First Edition: January 5, 2018

Kaiser Health News: Trump Administration Rule Paves Way For Association Health Plans
Critics, though, are wary about whether the plans will provide consumers adequate protection. “This approach allows associations to offer coverage that doesn’t have to come into compliance with all the critical consumer protections that would otherwise apply to small employers and individuals. It might not be as comprehensive,” said Kevin Lucia, project director at Georgetown University’s Health Policy Institute. (Appleby, 1/4)

Kaiser Health News: Maine Voters Chose Medicaid Expansion. Why Is Their Governor Resisting?
At least 70,000 low-income Maine residents like Donna Wall should gain Medicaid health insurance because of the ballot measure that passed last fall. Advocates collected signatures to put the question to voters, and, in November, Maine became the first state to get approval at the ballot box to expand Medicaid, passing with 59 percent approval. But even though voters here in Maine decided to expand Medicaid, the law’s fate is unclear. Republican Gov. Paul LePage has said that opening up the program to more poor adults threatens the state’s financial stability and that lawmakers shouldn’t raise taxes to pay for it. (Varney, 1/5)

Kaiser Health News: Podcast: ‘What The Health?’ While You Were Celebrating …
The year in health policy has already begun: The Trump administration Thursday released a long-awaited regulation aimed at making it easier for small businesses and others to form “association health plans.” Now advocates and opponents will be able to weigh in with more specific recommendations. Meanwhile, in December, the health policy focus was on the tax bill and its repeal of the Affordable Care Act’s “individual mandate” penalty for most people who don’t have health insurance. But some recent key court decisions could reshape the benefits millions of people receive as part of their health coverage. (1/4)

Kaiser Health News: From Retirement To The Front Lines Of Hepatitis C Treatment
When a hepatitis C treatment called Harvoni was released in 2014, Dr. Ronald Cirillo knew it was a big deal. “It’s the reason that dragged me out of retirement!” he said. Cirillo specialized in treating hepatitis C for more than 30 years in Stamford, Conn., before retiring to Bradenton, Fla. During his time in Connecticut, the only available treatment for hepatitis C had terrible side effects and didn’t work well. It cured the viral infection less than half the time. But the newer drugs, Harvoni and Sovaldi, cure almost everybody, with few adverse reactions. (Ochoa, 1/5)

The New York Times: Trump Proposes New Health Plan Options For Small Businesses
The Trump administration on Thursday proposed sweeping new rules that could make it easier for small businesses to band together and create health insurance plans that would be exempt from many of the consumer protections mandated by the Affordable Care Act. As many as 11 million Americans “could find coverage under this proposal,” the Labor Department said in issuing the proposed rules, which carry out an executive order signed by President Trump on Oct. 12. The public will have 60 days to comment on the proposal before the Trump administration adopts final rules with the force of law. (Pear, 1/4)

The Washington Post: Trump Administration Proposes Rules For Health Plans Without Certain ACA Protections
The proposal, issued by the Labor Department, would carry out the most significant part of an executive order that President Trump signed in October, directing the government to foster alternative types of insurance. Proponents say the association health plans would be less expensive and enhance consumer choice, while critics — including the insurance industry — fear they would promote substandard coverage and weaken the ACA’s already fragile insurance marketplaces. Specifically, the rules would allow such health plans to be reclassified so they no longer would have to include a set of 10 essential health benefits — including maternity care, prescription drugs and mental health services — that the ACA requires of insurance sold to individuals and small companies. (Goldstein, 1/4)

The Wall Street Journal: Trump Administration Proposal Would Exempt Small Businesses From Some ACA Rules
[A] senior official said there are nondiscrimination provisions in the rule, a draft of which was released on Thursday, that would prevent an association from cherry-picking employers with healthy workforces or charging higher premiums to less-healthy people. An association couldn’t charge different premiums to different small employers based on health factors, the official said. But allowing the plans not to cover the mandatory ACA benefits could enable associations to essentially exclude people by not offering coverage for specific treatments, such as chemotherapy, said Timothy Jost, an emeritus law professor at Washington and Lee University in Lexington, Va. “There are plenty of opportunities for discrimination,” he said. (Armour, 1/4)

Los Angeles Times: Trump's Move To Make Skimpier Health Plans More Available Threatens To Undermine Obamacare
[M]any patient groups and consumer advocates — who are already alarmed by Trump administration efforts to undermine the 2010 health law — fear that less comprehensive health plans will leave Americans without vital protections. "The rule proposed today will almost certainly result in more people facing financial distress when an unexpected health crisis happens and they discover their association health plan coverage is inadequate," said Chris Hansen, president of the advocacy arm of the American Cancer Society. By allowing healthier Americans to buy plans that don't cover expensive medications or other medical benefits, these plans also risk driving up costs for sick patients who need the more extensive coverage. (Levey, 1/4)

The Associated Press: In New Rule, Trump Tries To Deliver A Health Care Promise
Don't look for revolutionary changes, said analyst Elizabeth Carpenter of the health industry consultancy Avalere Health. "The impact on the markets and on consumers really may depend on whether it is easy enough for the groups potentially affected to take advantage of the rule," she said. No sweeping consequences are seen for the more than 170 million Americans with employer-sponsored coverage, or the nearly 30 million still uninsured. (Alonso-Zaldivar, 1/4)

The New York Times: Trump Administration Takes Step That Could Threaten Marijuana Legalization Movement
The viability of the multibillion-dollar marijuana legalization movement was thrown into new doubt on Thursday when the Trump administration freed prosecutors to more aggressively enforce federal laws against the drug in states that have decriminalized its production and sale, most recently California. Attorney General Jeff Sessions, long a vocal opponent of the legalization of marijuana, rescinded an Obama-era policy that discouraged federal prosecutors in most cases from bringing charges wherever the drug is legal under state laws. (Savage and Healy, 1/4)

The Associated Press: Federal Pot Policy Change Sparks Confusion, Crackdown Fears
Officials wouldn't say if federal prosecutors would target pot shops and legal growers, nor would they speculate on whether pot prosecutions would increase. The action by Attorney General Jeff Sessions was not unexpected given his longtime opposition to pot, but comes at a heady time for the industry as retail pot sales rolled out New Year's Day in California. (1/5)

The Associated Press: Q&A: What Does Sessions’ Policy Mean For The Future Of Weed?
A federal law blocks the Justice Department from interfering with medical marijuana programs in states where it is allowed. Justice Department officials said they would follow the law, but would not preclude the possibility of medical-marijuana related prosecutions. (Gurman, 1/4)

The New York Times: California Defiant In Face Of Federal Move To Get Tough On Marijuana
The sale of recreational cannabis became legal in California on New Year’s Day. Four days later, the Trump administration acted in effect to undermine that state law by allowing federal prosecutors to be more aggressive in prosecuting marijuana cases. A memo by Attorney General Jeff Sessions on Thursday was widely interpreted in the nation’s most populous state as the latest example of Trump vs. California, a multifront battle of issues ranging from immigration to taxes to the environment. (Fuller, 1/4)

The Hill: CDC Schedules Briefing On Preparing For Nuclear Detonation 
The Centers for Disease Control and Prevention (CDC) has scheduled a briefing for later this month on how to plan and prepare for a nuclear detonation. The briefing, for CDC employees, is part of a monthly series at the agency meant to "further strengthen CDC's common scientific culture and foster discussion and debate on major public health issues." (Hellmann, 1/4)

The New York Times: Virginia Official Pulls Republican’s Name From Bowl To Pick Winner Of Tied Race
An official of the Virginia State Board of Elections pulled the name of David Yancey from a blue and white stoneware bowl on Thursday, breaking a tied race that is pivotal to control of the state House of Delegates. The outcome in favor of Mr. Yancey, the Republican incumbent, means that the House remains narrowly in his party’s hands, 51 seats to 49, after a Democratic wave in November propelled by anger at President Trump. ...Virginia Democrats had hoped that under Ralph Northam, the governor-elect and a Democrat, thwarted liberal priorities would break through a logjam of Republican control of both houses of the General Assembly. Expanding Medicaid in the state was high on that list. (Gabriel, 1/4)

Politico: Medicaid Expansion Fight Looms After Virginia Statehouse Drawing
A showdown over Obamacare's Medicaid expansion pitting Republican lawmakers against Virginia's newly elected governor is almost certain following the GOP victory in a drawing to decide control of the state's House of Delegates. The expected fight in a purple state demonstrates the law's staying power even as a Republican president and Congress work to undo it. (Pradhan, 1/4)

The Hill: Trump Poised To Take Action On Medicaid Work Requirements
The Trump administration is preparing to release guidelines soon for requiring Medicaid recipients to work, according to sources familiar with the plans, a major shift in the 50-year-old program. The guidelines will set the conditions for allowing states to add work requirements to their Medicaid programs for the first time, putting a conservative twist on the health insurance program for the poor. (Sullivan, 1/5)

The Wall Street Journal: CVS, Walgreens Say Drug Prices Are Easing After Years Of Ballooning
After years of surging U.S. drug prices, the two largest drugstore companies said some pricey prescription medicines are becoming more affordable. CVS Health Corp. and Walgreens Boots Alliance Inc. said Thursday that their pharmacy revenues are taking a hit from an increase in generic alternatives, particularly for some expensive specialty drugs, along with slowing price inflation for name-brand medications. (Terlep, 1/4)

The Wall Street Journal: Drug Industry Is Ripe For A Wave Of Deals
Nearly a decade ago, a wave of megamergers gripped the pharmaceutical industry. In 2018, conditions are right for a sequel. Back then, concerns about growth and tougher regulations spurred deals like Pfizer ’s $68 billion acquisition of Wyeth and Merck & Co.’s $41 billion acquisition of Schering-Plough. Today, growth concerns are rising again, and several other factors, including consolidation in other parts of health care, are setting the stage for another wave of deals. (Grant, 1/5)

The Hill: More Than Half Think Painkillers A Major Problem, But Not A National Emergency: Report 
A little over half the country considers prescription painkiller addiction a major problem for the nation, but say it doesn't rise to the level of national emergency, a new report in the New England Journal of Medicine notes. In late October, President Trump declared the epidemic a national public health emergency; declaring some type of national emergency was the “first and most urgent” recommendation from the president’s commission to address the opioid epidemic. (Roubein, 1/4)

Los Angeles Times: California Bills Aim To Tackle Opioid Addiction By Curbing Excessive Prescriptions
Looking to combat the opioid abuse epidemic, a Silicon Valley legislator has introduced a slate of bills meant to clamp down on access to highly addictive prescription drugs. Assemblyman Evan Low (D-Campbell) authored three measures meant to provide a better understanding of patients’ access to these medications, building on an existing state database tracking prescriptions in California. “I don’t think there’s enough attention at the issue at hand, which is the system is not working,” Low said. (Mason, 1/4)

The Washington Post: The Cancer Death Rate Has Dropped Again. Here's Why.
The nation's overall cancer death rate declined 1.7 percent in 2015, the latest indication of steady, long-term progress against the disease, according to a new report by the American Cancer Society. Over nearly a quarter-century, the mortality rate has fallen 26 percent, resulting in almost 2.4 million fewer deaths than if peak rates had continued. But the report, released Thursday, shows that Americans' No. 2 killer remains a formidable, sometimes implacable, foe. An estimated 609,000 people are expected to die of the ailment this year, while 1.74 million will be diagnosed with it. (McGinley, 1/4)

The Hill: Shortage Of IV Fluids Caused By Hurricane Expected To Improve 
The Food and Drug Administration (FDA) is confident the shortage of saline IV fluids and bags caused by the hurricane that hit Puerto Rico last year will soon subside. The hurricane crippled a leading manufacturer — Baxter International — in Puerto Rico. But Baxter has announced all of their facilities on the island have returned to the commercial power grid, FDA Commissioner Scott Gottlieb said Thursday. (Hellmann, 1/4)

The Washington Post: Fewer Teens, Several Ethnic Groups Are Less Sexually Active
The number of high-school-aged teens who are having sex dropped markedly over a decade, a trend that includes substantial declines among younger students, African Americans and Hispanics, according to a new government report released Thursday. The survey by the Centers for Disease Control and Prevention showed especially steep declines in the past two years. It adds to evidence about ongoing progress in reducing risky behavior by teenagers, who are becoming pregnant, smoking cigarettes, drinking alcohol and using marijuana at lower rates than younger people before them, according to public health surveys. (Bernstein, 1/4)

The Hill: More High School Students Are Putting Off Having Sex
American high school students are having less sex than they were a decade ago, while those who are having sexual intercourse are doing so at a later age, according to a new government report. The research, released by the Centers for Disease Control and Prevention (CDC), shows just over 41 percent of students in grades 9 through 12 reported having had sexual intercourse, down from almost 47 percent in 2005 and from 53 percent in 1995. (Wilson, 1/4)

The New York Times: New Shingles Vaccine Is Cost Effective
The new shingles vaccine is expensive, but worth it, according to a new analysis in JAMA Internal Medicine. Shingles is a painful and sometimes debilitating nerve inflammation and blistering skin rash caused by the same virus that causes chickenpox. Anyone who has had chickenpox is susceptible to it many years later. (Bakalar, 1/4)

The New York Times: Antioxidants Don’t Ease Muscle Soreness After Exercise
Many people take antioxidants before or after exercise in the belief that this prevents muscle soreness. A thorough review of the scientific literature has found no solid evidence that it works. Researchers pooled data from 50 randomized placebo-controlled trials involving 1,089 participants. Some studies looked at antioxidant supplements taken before exercise, some after. The type of antioxidant studied varied — cherry juice, pomegranate juice, vitamins C and E, black tea extract and others in various doses. The studies used supplements as powders, tablets and concentrates. (Bakalar, 1/4)

Los Angeles Times: L.A. County Officials Confirm First Case Of Sexually Transmitted Zika Virus
L.A. County officials said Thursday that a woman had been infected with the Zika virus by her partner in the first case of sexually transmitted Zika virus in the county. A man who lives in L.A. County traveled to Mexico and became infected with the Zika virus in early November, and shortly afterward his female partner, who didn't travel to Mexico, also developed the infection, officials said. (Karlamangla, 1/4)