First Edition: July 9, 2019

Kaiser Health News: Federal Appeals Court Takes Up Case That Could Upend U.S. Health System
Here are five important things to know about the case. (Rovner, 7/9)

California Healthline: Medi-Cal Enrollment Among Immigrant Kids Stalls, Then Falls. Is Fear To Blame?
As California prepares to expand Medicaid coverage to young adults here illegally, the number of undocumented immigrant children in the program is slowly declining, new state data show. Unauthorized immigrant children have been eligible for Medi-Cal, the state’s Medicaid program for low-income residents, since May 2016, and their enrollment peaked nearly a year later at 134,374, according to the data from the state Department of Health Care Services. (Ibarra, 7/8)

The New York Times: Judge Blocks Trump Rule Requiring Drug Companies To List Prices In TV Ads
A federal judge ruled on Monday that the Trump administration cannot force pharmaceutical companies to disclose the list price of their drugs in television ads, dealing a blow to one of the president’s most visible efforts to pressure drug companies to lower their prices. Judge Amit P. Mehta, of the United States District Court in the District of Columbia, ruled that the Department of Health and Human Services exceeded its regulatory authority by seeking to require all drugmakers to include in their television commercials the list price of any drug that costs more than $35 a month. The rule was to take effect this week. (Thomas and Rogers, 7/8)

The Associated Press: Judge Strikes Down Rule Requiring Drug Ads To Reveal Prices
The narrow ruling by U.S. District Judge Amit Mehta in Washington, D.C., struck down a requirement that was set to go into effect within hours, on Tuesday. Drugmakers had argued that requiring them to disclose list prices amounted to coercion that would violate their free speech rights under the Constitution. But in his 27-page ruling Mehta avoided debating the First Amendment, saying simply that the Trump administration had failed to show it had legal authority under the statutes that govern federal programs such as Medicare to require price disclosure. (Alonso-Zaldivar, 7/8)

Reuters: U.S. Judge Strikes Down Trump Administration Rule Requiring Drug Prices In TV Ads
Mehta in his ruling set aside the entire rule as invalid, saying the HHS lacked authority from the U.S. Congress to compel drug manufacturers to disclose list prices. "It is outrageous that an Obama appointed judge sided with big PhRMA to keep high drug prices secret from the American people, leaving patients and families as the real victims," White House spokesman Judd Deere said in a statement, referring to President Donald Trump's Democratic predecessor, Barack Obama. (Bellon and Raymond, 7/8)

The Washington Post: Federal Judge Blocks Trump Rule Requiring Drug Prices In TV Ads
Three drug manufacturers — Merck, Eli Lilly and Amgen — sued the administration after the Department of Health and Human Services finalized the rule in May, arguing that HHS overstepped its authority because it did not have permission from Congress to impose the requirement. HHS Secretary Alex Azar, formerly the president for the U.S. division of Eli Lilly, has sought to deliver drug pricing wins that President Trump can tout on the campaign trail. In May, Azar called the rule “the single most significant step any administration has taken toward a simple commitment: American patients deserve to know the prices of the health care they receive.” (Abutaleb, 7/8)

The Wall Street Journal: Trump Rule Requiring Drug Prices In TV Ads Blocked
The administration said the goal of the rule was to increase transparency, which would put pressure on drugmakers to keep prices low. It argued that list prices matter to patients, especially consumers with high deductibles who must often pay the full amount. The U.S., one of the few countries to allow TV ads for drugs, currently requires them to disclose side effects and other information. “If drug companies are ashamed of those prices—lower them!” Mr. Trump tweeted in May. (Armour, 7/8)

CNN: Judge Nixes Administration Rule To Require Drug Prices In TV Ads
While the new rule does not have an enforcement mechanism, Azar said failing to include the price would be considered a deceptive trade practice and could prompt lawsuits by industry rivals. (Luhby, 7/8)

The New York Times: Obamacare In Jeopardy As Appeals Court Hears Case Backed By Trump
A federal appeals court panel will hear arguments Tuesday on whether a federal judge in Texas was correct in striking down the Affordable Care Act, a case with enormous stakes not only for millions of people who gained health insurance through the law but for the political futures of President Trump and other candidates in the 2020 elections. The case, which could make its way to the Supreme Court ahead of those elections, threatens insurance protections for people with pre-existing medical conditions and many other sweeping changes the 2010 law has made throughout the health care system. (Goodnough, 7/9)

The Associated Press: Latest 'Obamacare' Court Battle Plays Out In New Orleans
It's unclear when the panel will rule in a case that appears destined for the Supreme Court, which has reviewed the law before. The ultimate outcome will affect protections for people with pre-existing conditions; Medicaid expansions covering roughly 12 million people; and subsidies that help about 10 million others afford health insurance. Tuesday's arguments are the latest in a lawsuit filed by Republican officials in 18 states, led by the Texas Attorney General's Office. It was filed after Congress — which didn't repeal the law, despite pressure from President Donald Trump — reduced to zero the unpopular tax imposed on those without insurance. (McGill and Santana, 7/9)

The Wall Street Journal: Trump Hopes To Stem Tide Of Legal Setbacks On Health Care
The broader legal fight will likely stretch beyond the 2020 election. Whoever is elected will decide whether to drop or defend lawsuits over such issues as contraception coverage, family planning funding, and health plans that don’t comply with the ACA. “Medicaid work requirements? Another administration will not defend that,” said Loren Adler, associate director of the Center for Health Policy at the Brookings Institution. He said the Trump administration has seemed to stretch legal boundaries more than previous administrations. (Armour, 7/8)

Politico: Long-Shot Legal Challenge Could End Obamacare During The 2020 Campaign
Legal experts across the political spectrum, who had earlier dismissed the lawsuit as a long shot, contend Reed’s decision was an overreach. Even if the individual mandate was unconstitutional, they say unrelated provisions of the law — like the expansion of Medicaid to millions of low-income adults in nearly two-thirds of states — should be allowed to stand. Even a pair of Republican attorneys general in Ohio and Montana, which both expanded Medicaid, have argued that O’Connor’s ruling went too far and would have detrimental consequences. “There’s a pretty strong bias … to try to preserve things under law, rather than knock them down,” said Tom Miller, a health care expert at the conservative American Enterprise Institute. “The preponderant stance has been to go minimal in terms of knocking out broad federal laws.” (Demko, 7/8)

Los Angeles Times: Trump Officials Tell One Court Obamacare Is Failing And Another It’s Thriving
As they push a federal court to repeal the Affordable Care Act, Trump administration lawyers are arguing the law is no longer workable because Congress eliminated a penalty on people who don’t have health insurance. But for months, senior administration officials and lawyers have been making the exact opposite case in other settings, a review of government reports, court filings and public statements made by Trump appointees shows. In fact administration officials, including White House economists, this year repeatedly have hailed the strength of insurance marketplaces created by the 2010 law. (Levey, 7/8)

Politico: Trump Aims To Shake Up Kidney Care Market
The Trump administration this week will announce a series of initiatives to encourage more kidney transplants and treatment at home, the start of a process intended to overhaul a market in which the federal government spends more than $100 billion per year. President Donald Trump is slated to unveil the strategy in a speech Wednesday morning and is eyeing additional actions like a possible executive order, according to four individuals with knowledge of the upcoming announcement. (Diamond and Roubein, 7/8)

The Washington Post: House To Vote On New Border Bill Amid Outcry Over Conditions At Migrant Detention Centers
The House will consider new legislation to address the treatment of migrants at the southern border, Speaker Nancy Pelosi said Monday — less than two weeks after passage of a $4.6 billion emergency spending package left scores of Democrats angered about a lack of accountability for the Trump administration. “Legislation is necessary,” Pelosi (D-Calif.) said in a letter to Democrats, pointing to House provisions that were left out of the Senate-negotiated spending bill that ultimately passed last month — including medical care standards for migrants in U.S. custody, a 90-day limit on children’s stays in federal “influx shelters” and guaranteed access to border facilities without notice for members of Congress. (DeBonis and Kim, 7/8)

The Hill: Pelosi Cites 'Necessary' New Laws To Tackle Border Crisis
Pelosi has urged President Trump to adopt the additional protections unilaterally. But her latest message suggests she's not holding her breath for the administration to act on its own to ensure that those placed in federal custody after arriving at the U.S.-Mexico border have ready access to medical treatment, hygiene products and other simple necessities. "Whether or not the President responds to our request to improve medical care standards for the health and safety of children, and while Senator McConnell still refuses to help the children suffering in these deplorable conditions, we must lead a Battle Cry across America to protect the children," Pelosi wrote in the "Dear Colleague" letter.  (Lillis, 7/8)

Politico: Juul Arms To Fight Sweeping E-Cig Ban On Its Home Turf
Juul is gearing up for an all-or-nothing fight over the surge of local bans on vaping around the country. And the battle is starting in its headquarters city of San Francisco, which just enacted the nation's first blanket prohibition on e-cigarette sales. More than 200 jurisdictions have placed limits on selling flavored tobacco products, including nearly two dozen cities and counties in California. San Francisco's ordinance, signed last week, goes further by cutting off all sales, including online purchases delivered to city addresses, until the products go through FDA reviews. (Colliver, 7/9)

The New York Times: Aid In Dying Soon Will Be Available To More Americans. Few Will Choose It.
On Aug. 1, New Jersey will become the eighth state to allow doctors to prescribe lethal medication to terminally ill patients who want to end their lives. On Sept. 15, Maine will become the ninth. So by October, 22 percent of Americans will live in places where residents with six months or less to live can, in theory, exercise some control over the time and manner of their deaths. (The others: Oregon, Washington, Vermont, Montana, California, Colorado and Hawaii, as well as the District of Columbia.) But while the campaign for aid in dying continues to make gains, supporters are increasingly concerned about what happens after these laws are passed. (Span, 7/8)

NPR: Roughly 20% Of U.S. Hospice Programs Cited For Serious Deficiencies, Inspectors Say
We all hope for some peace and comfort at the end of life. Hospices are designed to make that possible, relieving pain and providing emotional and spiritual support. But two new government studies released Tuesday morning find that the vast majority of hospices have sometimes failed to do that. And there's no easy way for consumers to distinguish the good hospices from the bad. (Jaffe, 7/9)

The Washington Post: Hospice Neglect Includes Maggots, Uncontrolled Pain, According To Inspector General Report
A state inspector in Missouri documented the grim details: a deep, poorly treated pressure wound on the patient’s tailbone, apparent pain that caused grimacing and — in a crisis requiring a trip to the emergency room — a “maggot infestation’’ where the feeding tube entered his abdomen. The official cited Vitas Healthcare, the nation’s largest hospice chain, for putting the patient in “immediate jeopardy,” the most severe category of violation. The inspector found that Vitas staffers had skipped home visits and failed to assess the amount of pain the patient endured. (Rowland, 7/9)

The Associated Press: Abortion Arguments At Play In Limiting Veterans' IVF Benefit
A federal program to help injured veterans and their spouses conceive children through in vitro fertilization is being hobbled by anti-abortion forces that oppose how the process can lead to embryos being destroyed. Since 2012, Democrats in Congress have repeatedly championed legislation permanently extending IVF benefits to veterans whose injuries in the line of duty have left them unable to conceive children otherwise. But those bills have fizzled in the face of opposition from Catholic bishops and others in favor of a temporary program that must be reauthorized every year, complicating efforts by eligible veterans to begin or extend their families. (Carr Smyth, 7/8)

The Associated Press: Kansas Judge Won't Give Go-Ahead For Telemedicine Abortions
A state-court judge declined Monday to give a Kansas clinic permission to provide telemedicine abortions. Shawnee County District Judge Teresa Watson rejected a request from the Trust Women Foundation for an injunction to block the state from subjecting the clinic and its doctors to enforcement of state laws against telemedicine abortions. She did so despite another judge's ruling that no ban can be enforced and a Kansas Supreme Court ruling in April that access to abortion is a "fundamental" right under the state constitution. (Hanna, 7/8)

The Associated Press: ACLU Effort To Put Abortion Ban To Vote Can Proceed
An appellate court panel ruled Monday that the American Civil Liberties Union can soon begin collecting signatures that would put a new Missouri law banning abortions at eight weeks of pregnancy to a public vote. A three-judge panel of the state's Court of Appeals found that GOP Secretary of State Jay Ashcroft was "without authority" to reject petitions to put the law on the 2020 ballot on constitutional grounds. The 31-page ruling was issued just hours after the panel heard oral arguments in the case. (Hollingsworth, 7/8)

The New York Times: Supplements And Diets For Heart Health Show Limited Proof Of Benefit
Millions of Americans use dietary supplements and a variety of diets to protect their heart health. But a large new analysis found that there was strikingly little proof from rigorous studies that supplements and some widely recommended diets have the power to prevent heart disease. The new research, published in the Annals of Internal Medicine, reviewed data from hundreds of clinical trials involving almost a million people and found that only a few of 16 popular supplements and just one of the eight diets evaluated had any noticeable effect on cardiovascular outcomes. (O'Connor, 7/8)

CNN: Supplements Probably Aren't Helping Your Heart, Research Suggests
The findings were unsurprising, said Susan Jebb, a professor of diet and population health at the University of Oxford. "Except to prevent or correct specific deficiencies" such as low vitamin D levels, or in specific circumstances such as pregnancy, "there is generally good agreement that dietary supplements should not be recommended to the general population." (Azad, 7/8)

NBC News: Most Dietary Supplements Do Not Protect Against Heart Attack And Stroke
Still, the findings may do little to shake Americans' strong faith in supplements and vitamins. An estimated 3 out of 4 people in the United States take at least one dietary supplement, and Americans are projected to spend $32 billion on them this year alone. But, according to Khan's review of the available science, it's largely a waste of money — at least when it comes to heart health. (Edwards, 7/8)

NPR: Looking For A New Doctor? Here's How To Pick One
Finding a good primary care doctor can feel a little bit like dating. It's awkward. Your expectations are high. You know it's rough out there, but you're still secretly hoping to find the one. So where do you begin? Just like dating, finding a doctor you click with is all about trusting your intuition. "What you get in a snapshot isn't that far from the truth," says Dr. Kimberly Manning, a primary care doctor and associate professor at Emory University. "In terms of interactions, in how someone talks to you — I think those things can be really powerful markers to help you decide if this is a good fit." (Gordon, 7/8)

The Washington Post: One-Third Of Babies Exposed To Zika In-Utero Suffered Developmental Problems Into Toddler Years, Study Says
A new study of toddlers exposed to the Zika virus during their mothers’ pregnancies found that nearly a third suffered developmental delays and other problems — even if they were born without the abnormally small heads and underdeveloped brains often associated with the virus. The study of more than 200 babies, published Monday in the journal Nature Medicine, also shows that a very small number of children born with the congenital condition known as microcephaly had their symptoms improve. Conversely, a very small number of the children born without symptoms of microcephaly went on to develop it. (Bever, 7/8)

NPR: Travis Rieder's 'Pain' Tells Of Bioethicist's Lonely Struggle To Quit Opioids Alone
In 2015, Travis Rieder, a medical bioethicist with Johns Hopkins University's Berman Institute of Bioethics, was involved in a motorcycle accident that crushed his left foot. In the months that followed, he underwent six different surgeries as doctors struggled first to save his foot and then to reconstruct it. Rieder says that each surgery brought a new wave of pain, sometimes "searing and electrical," other times "fiery and shocking." (Gross, 7/8)

The New York Times: To Reduce Hospital Noise, Researchers Create Alarms That Whistle And Sing
Hospitals today can be sonic hellscapes, which studies have shown regularly exceed levels set by the World Health Organization: droning IV pumps, ding-donging nurse call buttons, voices crackling on loudspeakers, ringing telephones, beeping elevators, buzzing ID scanners, clattering carts, coughing, screaming, vomiting. Then there are the alarms. A single patient might trigger hundreds each day, challenging caregivers to figure out which machine is beeping, and what is wrong with the patient, if anything. (Rueb, 7/9)

The New York Times: When ‘Bad’ Cholesterol Gets Too Low, Stroke Risk May Rise
Maintaining a low level of LDL, or “bad” cholesterol, is important for cardiovascular health, but extremely low LDL may also have risks, researchers report. The scientists studied 96,043 people for an average of nine years, recording their LDL level biennially and tracking cases of hemorrhagic stroke, caused by the rupture of a blood vessel in the brain. About 13 percent of strokes are of the hemorrhagic type. (Bakalar, 7/8)

The Associated Press: Flying Blind: Apps Help Visually Impaired Navigate Airport
Navigating airports can be tricky. They’re loud, crowded and not always laid out intuitively. They’re even more challenging for visually impaired people. Chieko Asakawa knows those challenges firsthand, and she has also devised a remedy. Asakawa has been blind since she was 14 and is now an IBM Fellow and a professor in Carnegie Mellon University’s Robotics Institute. This spring, she and other researchers at Carnegie Mellon launched a navigation app for Pittsburgh International Airport that provides turn-by-turn audio instructions to users on how to get to their destination, be it a departure gate, restaurant or restroom. (De Groot, 7/8)

Los Angeles Times: Want To Build A Dragon? A New Book Explains How To Use Gene Editing To Get It Done
Scientists are using gene-editing technologies to make mosquitoes that can't spread malaria, combat diseases caused by a single errant letter in a string of DNA and create designer babies that are protected against HIV. They may be thinking too small. A father-daughter team is plotting the best way to create a dragon. They've even written a new book to explore how they'd do it. (Miller, 7/8)

The Associated Press: Teen Odds Of Using Marijuana Dip With Recreational Use Laws
New research suggests legalizing recreational marijuana for U.S. adults in some states may have slightly reduced teens' odds of using pot. One reason may be that it's harder and costlier for teens to buy marijuana from licensed dispensaries than from dealers, said lead author Mark Anderson, a health economist at Montana State University. (7/8)

Los Angeles Times: Want To Do Something About Global Warming? Talk About It With Your Family And Friends
There's the old saying that you should never discuss politics or religion in polite company. Nowadays, it seems climate change has joined that list. Barely more than a third of Americans broach the subject often or even occasionally, according to a recent survey by researchers at the Yale Program on Climate Change Communication. All this not talking about climate change has given Americans a rather skewed perception of what the rest of the country thinks about the issue. (Rosen, 7/8)

The Washington Post: Sandy Hook: First, They Lost Their Children. Then, The Conspiracies Started. Now, The Parents Of Newtown Are Fighting Back.
It was just weeks after 26 people were gunned down at Sandy Hook Elementary School when Lenny Pozner first saw people speculating online that the rampage had been staged, with crisis actors responding to a fake attack. His 6-year-old son, Noah Pozner, who had gone to school that morning in a Batman sweatshirt, was one of the 20 children killed in Newtown, Conn., in December 2012. (Svrluga, 7/8)

The Associated Press: Top Virginia Republican Proposes Gun-Control Measure
A top Virginia Republican is calling for a broad ban on guns in government buildings, surprise legislation he filed the day before state lawmakers are set to debate gun laws. Senate Majority Leader Tommy Norment filed a bill Monday that would extend a state prohibition on guns in courthouses to any "building owned or used by a locality for governmental purposes." It would also increase the penalty for breaking the law from a misdemeanor to a felony. (7/8)

The Washington Post: Leading GOP Senator Files Gun Control Bill On Eve Of Special Session In Virginia
Norment’s bill, which caught GOP colleagues off guard, goes further than a similar measure proposed by a Republican delegate. Both are the strongest signs that some GOP lawmakers might support at least one priority set by Gov. Ralph Northam (D) when he called the General Assembly back to work. Northam ordered the special session in the wake of the May 31 mass shooting in Virginia Beach in which 12 people were killed. Republicans who control the legislature have stymied gun control bills year after year and have accused Northam of trying to capi­tal­ize on tragedy for political gain. (Schneider and Vozzella, 7/8)

Los Angeles Times: UCLA Has Paid More Than $3.5 Million In Settlements Over Former Gynecologist
A patient who alleged she was sexually assaulted by a UCLA Health gynecologist was awarded $2.25 million in a settlement finalized last month with the University of California regents, according to university records released Monday. The patient’s accusation stemmed from a February 2018 appointment with Dr. James M. Heaps. Heaps was charged in early June with sexual battery and exploitation in connection with his treatment of two patients — including the woman whose claim was settled last month. (Cosgrove, Watanabe and Winton, 7/8)

Los Angeles Times: California Senate Approves Newsom Bill To Protect Utilities From Wildfire Costs
There’s been no shortage of criticism for Gov. Gavin Newsom’s plan to help California’s largest utilities stave off bankruptcy from costs associated with wildfires: No focus on prevention efforts. More difficulty proving utility negligence. Too much of the financial burden falling on millions of utility customers. The governor, six months into his first year in office, managed to overcome some of those complaints with a Senate vote of approval Monday. But he still faces a crucial test this week as he attempts to convince the rest of the California Legislature to ratify a multibillion-dollar utility wildfire fund before lawmakers leave Sacramento for a one-month recess. (Luna, 7/8)