First Edition: June 8, 2018

Kaiser Health News: Kate Spade’s Death Ignites Concern About Rising Suicide Rate
Fashion designer Kate Spade’s death Tuesday has reminded Americans of the enormous toll of suicide, a growing problem that claims nearly 45,000 lives a year. Suicide rates in the U.S. have risen nearly 30 percent since 1999, according to a report released Thursday from the Centers for Disease Control and Prevention. Suicides increased in both men and women, in all ethnic groups and in both urban and rural areas. Suicide and “self-harm,” a category that includes attempted suicides, cost the nation $70 billion a year in medical care and lost work time. (Szabo, 6/7)

Kaiser Health News: He Started Vaping As A Teen And Now Says Habit Is ‘Impossible To Let Go’
The debate over the health risks of Juul, vaping and e-cigarettes is now spilling into the public square. In one of the most restrictive measures nationwide, San Francisco voters this week upheld by what looks to be a large majority — nearly 70 percent in a preliminary tally — a ban on the sale of flavored vaping products, as well as conventional menthol cigarettes. (Daley, 6/8)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Health Care Politics, Midterm Edition 
The 2018 midterm elections were supposed to be a referendum on President Donald Trump, not about issues such as health care. Still, voters, Democrats and, to a lesser extent, Republicans seem to be keeping health care on the front burner. The news from Medicare’s trustees that its hospital trust fund is on shakier financial footing than it was last year, hefty premium increases being proposed in several states and activity on Medicaid expansion all take on a political tinge as the critical elections draw closer. (6/7)

The New York Times: Justice Dept. Says Crucial Provisions Of Obamacare Are Unconstitutional
The Trump administration told a federal court on Thursday that it would no longer defend crucial provisions of the Affordable Care Act that protect consumers with pre-existing medical conditions. Under those provisions of the law, insurance companies cannot deny coverage or charge higher rates to people with pre-existing conditions. The Justice Department said the provisions were part of an unconstitutional scheme that required most Americans to carry health insurance. (Pear, 6/7)

The Associated Press: Justice Department Takes Aim At Heart Of Health Law
The decision, announced in a filing in a federal court in Texas, is a rare departure from the Justice Department's practice of defending federal laws in court. Texas and other Republican-led states are suing to strike down the entire law because Congress recently repealed a provision that people without health insurance must pay a fine. The repeal takes effect next year. Texas says that without the fine in place the requirement to have health insurance is unconstitutional and that the entire law should be struck down as a result. (Sherman, 6/8)

The Washington Post: Trump Administration Won’t Defend ACA In Case Brought By GOP States
The bold swipe at the ACA, a Republican whipping post since its 2010 passage, does not immediately affect any of its provisions. But it puts the law on far more wobbly legal footing in the case, which is being heard by a GOP-appointed judge who has in other recent cases ruled against more minor aspects. The administration does not go as far as the Texas attorney general and his counterparts. In their suit, lodged in February in the U.S. District Court for the Northern District of Texas, they argue that the entire law is now invalid. By contrast, the Justice brief and letter say many other aspects of the law can survive because they can be considered legally distinct from the insurance mandate and such consumer protections as a ban on charging more or refusing coverage to people with preexisting medical conditions. (Goldstein, 6/7)

The Wall Street Journal: Justice Department Won’t Defend Affordable Care Act In Lawsuit Brought By States
The decision to attack the ACA in this way involves a legal, political and policy gamble by the Trump administration, suggesting how much the president still wants to dismantle his predecessor’s signature health law after a failed ACA repeal effort by Republicans a year ago. The move could rattle the insurance markets and shake up the GOP message on health care months before the midterm elections. (Armour, 6/7)

CNN: Trump Moves Pushing Up Obamacare Premiums For 2019
Brace yourselves -- it looks like Obamacare premiums could jump by double digits again next year. Insurers in several states have requested large rate hikes for 2019, with many pointing to steps taken by President Donald Trump and Republicans in Congress as the main reasons why. New York insurers want to hike rates by 24%, on average, while carriers in Washington are looking for a 19% average premium increase. In Maryland, CareFirst is asking for an average 18.5% rate bump for its HMO plans and a 91% spike for its PPO policies (which have far fewer enrollees), while Kaiser Permanente wants to boost premiums by more than 37%, on average. (Luhby, 6/7)

Modern Healthcare: N.C. Farm Bureau Asks State Lawmakers To OK Coverage That Skirts ACA 
The North Carolina Farm Bureau is hoping to follow Tennessee and Iowa organizations in creating a cheaper health plan that eschews Affordable Care Act rules by varying the price of coverage based on a person's health status. Larry Wooten, president of the Raleigh-based North Carolina Farm Bureau, asked a state Senate healthcare committee on Thursday to pass legislation allowing the organization to launch an association health plan that bypasses ACA rules. (Livingston, 6/7)

Politico: The 2 Words You Can’t Say In A Democratic Ad
Democratic voters want single payer health care. But don’t expect to hear Democratic candidates talk about it — at least not in those words. To avoid divisive intraparty fights that drive candidates left — only to be attacked by Republicans for favoring socialized medicine — the Democratic Congressional Campaign Committee warned aspirants last year about the political liabilities of endorsing “single payer,” according to sources familiar with the advice. An influential progressive group even urged candidates to discard the often-misunderstood phrase and embrace “Medicare for all” to draw strong connections with the popular seniors’ health program. (Haberkorn, 6/8)

The Hill: Pelosi: 'Medicare For All' Should Be 'Evaluated' If Dems Win House 
House Democratic Leader Nancy Pelosi (Calif.) said Thursday that "Medicare for All" proposals should be “evaluated” if Democrats win back the House this year, adding “it’s all on the table." Pelosi has long backed a public option for health insurance, but has not supported going further — as many Democrats want — and setting up government-run, universal health insurance. (Sullivan, 6/7)

The Hill: Poll: Health Care A Top Issue For Voters Ahead Of Midterms 
More than 1 in 5 voters, 22 percent, said in a new NBC News–Wall Street Journal poll that health care is their top issue in the November midterm elections. The economy and jobs followed at 19 percent, with guns at 13 percent, taxes and spending at 11 percent and immigration at 10 percent. The poll found Democrats are more likely to consider health care a top issue. (Hellmann, 6/7)

The New York Times: House Votes To Trim Unused Funding, A Gesture Of Fiscal Restraint
With annual budget deficits nearing $1 trillion, the House took a modest step on Thursday to broadcast fiscal responsibility, narrowly approving a White House plan to rescind nearly $15 billion in unspent funding that had been approved in past years. The bill would reduce actual spending by a total of $1.1 billion from 2018 to 2028, according to the Congressional Budget Office, a small act of penance after Congress approved a $1.5 trillion tax cut in December, then a $1.3 trillion spending plan in March whose heft exasperated conservatives. The new bill would have little practical effect, given that much of the funding was not expected to be spent anyway. (Kaplan, 6/7)

The Associated Press: Trump Plan To Cut $15B In Spending Squeaks Through House
While Democrats blasted the cuts, the real objection to some of them, such as $7 billion from popular Children's Health Insurance Program funding, is that it would take that money off the table so it couldn't be used later as it was in the earlier spending bill. The CHIP cuts wouldn't affect enrollment in the program, which provides health care to children from low-income families that don't qualify for Medicaid. "Targeting CHIP for a rescission prevents Congress from reinvesting in other priorities like child and maternal health, early childhood education, biomedical research and our community health centers," said New York Rep. Nita Lowey, the top Democrat on the Appropriations Committee. (Taylor, 6/7)

The Associated Press Fact Check: Trump's Overhaul Of Vets Care Is No Quick Fix
President Donald Trump is setting up veterans for likely disappointment as he tells them they have freedom to get quick medical care from private doctors when they're unhappy with government-run health care. He is casting a bill that he signed into law Wednesday as an immediate cure-all to long wait times for medical treatment. But he glosses over the fact that the private-sector program often takes longer to provide care than Department of Veterans Affairs medical centers. Trump also neglects to mention that the White House is opposing a plan to fund the newly expanded Choice program, which could see escalating costs as more veterans seek the flexibility of picking their own doctors. (6/7)

Reuters: U.S. Suicide Rates See Sharp Increase From 1999 To 2016: CDC
Suicide rates rose in nearly every U.S. state from 1999 to 2016, with the rate spiking by more than 30 percent in half of the country, the Centers for Disease Control and Prevention (CDC) reported on Thursday. Though mental health is often blamed for suicides, more than half of the people who took their own lives in 27 states in 2015 had not been diagnosed with a mental illness, the CDC said. (Brice, 6/7)

The New York Times: Defying Prevention Efforts, Suicide Rates Are Climbing Across The Nation
The new analysis found that nearly 45,000 Americans aged 10 or older died by their own hand in 2016. The increase varied widely by state, from a low of 6 percent in Delaware to more than 57 percent in North Dakota. The rate declined in just one state, Nevada, where it has historically been higher than average. Social isolation, lack of mental health treatment, drug and alcohol abuse and gun ownership are among the factors that contribute to suicide. Suicide is the tenth leading cause of death in the United States, and one of three that is increasing. The other two are Alzheimer’s disease and drug overdose, in part because of the spike in opioid deaths, said Dr. Anne Schuchat, principal deputy director of the C.D.C. (Carey, 6/7)

Los Angeles Times: Suicides Have Increased By More Than 30% Since 1999 In Half The States, CDC Says
In a closer look at suicides in 2015, CDC researchers found that 29.4% took place within two weeks of a crisis — most commonly a breakup or other problem related to an intimate-partner relationship. Among the less-common factors presumed to have contributed to the suicides studied were physical health problems, legal difficulties, a family relationship issue or a job-related problem. (Healy, 6/7)

The Washington Post: Suicide Rates Rise Sharply Across The United States, New Report Shows
“The data are disturbing,” said Anne Schuchat, the CDC's principal deputy director. “The widespread nature of the increase, in every state but one, really suggests that this is a national problem hitting most communities.” It is hitting many places especially hard. In half of the states, suicide among people age 10 and older increased more than 30 percent. “At what point is it a crisis?” asked Nadine Kaslow, a past president of the American Psychological Association. “Suicide is a public health crisis when you look at the numbers, and they keep going up. It’s up everywhere. And we know that the rates are actually higher than what’s reported. But homicides still get more attention.” (Nutt, 6/7)

The Wall Street Journal: CDC Finds Rise In Suicide Rates Across The U.S.
“We have a long way to go to strengthen our community and health systems to make sure when someone is at risk we get them to care,” said Jerry Reed, an executive committee member of the National Action Alliance for Suicide Prevention. The alliance is working with more than 250 hospitals to ensure that someone brought in after a suicide attempt is connected to long-term mental-health care, Dr. Reed said. Churches, schools and police also need to get better at recognizing people at risk for suicide and helping them get treatment or feel less isolated, he said. Limiting access to guns for people who are unwell is also a priority, he said. “We have to ask people who are at risk if they have a firearm, and while they’re in recovery or treatment, recommend safe storage of that firearm,” he said. “It might be a good idea while they’re in treatment if someone could hold onto that firearm.” (Whalen, 6/7)

NPR: U.S. Suicide Rates Rise By More Than 30 Percent In Half Of States Since 1999
"So it's not just about firearms, it's also about other methods of suicide such as hanging, suffocation, poisoning and the like," she said. "We are concerned with all aspects of suicide prevention, including access to lethal means, and so we do include that in a comprehensive approach to suicide prevention." But Anestis believes that it's important to not beat around the bush when it comes to guns and to talk about the importance of things like setting waiting periods for purchase, and storing guns locked and unloaded. (Greenfieldboyce, 6/7)

The New York Times: Kate Spade’s Suicide Prompts Self-Disclosure And An Outpouring Of Empathy
When news of Kate Spade’s suicide broke Tuesday morning, many readers responded with an outpouring of empathy and support for both Ms. Spade and her family. The death also prompted several Times commenters to reflect on how their own lives had been touched by a similar experience. Many of those readers discussed their personal experiences with suicidal depression and stories of relatives and friends who had taken their own lives. (Moore, 6/7)

The New York Times: What To Do When A Loved One Is Severely Depressed
Reports of Kate Spade’s suicide and struggle with depression have transformed her from symbol of polished prep to a blunt reminder that suffering affects all types. Her death has inspired hundreds to tweet some version of the same message: Mental illness is nothing to be ashamed of. (Murphy, 6/7)

Reuters: U.S. Expands China Health Alert Amid Illness Reports
The U.S. State Department on Friday issued an expanded health alert for all of China amid reports some U.S. diplomats based in the country had experienced a mysterious malady that resembles a brain injury and has already affected U.S. personnel in Cuba. A previous statement in May only mentioned the southern Chinese city of Guangzhou as the location for the health alert, though it was sent to U.S. citizens throughout the country. (Martina, 6/8)

The New York Times: U.S. Issues Alert To Americans In China In Wake Of Sonic Attack Fears
The alert, posted on the department’s website, said those who suspected that they had such symptoms should not try to locate the source of any “unidentified auditory sensation” and should seek medical care as soon as possible. More than two million American citizens travel to China each year, and about 175,000 Americans hold Chinese resident visas. The advisory came after at least two employees at the United States Consulate in the southern city of Guangzhou, who showed symptoms similar to those suffered by American diplomats in Cuba in 2016, were flown out this week for testing by specialists at the University of Pennsylvania. (Perlez and Myers, 6/8)

The Associated Press: White House Launches Anti-Opioid Ad Campaign Aimed At Youth
The White House launched a series of new advertisements Thursday aimed at warning young people about the dangers of opioids, taking another step in the effort to turn the tide against the deadly epidemic. The White House said its first public service campaign would include several partners, including the Ad Council and the Truth Initiative, surrounding four new ads featuring the true stories of young people who have battled addiction. (Thomas, 6/7)

The Associated Press: Superbug Infections Rising Among Injection Drug Users
One type of superbug bacteria is increasingly spreading among people who inject drugs, according to a new government report. Users of heroin and other injection drugs were 16 times more likely than other people to develop severe illnesses from MRSA, said the report published Thursday. "Drug use has crept up and now accounts for a substantial proportion of these very serious infections," said Dr. William Schaffner of Vanderbilt University, one of the study's authors. (Stobbe, 6/7)

The Associated Press: Lawsuit: Washington Jail Must Provide Addiction Treatment
In a novel case that could have national implications, the Washington state chapter of the American Civil Liberties Union sued a county sheriff's office to force it to provide opiate-withdrawal medication to prisoners, rather than requiring them to go cold turkey. The lawsuit, filed Thursday in U.S. District Court in Seattle, says the Whatcom County Jail's refusal to provide the medicine violates the Americans with Disability Act, because opioid addiction qualifies as a disability under the law. Prisoners suffering from opioid addiction are as entitled to medication as those with any other condition requiring medical treatment, the lawsuit says. (Johnson, 6/7)

Stat: Pressure Mounts On Drug Makers To Move Birth Control Over The Counter
Drug makers are facing growing pressure to sell contraception without a prescription. And this weekend, the nation’s largest physicians group could join in the chorus calling to expand access to birth control. At the American Medical Association’s annual meeting in Chicago, delegates will vote on a resolution to encourage contraceptive makers to submit applications to the Food and Drug Administration to switch the status of their pills from prescription to over the counter. If it passes, the new policy would be directed more squarely at drug makers than the AMA’s current policy, which focuses on the FDA’s role. (Thielking, 6/8)

Stat: Lundbeck Will Pay $52 Million For Illegally Using A Charity To Assist Patients
Yet another drug maker has agreed in principle to pay a stiff fine to resolve an investigation into its relationships with patient charities. The latest company to do so is the U.S. subsidiary of Lundbeck (HLUYY), a Danish drug maker that will fork over $52.6 million. The announcement comes two years after the U.S. Attorney issued a subpoena in connection with an investigation of payments that Lundbeck made to an unspecified number of charities that provided financial assistance to patients taking various medicines. (Silverman, 6/7)

The New York Times: Blood Test Might Predict Pregnancy Due Date And Preterm Birth
Scientists have developed an inexpensive blood test to predict a pregnant woman’s due date and possibly identify women who are at risk of giving birth prematurely. The research, which is still preliminary and involved small numbers of women, was led by a prominent pioneer in the field of genetic blood testing, Stephen Quake at Stanford University, who said the test could eventually provide a low-cost method of gauging the gestational age of a developing fetus. (Belluck, 6/7)

Stat: Blood Test Might Help Predict Both Preterm And Healthy Delivery Dates
“It’s really hard to understate the potential of what these folks are proposing,” said Dr. Thomas McElrath, a maternal-fetal medicine specialist at Brigham and Women’s Hospital and an associate professor at Harvard Medical School in Boston. “The potential for how that may feed into care and into research and into furthering not just maternal but neonatal outcomes is huge. We’re just probably beginning to get a sense of what that may involve.” (Weintraub, 6/7)

The Associated Press: Study Says Vaping By Kids Isn't Up, But Some Are Skeptical
Vaping held steady last year in high school students and declined in middle school kids, according to new government data, but some researchers are skeptical because the survey may have missed out on a booming e-cigarette brand. The Centers for Disease Control and Prevention survey did not specifically ask about Juul e-cigarettes, and research suggests some kids don't equate the trendy devices with other types of e-cigarettes. (6/7)

The New York Times: Tonsillectomy Risks May Outweigh Benefits
More than 530,000 children have their tonsils or adenoids removed in the United States each year to prevent recurrent infections and sleep or breathing disorders. But a new study suggests that the surgery may have long-term risks that in some cases outweigh any short-time benefits. The report, in JAMA Otolaryngology — Head and Neck Surgery, compared 60,667 Danish children under 9 who had tonsillectomies, adenoidectomies or both with 1.1 million who had not had the surgeries. They were born between 1979 and 1999, and researchers followed their health for up to 30 years. (Bakalar, 6/7)

The New York Times: Depression In Older People Tends To Be More Severe
Depression in older people tends to be more severe, last longer and be less likely to remit than the same disease in younger people, a new study concludes. The reason remains unknown, but it is apparently unconnected to known risk factors like social isolation or the chronic diseases of old age. In a study published in Lancet Psychiatry, Dutch researchers followed 1,042 people ages 18 to 88 with diagnoses of major depression. They tracked four indicators of disease over two years: the likelihood of still having the diagnosis at the end of the study, how persistent symptoms were over time, the likelihood of reaching remission and the degree of improvement in depression severity. (Bakalar, 6/7)

Stat: A Set Of Ancient Teeth Unlock A Bacterial Secret About The Bubonic Plague
Nearly 4,000 years ago, a woman and a man were buried together just east of the Volga River in modern-day Russia, with a secret locked away in the pulp of their teeth. The bodies were uncovered just a few years ago, the teeth pulled and sent westward to the Max Planck Institute in Germany, where Maria Spyrou was working on a Ph.D. in paleogenetics. When she subjected the pulp to a bevy of genetic tests, she found something surprising: an ancestor of the bacteria responsible for the Black Death. (Swetlitz, 6/8)

The Associated Press: E-Cigarette Sellers Turn To Scholarships To Promote Brands
A growing number of e-cigarette and vaporizer sellers have started offering college scholarships as a way to get their brands listed on university websites and to get students to write essays about the potential benefits of vaping. The tactic is taken from a method that was once believed to improve a site's ranking in search results, and it has successfully landed vaping brands on the sites of some of the nation's best-known universities, including Harvard. It also has drawn criticism that the scholarships are a thinly disguised ploy to attract young customers. (6/8)

The Hill: Virginia Governor Signs Medicaid Expansion Into Law 
Virginia Gov. Ralph Northam (D) on Thursday signed a budget that includes Medicaid expansion, making Virginia the 33rd state to expand the program under ObamaCare. The signing caps a years-long battle in the state over Medicaid expansion, which Democrats have pushed for but Republicans long resisted. After Democratic gains in the state legislature and Northam’s victory last year, enough Republicans got on board with Medicaid expansion for it to pass the General Assembly. (Sullivan, 6/7)

The Washington Post: Northam Signs Medicaid Expansion Into Law On Steps Of Virginia Capitol
With his signature, Northam (D) brought a Medicaid battle that raged for four years under his predecessor to an upbeat, bipartisan close. Immediately afterward, he rewarded two senators who had been crucial to the bill’s passage — Democrat Richard L. Saslaw (Fairfax County) and Republican Emmett W. Hanger (Augusta) — with ceremonial pens used to sign the bill. “We showed Virginia and the world that chaos and partisan warfare may dominate Washington, but here in Richmond, we still work together to do the right thing for our people, not our political party,” Northam told hundreds of activists and about 30 legislators at the ceremony. Expansion takes effect Jan. 1. (Vozzella, 6/7)

The Associated Press: Medicaid Work Requirement Bill Sent To Michigan Governor
The Republican-led Michigan Legislature on Thursday gave final approval to a bill requiring able-bodied adults in the state's Medicaid expansion program to meet work or job-related requirements, sending it to Gov. Rick Snyder for his expected signature. Starting in 2020, adults age 18 to 62 would have to show workforce engagement averaging 80 hours a month — through work, school, job or vocational training, an internship, substance abuse treatment or community service. Michigan would first seek a federal waiver to implement such requirements that have been embraced by President Donald Trump's administration. (Eggert, 6/7)

The Associated Press: Records: Louisiana Spent Over $1M Defending Abortion Laws
Louisiana has spent more than $1 million to defend its abortion restrictions against a series of lawsuits since 2014, according to documents obtained by The Associated Press through open-records requests. And it's set to spend even more. Contracts with private law firms show the state repeatedly adding thousands of dollars to the agreements, extending them as the cases drag on while Louisiana fights to implement anti-abortion policies that have been halted by the courts. State officials say they'll keep spending to defend their laws. They say you can't put a price tag on human life. (Izaguirre, 6/7)

The Associated Press: Iowa Judge Rules Transgender Women Deserve Surgery Coverage
Iowa cannot deny two transgender women Medicaid coverage for sex reassignment surgery, a state court judge ruled Thursday, declaring a policy denying their care violates the Iowa Constitution and its civil rights law. Carol Ann Beal of northwest Iowa and EerieAnna Good of the Quad Cities in eastern Iowa filed the lawsuit last year after their Medicaid provider and the Iowa Department of Human Services denied surgery requests recommended by doctors. (Pitt, 6/7)

The Associated Press: Ohio State Says More Victims In Alleged Doctor Misconduct
Former student-athletes from more than a dozen Ohio State sports teams have now reported alleged sexual misconduct by a university doctor who died in 2005. Investigators have scheduled or conducted interviews with more than 130 people who said they have information about possible misconduct by Dr. Richard Strauss, the university said Thursday. Reports also came from former non-athlete patients of the student health center. (6/7)

The New York Times: Doctor Who Danced During Surgery Is Suspended By Georgia Medical Board
A dermatologist who can be seen on video dancing to the hip-hop song “Cut It” while performing a surgical procedure was suspended on Thursday by the Georgia medical board, which said her continued practice “poses a threat to the public health, safety, and welfare.” The dermatologist, Dr. Windell Davis-Boutte, is the medical director and chief executive of Boutté Contour Surgery & Skin in Lilburn, Ga., an Atlanta suburb. On her website she describes herself as a “DOCTOR TO THE STARS!” — someone with “a surgeon’s hands” and “a woman’s touch.” (Caron, 6/7)