First Edition: February 21, 2019

Kaiser Health News: Trump Administration Plan To Beat HIV Hits Rough Road In Rural America
One of the goals President Donald Trump announced in his State of the Union address was to stop the spread of HIV in the U.S. within 10 years.In addition to sending extra money to 48 mainly urban counties, Washington, D.C., and San Juan, Puerto Rico, Trump’s plan targets seven states where rural transmission of HIV is especially high. Health officials and doctors treating patients with HIV in those states say any extra funding would be welcome. But they say strategies that work in progressive cities like Seattle won’t necessarily work in rural areas of Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma and South Carolina. (Fortier, 2/21)

California Healthline: More States Say Doctors Must Offer Overdose Reversal Drug Along With Opioids
In a growing number of states, patients who get opioids for serious pain may leave their doctors’ offices with a second prescription — for naloxone, a drug that can save their lives if they overdose on the powerful painkillers. New state laws and regulations in California, Virginia, Arizona, Ohio, Washington, Vermont and Rhode Island require physicians to “co-prescribe” or at least offer naloxone prescriptions when prescribing opioids to patients considered at high risk of overdosing. (Ostrov, 2/21)

California Healthline: Teachers Strike In US Cities To Demand More School Nurses, Better Pay
As teachers across the country walk out of their classrooms, hit the picket lines and demand higher pay, they’re keeping school nurses in mind — asking for more of them or, at the very least, better pay for them. Oakland, Calif., teachers plan to strike Thursday if they can’t hammer out a deal with the district that includes a “living wage” and more nurses and counselors. Last week in Denver, thousands of educators and school nurses went on strike and marched to the state Capitol asking for a significant raise — and got it. (Ibarra, 2/20)

The Associated Press: Government Headed For Close To Half Of Nation's Health Tab
Even without a history-making health care remake to deliver "Medicare-for-all," government at all levels will be paying nearly half the nation's health care tab in less than 10 years, according to a federal report released Wednesday. The government growth is driven by traditional Medicare, which is experiencing a surge in enrollment as aging baby boomers shift out of private coverage, according to the analysis from the Centers for Medicare and Medicaid Services, part of the U.S. Department of Health and Human Services. (Alonso-Zaldivar, 2/20)

The Washington Post: Spending Forecast Offers Ammunition — And Some Alarm — For Democrats Pushing Medicare Expansion
Aging baby boomers will consume an ever-larger share of the nation’s health-care spending over the coming decade, regardless of the success of Democrats running for president with ambitious plans to broaden Medicare. The number of people covered through Medicare — and spending on the federal insurance program for older and disabled Americans — is expected to grow more rapidly than private insurance or Medicaid, eating up a larger chunk of health spending, according to a yearly forecast of U.S. health-care expenditures released Wednesday. (Goldstein, 2/21)

The Wall Street Journal: Health-Care Spending Projected To Accelerate As Population Ages
The report from actuaries at the Centers for Medicare and Medicaid Services is likely to add to the pressures making health care a significant issue in the 2020 election. Health care’s share of the economy is projected to climb to 19.4% by 2027 from 17.9% in 2017, assuming no legislative changes to the U.S. health system. The faster rate of growth would follow a slower tempo seen in 2017, when increases decelerated to a pace not seen since just after the 2007-09 recession. “While Medicare spending is expected to accelerate the fastest among payers and contribute to the increase, growth in health prices and disposable personal income are also significant contributors,” said Andrea Sisko, an economist at CMS and lead author of the study published in the journal Health Affairs. (Armour, 2/20)

The New York Times: Build Your Own ‘Medicare For All’ Plan. Beware: There Are Tough Choices.
“Medicare for all” is popular, and not just among Democrats. Most Republicans favor giving people under 65 at least the choice to buy into Medicare. But when people hear arguments against it, their support plummets. It turns out that most people don’t really know what Medicare for all means. Even asking three policy experts might yield three different answers. By our count, there are at least 10 major proposals to expand Medicare or Medicaid. (Frakt and Carroll, 2/21)

The New York Times: Critic Of Waste At Veterans Affairs Now Faces Questions About His Travel Costs
A top adviser at the Department of Veterans Affairs, who was an outspoken critic of wasteful practices there before he joined the department, has come under fire for billing the government for the cost of commuting between the department’s headquarters in Washington and his home in California. The adviser, Darin Selnick, who is spearheading a controversial plan to shift billions of dollars from government-run veterans’ hospitals to private health care providers, spent more than $13,000 on his bicoastal commute in three months, including airfare, hotel stays and other outlays, according to expense reports published by the nonprofit news organization ProPublica. (Philipps, 2/20)

Stat: Drug Spending Could Rise 6.1 Percent Annually By 2020, Federal Projections Show 
Spending on prescription drugs is expected to increase at an accelerating rate over the next 10 years, according to government estimates released Wednesday — ramping up to as much as 6.1 percent growth by 2020. The Office of the Actuary at the Centers for Medicare and Medicaid Services annually forecasts how much money patients, insurance companies, and the government will spend on health care in the coming decade — so-called national health expenditures. Broadly, they predict total health spending in the U.S. will increase by an annual average of 5.5 percent until 2027. (Swetlitz, 2/20)

The Hill: Bill Would Let Patients Buy Cheaper Insulin From Other Countries
A bill introduced by Rep. Peter Welch (D-Vt.) on Wednesday would let patients import cheaper insulin from Canada and other countries. ... Insulin, which is used to treat diabetes, can cost diabetics thousands of dollar a year in the U.S. because of the lack of generic competition, but it's often cheaper in other countries. The bill would legalize importation of insulin from Canada by patients, pharmacists and wholesalers for two years before expanding to other countries with safety standards similar to the U.S. (Hellmann, 2/20)

The Associated Press: Florida Governor Wants To Import Drugs From Canada
Florida's governor on Wednesday proposed bringing cheaper, Canadian prescription drugs to Florida as a way to cut health care costs. Gov. Ron DeSantis said that he wants to create an importation program that brings Canadian prescription drugs to the Sunshine State. It is illegal to import unapproved prescription drugs into the United States. But the U.S. Department of Health and Human Services secretary has the power to approve a program allowing drugs from Canada. (Schneider, 2/20)

The Hill: Florida GOP Governor Working With Trump To Import Cheaper Drugs From Canada 
Significantly, given that state action would require federal approval to take effect under a 2003 law, DeSantis said he had personally spoken to Trump over the weekend and that Trump said his administration would approve the move. “I want you to know I spoke personally to President Trump on both Sunday and Monday about this,” DeSantis said. “He's not only supportive, he's enthusiastic, and he wanted me to tell all of you here today that he supports what we're doing and he will take the necessary executive actions to make sure that we can act under this 2003 law.” (Sullivan, 2/20)

Stat: The Seven Executives Who Will Defend Pharma Before Congress 
Meet pharma’s new Gang of Seven, a disparate group of executives about to face congressional questions on what they have in common: Their companies sell drugs, and drugs keep getting more expensive. On Tuesday, the Senate Finance Committee will poke, prod, and pry the leaders of Merck, Pfizer, AstraZeneca, Johnson & Johnson, AbbVie, Sanofi, and Bristol-Myers Squibb. It’s a televised crucible that arrives amid bipartisan furor over the cost of medicine. Just how those seven executives defend themselves could have sweeping implications for how Washington deals with drug pricing. (Garde and Florko, 2/21)

The New York Times: U.S. Investigating Johnson & Johnson Over Baby Powder’s Safety
The Justice Department and Securities and Exchange Commission are investigating Johnson & Johnson over concerns about possible asbestos contamination of its popular baby powder and other talc-based products, the company said Wednesday. In a securities filing, Johnson & Johnson said it was “cooperating with these government inquiries and will be producing documents in response” to subpoenas it had received. In a separate statement, the company said that “the inquiries are related to news reports” about the welter of lawsuits it faces from consumers who claim its talc products caused cancers. (Hsu, 2/21)

Reuters: Johnson & Johnson Receives Federal Subpoenas Related To Baby Powder Litigation
The company said it intends to "cooperate fully with these inquiries and will continue to defend the Company in the talc-related litigation." The disclosure in Johnson & Johnson's annual report on Wednesday is the first time that the company disclosed it had received subpoenas from federal agencies regarding its talc powder products. The Justice Department declined to comment and the SEC did not immediately respond to requests for comment. (2/21)

The Wall Street Journal: Johnson & Johnson Is Subpoenaed For Talc Safety Information
The talc-powder litigation threatens J&J’s carefully cultivated image. At least 13,000 lawsuits against the company claim that use of Johnson’s Baby Powder and other talc products caused ovarian cancer and mesothelioma, as the lawsuits allege. J&J says decades of testing have shown its baby powder is safe and asbestos-free, and that it doesn’t cause cancer. (Loftus, 2/20)

The Associated Press: Advocates Say US Still Separates Migrant Families Needlessly
Months after the Trump administration announced an end to its widescale separation of migrant parents and children, the policy remains a heated issue in the courts and at the border as critics contend the government is still needlessly breaking up immigrant families. The Texas Civil Rights Project released a report Thursday that counts 272 separations at a single Texas courthouse since June, when President Donald Trump issued an executive order ending widespread separations amid public outrage. (2/21)

The Wall Street Journal: New Details Of Amazon, Berkshire Hathaway, JPMorgan Health Venture Emerge In Court Testimony
A health-care joint venture launched by Amazon.com Inc., Berkshire Hathaway Inc. and JPMorgan Chase & Co. is looking at how to redesign health insurance, among other efforts, according to newly unsealed court testimony from an executive at the health startup. The three companies announced the venture last year with stated goals of trying to improve health care and rein in costs for their employees. The still-unnamed venture has released few specifics, however, about its long-term aims. (Kamp and Wilde Mathews, 2/20)

Stat: Unsealed Testimony Reveals A Goal Of Atul Gawande Venture: ‘Make Health Insurance Intelligible’
Making insurance intelligible is the core mission of the health care venture led by Atul Gawande and founded by Amazon, Berkshire Hathaway, and J.P. Morgan Chase, according to testimony unsealed on Wednesday from the venture’s chief operating officer. The COO, Jack Stoddard, also focused on the venture’s approach to prescription drug prices — and to the flaws and foibles of a notoriously opaque system. “You can imagine our employers are — just given who supports us — are incredibly allergic to market inefficiencies,” Stoddard said. (Sheridan, 2/20)

The Associated Press: Trouble At CVS Health Long-Term Care Business Weighs Heavily
CVS Health is setting 2019 earnings expectations well below Wall Street forecasts, as the company struggles to fix part of its business while blending in a major acquisition and attempting to change how customers use its stores. The drugstore chain and pharmacy benefit manager also is dealing with industry-wide pressure to reduce what customers pay for prescriptions. (Murphy, 2/20)

The Wall Street Journal: CVS Gives Downbeat Earnings Outlook For First Year As Merged Company
The Woonsocket, R.I.-based company, which in November completed its nearly $70 billion acquisition of insurer Aetna Inc., said that it was taking rapid steps to address the problems, including a cost-cutting effort, and that its ambitious deal positioned it for long-term growth. CVS, which has said that its deal to bring together drugstores, pharmacy-benefit management and insurance would help it cut health-care costs and improve care, said it was building new offerings. (Wilde Mathews and Al-Muslim, 2/20)

The Wall Street Journal: Nonprofits Grow Uneasy With Philanthropy Tainted By Opioid Proceeds
Two prominent institutions, the New York Academy of Sciences and Columbia University, are joining the list of universities, museums and nonprofits currently reviewing their philanthropic relationships with members of the Sackler family, owners of pain-pill maker Purdue Pharma LP. Forbes ranked the Sacklers the 19th-richest family in America in 2016 at $13 billion. While a total assessment of the family’s philanthropy is unclear, millions have been given away by family entities. (Hopkins, 2/20)

CNN: FDA Chief: Federal Government Might Step In If States Don't Change Lax Vaccine Laws
The head of the US Food and Drug Administration says that if states don't require more schoolchildren to get vaccinated, the federal government might have to step in. Nearly all states allow children to attend school even if their parents opt out of vaccines. These vaccine exemptions are especially popular in Washington state, where a measles outbreak started last month that has now sickened at least 67 people in four states. And New York has been working to contain its largest outbreak in decades, which began in October and has sickened more than 200 people. (Cohen and Bonifield, 2/20)

The Washington Post: Some Anti-Vaccination Parents Cite Religious Exemptions. Measles Outbreaks Could Change That.
Recent measles outbreaks in states such as Washington, New York and New Jersey have cast a spotlight on a group of Americans who receive exemptions from immunizing their children on the grounds that the vaccines violate their religious freedoms. Now the states that suffered outbreaks are taking aim at those exemptions. In recent weeks, lawmakers in the New Jersey, New York, Iowa, Maine and Vermont state legislatures have proposed eliminating religious exemptions for vaccines. A Washington state representative has proposed tightening the state’s religious exemption while eliminating a separate law that allows for a personal or philosophical exemption from immunization. (Pulliam Bailey, 2/21)

NPR: Vaccine Discussions May Be Most Helpful During Early Pregnancy
In 2017, Kim Nelson had just moved her family back to her hometown in South Carolina. Boxes were still scattered around the apartment, and while her two young daughters played, Nelson scrolled through a newspaper article on her phone. It said religious exemptions for vaccines had jumped nearly 70 percent in recent years in the Greenville area — the part of the state she had just moved to. She remembers yelling to her husband in the other room, "David, you have to get in here! I can't believe this." (Olgin, 2/20)

The Wall Street Journal: Is It Time For A Better Hospital ID Bracelet?
The pesky but essential hospital ID bracelet is getting a makeover. At hospitals across the country, the wristband bearing a patient’s name and date of birth is going high tech or super sleek. And if some doctors have their druthers, it will disappear altogether. Critics say ID bracelets collect germs and can be hard to read, leading to mistakes. They can fall off and get lost. While high-tech wristbands allow hospitals to track patients at all times, some doctors say the best bracelet is none at all. (Lagnado, 2/20)

The New York Times: The Medical Tech That Helps You When Your Doctor Can’t
You (or your employer) pay for health insurance every month. In exchange, you assume that if you have any health-related needs, they’ll be covered. Yet there are gaps in the system that your provider may not want to pay for. Now, a wave of medical start-ups want to fill in those gaps. As Silicon Valley looks for the next big thing to pour money into, health care looks like an increasingly tantalizing field. According to Forbes, more than $2.8 billion worth of venture capital was invested in health care start-ups in September 2018 alone. An increase of 70 percent over the previous year. (Ravenscraft, 2/20)

The Wall Street Journal: WHO Reacts To Chinese Gene-Edited Twins With Plan For Global Guidelines
The World Health Organization established a new committee to set guidelines for scientists editing human DNA, just months after the controversial births of the world’s first gene-edited babies in China. The WHO’s 18-member committee of scientific experts, which includes a Chinese bioethicist, will meet in Geneva next month to “examine the scientific, ethical, social and legal challenges associated” with editing human genes and it will make recommendations, the organization said in a statement. (Rana, 2/21)

CNN: Heart Attacks Rising Among Young Women, Study Shows
The risk of having a heart attack appears to be rising among young women, according to a new study, and researchers are trying to figure out why. When analyzed across five-year intervals, the overall proportion of heart attack-related hospital admissions in the United States attributable to young patients, ages 35 to 54, steadily climbed from 27% in 1995-99 to 32% in 2010-14, with the largest increase observed in young women, according to the study, published recently in the journal Circulation. (Howard and Nedelman, 2/19)

The New York Times: Teenagers Say Depression And Anxiety Are Major Issues Among Their Peers
Most American teenagers — across demographic groups — see depression and anxiety as major problems among their peers, a new survey by the Pew Research Center found. The survey found that 70 percent of teenagers saw mental health as a big issue. Fewer teenagers cited bullying, drug addiction or gangs as major problems; those from low-income households were more likely to do so. (Zraick, 2/20)

The New York Times: Sleepless Flies Lived Long Lives. Why Not Us?
Sleep — that absurd, amazing habit of losing consciousness for hours on end — is so universal across the animal kingdom that we usually assume it is essential to survival. Now, however, scientists who repeatedly disturbed the sleep of more than a thousand fruit flies are reporting that less slumber may be necessary for sustaining life than previously thought, at least in one species. A handful of studies involving dogs and cockroaches going back to the late 19th century suggest that being deprived of sleep can result in a shortened life span. (Greenwood, 2/20)

Los Angeles Times: California Lawmakers Propose Soda Tax, Outlawing Super-Size Sugary Drinks
California restaurants and stores would be prohibited from selling “Big Gulp”-style sodas and consumers would face taxes on sugar-sweetened soft drinks under bills announced Wednesday by five state lawmakers to address a “public health crisis” of obesity in the Golden State. The proposals include a ban on the sale of unsealed "sugar-sweetened beverage" portions larger than 16 ounces at food-service businesses, including restaurants with self-service soda fountains, stores such as 7-Eleven, and sports arenas. (McGreevy, 2/20)

The New York Times: As Colorado Moves To Bar Abstinence-Only Sex Education, Teenagers Take The Lead
Last year, when Clark Wilson was in eighth grade, his sex education teacher repeatedly rolled a piece of tape on a table until it lost its stickiness, using words like “tainted” and “impure” to describe those who engage in premarital sex. The lesson: “People are like tape and once they have sex they’re dirty and can’t have meaningful relationships,” said Clark, now 15 and a freshman at a Colorado high school in the Denver suburb of Highlands Ranch. (Levin, 2/21)

The Washington Post: Nurse Charged In Fatal Drug-Swap Error Pleads Not Guilty
A Tennessee nurse charged with reckless homicide after a medication error killed a patient pleaded not guilty on Wednesday in a Nashville courtroom packed with other nurses who came in scrubs to show their support. The error happened at Vanderbilt University Medical Center in December 2017 when RaDonda Vaught injected 75-year-old Charlene Murphey with the paralytic vecuronium instead of the sedative Versed. (Loller, 2/20)

The Associated Press: Mormon Church Won't Oppose Gay Conversion Therapy Ban
The Mormon church won't stand in the way of a proposal to ban gay conversion therapy for minors in its home base of Utah, leaders said Wednesday, a position that advocates heralded as a milestone in the conservative state. The announcement is key in part because LGBT members have historically reported that church leaders encouraged them to attend therapy aimed at changing their sexual orientation, said Troy Williams with the group Equality Utah. (2/20)

The Washington Post: Gender-Neutral Licenses: Maryland Senate Gives Initial Approval Despite Republican Objections
The Maryland Senate gave initial approval Wednesday to a bill allowing gender-neutral driver’s licenses, an option already available in five states and the District. The legislation would give applicants the option to identify as male, female or unspecified. For applicants who request it, the Motor Vehicle Administration would be required to issue licenses or identification cards that show an “X” instead of an “M” for male or an “F” for female. (Wiggins, 2/20)

The Hill: Connecticut Governor Pitches Statewide Soda Tax
Connecticut Gov. Ned Lamont (D) wants his state to become the first to levy an extra tax on sugary drinks and sodas. In a budget proposal rolled out Wednesday, Lamont asked legislators to impose a new 1.5 cents per ounce tax on sugar-sweetened beverages. The tax would generate about $163 million in new revenue for the next fiscal year, Lamont's office estimated. (Wilson, 2/20)

CNN: For Nearly 2 Decades, Grand Canyon Tourists Were Exposed To Radiation Beyond The Federal Limit, Safety Manager Says
Uranium ore stored at the Grand Canyon National Park museum may have exposed visitors and workers to elevated levels of radiation, according to the park's safety, health and wellness manager. Elston Stephenson told CNN that he began asking officials from the National Park Service and Department of the Interior last summer to warn workers and tourists they had possibly been exposed to unsafe levels of radiation. After his requests were ignored, he said he sent an email to all park staff at the Grand Canyon on February 4. (Boyette and Moshtaghian, 2/20)

The Associated Press: Maryland Doctor Accused Of Sex Misconduct Loses License
A Maryland allergy doctor has lost his license over what the state Board of Physicians determined was immoral and sexual misconduct with three teenage girls. The Baltimore Sun reports the board says it began investigating Surender K. Vaswani in 2017 and made a final determination in January after reviewing the girl’s allegations. (2/21)

The Associated Press: Baltimore Mayor Names City’s Next Health Commissioner
Baltimore’s mayor has named an African American pediatrician as the city’s next health commissioner. Dr. Letitia Dzirasa will take over the role next month, overseeing a department with some 800 employees and a $150 million annual budget. Dzirasa earned a doctorate of medicine from Meharry Medical College in Tennessee. She did her residency at Johns Hopkins School of Medicine. She most recently worked as a “health innovation officer” at a Baltimore-based software company she founded with her husband. (2/20)