First Edition: July 2, 2018

Kaiser Health News: How ER Bills Can Balloon By As Much As $50K For ‘Trauma Response’
On the first morning of Jang Yeo Im’s vacation to San Francisco in 2016, her 8-month-old son, Park Jeong Whan, fell off the bed in the family’s hotel room and hit his head. There was no blood, but the baby was inconsolable. Jang and her husband worried he might have an injury they couldn’t see, so they called 911, and an ambulance took the family — tourists from South Korea — to Zuckerberg San Francisco General Hospital (SFGH). (Gold and Kliff, 7/2)

Kaiser Health News: Judge Blocks Kentucky Medicaid Work Requirement
“Today’s decision is disappointing,” said Seema Verma, administrator of the Centers for Medicare & Medicaid Services. “States are the laboratories of democracy and numerous administrations have looked to them to develop and test reforms that have advanced the objectives of the Medicaid program. The Trump administration is no different.” The administration is now reviewing its legal options, she said. (Galewitz, 6/29)

The New York Times: Judge Strikes Down Kentucky’s Medicaid Work Rules
A federal judge on Friday blocked Kentucky’s closely watched plan to require many Medicaid recipients to work, volunteer or train for a job as a condition of coverage. The state had been poised to start carrying out the new rules next week and to phase them in fully by the end of this year. (Goodnough, 6/29)

The Washington Post: Kentucky’s Requirement That Medicaid Recipients Must Work Is Blocked By A Federal Judge
The decision by U.S. District Judge James E. Boasberg vacates that approval and sends the state’s program, Kentucky HEALTH, back to the federal Department of Health and Human Services for further review. Boasberg said that top HHS officials “never adequately considered whether [the program] would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid.” That “signal omission” renders the decision “arbitrary and capricious,” he concluded. (Sun and Goldstein, 6/29)

The Wall Street Journal: Judge Blocks Kentucky’s Plan For Work Requirements On Medicaid
The judge vacated the HHS approval and sent the proposal back to the department for further review. Kentucky had hoped to save about $33 million as it reduced the number of beneficiaries by about 90,000 through the new requirements under its new Medicaid program, called Kentucky HEALTH. “The Secretary never provided a bottom line estimate of how many people would lose Medicaid with Kentucky HEALTH in place,” wrote Judge Boasberg, who was appointed by President Barack Obama. “This oversight is glaring, especially given that the risk of lost coverage was ‘factually substantiated in the record.’ ” (Armour, 6/29)

The Associated Press: Federal Judge Blocks Kentucky's Medicaid Work Requirements
The decision is a setback for the Trump administration, which has been encouraging states to impose work requirements and other changes on Medicaid, the joint state and federal health insurance program for the poor and disabled. Kentucky was the first state in the country to get that permission, and the new rules were scheduled to take effect Sunday in a northern Kentucky suburb of Cincinnati. (Beam and Alonso-Zaldivar, 6/29)

Politico: Judge Blocks Kentucky’s Medicaid Work Requirement
The ruling carries broad implications for Republicans across the country hoping to trim enrollment in Medicaid, which now covers more than 70 million Americans. Three other states have received federal approval for work rules — Arkansas, Indiana and New Hampshire — and several other states are seeking permission. The Arkansas work requirement took effect earlier this month. (Pradhan, 6/29)

NPR: Federal Judge Blocks Medicaid Work Requirements In Kentucky
A number of health policy experts praised the ruling, which they've described as "scathing" and "savage." "The court made the right decision," says Elizabeth Lower-Basch, director of income and work supports at the Center for Law and Social Policy. "It found that HHS did not even consider the basic question of whether the waiver would harm the core Medicaid goal of providing health coverage, and it prohibits Kentucky from implementing it until HHS makes such an assessment." (Kodjak, 6/29)

The New York Times: Bulwark Against An Abortion Ban? Medical Advances
As partisans on both sides of the abortion divide contemplate a Supreme Court with two Trump appointees, one thing is certain: America even without legal abortion would be very different from America before abortion was legal. The moment Justice Anthony M. Kennedy announced his retirement, speculation swirled that Roe v. Wade, the landmark 1973 ruling that legalized abortion, would be overturned. Most legal experts say that day is years away, if it arrives at all. A more likely scenario, they predict, is that a rightward-shifting court would uphold efforts to restrict abortion, which would encourage some states to further limit access. (Belluck and Hoffman, 7/1)

The Associated Press: Collins Opposes A Nominee Who Would Overturn Abortion Ruling
Republican Sen. Susan Collins, a key vote on President Donald Trump's pick for the Supreme Court, said Sunday she would oppose any nominee she believed would overturn the landmark Roe v. Wade decision that legalized abortion. The White House is focusing on five to seven potential candidates to fill the vacancy of retiring Justice Anthony Kennedy, a swing vote on the court. The Maine senator said she would only back a judge who would show respect for settled law such as the 45-year-old Roe decision, which has long been anathema to conservatives. (Yen and Thomas, 7/2)

Politico: Collins: New Justice Should Not Favor Overturning Roe V. Wade
“Roe v. Wade is a constitutional right that is well-established,” Collins said on “State of the Union” on CNN. “And no less an authority than Chief Justice [John] Roberts said that repeatedly at his confirmation hearing.“ Trump last week said he wouldn’t ask potential Supreme Court nominees about abortion rights — a departure from his stance on the campaign trail, when he said he would nominate to the Supreme Court only people who oppose abortion. (Kullgren, 7/1)

The Hill: Manchin Warns Trump Against Picking Court Nominee Who Will Overturn Roe V. Wade  
Sen. Joe Manchin (D-W.Va.) is signaling that President Trump should avoid picking a Supreme Court nominee that is openly pushing to overturn Roe v. Wade, instead encouraging him to choose a "centrist." "All of that stuff is red flags for all Americans. And I think he needs to get a jurist basically looking at the law. The Roe v. Wade has been the law for 40-some years," Manchin told a West Virginia radio station on Friday when asked if he wanted a jurist who would overturn the 1973 Supreme Court case that established the right to an abortion. (Carney, 6/29)

Politico: The Truth Behind Bob Casey’s ‘Pro-Life’ Stand
Sen. Bob Casey calls himself a pro-life Democrat. But his voting record paints a different picture. After a decade in the Senate, Casey has become an increasingly reliable vote in support of abortion rights — scoring as high as 100 percent on NARAL Pro-Choice America’s vote tally in 2016 and 2017. Anti-abortion groups insist he’s no champion of their cause — and view him as unlikely to support President Donald Trump’s nominee for the Supreme Court, whose confirmation will be a proxy battle on the future of Roe v. Wade. (Haberkorn, 7/2)

The New York Times: Supreme Court Defeat For Unions Upends A Liberal Money Base
The Supreme Court decision striking down mandatory union fees for government workers was not only a blow to unions. It will also hit hard at a vast network of groups dedicated to advancing liberal policies and candidates. Some of these groups work for immigrants and civil rights; others produce economic research; still others turn out voters or run ads in Democratic campaigns. Together, they have benefited from tens of millions of dollars a year from public-sector unions — funding now in jeopardy because of the prospective decline in union revenue. (Scheiber, 7/1)

The New York Times: How Conservatives Weaponized The First Amendment
On the final day of the Supreme Court term last week, Justice Elena Kagan sounded an alarm. The court’s five conservative members, citing the First Amendment, had just dealt public unions a devastating blow. The day before, the same majority had used the First Amendment to reject a California law requiring religiously oriented “crisis pregnancy centers” to provide women with information about abortion. Conservatives, said Justice Kagan, who is part of the court’s four-member liberal wing, were “weaponizing the First Amendment.” (Liptak, 6/30)

The Wall Street Journal: Trump Says He Has Narrowed List Of Possible Supreme Court Picks To Five
President Donald Trump said on Friday that he planned to interview one or two candidates this weekend at his Bedminster, N.J., resort to fill Supreme Court Justice Anthony Kennedy’s seat, and plans to announce his final pick on July 9. “I’ve got it narrowed to about five,” he said, including two women. The president also said he wouldn’t specifically ask candidates about Roe v. Wade, the landmark ruling making abortion legal. However, a potential nominee’s approach to the issue has been a factor in creating Mr. Trump’s list of 25 conservative candidates. (Radnofsky and Nicholas, 6/29)

The Washington Post: States Act On Their Own To Fill Holes Washington Is Knocking In Affordable Care Act
The first Sunday after his inauguration, New Jersey Gov. Phil Murphy signed an executive order directing state agencies to report everything they could do to ramp up the visibility of the Affordable Care Act and persuade more people to buy health coverage under the law. Four months later, the Democratic governor signed into law a requirement that makes New Jersey the first state in a dozen years to compel most residents to carry insurance. As bureaucrats in Trenton scramble to set the mandate in motion, New Jersey’s decisions are at the forefront of a nascent movement with states stepping out on their own to counteract Washington’s efforts to erode the ACA. (Goldstein, 7/1)

The New York Times: Parents And Children Remain Separated By Miles And Bureaucracy
Yeni González emerged into the warm evening air in Eloy, Ariz., her hair braided by the other women in the detention center. We’re braiding up all your strength, they had told her in Spanish. You can do it. Ms. González, who had been released on a bond, was meeting her lawyer on Thursday and would soon join the volunteers who were driving her to New York City to find her three young children — Lester, Jamelin and Deyuin — who had been taken away from her more than a month before at the southern border. (Correal, 6/30)

The Associated Press: Separations At The Border Didn’t Worry Some Trump Officials
The government’s top health official could barely conceal his discomfort. As Health and Human Services secretary, Alex Azar was responsible for caring for migrant children taken from their parents at the border. Now a Democratic senator was asking him at a hearing whether his agency had a role in designing the Trump administration’s “zero tolerance” policy that caused these separations. The answer was no. (Long and Alonso-Zaldivar, 7/2)

The Wall Street Journal: How To Teach Legal Rights To Migrant Children: Games And Coloring
At the Catholic Charities of the Archdiocese of New York, advocates are faced with explaining legal rights to hundreds of children who have been separated from the adults they were traveling with when they illegally entered the U.S. The group is providing legal services for about 350 children, most of whom are 10 years old or younger and can’t fully comprehend the legal choices in the group’s “Know Your Rights” training. (West and Campo-Flores, 7/1)

Los Angeles Times: 'We Beg You To Help Us.' Immigrant Women In Detention Describe Their Treatment, Share Fears About Their Children
The words appear on a scrap of paper, scrawled in pencil by an immigrant mother held at a detention center: “We beg you to help us, return our children. Our children are very desperate. My son asks me to get him out and I’m powerless here.” In another letter, childish print on notebook paper, a mother spoke of her son: “It’s been a month since they snatched him away and there are moments when I can’t go on.… If they are going to deport me, let them do it — but with my child. Without him, I am not going to leave here.” (Hennessy-Fiske, 7/2)

Stat: Congress Presses For Transparency At Groups Supporting NIH, CDC
The National Institutes of Health has hit a series of ethical snags in recent years, with questions about whether work funded by nonprofit groups has come with too many conditions attached or otherwise failed to meet certain ethical standards. Congress has taken notice. In what amounts to a written warning from Capitol Hill, a House committee last week included language in a spending agreement that emphasizes existing requirements on funding from the Foundation for the NIH and the CDC Foundation. (Facher, 7/2)

Stat: FDA Hints It Wants Flexility From Congress To Pay More Staff Higher Salaries
 In a recent report to Congress, the Food and Drug Administration expressed gratitude for a 2016 law that enabled the agency to pay some staff higher salaries and hire them more quickly. It has also intimated that it would be useful for Congress to expand those powers to more staff in the future. The FDA has long faced challenges hiring staff, due in part to bureaucratic hangups, and in part due to the fact that the agency is competing with the private sector, which can afford to pay employees more. (Swetlitz, 7/2)

The Associated Press: Health Official Who Urged Abstinence Says Views Have Changed
The head of the nation's top public health agency once opposed condoms and needle exchange programs as ways to stop the spread of sexually transmitted diseases. This week, in one of his first media interviews since taking office, Dr. Robert Redfield Jr. said his views have changed. "I think the data is just clear that these strategies work. When you see evidence that these strategies work, you need to embrace them," said Redfield, director of the Atlanta-based Centers for Disease Control and Prevention. (Stobbe, 6/29)

Politico: Meet The HHS Officials Who Tweet Like Trump
One staffer publicly mocked senators who criticized Donald Trump as “clueless” and “crazy.” Another accused Hillary Clinton of having a campaign aide killed and employing pedophiles. A third wrote the “shameful” press was trying to deny Trump his victories. These are not faceless trolls but midlevel political appointees at the Health and Human Services Department who have helped shape the agency’s communications strategy — even while taking a page out of President Donald Trump’s playbook. (Diamond, 6/29)

The Wall Street Journal: Amazon’s PillPack Deal Gives It Access To Sensitive Health Data
Amazon.com Inc. knows more about consumers’ online-shopping habits than any other retailer. Now it is about to get its hands on the most intimate of personal data: people’s health conditions. Last week’s acquisition of online pharmacy startup PillPack will give Amazon insight into people’s prescriptions, putting the tech company into the highly regulated realm of health information with more restrictions than it is accustomed to on data-mining. (Stevens and Terlep, 7/1)

Stat: Pharma Drops Its Lawsuit Against Nevada Over Drug Pricing Transparency Law 
After months of suspense, two pharmaceutical industry trade groups have agreed to drop a lawsuit against the state of Nevada over a new law that requires drug makers to report a wide array of pricing information about their diabetes medicines. The move comes just weeks after state officials modified a regulation to allow companies to mark certain pricing data as confidential when they begin complying with the new transparency law, according to court documents. (Silverman 6/29)

Stat: FDA Scolds Pfizer For A Video That Failed To Mention Risks Of A Vaginal Ring
After months of silence about drug company promotional practices, the Food and Drug Administration scolded Pfizer (PFE) over a consumer video that created a “misleading impression” of the Estring vaginal ring because there was no risk information. The agency objected to a staged interview between a physician and a patient — both of whom were paid and trained Pfizer spokespeople — discussing the ring, which is used to treat moderate to severe symptoms of vulvar and vaginal atrophy due to menopause. Not only did the video fail to include risk information, but the patient claimed she did not suffer any side effects while experiencing “instant relief.” (Silverman, 6/29)

The Washington Post: Opioid Addiction And Overdoses In Children Devastate Parents
“Brian has been dead for 136 days,” says his mother, Vicki Bishop. “I watched him die over many years, and it was a long, slow, horrible death.” Her son’s decades-long battle with opioids blotted out the sun in her own life, says Bishop, 65, of Clarksburg, Md. It held her in the clenched fist of shock and anticipation shared by millions of American parents who are traumatized by a child’s substance use. “I spent so many years in stages of anxiety and depression,” Bishop says. “I worried about Brian 24/7. His disease took over my life.” (Fleming, 6/30)

The Washington Post: Guidance For Families Dealing With Substance-Use Disorders
Licensed professional counselor Pat Aussem works with the nonprofit Partnership for Drug-Free Kids to offer guidance to families navigating substance-use disorders. Here are some suggestions she offers parents. (Fleming, 6/30)

The Washington Post: Blue-Lit Bathrooms Make It Hard For Drug Users To See Veins But May Have Unintended Consequences
Isolated, easily accessible and free from surveillance cameras and security guards, public restrooms have long been a place for illicit activities. And with a relentless opioid epidemic ravaging the nation, they have become a laboratory of sorts for drug users searching for a private space to get high. It presents a problem for business owners concerned not only about the safety of their customers but also of their employees — the ones cleaning up blood splatter, picking up used needles or calling 911 when a user has overdosed in the washroom. It has forced retailers to search for solutions such as placing cameras outside the facilities, securing the doors with lock pads or removing drop ceilings, where users often hide drug paraphernalia. (Bever, 6/29)

The New York Times: Emergency Rooms Run Out Of Vital Drugs, And Patients Are Feeling It
George Vander Linde tapped a code into the emergency room’s automated medicine cabinet. A drawer slid open and he flipped the lid, but found nothing inside. Mr. Vander Linde, a nurse, tried three other compartments that would normally contain vials of morphine or another painkiller, hydromorphone. Empty. Empty. Empty. The staff was bracing for a busy weekend. Temperatures were forecast for the 90s and summer is a busy time for hospital emergency departments — the time of year when injuries rise from bike accidents, car crashes, broken bottles and gunshots. (Thomas, 7/1)

Stat: A Daredevil Researcher’s Quest: To Restore Sight Lost To Glaucoma Using VR
Academics and companies all over the world are betting on virtual reality to help patients with conditions like anxiety, depression, PTSD, and ADHD. Huberman believes in the potential of the technology for vision issues, too, but he speaks about it less like an evangelist than someone who’s discovered a useful tool. He’s also harnessing it in pioneering ways. In the case of his glaucoma clinical trial, [Andrew] Huberman is asking patients to gaze at flashing white dots in the hopes that they can trigger the firing of neurons that connect the eye to the brain and coax them to regenerate. (Robbins, 7/2)

The New York Times: Doctor, Your Patient Is Waiting. It’s A Red Panda.
Hoppy, a young red panda, was the first patient of the day, carried — and anesthetized — into the exam room so he could get a physical. Then Mildred, a 24-year-old barnacle goose, wobbled painfully across the floor as veterinarians analyzed her gait. They couldn’t see any improvement 10 days after an earlier exam. Replacement of the degenerating joints isn’t an option for a goose. Maybe acupuncture could help? (Weintraub, 6/29)

The New York Times: Endless Gaming May Be A Bad Habit. That Doesn’t Make It A Mental Illness.
The World Health Organization last month added “internet gaming disorder” to its manual of psychiatric diagnoses, and the reaction was, shall we say, muted. At a time when millions of grown adults exchange one-liners with Siri or Alexa, the diagnosis seems years overdue, doesn’t it? (Carey, 7/2)

The Washington Post: Kayla Rahn: Alabama Woman Has 50-Pound Ovarian Cyst Surgically Removed
For months, Kayla Rahn had been struggling with abdominal pain, swelling and shortness of breath. She had also been packing on pounds, gaining weight that seemed impossible to lose. People would ask whether she was pregnant — perhaps even with twins? — and when she was due. They would also volunteer to load groceries for her. “I used to tell them I was going to name it Taco Bell,” the 30-year-old told The Washington Post about the jokes she used to make in response to all the awkward pregnancy questions. (Bever, 6/29)

The New York Times: Marriage May Be Good For Your Heart
Being married may reduce the risk of heart disease and cardiovascular death, a review of studies has found. Researchers pooled data on more than two million participants in 34 studies carried out in the United States, Britain, Japan, Russia, Sweden, Spain, Greece and eight other countries. (Bakalar, 6/29)

The New York Times: More Americans Evacuated From China Over Mysterious Ailments
The State Department has evacuated at least 11 Americans from China after abnormal sounds or sensations were reported by government employees at the United States Consulate in the southern city of Guangzhou, officials said, deepening a mystery that has so far confounded investigators. At least eight Americans associated with the consulate in Guangzhou have now been evacuated, according to one official, who spoke on condition of anonymity because of the sensitivity of the matter. (Myers, 6/30)

The Wall Street Journal: U.S. Evacuates More Americans From China After Mystery Illness Complaints
U.S. Embassy staff were told in June that the evacuations of the Americans, who were associated with the U.S. consulate in the Chinese city of Guangzhou, weren’t all connected to the mysterious symptoms, a person familiar with the situation said. More than 250 people connected to U.S. missions in China have requested and received medical evaluations, according to an embassy notice sent last week to staff. To date, only one American in China has been confirmed as having symptoms and clinical findings consistent with those experienced by U.S. diplomats in Cuba, according to the embassy notice. (Chen, 7/1)

The New York Times: 820 Children Under 6 In Public Housing Tested High For Lead
Even though the New York City Housing Authority has been under a microscope for flouting lead-paint safety regulations for years, the exact number of children residing in public housing poisoned by lead was never disclosed. Over the weekend, the city department of health offered a number: It said that 820 children younger than 6 were found to have elevated levels of lead in their blood between 2012 and 2016. (Ferre-Sadurni, 7/1)

The Associated Press: School District Gets $15.6M To Remove Mold, Asbestos
State and local leaders say The School District of Philadelphia will get $15.6 million to remove lead, mold and asbestos at 57 school buildings around the city. Pennsylvania Gov. Tom Wolf made the funding announcement Friday. He was joined by Mayor Jim Kenney, Superintendent William Hite and other officials. Hite says, "The health and safety of our students is critical." (6/29)

The Associated Press: Pharmacy Chain, Ohio Health Department Sued Over HIV Mailing
A class-action lawsuit has been filed with the Ohio Court of Claims against CVS Caremark and the state Health Department over a mailing that might have publicly disclosed the identity of 6,000 HIV patients. The Columbus Dispatch reports the lawsuit filed by a Cleveland-area attorney says the state shared private medical information with CVS last summer without patients' authorization, allowing CVS to make a marketing pitch to non-customers about its pharmacy services. (6/30)

The Wall Street Journal: Long Islanders Take Shelter From Tick Threat This Summer
Fear of tick-borne illnesses in eastern Long Island has some residents choosing to spend their summer inside their homes rather than the great outdoors. John Rasweiler, 65, who lives in Southold on the island’s North Fork, said that even just a simple walk across his lawn from his car to the front door of his home could lead to a parasite bite. “And in the 10, 15 seconds that I’m crossing that, I have actually picked up ticks,” he said. (Korte, 7/1)