First Edition: December 18, 2019

Kaiser Health News: Don’t Toss That E-Cig: Vaping Waste Is A Whole New Headache For Schools And Cities
In her office at Boulder High School, the assistant principal has a large cardboard box where she can toss the spoils of her ongoing battle with the newest student addiction. “This is what I call the box of death,” said Kristen Lewis. “This is everything that we’ve confiscated.” The box is filled with vape pens like Juuls, the leading brand of e-cigarettes, dozens of disposable pods for nicotine liquid, and even a lonely box of Marlboros. (Daley, 12/18)

Kaiser Health News: Listen: The Cost Of PrEP, The HIV Prevention Pill
KHN correspondent Shefali Luthra joined a discussion on the Vox podcast “Today, Explained” about the cost dynamics surrounding pre-exposure prophylaxis, or PrEP, a game-changing drug that prevents the transmission of HIV. Gilead Sciences — the manufacturer of the brand-name versions of this preventive medicine, such as Truvada and Descovy — seeks to extend its patent but faces pushback from federal lawmakers, including Sen. Bernie Sanders (I-Vt.) and Rep. Alexandria Ocasio-Cortez (D-N.Y.). (12/18)

The New York Times: Doctors Win Again, In Cautionary Tale For Democrats
Democratic voters eager to see “Medicare for all” or some other major health overhaul pass the next time they control the White House may want to take a close look at what happened this week in Congress. Leaders from both parties had unveiled legislation to stop surprise medical bills, the often exorbitant bills faced by patients when they go to a hospital that takes their insurance but are treated by a doctor who does not. The White House and major consumer groups had also endorsed the plan, which was to be included in the year-end spending bill. But to the negotiators’ consternation, the spending package that emerged on Monday — and was passed on Tuesday by the House — had nothing about surprise bills. (Sanger-Katz, 12/17)

The Wall Street Journal: The Affordable Care Act’s Legacy, Nearly 10 Years Later
Nearly a decade after its passage along party lines under President Obama, the Affordable Care Act is deeply ingrained in the U.S. health-care system, influencing everything from seniors’ drug costs to calorie disclosures on restaurant menus. It added about 20 million people to the ranks of the insured. But it also remains a political flashpoint. After a decade of funding fights and a series of court challenges, the ACA faces a fresh legal case, brought by a group of Republican-led states and backed by the Trump administration, that aims to strike it down. (Wilde Mathews, 12/17)

The Washington Post: House Passes $1.4 Trillion Spending Bill With Trump Support That Would Gut Key Parts Of Affordable Care Act
The House on Tuesday approved a $1.4 trillion spending package that would stave off a looming shutdown and fund the federal government through September, acting in a burst of bipartisanship just a day before Democrats plan to impeach President Trump. The legislation would also remove three controversial taxes from the Affordable Care Act, the 2010 law that was a top legislative achievement of President Barack Obama. (Werner and DeBonis, 12/17)

The Associated Press: House Passes $1.4T Government Spending Bill Amid Impeachment
The sweeping legislation, introduced as two packages for political and tactical purposes, is part of a major final burst of legislation that’s passing Congress this week despite bitter partisan divisions and Wednesday’s likely impeachment of Trump. Thursday promises a vote on a major rewrite of the North American Free Trade Agreement, while the Senate is about to send the president the annual defense policy bill for the 59th year in a row. (12/17)

The Hill: Analysis: Repeal Of ObamaCare Taxes In Bipartisan Spending Deal Costs $373B
The repeal of three ObamaCare taxes in the bipartisan government funding deal poised to pass Congress this week will deprive the government of $373.3 billion over 10 years, according to a nonpartisan analysis. The analysis released Tuesday by Congress’s Joint Committee on Taxation, the companion of the Congressional Budget Office, analyzed the cost of repealing three taxes that were passed in ObamaCare as a way to help fund the law’s coverage expansion. (Sullivan, 12/17)

Los Angeles Times: Federal Spending Deal Funds Gun Safety Research, Increases Wildfire Spending
Among the many provisions included is one that California and other Western states still recovering from destructive wildfires have sought for years. It ends a long-standing practice known as “fire-borrowing,” which required the U.S. Forest Service to raid its other funds whenever it ran out of money to pay for fighting wildfires. Faced with increasingly long and costly fire seasons, the Forest Service often wound up strapped for cash as a result of a firefighting budget that amounted to a fraction of what it actually cost to fight fires. (Phillips, 12/17)

The Hill: Advocates Hopeful Gun Violence Research Funding Will Lead To Prevention 
Doctors and advocates are hopeful that new funding for federal agencies to study gun violence will prove to be the first step in preventing mass shootings, suicides and other firearm deaths. For the first time in 23 years, a government spending bill will set aside funds — in this case, $25 million — for the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH) to collect data on what the American Medical Association has called a public health crisis. (Hellmann, 12/18)

Stat: Lawmakers Slip A Win For Pharma Into Federal Spending Package
Lawmakers quietly tucked a boost for the pharmaceutical industry in the massive, end-of-year spending package they unveiled late Monday — a surprising turn for a Congress that has, at least rhetorically, pushed to rein in pharma’s high prices. The provision, just three lines and 17 words in a 1173-page bill, would effectively expand the definition of biologic drugs, a category that includes presumably more complicated medicines made from living cells. (Florko, 12/17)

Politico: Trump Slashed Puerto Rico’s Medicaid Money As Part Of Budget Deal
President Donald Trump intervened to cut the federal government's Medicaid funding for Puerto Rico as part of a larger government spending deal, according to four sources with knowledge of the discussions. The budget deal unveiled by lawmakers this week allocates up to $5.7 billion in Medicaid funds for the island over two years — instead of $12 billion over four years that Republican and Democratic leaders on two key congressional committees had endorsed after months of negotiating a long-term financial path for Puerto Rico. (Pradhan, 12/17)

Politico: Cannabis, Corruption And Cryptocurrency: All The Weird Stuff In The Budget Deal
Special Olympics spared from cuts: The Trump administration tried to kill the popular program in its budget. Education Secretary Betsy DeVos defended the cut before Congress. But after the administration faced backlash on social media and from lawmakers, President Donald Trump said he had “overridden” his people to restore funding for the games. Now, Special Olympics funding will rise to $20.1 million, a more than 14 percent boost. (12/17)

Politico: Democrats Say HHS Stonewalling Probe Into Verma’s PR Contracts
Four senior Democratic lawmakers said HHS must turn over more documents about Medicare and Medicaid chief Seema Verma's extensive use of public relations consultants, claiming the department has largely been uncooperative with their investigation. The lawmakers said information so far provided by the health department has prompted new questions about Verma’s role in shaping communications contracts, including some that helped burnish her personal brand. (Diamond, 12/17)

The New York Times: Teen Marijuana Vaping Soars, Displacing Other Habits
Teenagers are drinking less alcohol, smoking fewer cigarettes and trying fewer hard drugs, new federal survey data shows. But these public health gains have been offset by a sharp increase in vaping of marijuana and nicotine. These diverging trend lines, published Wednesday, are among the findings in the Monitoring the Future survey — a closely watched annual study by the National Institute on Drug Abuse, or NIDA, of eighth, 10th and 12th graders. The survey shows that youth drug use and experimentation continue to undergo significant evolution. (Richtel, 12/18)

The Associated Press: Survey Shows Boom In Marijuana Vaping Among School Kids
About 1 out of 5 high school students in the U.S. say they vaped marijuana in the past year, and its popularity has been booming faster than nicotine vaping, according to a report released Wednesday. “The speed at which kids are taking up this behavior is very worrisome,” said Dr. Nora Volkow of the National Institute on Drug Abuse, the federal agency that pays for the large annual teen survey. (12/18)

The Washington Post: Teen Vaping Of Marijuana Surges In 2019 Government Survey
“Any marijuana use among kids is a bad idea,” said Neal Benowitz, a clinical pharmacologist and emeritus professor of medicine at the University of California at San Francisco who studies vaping. “From my perspective, marijuana use is much more hazardous” than tobacco or nicotine use. He noted research that has shown marijuana’s impact on memory and learning, traffic accidents and, among some heavy users, the onset of psychosis, as well as the risk of contaminants in black-market products. (Bernstein, 12/18)

The Wall Street Journal: Youth Marijuana Vaping On The Rise, Researchers Say
Concerns about the rapid rise of youth vaping, particularly nicotine vaping, has spurred bans and regulation across the country, including a proposal to raise the minimum age to purchase tobacco products to 21 years old in a year-end congressional spending bill. But an increasing number of adolescents are also vaping marijuana oils, specifically THC, the psychoactive ingredient in cannabis. The overall percentage of middle-school and high-school students who said that they had tried vaping THC increased 32% from 2017 to 2018, an increase of roughly one million students, said Daisy Dai, an associate professor at the University of Nebraska Medical Center and author of the second report, which used data from the National Youth Tobacco Survey. (Abbott, 12/18)

Reuters: More Than 20% Of U.S. High School Seniors Vaped THC In 2019: Study
Stanton Glantz, a tobacco control expert at the University of California San Francisco who was not involved in the study, said kids who try vaping nicotine are more prone to vaping THC or smoking cigarettes. "It's like the Bermuda Triangle of substance abuse. There's good research out there showing any kid who does any of those is more likely to do the other ones," Glantz said in a phone interview. (12/18)

Los Angeles Times: 12th-Graders ‘Hooked’ On Vaping More Than Doubled In The Last Year
In a yearly poll of U.S. high school students, 14% of 12th-graders acknowledged they had used an e-cigarette to “vape” marijuana at least once in the past month. That’s nearly double the figure from the year before, when 7.5% of high school seniors said they had vaped marijuana in the past 30 days. In the 44 years that 12th-graders have shared details of their tobacco, drug and alcohol use with public health researchers, only one substance has taken hold more quickly: The share of high school seniors who had used an e-cigarette to inhale nicotine in the previous month jumped from 11% in 2017 to nearly 21% in 2018. (Healy, 12/17)

The Associated Press: Bill To Raise Tobacco Age Has Unlikely Allies: Altria, Juul
Congress is moving to pass the biggest new sales restrictions on tobacco products in more than a decade, with support from two unlikely backers: Marlboro-cigarette maker Altria and vaping giant Juul Labs. The legislation would raise the minimum age to purchase all tobacco products, including electronic cigarettes, from 18 to 21 nationwide, a step long-sought by health advocates. (Perrone and Lardner, 12/17)

The Associated Press: US Permits Sale Of Cigarettes With 95% Less Nicotine
U.S. health officials on Tuesday endorsed a type of cigarette that could help ease the addictive grip of smoking by delivering very low levels of nicotine. The Food and Drug Administration will allow 22nd Century Group to begin selling the first low-nicotine cigarettes reviewed by federal health regulators. The products contain roughly 95% less nicotine than standard cigarettes, according to the FDA. (12/17)

Reuters: Addictive Nicotine In Juul Nearly Identical To A Marlboro: Study
The nicotine formula used by controversial e-cigarette maker Juul Labs Inc is nearly identical to the flavor and addictive profile of Altria Group Inc's highly successful Marlboro cigarette brand, new research suggests. A study released on Tuesday from researchers at Portland State University in Oregon helps to explain why a growing number of young people who never smoked cigarettes have become regular users of Juul vaping devices. (12/17)

The Associated Press: Most US Opioid Overdose Deaths Accidental, 4% Are Suicide
Accidental overdoses cause 90% of all U.S. opioid-related deaths while suicides account for far fewer of these fatalities than previously thought, a new analysis published Tuesday suggests. Rising use of heroin and illicit, highly potent synthetic opioids including fentanyl has likely contributed to the unintentional death rate, which surged nine-fold between 2000 and 2017, the researchers said. Opioid suicides also went up during that time but their share of all opioid-related deaths shrank. (12/17)

The Associated Press: 11 Senators Ask Purdue Pharma Not To Give CEO A Bonus
OxyContin maker Purdue Pharma shouldn't give its CEO a bonus next year as the company goes through bankruptcy and tries to settle 2,700 lawsuits over the opioid crisis, 11 U.S. senators said in a letter Tuesday. A bankruptcy judge approved the company's plan to award bonuses to other employees earlier this month, but delayed a decision on whether CEO Craig Landau should receive an expected $1.3 million next year. (12/17)

The Associated Press: Michigan Sues Opioid Distributors Under Drug Dealer Law
Michigan on Tuesday sued four companies over the deadly painkiller epidemic, becoming what state Attorney General Dana Nessel said is the first state to sue major opioid distributors under a liability law that is typically used to go after drug dealers. The lawsuit was filed in Wayne County and names as defendants AmerisourceBergen, Cardinal Health, McKesson and Walgreens, which have also been sued in other states. (12/17)

Reuters: U.S. Sues CVS For Fraudulently Billing Medicare, Medicaid For Invalid Prescriptions
CVS Health Corp and its Omnicare unit were sued on Tuesday by the U.S. government, which accused them of fraudulently billing Medicare and other programs for drugs for older and disabled people without valid prescriptions. The Department of Justice joined whistleblower litigation accusing Omnicare of violating the federal False Claims Act for illegally dispensing drugs to tens of thousands of patients in assisted living facilities, group homes for people with special needs, and other long-term care facilities. (Stempel, 12/17)

The Associated Press: DOJ Sues CVS Over 'Stale' Omnicare Prescription Refills
The Department of Justice said in federal court papers filed Tuesday that Omnicare’s pharmacies sent drugs to people living in residential facilities based on “stale, invalid prescriptions.” It accused the company of fraudulently billing government-funded programs like Medicaid and Medicare for drugs dispensed without a valid prescription from 2010 to 2018. The DOJ said the practice put the safety of thousands of patients at risk because people kept taking the same drugs for months — or in some cases, years — without talking to a doctor. (Murphy, 12/17)

The Associated Press: US Proposes New Rules To Increase Organ Transplants
The U.S. government is overhauling parts of the nation's transplant system to make sure organs from the dead no longer go to waste — and to make it easier for the living to donate. The rules proposed Tuesday aim to ease an organ shortage so severe that more than 113,000 Americans linger on the transplant waiting list — and about 20 die each day. (Neergaard, 12/17)

The Washington Post: Trump Administration Takes Steps To Boost Organs Available For Transplant
The effort could yield 6,000 more organs annually, health officials said, a step toward reducing the huge waiting list for kidneys, livers, hearts and other organs. More than 114,000 people are on that list; many wait years for an organ. Thirty-three of them die each day. The proposed changes, which would take effect in 2022, could increase organ donation and transplantation from about 36,000 annually to 42,000 by 2024, officials said. (Kindy and Bernstein, 12/17)

The Wall Street Journal: U.S. Adopts Policies To Ease Shortage Of Donated Organs
It is estimated that 20 U.S. patients die every day from lack of donor organs, the officials said, which can come from accident victims who donate an organ or, in some cases, from relatives of a patient. Transplant-organization officials estimate that 115,000 people are on transplant waiting lists, about 95% of whom need a kidney or liver. (Burton, 12/17)

The Associated Press: Navajo Nation To Create Its Own Managed Healthcare Entity
The Navajo Nation is seeking become one of the first Native American tribes to create it’s own managed healthcare entity, the tribe recently announced. The tribe said it plans to contract with Molina Healthcare to work toward a managed healthcare offering under New Mexico’s Centennial Care Medicaid program. Navajo Nation Counselor Daniel Tso, chair of the Health, Education and Human Services Committee, said the new entity “will be a one-of-a-kind medicaid program” designed to improve access and quality of healthcare on the largest Native American reservation. (12/18)

Reuters: U.S. Congress Approves Sweeping Military Housing Overhaul
The U.S. Congress on Tuesday approved the largest overhaul to the American military’s housing program in more than two decades, vowing to end slum-like living conditions and hold private landlords and defense officials accountable for them. The reforms, included in the yearly National Defense Authorization Act, aim to protect some 200,000 military families living on U.S. bases from health hazards including mold, lead, asbestos and pest infestations. (12/17)

The Associated Press: In Reversal, Border Agents Allow Sick 7-Year-Old To Enter US
A 7-year-old child who is unable to contain her own waste due to a congenital illness and who had been refused entry to the United States three times was finally allowed into the country Tuesday, after U.S. border agents exempted her and her mother from the Trump administration's “Remain in Mexico” policy. The reversal came after U.S. Customs and Border Protection received inquiries from The Associated Press and other media about the case. (Merchant, 12/17)

Los Angeles Times: California Leads The Country In Meth And Fentanyl Border Seizures By CBP
More than 60% of methamphetamine seized by Customs and Border Protection across the country came through California ports, according to data from the federal agency. During fiscal 2019, which ended Sept. 30, CBP agents in California seized more than 80,000 pounds of methamphetamine at the border. That figure accounted for 63% of all methamphetamine seized by CBP agents nationwide this year and represented a 66% increase from the amount seized in California in the last fiscal year. (Solis, 12/17)

The Wall Street Journal: Diabetes Blood-Sugar Data Outage Blamed On Cloud Provider Switch
DexCom Inc. said a switch in its cloud-computing service provider led to the recent failure of the data-sharing feature of the company’s blood-sugar monitoring devices for people with diabetes. Chief Executive Kevin Sayer said the San Diego, Calif., company switched cloud-service providers earlier this year for its data-sharing feature. “During that move, we introduced new components to our platform that weren’t configured for optimal performance,” Mr. Sayer said in a video that the company posted online Friday. “Those components failed, and when they did, there was disruption to core processes within the platform.” (Loftus, 12/17)

The Wall Street Journal: Hackers Get More Sophisticated With Ransomware Attacks
Hackers are getting more sophisticated and creative in their ransomware attacks, putting pressure on companies by threatening to publish stolen data and pointing out that such a move might bring regulatory fines. Ransomware attacks have become more common over the past year, with hackers attacking businesses, organizations and cities—and demanding ever higher sums from their victims. (Stupp, 12/18)

The New York Times: A New Drug Scourge: Deaths Involving Meth Are Rising Fast
The teenager had pink cheeks from the cold and a matter-of-fact tone as she explained why she had started using methamphetamine after becoming homeless last year. “Having nowhere to sleep, nothing to eat — that’s where meth comes into play,” said the girl, 17, who asked to be identified by her nickname, Rose. “Those things aren’t a problem if you’re using.” She stopped two months ago, she said, after smoking so much meth over a 24-hour period that she hallucinated and nearly jumped off a bridge. (Goodnough, 12/17)

NPR: To Improve Diversity In Alzheimer's Studies, Researchers Try Outreach
Black and Hispanic Americans are especially vulnerable to Alzheimer's disease. Yet they're often underrepresented in scientific studies of the disease. So on a cool Sunday morning in Cleveland, two research associates from Case Western Reserve University's School of Medicine have set up an information table at a fundraising walk organized by the local chapter of the Alzheimer's Association. (Hamilton, 12/17)

The New York Times: The Quiet Brain Of The Athlete
Top athletes’ brains are not as noisy as yours and mine, according to a fascinating new study of elite competitors and how they process sound. The study finds that the brains of fit, young athletes dial down extraneous noise and attend to important sounds better than those of other young people, suggesting that playing sports may change brains in ways that alter how well people sense and respond to the world around them. (Reynolds, 12/18)

The New York Times: What A 5,700-Year-Old Wad Of Chewed Gum Reveals About Ancient People And Their Bacteria
When hunter-gatherers living in what is now southern Denmark broke down pieces of birch bark into sticky, black tar about 5,700 years ago, they almost certainly didn’t realize that they were leaving future scientists their entire DNA. Ancient people used the gooey birch pitch to fix arrowheads onto arrows and to repair a variety of stone tools. When it started to solidify, they rolled the pitch in their mouths and chewed on it, like some sort of primitive bubble gum. (Sheikh, 12/17)

The Wall Street Journal: The Rise Of Food Fetishes, Fueled By Social Media
Every decade has its culinary trends, from gelatin molds in the ’50s to pasta salads in the ’80s. In the 2010s, the defining development was the social-media-fueled fetishization of food. It was the sheer number of Instagram-worthy food crazes and sensations. Think avocado toast, the croissant-donut hybrid known as the Cronut, and anything and everything related to kale or bacon (or possibly both—say, a paleo-friendly kale-bacon salad). (Passy, 12/17)

The New York Times: Teaching Teens To See Eating As Part Of The Natural World
A cacophony of slapping noises filled the food lab at the High School for Environmental Studies in Manhattan one afternoon in late October. “Think of all the hands that have done this for thousands of years,” said Andrew Margon, an English teacher, as his students energetically pummeled lumps of corn masa into tortillas. The students were taking a cooking class as part of Food Ed., an interdisciplinary curriculum developed by the Stone Barns Center for Food and Agriculture, a nonprofit farm and educational center based near Tarrytown, N.Y., which also has a partner high-end restaurant. (Schiffman, 12/17)

Reuters: Clinic Waiting Room In Harlem Becomes Experiment In Humanizing Medicine
Brightly-colored artwork by patients adorns the walls of the waiting room at a small community healthcare center in New York City, the result of a project by two young doctors on a mission to humanize medicine. The two, who met in medical school, felt the decor of the waiting room at the Charles B. Rangel Community Health Center in Harlem did not reflect the identities and experiences of the patients it serves, who are mainly low-income African-American and Hispanic families dependent on Medicaid for healthcare costs. (12/17)

The Associated Press: Dental Patients Advised To Get Tested For HIV, Hepatitis
Some patients treated by a Tennessee dentist have been advised to get tested for HIV, hepatitis B and hepatitis C. The Tennessee Department of Health issued the recommendation after finding that Knoxville dentist Clarence “Buzz” Nabers did not ensure proper sterilization of dental equipment, news outlets reported. The recommendation was included in a letter Nabers sent to patients who visited his practice between Sept. 15, 2016, and Sept. 15, 2019. (12/17)

The Wall Street Journal: PG&E Wins Court Approval Of $13.5 Billion Deal With Wildfire Victims
PG&E Corp. won court approval for a $13.5 billion settlement with victims of fires linked to its equipment but the utility said it expects talks to continue with California Gov. Gavin Newsom, who last week said its bankruptcy-exit plan falls short of needed reforms. The pact with fire victims is the third and largest in a series of settlements aimed at putting a lid on damage claims from a series of blazes in recent years that left people dead, destroyed homes and businesses and plunged PG&E into bankruptcy in January. (12/17)

Los Angeles Times: Regulators Reach $1.6 Billion Proposed Settlement With PG&E
The California Public Utilities Commission filed the proposed settlement after investigating the role of PG&E’s equipment in igniting wildfires in 2017 in Butte, Calaveras, Lake, Mendocino, Napa, Nevada, Sonoma and Yuba counties, and the deadly 2018 Camp fire. Under the terms of the proposed settlement, PG&E would also be required to spend $50 million in shareholder money on system enhancements that regulators hope will lessen the risk of the utility’s equipment causing further disastrous wildfires. (Cosgrove, 12/17)

The Washington Post: Radford Freshman Aris Lobo-Perez Died In A Virginia Jail Cell Of Drug Overdose, Asthma
A college freshman found dead in his Virginia jail cell this summer died of opioid toxicity compounded by asthma, according to the state medical examiner’s office. Aris Lobo-Perez, who had attended Radford University for three weeks, was found dead at New River Valley Regional Jail on Sept. 12 after his arrest by campus police the night before for public intoxication. (Miller, 12/17)

The Wall Street Journal: New York City Death Certificates Will Now Include Male, Female Or ‘X’
The New York City Board of Health on Tuesday moved to allow death certificates to be issued with the gender designation of “X” for decedents who didn’t identify as male or female. The change follows a city law that went into effect on Jan. 1, 2019, that permits people born in New York City to apply to the city’s Department of Health and Mental Hygiene for a corrected birth certificate with an X designation for a gender marker. (West, 12/17)