First Edition: January 22, 2018

Kaiser Health News: How The Shutdown Might Affect Your Health
A government shutdown will have far-reaching effects for public health, including the nation’s response to the current, difficult flu season. It will also disrupt some federally supported health services, experts said Friday. In all, the Department of Health and Human Services will send home — or furlough — about half of its employees, or nearly 41,000 people, according to an HHS shutdown contingency plan released Friday. (1/19)

The New York Times: Open, Closed Or Something In Between: What A Shutdown Looks Like
The vast machinery of the federal government began grinding to a halt on Saturday morning, hours after the Senate failed to reach a funding deal. But like an aircraft carrier after its propellers stop turning, much of the bureaucracy will stay in motion for a while, and some essential services, like the armed forces, the post office and entitlement programs, will not stop working at all. ... While roughly half of the work force at the Department of Health and Human Services will be furloughed, the department said it would continue services that involve the safety of human life or the protection of property. Those include a suicide prevention hotline, patient care at the National Institutes of Health, and product recalls and other consumer protection services run by the Food and Drug Administration. (Landler, 1/20)

The Associated Press: How Shutdown Affects Key Parts Of Federal Government
Medicare, which insures nearly 59 million seniors and disabled people, will keep going. And so will Medicaid, which covers more than 74 million low-income and disabled people, including most nursing home residents. States will continue to receive payments for the Children's Health Insurance Program, which covers about 9 million kids. However, long-term funding for the program will run out soon unless Congress acts to renew it. Deep into a tough flu season, the Centers for Disease Control and Prevention will be unable to support the government's annual seasonal flu program. And CDC's ability to respond to disease outbreaks will be significantly reduced. (1/21)

The Washington Post: This Flu Season Keeps Getting Deadlier, And A Shutdown Will Make Things Worse
A bad flu season that has hit the entire continental United States has yet to peak and already has caused the deaths of more children than what normally would be expected at this time of the year, according to officials and the latest data released Friday. During the second week of January, more people sought care for flulike illnesses than at any comparable period in nearly a decade, the Centers for Disease Control and Prevention weekly report shows. Ten children died in the week ending Jan. 13, bringing the total number of pediatric deaths this flu season to 30. More than 8,900 people have been hospitalized since the season started Oct. 1. (Sun, 1/19)

The New York Times: Shutdown Goes Into Monday As Senate Inches Toward Deal
Senators failed on Sunday to reach an agreement to end the government shutdown, ensuring that hundreds of thousands of federal employees would be furloughed Monday morning even as the outlines of a potential compromise came into focus. For much of the day, feverish work by a bipartisan group of senators offered a reason for cautious optimism that a deal could be reached soon. By Sunday night, Senator Mitch McConnell of Kentucky, the majority leader, moved to delay until noon Monday a procedural vote on a temporary spending bill — a signal that talks were progressing. (Fandos and Kaplan, 1/21)

Los Angeles Times: Congress Fails To Reach Deal On Ending Federal Shutdown, Pushes Vote To Monday
Hopes for a breakthrough grew after Senate Majority Leader Mitch McConnell and Schumer, who had not spoken for a day, huddled briefly on the Senate floor and met later Sunday to consider the proposal for a three-week temporary funding bill brokered by a bipartisan group of senators. "The shutdown should stop today," McConnell said. "Let's step back from the brink, let's stop victimizing the American people and get back to work on their behalf." (Mascaro, 1/21)

The Wall Street Journal: Senate Fails To End Government Shutdown, Plans Vote On Three-Week Spending Bill
Without an agreement Sunday night, a blame game that Democrats and Republicans carried on all weekend was likely to intensify, lawmakers said. “I am really worried about where this thing goes because it’s going to get nastier in terms of rhetoric,” said Sen. Lindsey Graham (R., S.C.), predicting it would hit both parties. “First prize in a government shutdown is you get to be dumb, not dumber. That’s the best you can hope for.” (Peterson, Andrews and Hughes, 1/21)

NPR: Who Will Carry The Blame For The Shutdown? Maybe No One
While a lot of furious negotiation has been going on behind the scenes on Capitol Hill to end a partial government shutdown, to voters and cable news viewers it may look like most of the work in Washington is going into pointing fingers. As the countdown to shutdown hit zero, an official White House statement called Democrats "obstructionist losers." (Seipel, 1/21)

The Associated Press: Deportation Fears Have Legal Immigrants Avoiding Health Care
The number of legal immigrants from Latin American nations who access public health services and enroll in federally subsidized insurance plans has dipped substantially since President Donald Trump took office, many of them fearing their information could be used to identify and deport relatives living in the U.S. illegally, according to health advocates across the country. (Kennedy, 1/21)

The New York Times: Trump Tells Anti-Abortion Marchers ‘We Are With You All The Way’ And Shows It
In the daily din of scandal and turmoil that has dominated President Trump’s first year in office, it can be easily overlooked how transformative he has been in using his executive powers to curtail abortion rights. As thousands of anti-abortion marchers gathered on the National Mall in Washington in the annual March for Life on Friday, Mr. Trump ordered his administration to make it easier for states to cut off money for Planned Parenthood clinics that offer health care to low-income women. (Peters, 1/19)

The Associated Press: Trump Tells March For Life: 'We Are With You All The Way'
In an address broadcast from the White House Rose Garden, Trump said he's committed to building "a society where life is celebrated, protected and cherished. "The moment marked the president personally stepping to the forefront of the anti-abortion movement in the United States as the anniversary of his inauguration approaches. Last year, Vice President Mike Pence addressed the crowd in Trump's absence. In the year since, Trump has delivered on rules and policies he had promised in an effort to help curb abortion rights legalized 45 years ago. Chief among them is the confirmation of conservative Justice Neil Gorsuch. (1/19)

The Wall Street Journal: Trump Tells Antiabortion Marchers He Would Always Defend Right To Life
The president also touted his efforts to expand a policy to prevent federal funds from going to foreign organizations that perform or advise on abortions, spurring praise from antiabortion groups and criticism that the move would restrict women’s access to health care. Senior administration officials said last year that the ban now would apply to $8.8 billion in global health-assistance funds, expanding by almost 15 times the financial reach of an antiabortion policy first implemented by the Reagan administration in 1984. Coinciding with the march, officials at the Department of Health and Human Services said they are rescinding a federal Medicaid policy requiring states to pay for all non-abortion services performed at Planned Parenthood clinics. The move paves the way for states to exclude abortion providers from their Medicaid networks, significantly restricting the amount of money those clinics can receive. (Ballhaus and Hackman, 1/19)

Reuters: U.S. Health Agency Revokes Obama-Era Planned Parenthood Protection
U.S. health officials said on Friday they were revoking legal guidance issued by the Obama administration that had sought to discourage states from trying to defund organizations that provide abortion services, such as Planned Parenthood. The U.S. Department of Health and Human Services (HHS) officials also said the department was issuing a new regulation aimed at protecting healthcare workers' civil rights based on religious and conscience objections. (Humer and Abutaleb, 1/19)

The Washington Post: The Nation’s First Medicaid Work Rules Loom, And Many Fear Losing Health Coverage
Gov. Matt Bevin is exultant as his administration sets out to transform Medicaid. Only a week ago, he won federal permission to pursue a goal that has animated his two years in office: making hundreds of thousands of poor Kentuckians hold jobs or engage in their communities in other ways to keep their health insurance. It is an approach never tried by any state, and it will also transform lives. The un­or­tho­dox plan, Bevin has faith, will lift people into economic self-reliance, ease Kentucky’s stubbornly high rates of addiction and ill health, and propel the needy to “derive a sense of dignity by your own power.” From this capital city in the state’s Bluegrass region, he is buoyed by a sense of mission. “It’s a . . . joy that we are doing right by people,” Bevin says. (Goldstein, 1/19)

The Associated Press: Oregon Voters To Decide Medicaid Funding As Costs Rise
Oregon aggressively expanded its Medicaid rolls under the Affordable Care Act, adding enough people to leave only 5 percent of its population uninsured — one of America's lowest rates. Now, with the reduction of a federal match that covered those enrollees, the state is calling on voters to decide how to pay for its ballooning Medicaid costs. (Flaccus, 1/22)

Politico: The Religious Activists On The Rise Inside Trump's Health Department
A small cadre of politically prominent evangelicals inside the Department of Health and Human Services have spent months quietly planning how to weaken federal protections for abortion and transgender care — a strategy that's taking shape in a series of policy moves that took even their own staff by surprise. Those officials include Roger Severino, an anti-abortion lawyer who now runs the Office of Civil Rights and last week laid out new protections allowing health care workers with religious or moral objections to abortion and other procedures to opt out. Shannon Royce, the agency's key liaison with religious and grass-roots organizations, has also emerged as a pivotal player. (Diamond, 1/22)

The Hill: Top Dem Presses Trump Health Official On Potential Ethics Violation
Sen. Ron Wyden (D-Ore.) says it appears a senior Trump administration health official has violated her ethics agreement by reviewing applications from states that employed her consulting firm. Wyden, the top Democrat on the Senate Finance Committee, sent a letter to the Department of Health and Human Services general counsel on Friday pressing for answers about the ethics agreement of Seema Verma, the administrator of the Centers for Medicare and Medicaid Services (CMS). (Sullivan, 1/19)

The Wall Street Journal: CDC To Scale Back Work In Dozens Of Foreign Countries Amid Funding Worries
The Centers for Disease Control and Prevention plans to scale back or discontinue its work to prevent infectious-disease epidemics and other health threats in 39 foreign countries because it expects funding for the work to end, the agency told employees. The CDC currently works in 49 countries as part of an initiative called the global health security agenda, to prevent, detect and respond to dangerous infectious disease threats. It helps expand surveillance for new viruses and​ ​drug-resistant bacteria, modernize laboratories to detect dangerous pathogens​and train workers who respond to epidemics. (McKay, 1/19)

The Wall Street Journal: How Hospitals’ Woes Are Making Health Lines Blur
Hospital chains are responding to continued health-care consolidation with some vertical integration of their own. It is the latest sign that traditional industry borders are starting to break down. Four large systems, comprising about 300 hospitals in total, said this week that they are banding together to create a nonprofit generic-drug company. The goal is to curb shortages of commonly used medicines in hospitals as well as to pre-empt financial damage from sudden price increases on them. (Grant, 1/19)

The New York Times: 1 Son, 4 Overdoses, 6 Hours
The torrent of people who have died in the opioid crisis has transfixed and horrified the nation, with overdose now the leading cause of death for Americans under 50. But most drug users do not die. ... In the 20 years that Patrick has been using drugs, he has lost track of how many times he has overdosed. He guesses 30, a number experts say would not be surprising for someone taking drugs off and on for that long. Patrick [Griffin] and his family allowed The New York Times to follow them for much of the past year because they said they wanted people to understand the realities of living with drug addiction. Over the months, their lives played out in an almost constant state of emergency or dread, their days dictated by whether Patrick would shoot up or not. (Seelye, 1/21)

The New York Times: How A ‘Perfect Storm’ In New Hampshire Has Fueled An Opioid Crisis
They sat on plastic chairs in a corner of the Manchester fire station, clutching each other in a desperate farewell. Justin Lerra was 26 when he turned himself in last summer to the fire department’s “safe station” program, which helps get drug users into treatment. He had been using drugs for seven years. His girlfriend, Sarah, who asked that her last name not be published, was pregnant and had told him that if he didn’t stop using, she would leave him. (Seelye, 1/21)

The Hill: HHS Extends Trump's Emergency Declaration For Opioids 
The Trump administration has extended the opioid public health emergency issued by President Trump, days before that declaration was set to expire. In October, President Trump announced in the White House’s East Room that he was declaring the opioid epidemic a national public health emergency. The move was without precedent, as such declarations had in the past been reserved for natural disasters and the outbreak of infectious diseases. (Roubein, 1/19)

The Washington Post: Experiences With Opioid Addiction And Loss Fuel Md. Congressional Hopefuls
The candidates forum had the feel of a group-therapy session at times, as three of six Democrats running for an open congressional seat shared stories of close relatives who overdosed on opioids. A brother-in-law. A nephew. A father. “In the next 10 years with opioids, there will be probably a million people dead,” Total Wine co-founder David Trone said Wednesday night at a Hood College forum focused on health care and opioids. (Portnoy, 1/20)

The Associated Press: Debate On In Massachusetts Over Safe Sites For Drug Users
The idea may seem jarring at first: Creating safe spaces where drug users can shoot up under the watchful eye of staff trained in helping counter the effect of potentially fatal overdoses — all with the approval of public health officials. But the terrible toll taken by the state’s opioid battle in recent years have prompted some lawmakers, activists and medical groups to endorse the idea of “supervised injection sites” as another way to reduce overdose deaths. (Leblanc, 1/21)

The Washington Post: The Bad Flu Season Has Revealed A Dangerous Problem With Our Medical Supply Chain
Flu season in the United States typically peaks in February, but this year’s outbreak is already one of the worst on record. As of Jan. 6, 20 children have died of influenza, and overall mortality caused by the flu is already double that of last year’s. One reason the flu is so severe this season is that the dominant strain is H3N2, which has an impressive ability to mutate and is particularly aggressive against Americans over 50. (Morten Wendelbo and Christine Crudo Blackburn, 1/21)

Los Angeles Times: Death Toll Jumps Sharply After California Experiences Its Worst Week Of The Flu Season
The death toll from influenza in California rose sharply on Friday, amid a brutal flu season that has spread across the nation. State health officials said that 32 people under 65 died last week of the flu, making it the deadliest week this season so far. In total, 74 people under age 65 have died of the flu since October, compared with 14 at the same time last year. (Karlamangla, 1/19)

The Wall Street Journal: What If Children Should Be Spending More Time With Screens?
Imagine someone traveling through time to the days before the internet, regaling audiences with fantastical tales of a future in which children can access devices containing the sum of all human knowledge and which gain new powers daily to instruct, create and bring people together. Now imagine this time traveler describing the reactions of most parents to these devices—not celebration, but fear, guilt and anxiety over how much time their children spend with them. That’s where we are today. Parents are frequently admonished that the most important thing to do with iPhones, iPads and computers is limit children’s access to them. (Mims, 1/22)

The Washington Post: Transgender Kids Are New Focus For Doctors And Entire Medical Field
The California wildfires were still raging last fall as Jennifer Bilstein and her 15-year-old son inched their way down Highway 101, a two-hour drive in ordinary times that took four hours through the smoke-filled air and yellow sky. She was determined to get Jacob to his doctor’s appointment on time. It was his second visit to the adolescent gender clinic, where Jacob — a shy boy with pink cheeks, a cowlick and black oversize glasses — was being medically evaluated to begin taking testosterone. (Solovitch, 1/21)

The New York Times: Yes, People Really Are Eating Tide Pods. No, It’s Not Safe.
It seems every few weeks another challenge takes social media by storm. Some, like the “Ice Bucket Challenge,” promote a cause. Others, like the bottle-flipping craze, are benign. But then there are those fads that are ill-informed or, worse, dangerous. The latest, the “Tide pod challenge,” belongs in that category. It involves biting down on a brightly colored laundry detergent packet of any brand and spitting out or ingesting its contents, an act that poses serious health risks. (Chokshi, 1/20)

The Wall Street Journal: China, Unhampered By Rules, Races Ahead In Gene-Editing Trials
In a hospital west of Shanghai, Wu Shixiu since March has been trying to treat cancer patients using a promising new gene-editing tool. U.S. scientists helped devise the tool, known as Crispr-Cas9, which has captured global attention since a 2012 report said it can be used to edit DNA. Doctors haven’t been allowed to use it in human trials in America. That isn’t the case for Dr. Wu and others in China. (Rana, Marcus and Fan, 1/21)

The New York Times: Oral Contraceptives Reduce Risk For Ovarian And Endometrial Cancers
The long-term use of oral contraceptives reduces the risk for ovarian and endometrial cancers, and the effect is especially evident in smokers, the obese and those who exercise infrequently, a new study found. Earlier studies have demonstrated an association of previous oral contraceptive use with reduced risk for these cancers in postmenopausal women. This study considered the impact of various health and lifestyle factors, including smoking, obesity and physical activity. (Bakalar, 1/19)

NPR: Cancer Patients Get Little Guidance From Doctors On Using Medical Marijuana
Even three queasy pregnancies didn't prepare Kate Murphy for the nonstop nausea that often comes with chemotherapy. In the early months of 2016, the Lexington, Mass., mother tried everything the doctors and nurses suggested. "But for the most part I felt nauseous 24/7," she said. Murphy, then 49 and fighting breast cancer, dropped 15 pounds from her already slim frame in just two months. Then, she remembered what a fellow cancer patient had advised while she was waiting for her first dose of chemo: "Make sure you get some medical marijuana." (Weintraub, 1/21)

The Wall Street Journal: Americans Say Marijuana Is Less Of Health Risk Than Tobacco, Poll Finds
Americans are polarized on many issues, but they tend to be on the same page when it comes to assessing the health risks from marijuana, compared with alcoholic beverages, tobacco or sugar. Far more people say a cigarette, an alcoholic drink or a candy bar are more harmful to a person’s overall health than pot, a new Wall Street Journal/NBC News survey finds. (Jamerson, 1/19)

NPR: What's The Science Behind Personalized Diets Based On Your DNA?
The idea that each of us has a unique nutrition blueprint within our genes is a delicious concept. Perhaps, this helps explain the growth in personalized nutrition testing and services such as Habit, Profile Precise and Nutrigenomix.So, what exactly can these tests tell you? (Aubrey, 1/22)

The New York Times: One Day Your Mind May Fade. At Least You’ll Have A Plan.
When Ann Vandervelde visited her primary care doctor in August, he had something new to show her. Dr. Barak Gaster, an internist at the University of Washington School of Medicine, had spent three years working with specialists in geriatrics, neurology, palliative care and psychiatry to come up with a five-page document that he calls a dementia-specific advance directive. (Span, 1/19)

NPR: When A Tattoo Literally Means Life Or Death
The man was unconscious and alone when he arrived at University of Miami Hospital last summer. He was 70 years old and gravely ill. "Originally, we were told he was intoxicated," remembers Dr. Gregory Holt, an emergency room doctor, "but he didn't wake up." "He wasn't breathing well. He had COPD. These would all make us start to resuscitate someone," says Holt. "But the tattoo made it complicated." (Hersher, 1/21)