First Edition: June 4, 2019

California Healthline: Newsom Proposes Penalty To Fund Health Insurance Subsidies
Claire Haas and her husband are at a health insurance crossroads. If they were single, each would qualify for a federal tax credit to help reduce the cost of their health insurance premiums. As a married couple, they get zip. “We talk about getting divorced every time we get our health care bills,” said Haas, 34, of Oakland. She has been married to her husband, Andrew Snyder, 33, for two years. “We kind of feel like we messed up. We shouldn’t have gotten married.” (Young and Ibarra, 6/3)

Kaiser Health News: Analysis: Why Alexa’s Bedside Manner Is Bad For Health Care
Amazon has opened a new health care frontier: Now Alexa can be used to transmit patient data. Using this new feature — which Amazon labeled as a “skill” — a company named Livongo will allow diabetes patients — which it calls “members” — to use the device to “query their last blood sugar reading, blood sugar measurement trends, and receive insights and Health Nudges that are personalized to them. ”Private equity and venture capital firms are in love with a legion of companies and startups touting the benefits of virtual doctors’ visits and telemedicine to revolutionize health care, investing almost $10 billion in 2018, a record for the sector. (Rosenthal, 6/4)

Kaiser Health News: Watch: A Status Update On Efforts To Address Surprise Medical Bills
KHN correspondent Rachel Bluth appeared on “PBS NewsHour Weekend” to talk with host Megan Thompson about the continuing problem of surprise medical bills and how the issue is playing on Capitol Hill. Bluth’s interview begins around the 10-minute, 55-second mark. (6/3)

Politico: Obamacare Rate Hikes Appear Modest For 2020
The era of annual eye-popping Obamacare rate hikes appears to be over. Premium increases in the law’s marketplaces are on track to be relatively modest for the second straight year, according to the first batch of 2020 rates proposed by insurers. The rate filings are an early indication that this year’s small rate hikes weren’t a fluke and that other Trump administration policies — including support for a lawsuit that could torch the Affordable Care Act — have proven less disruptive than some experts feared. (Demko, 6/3)

The Hill: Outside Group Knocks McConnell Over Health Care In TV Ad 
A left-leaning outside group on Monday is launching a TV ad knocking Senate Majority Leader Mitch McConnell (R-Ky.) over his efforts to repeal ObamaCare. The Ditch Mitch Fund, a group focused on trying to unseat McConnell in 2020, is running the five-figure TV ad in Louisville, Ky., and Lexington, Ky., as well as going up with a statewide digital buy in the Bluegrass State. (Carney, 6/3)

The Hill: Democrats Make Medicaid Center Of Kentucky Governor Fight
Kentucky Democrats want to make the state’s 2019 gubernatorial race ground zero in the battle over Medicaid expansion and work requirements. Democratic challenger Andy Beshear’s campaign is looking to take a page from his party’s 2018 midterm win, highlighting health care to upset the Republican incumbent Gov. Matt Bevin, who recently polled as the most unpopular governor in the country. (Weixel, 6/4)

The Washington Post Fact Checker: The Surprisingly True Comparison Between Infant Mortality In Ohio And Iran
[Rep. Tim] Ryan, who is seeking the Democratic presidential nomination, came up with a surprising way to illustrate racial inequality in the United States. When measuring infant mortality for all races combined, Youngstown has a lower rate than Iran. But when isolating the data for African Americans, the infant mortality rate in Youngstown exceeds the rate in Iran. The disproportionately high mortality rate for African American infants and mothers has raised public-health concerns for decades in the United States, not just in Youngstown or in Ohio. (Rizzo, 6/4)

The Associated Press: Senate Report Reveals Nearly 400 Troubled Nursing Homes
The federal government for years has kept under wraps the names of hundreds of nursing homes around the country found by inspectors to have serious ongoing health, safety or sanitary problems. Nearly 400 facilities nationwide had a "persistent record of poor care" as of April, but they were not included along with a shorter list of homes that get increased federal scrutiny and do have warning labels, according to a Senate report released Monday. (Alonso-Zaldivar, 6/3)

The Wall Street Journal: House Passes $19.1 Billion Disaster-Aid Package
The House passed a $19.1 billion disaster-aid package with a bipartisan majority, sending the legislation to the president’s desk after months of wrangling delayed the typically uncontroversial funding. Lawmakers voted 354-58 to approve the measure, exceeding the two-thirds threshold required under a fast-track procedure. Those who opposed the measure were all Republicans. (Duehren, 6/3)

The New York Times: F.D.A. Can Act Against Stem Cell Clinic, Judge Rules
A federal judge on Monday struck a blow against the rapidly growing stem cell industry, ruling for the Food and Drug Administration in its efforts to halt treatments by U.S. Stem Cell, a clinic in Sunrise, Fla., that blinded three patients by injecting a fat extract into their eyes. The decision does not shut down the clinic but states that the F.D.A. has the authority to regulate it and is entitled to an injunction against it. The judge, Ursula Ungaro of United States District Court for the Southern District of Florida, is expected to issue a further ruling shortly that will specify what action can be taken against the clinic. (Grady, 6/3)

The Washington Post: FDA Wins Groundbreaking Case Against For-Profit Stem Cell Company
Judge Ursula Ungaro agreed that the FDA has the authority to regulate a procedure that has become widespread in the burgeoning industry — using patients’ fat to create a stem cell treatment. The judge ruled that the FDA is entitled to an injunction ordering U.S. Stem Cell to halt the procedure. The judgment represents a major victory for the government, which has increasingly tried to constrain the industry even as it has rapidly expanded in recent years. (Wan and McGinley, 6/3)

The Associated Press: FDA: Sampling Finds Toxic Nonstick Compounds In Some Food
The Food and Drug Administration found substantial levels of a worrisome class of nonstick, stain-resistant industrial compounds in some grocery store meats and seafood and in off-the-shelf chocolate cake, according to FDA researchers. The FDA's food-test results are likely to heighten complaints by states and public health groups that President Donald Trump's administration is not acting fast enough or firmly enough to start regulating the manmade compounds. (Knickmeyer, Flesher and Casey, 6/3)

The Associated Press: Missouri Subpoenas Abortion Clinic Doctors Amid Legal Battle
A St. Louis judge on Tuesday is set to weigh whether physicians from the state's only abortion clinic can be forced to testify amid a legal fight over the facility's license. The state issued subpoenas to staffers, contractors and former medical residents who worked at Planned Parenthood's St. Louis facility, according to court documents filed by Planned Parenthood. (Ballentine, 6/4)

The Associated Press: Abrams To Go To Hollywood As Fears Grow Over GA Abortion Ban
After Georgia's Republican Gov. Brian Kemp postponed a trip to Hollywood amid fallout over the abortion ban he signed into law, his Democratic rival Stacey Abrams is planning to go instead. The Atlanta Journal-Constitution reports that Abrams will meet with Hollywood figures June 11 alongside the president of an abortion rights group. An invitation obtained by the newspaper says they'll address the "reality that employees in the state may not have full access to healthcare." (6/3)

The Associated Press: Judge Questions Reasons For Indiana Abortion Procedure Ban
A federal judge grilled an attorney for the state of Indiana on Monday over whether the Legislature had legitimate reasons for approving a law that would largely ban a second-trimester abortion procedure. The American Civil Liberties Union of Indiana is seeking a preliminary injunction blocking the restrictions on dilation and evacuation abortions, which the legislation calls "dismemberment abortion." (Davies, 6/3)

The Hill: Haley To Target Abortion-Rights Advocates Who 'Demand Conformity': 'That Is Not Real Feminism' 
Former U.S. Ambassador to the United Nations Nikki Haley on Monday is expected to lambast abortion-rights activists who she says are demanding “conformity.” Axios reports that the former South Carolina governor and U.N. ambassador under President Trump will criticize abortion-rights advocates in her keynote address at the Susan B. Anthony List's 12th annual Campaign for Life Gala on Monday evening. (Daugherty, 6/3)

The Washington Post: Virginia’s Top Democrats To Call For Stricter Gun Laws After Virginia Beach; One GOP Leader Willing To Talk
All three of Virginia’s statewide elected officials plan to stand together Tuesday to call for tighter gun safety policies in the wake of Friday’s mass shooting in Virginia Beach. Gov. Ralph Northam, Lt. Gov. Justin Fairfax and Attorney General Mark R. Herring, all Democrats, expressed frustration over the weekend that Republicans who control the General Assembly have repeatedly stifled efforts to consider any form of gun control. (Schneider, 6/3)

Reuters: Factbox: Virginia Beach Massacre Among Deadliest U.S. Workplace Shootings
The massacre on Friday of 12 people at a Virginia Beach, Virginia, municipal building was the work a veteran employee who had sent in his resignation hours before opening fire, according to police. The attack stands as the second-deadliest U.S. workplace shooting since 2000. Here are some of the others. (Goldberg, 6/3)

The Washington Post: Virginia Beach Mass Shooter Reveals Little In Resignation Note Sent Day Of Massacre
DeWayne Craddock submitted a short and courteous resignation letter Friday, telling a Virginia Beach official it had been a “pleasure” to work for the city. Hours later, he fatally shot 12 people, almost all of whom were colleagues. The striking disconnect in the email released Monday by Virginia Beach officials deepened the mystery around what prompted the nation’s worst mass shooting this year. Investigators continue to probe Craddock’s personal and professional life, looking for a motive. (Miller, Shapira and Zauzmer, 6/3)

The Washington Post: FDA To Make It Easier For Doctors To Get Unapproved Cancer Drugs For Patients
The Food and Drug Administration plans to provide “concierge service” to doctors seeking access to unapproved drugs for cancer patients who have no other treatment options, the agency announced Monday. The goal is to remove any “perceived hurdles” for physicians who want to use the agency’s “expanded access” program, said Richard Pazdur, director of the agency’s Oncology Center for Excellence. The pilot program will include Project Facilitate, a new call center run by the agency’s oncology staff to provide a single point of contact for doctors submitting requests to the program. (McGinley, 6/3)

The Associated Press: US Aims To Help More Cancer Patients Try Experimental Drugs
Sally Atwater's doctor spent two months on calls, messages and paperwork to get her an experimental drug he thinks can fight the lung cancer that has spread to her brain and spine. Nancy Goodman begged eight companies to let her young son try experimental medicines for a brain tumor that ultimately killed him, and "only three of the companies even gave me a reason why they declined," she said. (Marchione, 6/3)

The Associated Press: Humana Takes Rare Step Of Squashing Centene Deal Talk
Centene shares are tumbling after Humana took the rare step of publicly refuting reports that it's interested in buying the company. Centene Corp., based in St. Louis, is in the midst of a $15 billion takeover of WellCare, another insurer specializing in government funded health coverage. Humana said in a prepared statement Monday that it will not make a bid for Centene, which specializes in running state-based Medicaid coverage programs. Humana is one of the nation's largest providers of privately run Medicare Advantage plans. (6/3)

The Wall Street Journal: Humana Says It Won’t Do Deal With Centene
The unusual announcement suggests Centene’s agreement in March to buy WellCare for $15.3 billion will move ahead, though some activist investors had pushed for the St. Louis-based health insurer to sell itself. Humana, of Louisville, Ky., said in a filing with the Securities and Exchange Commission Monday that “in light of the significant investor speculation and persistent market rumors,” it was making a one-time statement to “confirm that the company will not make a proposal to combine with Centene as an alternative to Centene’s proposed transaction with WellCare Health Plans Inc.” Humana said it planned no further comment. (Wilde Mathews, 6/3)

The Washington Post: Quest Diagnostics Discloses Breach Of 11.9 Million Patient Records
Quest Diagnostics, the medical testing company, said a data breach has affected about 11.9 million patients after an “unauthorized user’’ gained access to financial data, Social Security numbers and medical data but not laboratory test results. American Medical Collection Agency notified Quest about a potential intrusion on May 14 and then reported on the scope of the breach Friday. (Rowland, 6/3)

Stat: Measles Outbreaks Put U.S. At Risk Of Losing Prized 'Elimination' Status
With two large and still growing outbreaks in New York pushing the country’s measles count to a quarter-century high, public health officials are starting to grapple with an unpleasant prospect. The Rockland County and Brooklyn outbreaks have dragged on for eight months. If transmission from either of those outbreaks continues until late September, the United States will likely lose a hard-fought and prized status — that of a country deemed to have “eliminated” measles. (Branswell, 6/4)

Reuters: U.S. Health Officials Report 41 New Cases Of Measles Last Week
The United States recorded 41 new measles cases last week, bringing the year's total number of cases to 981 in the worst outbreak of the disease since 1992, federal health officials said on Monday. The U.S. Centers for Disease Control and Prevention said the number of cases of the highly contagious and sometimes deadly disease rose 4% in the week ended May 31 from the prior week. The 2019 outbreak, which has spread to 26 states, is the worst since 1992, when 2,126 cases were recorded. (6/3)

The Associated Press: More States Sue Opioid Maker Alleging Deceptive Marketing
California, Hawaii, Maine and the District of Columbia filed lawsuits Monday against the maker of OxyContin and the company's former president, alleging the firm falsely promoted the drug by downplaying the risk of addiction while it emerged as one of the most widely abused opioids in the U.S. The lawsuits were the latest by states and local governments against drugmaker Purdue Pharma as the country grapples with an opioid epidemic. (Oxford, 6/3)

The Associated Press: Researchers Pose As Heroin Users To Find Treatment Gaps
Researchers posing as heroin users seeking help contacted hundreds of treatment clinics in U.S. states with the highest overdose death rates. The study found the "secret shoppers" were denied appointments much of the time, especially if they said they were insured through Medicaid. Scientists wanted to understand why more people aren't treated with an effective anti-addiction drug available in doctor's offices. (Johnson, 6/3)

The Associated Press: Mutation That Protects Against HIV Raises Death Rate
People with a DNA mutation that reduces their chance of HIV infection may die sooner, according to a study that suggests tinkering with a gene to try to fix one problem may cause others. The study authors cited the case of the Chinese researcher who tried to produce this mutation in twin girls before their birth, to reduce their risk for HIV.  His work, which produced the first gene-edited babies, was widely condemned as unethical and risky, and the new paper illustrates one reason for concern. (6/3)

NPR: Chinese CRISPR Experiment May Increase Twins' Risk Of Early Death, Study Finds
The Chinese scientist, He Jiankui, announced last fall that he had created twin girls from an embryo whose DNA he edited in his lab using the powerful gene-editing tool CRISPR. He said he modified a gene known as CCR5 to protect the girls from the AIDS virus. But there's also evidence the CCR5 variation has other effects, such as making people more vulnerable to the West Nile and influenza viruses. "We know it has many different effects. The question is: Is it overall beneficial or detrimental to have this mutation?" Nielsen says. "That was not known." (Stein, 6/3)

The New York Times: Their Children Were Conceived With Donated Sperm. It Was The Wrong Sperm.
Seventeen years ago, when she was in her thirties, Cindy and her female partner decided they wanted to have children. The couple spent hours pouring over sperm donor profiles, finally settling on an anonymous man with a clean medical record and few health issues in his family. He was an anonymous donor, and they knew him only by his identifying number. Cindy gave birth to a healthy baby boy. Eventually the couple used the same donor to conceive again — and soon enough they were raising two boys. (Mroz, 6/3)

The New York Times: Protecting Sleep In The Hospital, For Both Patients And Doctors
It was 11 p.m. and my 5-year-old patient was sleeping peacefully in her hospital bed, snuggled up with her mother and several stuffed animals. Her breathing was quiet and soft. Her bedside heart rate monitor, which glowed a faint yellow in the dark hospital room, was turned to “silent.” “Sorry, I have to take a listen to her heart,” I whispered to her mother, tapping her shoulder lightly. Her mother and I had a good relationship: I had served as an advocate for her daughter several times during her seven-week stay in the ward. She had a rare disease that had been a medical mystery for many months, but she would be transferred to a more specialized center soon. (Kalaichandran, 6/4)

The Washington Post: Gen Z Kids Are The Stars Of Their Parents’ Social Media — And They Have Opinions About That
Alison Santighian flicks her finger over her smartphone screen, and her Facebook profile scrolls past in a blur. She is looking for a particular photo from a few days ago, a picture her 9-year-old son, Arsen, didn’t want her to take. “Found it!” she says. Arsen, sitting beside her on the family’s patio at their Bethesda, Md., home, peers over her shoulder. “He looked very handsome that day,” Alison explains, and Arsen rolls his eyes. He was dressed in a dapper white suit for a piano performance, and when Alison asked him to pose for a picture that she could share with her Facebook followers, Arsen said he’d rather not. (Gibson, 6/3)

The Wall Street Journal: Safe Space Or Police State: How Far Should You Go In Monitoring Your Kids Online?
School is almost out and parents know what that means: no homework, later bedtimes and kids who want to bend the rules on screen time. During those long summer days, parents worry about how to make sure kids aren’t getting into trouble online. There are tools available that can monitor every picture, email and text message a kid sends or receives—even every Google doc a child creates—and alert parents at any sign of mischief. But at what point do you cross the line from parental duty to police state? (Jargon, 6/4)

The New York Times: Sweden Finds A Simple Way To Improve New Mothers’ Health. It Involves Fathers.
The weeks after a mother gives birth are a universally vulnerable period. She is recovering physically and mentally, while dealing with sleep deprivation, round-the-clock caregiving and possibly breast-feeding. Yet after a few days in the hospital, she often doesn’t see a doctor for six weeks. A new study suggests a way to make a significant difference in mothers’ postpartum health: Give the other parent paid leave, and the flexibility to use it on days the mother needs extra support, even if it just means a couple of days at home. (Miller, 6/4)

NPR: Octopuses' Big Brains And Unique Behavior Spur Basic Research
At the Marine Biological Laboratory in Woods Hole, Mass., there's a room filled with burbling aquariums. A lot of them have lids weighed down with big rocks. "Octopuses are notorious for being able to, kind of, escape out of their enclosures," says Bret Grasse, whose official title at MBL is "manager of cephalopod operations" — cephalopods being squid, cuttlefish and octopuses. He's part of a team that's trying to figure out the best ways to raise these sea creatures in captivity, so that scientists can investigate their genes and learn the secrets of their strange, almost alien ways. (Greenfieldboyce, 6/3)

The Associated Press: Perk Up: California Says Coffee Cancer Risk Insignificant
California officially gave its blessing to coffee Monday, declaring the beverage does not pose a "significant" cancer risk. The rule, proposed a year ago by regulators, means coffee won't have to carry ominous warnings that the beverage may be bad for you. The state took the rare move after a Los Angeles judge found Starbucks Corp. and other companies failed to show that benefits from drinking coffee outweighed risks from a byproduct of the roasting process. (6/3)

The Wall Street Journal: Coffee Doesn’t Warrant A Cancer Warning In California, Agency Says
The safety of coffee has been in dispute in California since a state court judge ruled last spring that coffee must carry a cancer warning because of the presence of acrylamide, a potentially carcinogenic chemical created during the roasting process. A branch of the World Health Organization came out with a conflicting decision in June 2018, finding inadequate evidence that drinking coffee causes cancer, based on a review of more than 1,000 studies. (Randazzo, 6/3)

ProPublica: One Cardiac Arrest. Four 911 Callers. And A Tragic Outcome.
When Rena Fleury collapsed in the stands during her son’s high school football game last August, there was reason to be hopeful. At 45, she was on the young side for a cardiac arrest, which improved her odds of surviving. And she was in a public place, which, studies show, also increased her chances. Plus, she was in Cumberland, a “heart safe” community where emergency medical personnel are among the most highly trained in the state. (Arditi, 6/4)

The Associated Press: Maine Could Allow Terminally Ill To Get Life-Ending Meds
Maine would allow doctors to prescribe terminally ill people a fatal dose of medication under a bill that faces final legislative action in the state Senate. The Democratic-led Maine House voted 73-72 to enact the bill Monday as lawmakers recounted the last days of their own loved ones. Democratic Rep. Michele Meyer said no one knows how precious life is like a dying patient seeking a peaceful end. (6/3)

The Associated Press: San Francisco Eyes Forced Treatment For Mentally Ill Addicts
San Francisco supervisors were expected to consider a proposal Tuesday that could force drug addicts with serious mental illnesses into treatment. Mayor London Breed and other supporters of the proposal say the move — known as conservatorship — is necessary to help addicts who are often homeless and suffering from a mental illness, making them a danger to themselves. They say the number of people who could be forced into treatment is small, likely fewer than 50. (6/4)

The Washington Post: Rocky Mountain Spotted Fever: Kentucky 2-Year-Old Jackson Oblisk Survives Rare Tick-Borne Illness
For days, Jackson Oblisk had been running a high fever, and the toddler’s small body was covered in tiny red spots. His pediatrician had suspected it was a viral rash and had sent him home to recover, his mother said. But the toddler was not getting better; he was getting worse, she said. When his mother, Kayla Oblisk, offered him his favorite food, a peanut butter sandwich, he just held it in his hand. When she turned on his favorite movie, “The Greatest Showman,” he slept through it. (Bever, 6/3)