First Edition: December 23, 2019

Kaiser Health News: For Her Head Cold, Insurer Coughed Up $25,865
Alexa Kasdan had a cold and a sore throat. The 40-year-old public policy consultant from Brooklyn, N.Y., didn’t want her upcoming vacation trip ruined by strep throat. So, after it had lingered for more than a week, she decided to get it checked out. Kasdan visited her primary care physician, Dr. Roya Fathollahi, at Manhattan Specialty Care just off Park Avenue South, and not far from tony Gramercy Park. The visit was quick. Kasdan got her throat swabbed, gave a tube of blood and was sent out the door with a prescription for antibiotics. She soon felt better and the trip went off without a hitch. Then the bill came. (Harris, 12/23)

Kaiser Health News: Paying It Forward: ‘Bill Of The Month’ Series, A Vital Toolkit For Patients, Wraps Year 2
In 2018, KHN and NPR launched “Bill of the Month,” a crowdsourced investigation in which we dissect, investigate and explain medical bills you send us. In telling the story behind one patient’s bill each month, our goal is to understand the genesis of the often exorbitant and baffling charges that pervade the American medical system. This year, we’ve delved into patients’ predicaments from pricey treatments for cat bites and snakebites, to the crippling costs of medical gear ($882 for a knee brace) and high-priced high tech (a $540,842 bill for dialysis, $4,836 for laughing gas during childbirth). (Norman, 12/23)

California Healthline: California AG Details ‘Historic’ Settlement Agreement In Sutter Health Antitrust Case
Under terms of the agreement, Sutter will continue to operate as an integrated system. But it has agreed to end a host of practices that Becerra alleged unfairly stifled competition, including all-or-nothing contracting deals demanding that an insurer that wanted to include any one of the Sutter hospitals or clinics in its network must include all of them — even if some of those facilities were more expensive than a competitor. The agreement includes the appointment of a jointly approved special monitor who will be charged with ensuring that Sutter is following the terms of the agreement for at least the next 10 years. (Gold, 12/20)

Kaiser Health News: Electronic Health Records Creating A ‘New Era’ Of Health Care Fraud, Officials Say
Derek Lewis was working as an electronic health records specialist for the nation’s largest hospital chain when he heard about software defects that might even “kill a patient.” The doctors at Midwest (City) Regional Medical Center in Oklahoma worried that the software failed to track some drug prescriptions or dosages properly, posing a “huge safety concern,” Lewis said. Lewis cited the alleged safety hazards in a whistleblower lawsuit that he and another former employee of Community Health Systems (CHS) filed against the Tennessee-based hospital chain in 2018. (Schulte and Fry, 12/23)

Kaiser Health News: Texas Law Highlights Dilemma Over Care For Patients With No Hope Of Survival
Critically ill Tinslee Lewis ― a Fort Worth baby embroiled in a dispute between her family and a hospital over whether to continue life-sustaining treatment ― is the most recent public face of the heartbreaking and intractable dilemmas often confronted quietly in intensive care units. But her circumstances are complicated by a rare law that Texas enacted two decades ago, which critics say gives hospitals the upper hand on whether to stop treatment. Just 15 to 20 years ago, disputes between doctors and families over the futility of further medical care flared once or twice each year, said Dr. Robert Truog, a pediatric intensive care physician at Boston Children’s Hospital. (Huff, 12/23)

Kaiser Health News: Government-Funded Day Care Helps Keep Seniors Out Of Nursing Homes And Hospitals
Two mornings a week, a van arrives at the Escondido, Calif., home of Mario Perez and takes him to a new senior center in this northern San Diego County town, where he eats a hot lunch, plays cards and gets physical therapy to help restore the balance he lost after breaking both legs in a fall. If he wants, he can shower, get his hair cut or have his teeth cleaned. Those twice-weekly visits are the highlights of the week for Perez, a 65-year-old retired mechanic who has diabetes and is legally blind. (Basheda, 12/23)

The Associated Press: Obamacare Sign-Ups Steady As Debate Persists Over Its Future
More than 8 million people have signed up for coverage next year under former President Barack Obama's health care law, the government said Friday, a sign of continued demand for the program amid persistent uncertainty over its future. Preliminary numbers from the Centers for Medicare and Medicaid Services showed that 8.3 million people enrolled from Nov. 1-Dec. 17, about 2 percent fewer than last year. The final number will be higher after states that run their own sign-up drives report their results. National totals are usually released in March. (Alonso-Zaldivar, 12/20)

The Washington Post: Sign-Ups For Affordable Care Act Health Plans Hold Steady With No Insurance Penalty
The enrollment snapshot shows a marginal increase in newcomers buying insurance through the federal marketplace — now just over 2 million. The Trump administration has been trying to dismantle the law yet has vowed to run a smooth enrollment system as long as the statute exists. On Friday, a top administration health official said the enrollment tally shows the insurance exchange is stable. (Goldstein, 12/20)

Reuters: Sign-Ups For 2020 Obamacare Insurance On HealthCare.Gov Fall To 8.3 Million: CMS
These numbers are preliminary and do not represent final 2020 Exchange Open Enrollment figures, the Centers for Medicare & Medicaid Services (CMS) said. On Monday, the CMS extended the deadline for enrollment via the website by three days to Dec. 18 after people faced technical issues during the final hours of the enrollment deadline. (12/20)

The Washington Post: Democratic Presidential Aspirants Disregard Political Gift Of ACA Court Ruling
Less than an hour after an appeals court invalidated part of the Affordable Care Act and pushed off a decision on the rest of it, congressional Democrats began punching, accusing President Trump and his party of imperiling Americans’ insurance and consumer health protections. But on a debate stage Thursday night, Democrats vying for their party’s nomination for president did not mention the major court decision. (Goldstein and Sullivan, 12/20)

The Washington Post: Abortion. Transgender Rights. Voting Access. Polarizing Issues Could Dominate Statehouse Agendas In 2020.
Republican-controlled state legislatures are gearing up to try to tighten abortion laws across the country, while some states controlled by Democrats are looking to enshrine the right to choose into law. It’s one of a handful of deeply polarizing issues that could dominate state legislatures in 2020, a potential sign of the partisan gridlock that’s to come — and the efforts to rally supporters during a hyperpartisan presidential election year. With about 38 state legislatures set to reconvene in January, according to the National Conference of State Legislatures, lawmakers are preparing to debate issues that affect life’s most intimate decisions. (Craig and Wax-Thibodeaux, 12/22)

The Washington Post: Congress Showers Health Care Industry With Multibillion-Dollar Victory After Wagging Finger At It For Much Of 2019
Vilified by lawmakers from both parties for months, the health-care industry this year appeared to face an existential threat to its business model. But this week, pharmaceutical companies, hospitals, insurance companies and medical device manufacturers practically ran the table in Congress, winning hundreds of billions of dollars in tax breaks and other gifts through old-fashioned lobbying, re-exerting their political prowess. “It’s the ‘no special interest left behind bill’ of 2019. That’s what it feels like this is,” said Andy Slavitt, a former health administrator who served in the Obama administration. “There’s no other explanation.” (Stein and Abutaleb, 12/20)

The Hill: Hospital Opposition To State Health Care Reforms Foreshadows Challenges For Congress 
State lawmakers seeking to rein in health care costs are facing formidable pushback from hospitals, foreshadowing the obstacles a Democratic president and Congress would also face if they try to follow through on bold promises for health reform. As Democratic presidential candidates argue about the merits of “Medicare for All” versus a public option, states are pursuing the latter and getting hammered by hospitals and insurance companies that would stand to lose money under those changes. (Hellmann, 12/21)

The Hill: Lawmakers Back To Square One On 'Forever Chemicals' 
Lawmakers must largely start anew after a major attempt to regulate a cancer-linked chemical that is spreading into the water supply across the United States was stripped from legislation this week, striking the best bet in years to address the problem. The class of chemicals abbreviated as PFAS is used in products ranging from raincoats to nonstick cookware to firefighting foam. It’s been deemed a “forever chemical” due to its lingering persistence in the environment and in the human body. (Beitsch, 12/22)

The New York Times: Sutter Health To Pay $575 Million To Settle Antitrust Lawsuit
Sutter Health, the large hospital system in Northern California, said Friday that it had agreed to pay $575 million to settle claims of anti-competitive behavior brought by the California state attorney general as well as unions and employers. In addition to the settlement amount — which will go to compensate employers, unions and the state and federal governments — Sutter will also be prohibited from engaging in several practices that the state attorney general and others said the hospital system used to ensure its dominance. (Thomas, 12/20)

The Associated Press: Health System Pays $575 Million To Settle Anti-Trust Lawsuit
Becerra called it “one of the largest actions against anti-competitive conduct in the health care marketplace across the country, with unprecedented levels of injunctive relief to restore competition in the market.” It is larger than recent similar settlements with other providers in North Carolina and Washington state, his office said. The settlement immediately set off a debate between hospitals and consumer advocates over whether it will limit or increase health care costs. (Thompson, 12/20)

The New York Times: Vaping Patients May Be Prone To Relapse, C.D.C. Warns
Health officials are warning doctors to more closely monitor patients with severe lung damage caused by vaping, because some have relapsed or died shortly after being sent home from the hospital. The recommendations are part of four new reports about the nationwide outbreak of severe illnesses from vaping, which has hospitalized 2,506 people and killed 54 as of Dec. 17. The reports were published on Friday, two by the Centers for Disease Control and Prevention, and two by The New England Journal of Medicine. (Grady, 12/20)

The Associated Press: 'Vast Majority' Of Vaping Illnesses Blamed On Vitamin E
Health officials now blame vitamin E acetate for the “vast majority” of cases in the U.S. outbreak of vaping illnesses and they say doctors should monitor patients more closely after they go home from the hospital. The Centers for Disease Control and Prevention announced the updated advice Friday. And, in a related move Friday, authorities investigating how patients obtained possibly tainted vape products said they have shut down 44 websites advertising the sale of illicit vaping cartridges containing THC. (Johnson, 12/20)

The Washington Post: Evidence Mounts That Vitamin E Acetate Is To Blame For Vaping-Related Illnesses, Deaths
The vast majority used products containing THC, the psychoactive ingredient in marijuana. By comparison, no vitamin E acetate was found in the lung fluids of any of 99 healthy individuals in a comparison group. Those people either vaped nicotine exclusively, smoked only cigarettes or said they never smoked. Researchers also found no evidence of other potential toxins in the healthy comparison group. (Sun, 12/20)

NPR: Vaping-Related Lung Injuries Declining, As CDC Confirms Vitamin E Acetate As Main Culprit
"That doesn't mean that there aren't other chemicals that can or are causing lung injury," Schuchat said during a telephone news conference. But backed with additional data about vitamin E acetate found in lung samples from people who were injured after vaping, she attributes the bulk of the outbreak to that additive. (Harris, 12/20)

USA Today: Vaping Lung Injuries From THC Killing And Reinjuring Older Users
Vaping-related lung injuries peaked in September and are on the decline, federal officials said Friday, and the link to the additive vitamin E acetate in marijuana-based THC is growing stronger. The Centers for Disease Control and Prevention reported 2,506 people have been hospitalized in 50 states and 54 died as of Tuesday. The CDC found an alarming new trend among lung injury patients after leaving hospitals – 31 returned to the hospital and seven died. (O'Donnell and Alltucker, 12/20)

The New York Times: Vaping On Campus: No Parents, No Principals, A Big Problem
Gail Moody had her first e-cigarette inhale of the day moments after waking up one recent morning. She took more puffs while showering. Aerosolized nicotine filled her lungs again during a break in her morning run, between mouthfuls of lunch, and as she worked at a tobacco shop near the University of Georgia, where she is a sophomore. “Wow,” said Ms. Moody, 19, glancing at the sleek black stick in her right hand that evening. “I’m more addicted to this than I thought.” (Levin, 12/22)

The Associated Press: Montana Vape Shop Turns To Home Kits To Dodge Flavored Ban
A Montana vape store chain has announced plans to offer customers do-it-yourself vaping kits to combat the state's new temporary ban on the sale of flavored vaping products. Montana Public Radio reported Thursday that Freedom Vapes stores in the cities of Bozeman and Hamilton and the town of Belgrade are offering the workaround to help maintain business. (12/20)

USA Today: ICE, Asylum Under Trump: An Exclusive Look At US Immigration Detention
At 2:04 p.m. on Oct. 15, a guard at the Richwood Correctional Center noticed an odd smell coming from one of the isolation cells. He opened the door, stepped inside and found the lifeless body of Roylan Hernandez-Diaz hanging from a bedsheet. The 43-year-old Cuban man had spent five months in immigration detention waiting for a judge to hear his asylum claim. As his time at Richwood dragged on, he barely answered questions from security or medical staff, who noted his “withdrawn emotional state.” He refused to eat for four days. The day after his death, 20 other detainees carried out what they say was a peaceful protest. They wrote “Justice for Roylan” on their white T-shirts, sat down in the cafeteria and refused to eat. Guards swooped in and attacked, beating one of them so severely he was taken to a hospital, according to letters written by 10 detainees that were obtained by the USA TODAY Network and interviews with two detainees’ relatives. (12/20)

The Associated Press: DHS Watchdog Finds No Wrongdoing In Deaths Of 2 Migrant Kids
The Department of Homeland Security's internal watchdog found no wrongdoing or misconduct by immigration officials in the deaths of two migrant children last December. The Inspector General for the Department of Homeland Security released two brief statements Friday evening on the deaths of Jakelin Amei Rosmery Caal Maquin, who died Dec. 8 at age 7, and Felipe Gómez Alonzo, who died Dec. 24 at age 8. (12/20)

The Washington Post: DHS Inspector General Finds ‘No Misconduct’ In Deaths Of Two Guatemalan Migrant Children
Each report concluded that the “investigation found no misconduct or malfeasance by DHS personnel.” Officials have said they were the first children to die in Border Patrol custody in a decade. Three other Guatemalan children, ranging in age from 2 to 16, died after being taken into Border Patrol custody in April and May. DHS officials have not released results of internal investigations into those deaths. (Moore, 12/20)

The Wall Street Journal: Trump Administration Awards Migrant Detention Contracts Days Before California Would Ban Them
The federal agency in charge of immigrant detention has awarded multiyear contracts for private companies to run facilities in California just over a week before a new state law forbidding them goes into effect. Lawmakers in Sacramento passed a bill in September—signed the next month by Democratic Gov. Gavin Newsom —that bans new contracts for for-profit prison facilities beginning Jan. 1. As the legislation was being drafted, the definition was expanded to include immigrant detention, as the Trump administration’s border policies and the conditions in which it held migrants drew increasing criticism. (Lazo, 12/20)

The Washington Post: Under Secret Stephen Miller Plan, ICE To Use Child Migrant Information To Expand Deportation Efforts, Raising Fears Parents Will Face Arrest
The White House sought this month to embed immigration enforcement agents within the U.S. refugee agency that cares for unaccompanied migrant children, part of a long-standing effort to use information from their parents and relatives to target them for deportation, according to six current and former administration officials. Though senior officials at the Department of Health and Human Services rejected the attempt, they agreed to allow Immigration and Customs Enforcement agents to collect fingerprints and other biometric information from adults seeking to claim migrant children at government shelters. (Miroff, 12/20)

The New York Times: Stranded On Border, This Migrant Became The Camp Doctor
Under a canopy on the edge of a squalid encampment, a young physician named Dairon Elisondo Rojas holds office hours every day from 10 to 4. On a recent afternoon, he saw children with diarrhea, colds and asthma, among other ailments. Some he examined, treated and sent on their way with cough or cold medicine. For those who required special care, like a boy with a broken leg, Dr. Elisondo arranged a transfer to the local Mexican hospital. (Jordan and Ferman, 12/22)

Reuters: Novartis Wins Medicaid Approval For New Sickle Cell Drug In Key U.S. States
Novartis AG has secured Medicaid coverage for a pricey new sickle cell disease therapy in two U.S. states just weeks after winning U.S. approval, following an early campaign to convince local officials of its value, according to a company executive and a Reuters review of public filings. The approvals from the Florida and Alabama Medicaid health programs for the poor and disabled mark exceptionally fast acceptance for the treatment, which can cost up to $113,000 annually for an individual patient, excluding discounts, said Ameet Mallik, who heads the Swiss drugmaker's U.S. oncology division. (12/20)

Reuters: Merck Says Ebola Vaccine To Be Available At Lowest Access Price For Poor Nations
Merck & Co said on Friday it expects to make licensed doses of its recently approved Ebola vaccine available in the third quarter of 2020 and price the single-dose injection at the lowest possible access price for poor and middle-income countries. The vaccine, Ervebo, was approved by the U.S. Food and Drug Administration on Thursday, a month after Europe gave its nod to the vaccine, a move that has been hailed by the World Health Organization. (12/20)

The Wall Street Journal: Drugmakers Turn To Data Mining To Avoid Expensive, Lengthy Drug Trials
Drugmakers are trying to win drug approvals by parsing vast data sets of electronic medical records, shifting away from lengthy, and costly, clinical trials in patients. Pfizer Inc., Johnson & Johnson and Amgen Inc. are among the drugmakers that have submitted the data-mining analyses to the U.S. Food and Drug Administration in seeking approval to sell new medicines or for new uses for older ones. The FDA has approved new uses for breast cancer, bladder cancer and leukemia drugs in part based on the data. (Loftus, 12/23)

The Washington Post: A Major Funder Of The Anti-Vaccine Movement Has Made Millions Selling Natural Health Products
The nation’s oldest anti-vaccine advocacy group often emphasizes that it is supported primarily by small donations and concerned parents, describing its founder as the leader of a “national, grass roots movement.” But over the past decade a single donor has contributed more than $2.9 million to the National Vaccine Information Center, accounting for about 40 percent of the organization’s funding, according to the most recent available tax records. That donor, osteopathic physician Joseph Mercola, has amassed a fortune selling natural health products, court records show, including vitamin supplements, some of which he claims are alternatives to vaccines. (Satija and Sun, 12/20)

Reuters: J&J To Buy Remaining Stake In Verb Surgical To Strengthen Digital Surgery Portfolio
Johnson & Johnson said on Friday it would acquire the remaining stake in Verb Surgical Inc, from Verily, Alphabet Inc's life sciences division. Bolstering its Ethicon unit, which makes surgical equipment, J&J in 2015 formed an independent company called Verb Surgical with Verily to create smaller, smarter and less costly robotic-assisted systems for surgery. (12/20)

The Wall Street Journal: Mayo Clinic Names Health IT Vet To Head Its Digital Health-Care Businesses
The Mayo Clinic has named health-care technology veteran John Halamka as the head of its digital health-care businesses. One of his focus areas will be looking at how neural networks, machine learning and artificial intelligence can improve health care. Dr. Halamka, also a practicing emergency medicine physician, will be president of the Mayo Clinic Platform, a newly created position, when he joins on Jan. 1. The Mayo Clinic Platform is a strategic initiative to improve health care through insights and knowledge derived from data. It is a part of Mayo charged with developing clinical innovations and transforming health care. (McCormick, 12/23)

The New York Times: Alzheimer’s Tests Soon May Be Common. Should You Get One?
Not long ago, the only way to know if someone had Alzheimer’s disease was to examine the brain in an autopsy. That is changing — and fast — with brain scans and spinal taps that can detect beta amyloid, the telltale Alzheimer’s protein. There is a blood test on the horizon that can detect beta amyloid, and researchers are experimenting with scans to look for another protein, called tau, also characteristic of Alzheimer’s. (Kolata, 12/20)

The Washington Post: Traveling The Loneliest Road
She had been waiting more than a week for the black ice to melt and the farm roads to clear, but Marlene Kennedy, 84, was unwilling to wait any longer. She changed into snow boots, tucked her heart medication into her purse, and stepped out to the porch. She held onto a railing with one hand and to her daughter with the other, inching down the frozen walkway toward her garage, trying not to think about her husband’s slip and fall, which had shattered his hip and eventually forced him into a nursing home located more than an hour away. (Saslow, 12/21)

The New York Times: What You’re Unwrapping When You Get A DNA Test For Christmas
The company GEDmatch, the DNA database that facilitated an arrest in the Golden State Killer case and in dozens of other cases since, emerged from a desire to connect people to their relatives. For the past decade, the site’s co-founder Curtis Rogers has been running the company out of a small yellow house in Lake Worth, Fla. When Mr. Rogers first learned that the DNA of GEDmatch users had played a critical role in identifying a suspected serial killer, he was upset. (Murphy, 12/22)

The Wall Street Journal: ‘All You Need Is One Person On A Plane’: Stifling A Lethal Measles Outbreak
International health officials are expanding their efforts to prevent a potential spread of measles to more Pacific islands during the holiday travel period, following a large and deadly outbreak in Samoa. Tonga, Fiji and American Samoa, a U.S. territory, have all reported outbreaks or cases of measles in recent weeks. But Samoa, an independent country that is an eight-hour ferry ride from American Samoa, has suffered the largest outbreak by far. As of Saturday, measles had killed 79 people in the island nation and sickened more than 5,400 since September, out of a population of around 200,000. More than 60 of those who died were under the age of 4. (Cherney and McKay, 12/22)

NPR: Using Psilocybin To Help Smokers Quit Cigarettes
For many Americans, hallucinogens still evoke the psychedelic '60s, bringing to mind the sex-and-drugs lifestyle of the hippie counterculture. But that stereotype lags behind reality, by several decades. Today, psychedelic experimentation is more likely to refer to dozens of clinical trials taking place at universities and research facilities. (O'Neill, 12/22)

NPR: Busting Myths About The Flu And Flu Shot Can Save Lives
Thanksgiving leftovers are a distant memory, and December's extra travel, shopping and family commitments are already straining nerves, budgets and immune systems. It's officially "the holidays" — which also means we're well into a new flu season. It's never too late to benefit from a flu shot, even into December and January, says Dr. William Schaffner, an infectious disease specialist at Vanderbilt School of Medicine in Nashville. (Haelle, 12/20)

NPR: Worker Safety Agency Takes Aim At Silica Dust
The Department of Labor's workplace safety agency is getting ready to take new action to reduce workers' exposure to dangerous silica dust that can irreparably damage the lungs. But the agency's new program doesn't give special attention to the kitchen and bathroom countertop industry, which has recently seen cases of severe lung damage that have alarmed public health officials. (Greenfieldboyce, 12/21)

The Associated Press: What If You Knew A Cookie Would Take 20 Minutes To Run Off?
Would you put down that bag of chips if you saw it had 170 calories? What if the label said it would take 16 minutes of running to burn off those calories? Health experts for years have pushed for clearer food labeling to empower people to make better choices. In the U.S., a recent regulation requires calorie counts on packages to be bigger. Red, yellow and green labels signal the healthfulness of some foods in the United Kingdom. (12/20)

The Washington Post: Winter Weight Gain Can Be Avoided. Here's How.
These cold, dark winter days make me want to curl up with a book, perhaps while munching on holiday cookies. One could describe my conduct this way: sedentary behavior combined with snacking on sugary treats. A regular practice of these things may well lead to weight gain. (Adams, 12/22)

The Associated Press: Black Med Students Hope Slave Plantation Photo Inspires Kids
In the background of a powerful photo of 15 black medical students from Tulane University is a slave cabin. In the foreground stand the students, wearing the white lab coats that tell observers they're members of a highly trained and prestigious profession. “We are our ancestors’ wildest dreams," tweeted Russell Joseph Ledet, who conceived of the photo. (12/20)

The Washington Post: Museums, Other Institutions Start Stocking Special Glasses For Those With Colorblindness
Public spaces are packed with vivid color palettes, from the explosive shades of modern art to the covers of library books. But for people with colorblindness, the experience can be muted by an inability to take in the full spectrum of color. Now, museums and libraries are starting to take note — and stock special glasses designed to improve color vision. Institutions such as the Georgia O’Keeffe Museum, the California Academy of Sciences and the St. Johns Public County Library System in St. Augustine, Fla., have partnered with a company that produces eyewear for people with colorblindness. (Blakemore, 12/21)

The Washington Post: He Never Felt Well. It Took Doctors More Than 50 Years To Figure Out Why.
For as long as he can remember, Steven Knapp never felt well. “That was pretty much true from early childhood,” said Knapp, a self-described “Army brat” who was born in Germany and grew up in Turkey and a half-dozen states, including Georgia where he has lived since high school. (Boodman, 12/21)

The New York Times: Homelessness Rises 2.7 Percent, Driven By California’s Crisis, Report Says
Homelessness in the United States continued to rise this year, driven by soaring rates of homelessness in California, according to a new federal report that could prompt long-promised action for people living in the streets of Los Angeles and San Francisco. Homelessness rose 2.7 percent from 2018 to 2019, according to the annual assessment by the Department of Housing and Urban Development. (Fadulu, 12/20)

The Washington Post: Rise In U.S. Homelessness Driven By A Surge In California, HUD Says
A decline in homelessness in 29 states, as well as the District of Columbia, was offset by a spike in California of 21,000 people, or 16.4 percent, the Department of Housing and Urban Development announced Friday — evidence that homelessness in the nation’s most populous state is “at a crisis level and needs to be addressed by local and state leaders with crisis-like urgency,” HUD Secretary Ben Carson said in a statement. California leaders and advocacy groups share federal officials’ alarm over the state’s outsize role in that trend. But there’s significant disagreement over how to tackle the issue as the president singles out cities like San Francisco and Los Angeles as problems, clashing with a liberal state that often fights his policies. (Knowles, 12/21)

The New York Times: Black, Homeless And Burdened By L.A.’s Legacy Of Racism
Homelessness is Los Angeles’s defining crisis. Income inequality, a shortage of housing, failing mental health services and drug addiction all contribute to growing scenes of squalor across America’s second-largest city. The federal government recently estimated that a nearly 3 percent rise in homelessness nationwide this year was driven mostly by California. Yet it does not affect everyone equally. The historic displacement and fracturing of black communities in South Los Angeles have pushed black Angelenos like Mr. Wynn onto the streets at more than eight times the rate of other groups. In interviews with more than a dozen black men who are homeless in Los Angeles, the bitter inheritance of racism came up again and again. (Patel, Arango, Singhvi and Huang, 12/22)

The Washington Post: ‘She’s Just One More Missing Voice’: D.C. Says 117 Homeless People Died Here This Year
When Alice Carter died Wednesday after collapsing on a Northwest Washington street, there was no immediate outcry. She had slept on 17th Street north of Q Street for at least 15 years, an advocate said, a transgender woman struggling with addiction and mental-health issues. She recently secured housing through an assistance program, but it wasn’t enough to save her after a life led on the margins. (Moyer, 12/20)

The Associated Press: California Church To Pay Off $5.3M In Family Medical Bills
A Los Angeles church is paying off $5.3 million worth of medical debt for nearly 6,000 households in Southern California, according to one of the church's pastors. Christian Assembly purchased the debt for $53,000 and is working with a nonprofit organization to pay the outstanding bills for 5,555 families in 28 neighborhoods, co-lead pastor Tom Hughes said in a video posted online Thursday. “We are able to give a Christmas gift to the people of Los Angeles, no strings attached,” he said. (12/22)

The Associated Press: Governor: Update On Flint Water Crisis Probe To Come In 2020
An update is expected at the start of 2020 regarding a criminal investigation into the Flint water crisis that was one of the worst man-made environmental disasters in U.S. history, Michigan Gov. Gretchen Whitmer said. Whitmer told MLive.com on Tuesday that she trusts Michigan's Attorney General Dana Nessel “to do the right thing” in the probe of Flint's water crisis. (12/22)

The Associated Press: Nurses Defend Ohio Doctor Charged In Deaths At Hospital
Ten former colleagues of an Ohio hospital doctor who pleaded not guilty to murder in 25 patients' deaths are coming to his defense in a new lawsuit. The action was brought Thursday in Franklin County Common Pleas Court by nine nurses and a pharmacist once employed by Mount Carmel Health System in Columbus, NBC News reported. In it, the former employees argue that the hospital wrongfully terminated and defamed Dr. William Husel. (12/20)

The Wall Street Journal: In Virginia, Democrats Get Ready To Rule The Roost
Gun control. Civil rights. A minimum-wage increase. Virginia Democrats have a long list of goals for the legislative session that starts next month, and with their newfound power they are confident they can achieve many of them. “I’m excited for January to get here, because we’re going to do some good things for Virginia and really respond to what Virginians have asked for for many years,” Democratic Gov. Ralph Northam said in an interview. (Kamp and Calvert, 12/22)

The Washington Post: Detroit Green Liquid: Cancer-Causing Chemical Gushed Onto Highway
A bright greenish-yellow liquid gushed onto the side of a Michigan highway Friday, prompting a multiagency investigation that discovered the mystery substance was probably a chemical that is known to cause cancer. The hexavalent chromium-contaminated water that rushed from a retaining wall onto Interstate 696 in the Detroit suburb of Madison Heights appeared to come from a shuttered electroplating business, said Jill Greenberg, a spokesperson for the Michigan Department of Environment, Great Lakes and Energy. (Iati, 12/22)

The Associated Press: Virginia Health Officials Warn Of Possible Measles Exposure
Virginia health officials are mounting an effort to identify people who may have recently been exposed to a person with measles. The Virginia Department of Health said in a news release Saturday that the person visited the Richmond International Airport Tuesday night and a doctor’s office in suburban Richmond on Thursday afternoon. (12/22)

The Wall Street Journal: Brooklyn Hospital Center Plans To Sell Land To Finance Overhaul Of Campus
Facing financial pressure and increasing capital needs, the Brooklyn Hospital Center wants to redevelop its downtown Brooklyn campus and sell large parcels of its site to finance the project. The hospital plans in the coming weeks to submit initial paperwork to seek rezoning for the entire square-block site in a bid to encourage residential development. That is the start of a multiyear effort to gain technical approvals for the development. (West, 12/22)