%. Likewise, 17% of students surveyed in 2017 said they smoked cigarettes at least once, and 26% said they had been drunk. In the 1990s, those figures reached highs of 58% and 46%, respectively. “The rates of drug use among teenagers in our country are the lowest they’ve ever been for some drugs,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. (Kaplan, 12/13)

The Associated Press: Bill Banning Down Syndrome Abortions Heads To Ohio Governor
In one of their last acts of the year, Ohio lawmakers moved Wednesday to ban abortions based on a diagnosis of Down syndrome and sent the measure to Republican Gov. John Kasich, who is likely to sign it. Two states, Indiana and North Dakota, already have passed laws like the one that Ohio is advancing, touching off an emotional debate over women's rights, parental love and the relationship between doctor and patient. (12/13)

The Hill: Pa. Gov Says He'll Veto 20-Week Abortion Ban Passed By Legislature
Pennsylvania Gov. Tom Wolf (D) vowed to veto a bill passed by the state's legislature that would ban abortions after 20 weeks of pregnancy. "This bill is an attack on women, and it should never have reached my desk," Wolf tweeted Wednesday. "I will veto it, because all Pennsylvania women deserve to make their own health care decisions." (Hellmann, 12/13)

The Associated Press: Arkansas Abortion Facilities Threatened With Suspension
Two Arkansas abortion facilities were threatened with suspension — one for not listing the Red Cross on its emergency number list and another for using cloth booties on an exam table — under a new law that the abortion providers are challenging in federal court, according to documents released Wednesday. The state Department of Health issued notices of suspension to Planned Parenthood’s Fayetteville facility and to Little Rock Family Planning Services last week following their annual inspections, according to documents filed by the providers in federal court. The providers are challenging a law enacted this year requiring Arkansas to suspend or revoke abortion clinics’ licenses for violating any rule or law. (Demillo, 12/13)

The Washington Post: Judge Blasts District’s Handling Of Medicaid Contracts, Orders Reevaluation
The District government mishandled how it awarded lucrative contracts to manage care for Medicaid beneficiaries and must revaluate proposals by the end of January, an administrative law judge has determined. The ruling, written Nov. 30 but released Wednesday, comes in response to a protest filed with the Contract Appeals Board by MedStar, one of the region’s largest employers and operator of the city’s biggest hospital. It has implications for tens of thousands of Medicaid patients who were transitioning to a new company with a different network of doctors and specialists. (Nirappil, 12/13)

The Associated Press: Activism, Charity Sustain Sandy Hook Families 5 Years Later
Out of a senseless tragedy, they have sought ways to find meaning in advocacy. Many relatives of the 26 children and educators killed five years ago at Sandy Hook Elementary School have dedicated themselves to charity, activism and other efforts to channel their grief and, in many cases, to help prevent violence. (12/14)

The Washington Post: Nursery And Delivery Rooms At D.C.’s Public Hospital Will Not Reopen
The board of D.C.’s public hospital voted Wednesday to permanently close the facility’s nursery and delivery rooms, leaving a broad section of the nation’s capital east of the Anacostia River without a hospital where women can give birth and seek prenatal care. The obstetrics ward at United Medical Center has been closed since Aug. 7, when regulators shut it down after uncovering what they said were serious medical errors in the treatment of pregnant women and newborns. However, elected officials, maternal-health advocates and residents of Southeast Washington had expressed hope that it would reopen. (Jamison, 12/13)

The Associated Press: Fertility Doctor Faces Judge For Lying About Using Own Sperm
A retired Indianapolis fertility doctor accused of inseminating patients with his own sperm is set to plead guilty to charges that he lied to investigators. Dr. Donald Cline is scheduled to appear in a Marion County court Thursday, when a judge is expected to sentence him on two counts of obstruction of justice. Prosecutors say the 79-year-old Cline initially wrote to investigators denying he used his own sperm. (12/14)