First Edition: March 13, 2019

Kaiser Health News: How To Zero In On Your Final, Forever Home While Skirting Disaster
When Martha Powers and Larry Gomberg heard the news about Hurricane Florence bringing horrific winds and catastrophic flooding to Wilmington, N.C., they grimaced. Then, they felt relieved.“What if we had decided to build our retirement home there?” they said to each other in September, when the storm was making headlines. “What if our brand-new home had flooded?” (Lloyd, 3/13)

Kaiser Health News: New Health Plans Expose The Insured To More Risk
One health plan from a well-known insurer promises lower premiums but warns that consumers may need to file their own claims and negotiate over charges from hospitals and doctors. Another does away with annual deductibles but requires policyholders to pay extra if they need certain surgeries and procedures. Both are among the latest efforts in a seemingly endless quest by employers, consumers and insurers for the holy grail: less expensive coverage. (Appleby, 3/13)

The New York Times: National Cancer Chief, Ned Sharpless, Named F.D.A.’s Acting Commissioner
Dr. Norman E. “Ned” Sharpless, director of the National Cancer Institute, will serve as acting commissioner of the Food and Drug Administration, Alex M. Azar III, secretary of health and human services, announced on Tuesday. Dr. Sharpless temporarily will fill the post being vacated by Dr. Scott Gottlieb, who stunned public health experts, lawmakers and consumer groups last week when he abruptly announced that he was resigning for personal reasons. (Kaplan, 3/12)

The Wall Street Journal: National Cancer Institute Director Ned Sharpless To Be Acting FDA Commissioner
Dr. Sharpless, a native of Greensboro, N.C., studied math at UNC-Chapel Hill, where he also got his medical degree before completing his internship and residency at Massachusetts General Hospital in Boston. He was a clinical and research fellow at Dana-Farber Cancer Institute in Boston. Dr. Sharpless is the candidate favored by Dr. Gottlieb for the permanent job of FDA commissioner, according to a person familiar with the issue. Dr. Giroir has been backed by Mr. Azar, the person said. Dr. Giroir declined to comment. (Burton, 3/12)

Reuters: National Cancer Institute Chief To Serve As Acting FDA Head
"We have no doubt that Dr. Sharpless will continue to navigate and direct the FDA in a manner that best benefits patients, and we look forward to executing critical work with him in his new role," Ellen Sigal, founder and chair of Friends of Cancer Research, said in a statement. The search for a permanent FDA chief is still under way. (3/12)

The Washington Post: Nation’s Cancer Chief Appointed Acting FDA Commissioner
Part of Sharpless’s appeal is that he could start at the FDA relatively quickly. It’s also possible he would be nominated as permanent commissioner later. He has never been confirmed by the Senate — which is not required for the National Cancer Institute post or acting head of the FDA. But as a presidential appointee, he has been extensively vetted and has divested himself of financial holdings that could pose conflicts of interest. Sharpless has contributed to a number of Democratic candidates, including a total of $750 to Barack Obama’s 2008 and 2012 presidential campaigns, according to Federal Election Commission records. (McGinley and Goldstein, 3/12)

Politico: Cancer Institute Director Named Acting FDA Commissioner
Azar said in a statement that Sharpless’ "deep scientific background and expertise" will make him a strong leader for FDA. He added, "There will be no let-up in the agency’s focus, from ongoing efforts on drug approvals and combating the opioid crisis to modernizing food safety and addressing the rapid rise in youth use of e-cigarettes.” (Owermohle, 3/12)

The Associated Press: NIH Cancer Chief To Serve As Acting FDA Commissioner
Last Tuesday, Gottlieb said he would step in down in April after less than two years leading the FDA, a massive public health agency that regulates the food, drug, medical device and tobacco industries, among others. He was widely viewed as one of President Donald Trump’s most effective administrators, serving as a key messenger on the federal response to rising drug prices, the opioid epidemic and underage use of e-cigarettes. (Perrone, 3/12)

The New York Times: Congress Warns Against Medicaid Cuts: ‘You Just Wait For The Firestorm’
If President Trump allows states to convert Medicaid into a block grant with a limit on health care spending for low-income people, he will face a firestorm of opposition in Congress, House Democrats told the nation’s top health official on Tuesday. The official, Alex M. Azar II, the secretary of health and human services, endured more than four hours of bipartisan criticism over the president’s budget for 2020, which would substantially reduce projected spending on Medicaid, Medicare and biomedical research. (Pear, 3/12)

Modern Healthcare: Trump's Medicaid Budget Plan Could Hit States, Enrollees Hard
The $1.5 trillion Medicaid cuts and the national work requirement in President Donald Trump's new proposed budget inject fresh uncertainty into the fate of current state efforts by Republicans to overhaul the healthcare program for poor and disabled Americans. While details in the budget document are sparse, it appears the administration wants to replace the existing state waiver process for testing changes with a new national program granting states unfettered flexibility to customize their Medicaid programs, accompanied by tight federal spending caps. That's similar to the Senate Republicans' Graham-Cassidy plan to repeal and replace the Affordable Care Act in 2017, which failed to pass. (Meyer, 3/11)

The Associated Press: Trump's Cuts To Medicare Hospital Payments Trigger An Outcry
Democrats are accusing President Donald Trump of going back on his campaign promise to protect Medicare after he introduced a 2020 budget that calls for steep cuts in Medicare payments to hospitals. The budget embodies long-standing Republican ambitions "to make Medicare wither on the vine," House Speaker Nancy Pelosi said Tuesday. (3/12)

The Hill: Analysis: Just A Tenth Of Trump's Proposed Medicare Cuts Directly Affect Seniors
Only about a tenth of the proposed Medicare cuts in President Trump’s budget would directly impact seniors, according to a new analysis. The analysis from the Committee for a Responsible Federal Budget (CRFB) finds that the vast majority of the Medicare cuts in Trump’s budget, released on Monday, are to payments to hospitals and doctors, not cuts to benefits for seniors on the program. (Sullivan, 3/12)

The New York Times: Trump’s Proposed Budget Undermines His H.I.V. Plan, Experts Say
President Trump’s 2020 budget request of an extra $291 million to fight the spread of H.I.V., experts said on Tuesday, will not be remotely sufficient to meet the goal he announced in his State of the Union address: to nearly eliminate the AIDS epidemic in the United States within 10 years. Mr. Trump’s plan focuses on 48 counties where about half of new infections occur, and seeks to cut the rate of new infections by 90 percent — from about 40,000 a year to about 4,000. (McNeil, 3/12)

The New York Times: Treated Like A ‘Piece Of Meat’: Female Veterans Endure Harassment At The V.A.
Corey Foster spent her Army career caring for wounded troops, both as a flight medic in the Iraq war and at Walter Reed hospital, so she looked forward to one of the most celebrated benefits of military service — health care for life from the Department of Veterans Affairs. Then she walked through the door at a V.A. medical center in Temple, Tex. “You felt like you were a piece of meat,” said Ms. Foster, 34, who retired as a sergeant. “Standing in line at the registration desk, I was getting comments from the male patients behind me, looking me up and down. It was a major source of discomfort.” (Steinhauer, 3/12)

The Associated Press: New Pentagon Transgender Rule Sets Limits For Troops
The Defense Department has approved a new policy that will largely bar transgender troops and military recruits from transitioning to another sex, and require most individuals to serve in their birth gender. The memo outlining the new policy was obtained Tuesday by The Associated Press, and it comes after a lengthy and complicated legal battle. (3/12)

ProPublica: After Controversy, Heartland To Close Four Illinois Shelters For Immigrant Youth
Eight months after its shelters for immigrant children came under public scrutiny over allegations of abuse and lax supervision, Heartland Human Care Services says it will close four shelters in suburban Chicago and add staff, training and other resources at its remaining five facilities. The decision, announced to employees in a memo Friday, comes as another agency, Maryville Academy, plans to open two additional shelters, including one as early as next month. (Sanchez, Eldeib and Cohen, 3/13)

The Associated Press: Pentagon Seeks Base Site To House 5,000 Migrant Children
The Defense Department is reviewing a number of military bases to find a location that can house up to 5,000 unaccompanied migrant children as the U.S. braces for a surge of people crossing the U.S.-Mexico border this spring. The Department of Health and Human Services submitted the request for space late last week, as Homeland Security leaders warned that tens of thousands of families are crossing the border each month. That flow, said Homeland Security Secretary Kirstjen Nielsen, will grow worse this spring as the weather gets better. (3/12)

The Associated Press: Trump Vs. California Immigration Suit Heads To Appeals Court
The Trump administration will try to persuade a U.S. appeals court on Wednesday to block California laws aimed at protecting immigrants, seeking a win in one of numerous lawsuits between the White House and the Democratic-dominated state. At issue in the hearing before the 9th U.S. Circuit Court of Appeals is a 2018 administration lawsuit over three California laws that extended protections to people in the country illegally. (3/13)

The Associated Press: Senator Tours Florida Teen Detention Camp He Wants Shut Down
A Democratic senator from Oregon advocating against migrant youth detention camps says he toured a Florida facility and found children are being held there for too long in a restrictive environment. U.S. Sen. Jeff Merkley said that he talked to three boys who also confirmed reports that employees told teenagers they would not be reunited with family if they misbehaved. (3/12)

The New York Times: UnitedHealthcare Will Expand A Drug Discount Program Aimed At Lowering Consumer Costs
The insurance giant UnitedHealthcare said Tuesday that it will expand a program that passes drug discounts directly to consumers, a move that could lower costs for many who have struggled with high deductible payments and other out-of-pocket expenses. United said the plan would take effect next year and would be required for all new employer clients, although existing clients would be permitted to continue under the older system. Those clients will be “encouraged” to adopt the new plan when their contracts expire, but will not be required to do so, according to Matthew Stearns, a spokesman for OptumRx, the pharmacy benefit manager that is owned by United. (Thomas, 3/12)

The Wall Street Journal: UnitedHealth To Require Drug Rebates Go To Consumers
The move goes further than other major pharmacy-benefit managers, which haven’t made it mandatory to pass rebates on to consumers, according to UnitedHealth and industry consultants. The Trump administration has proposed a parallel approach that would affect Medicare and Medicaid plans, which pharmacy-benefit managers have generally opposed. “We’re focused on making sure the value we’re negotiating on behalf of our clients is passed on to the consumer,” said John Prince, chief executive of OptumRx. The move to make the shift mandatory for new clients “is a huge statement to the market,” he said. UnitedHealth officials say the employer-plan situation is different from Medicare, where shifting the rebate treatment could force up premiums significantly. (Wilde Mathews, 3/12)

The Associated Press: UnitedHealthcare Broadens Direct Drug Rebate Program
UnitedHealthcare said about a year ago that rebates would start shifting directly to the customer filling prescriptions for people covered by employer-sponsored health coverage that is fully insured. That's generally small employers. The insurer said that the initial program lowered drug costs by an average of $130 per prescription. UnitedHealthcare said Tuesday that its expanded requirement does not apply to existing employer customers that do not already give rebates directly to the consumer. (3/12)

Reuters: U.S. Congress Invites Pharmacy Benefit Managers To Third Drug Pricing Hearing
The U.S. Senate Finance Committee has invited executives from five pharmacy benefit managers to testify on April 3 on the rising costs of prescription medicines, in Congress's latest effort to question industry officials directly over an issue voters consistently cite as a top concern. Pharmacy benefit managers (PBMs) administer drug benefits for employers and health plans and also run large mail-order pharmacies. Drugmakers say they are under pressure to provide rebates to the handful of PBMs dominating the market to get their products included on preferred coverage lists. (3/12)

Stat: Senate Finance Committee Leaders Call 5 PBMs To Testify About Drug Prices
The hearing is the latest development in Grassley and Wyden’s ongoing and bipartisan investigation into high drug prices. The pair has already convened two hearings and launched an investigation into insulin pricing, actions that are quickly distinguishing the Senate Finance Committee as Congress’ most active body on the issue. (Florko, 3/12)

The New York Times: New Generic Blood Pressure Drug Is Approved To Relieve Shortages
The Food and Drug Administration said on Tuesday that it had approved a new generic version of the widely used blood pressure drug Diovan, or valsartan, which has been in short supply following recalls made because of chemical contamination. The new version is being made by Alkem Laboratories Limited, based in Mumbai, India. (Grady, 3/12)

The Wall Street Journal: Head Of U.S. Indian Health Agency Vows To Fix Issues That Allowed Pedophile Doctor To Evade Punishment
The top U.S. Indian Health Service official pledged before Congress on Tuesday to fix problems that allowed a doctor who sexually abused children while working for the agency to evade punishment. The remarks by Rear Adm. Michael Weahkee came as lawmakers pressed him on the broadening fallout after a joint investigation by The Wall Street Journal and the PBS series Frontline revealed the agency had mishandled the pedophile pediatrician for decades. (Weaver and Frosch, 3/12)

The Associated Press: Federal Appeals Court OKs Ohio Law Aimed At Abortion Funding
A divided federal appeals court Tuesday upheld an Ohio anti-abortion law that blocks public money for Planned Parenthood. The full 6th U.S. Circuit Court of Appeals reversed a lower federal court ruling. The Ohio law targeted funding that Planned Parenthood receives through the state's health department. That money is mostly from the federal government and supports education and prevention programs. (3/12)

Reuters: Appeals Court Says Ohio May Withhold Planned Parenthood Funding
"The affiliates are correct that the Ohio law imposes a condition on the continued receipt of state funds," Circuit Judge Jeffrey Sutton wrote for the majority. "But that condition does not violate the Constitution because the affiliates do not have a due process right to perform abortions." Sutton also found no proof the ban posed an undue burden on a woman's right to abortion, a right he said belonged to women, not to Planned Parenthood. (3/12)

Politico: Appeals Court Rules Ohio Can Defund Planned Parenthood
The case was one of several across the country addressing attempts to cut public dollars to Planned Parenthood and other providers who offer abortions in addition to a range of health care services. The 6th Circuit's ruling affects six state public health programs in Ohio, but doesn't touch Medicaid. The Supreme Court in December declined to review a case brought by other Republican-led states seeking to cut off Medicaid funding for Planned Parenthood and other reproductive health organizations that offer abortions. More than 20 states additionally have brought legal challenges over a Trump administration rule cutting tens of millions of dollars in Title X funding from Planned Parenthood and other abortion providers. (Ollstein, 3/12)

The Hill: House Dems To Push Pelosi For Vote On Bill That Would Allow Federal Funding Of Abortion
Abortion rights leaders in Congress will ask House Speaker Nancy Pelosi (D-Calif.) to hold a vote on a bill that would allow abortion coverage to receive federal funding. The bill would repeal a long-standing ban on abortion coverage in federal health programs like Medicaid.  (Hellmann, 3/12)

NPR: Purdue Pharma And Other Drug Companies Fight Opioid Disclosure
America's big drugmakers and pharmacy chains are scrambling to respond to hundreds of lawsuits tied to the deadly opioid epidemic. Billions of dollars are at stake if the companies are found liable for fueling the crisis. Even before judgments are rendered, companies like Purdue Pharma, Johnson & Johnson and CVS are already suffering damage to their reputations as evidence in civil suits reveals more about their internal workings. "The narrative is clearly shifting on this story," said David Armstrong, a senior reporter with ProPublica, who has covered the drug industry for years. "People want some sort of reckoning, some sort of accounting." (Mann, 3/13)

The Washington Post: How Fentanyl Triggered The Deadliest Drug Epidemic In U.S. History
Fentanyl, a powerful painkiller, has become the leading cause of overdose deaths in America. It’s 50 times more powerful than heroin and up to 100 times more powerful than morphine. (3/13)

The Washington Post: Baltimore Begins Construction On Center For Those With Substance-Use Disorders
Work began Friday to convert an old hospital building in West Baltimore into a facility that will provide a place for people using drugs or alcohol to sober up and perhaps get a jump-start on their way to treatment. The crisis stabilization center will be the first of its kind in the city and one of only a few nationally. It aims to divert some of the 16,000 people who go to hospital emergency rooms in Baltimore every year because of drugs and alcohol even when they do not need acute medical care. (Cohn, 3/12)

The Associated Press: Delaware Doctor Accused Of Trading Opioids For Sexual Favors
A Delaware doctor is accused of prescribing opioids in exchange for sexual favors to a female patient who was undergoing treatment for long-term drug addiction. The News Journal of Wilmington reports Deputy Attorney General Zoe Plerhoples said during an administrative hearing Monday that Nihar B. Gala’s behavior at several walk-in medical centers in 2017 endangered the patient. The state has asked for an administrative hearing officer to recommend the Board of Medical Licensure and Discipline revoke Gala’s medical license. (3/13)

The Hill: CDC Reports 228 Measles Cases In 12 States 
The Centers for Disease Control and Prevention (CDC) has confirmed 228 cases of measles in 12 states so far this year. The CDC has identified six outbreaks, which it defines as three or mores cases, in New York, Washington, Texas, Illinois and California. The cases are linked to unvaccinated American travelers bringing measles back into the U.S. from other countries where large measles outbreaks are occurring, such as Israel and Ukraine, the CDC says. (Hellmann, 3/12)

The New York Times: For Larger Customers, Eating Out Is Still A Daunting Experience
Rebecca Alexander’s worst experience dining while large happened just after she nailed a promotion at a nonprofit organization. She took her staff, and her new boss, to lunch at a promising downtown restaurant in Portland, Ore., where she lives. As the hostess led the group to a booth, Ms. Alexander, a 31-year-old who wears a size 30, knew in an instant there was no way she was going to squeeze into it. (Severson, 3/12)

The Wall Street Journal: Hysterectomy-Tool Warnings Didn’t Trigger Long-Term Return To Open Surgery
Warnings about the cancer-spreading risks associated with power morcellators and the subsequent decline in the devices’ use haven’t triggered a sustained rise in open surgery for hysterectomy patients as some critics feared, a new study has found. Surgeons once widely used power morcellators to slice tissue for removal through small incisions, often during hysterectomies for women with benign growths called fibroids. The U.S. Food and Drug Administration warned in April 2014 that the tools can inadvertently spread uterine cancer that can’t be reliably detected before surgery. (Kamp, 3/12)

Stat: Bill Aims To Balance Teen Authority And Parental Say In Mental Health
More than three decades ago, lawmakers in Washington state set the age of consent for mental health care at 13 to make it possible for teenagers to seek treatment without needing to involve their parents. That law also lets anyone over age 13 refuse mental health care — and keep all the details about their treatment private. ...Parents have pushed for change for years, arguing that the measure has hamstrung their ability to help their teenagers who urgently need mental health care, but aren’t willing or ready to go to treatment on their own. Now, Washington lawmakers are poised to give parents more rights — while still trying to strike a delicate balance that gives teens authority over their own mental health care. (Thielking, 3/13)

The New York Times: Children May Be Grown, But Parenting Doesn’t Seem To Stop
Bribing SAT proctors. Fabricating students’ athletic credentials. Paying off college officials. The actions that some wealthy parents were charged with Tuesday — to secure their children a spot at elite colleges — are illegal and scandalous. But they’re part of a broader pattern, albeit on the extreme end of the continuum: parents’ willingness to do anything it takes to help their grown children succeed. As college has become more competitive and young adults’ economic prospects less assured, parents have begun spending much more time and money on their children — including well after they turn 18. (Quealy and Miller, 3/13)

The New York Times: Exercise Vs. Drugs To Treat High Blood Pressure And Reduce Fat
Exercise can lower blood pressure and reduce visceral body fat at least as effectively as many common prescription drugs, according to two important new reviews of relevant research about the effects of exercise on maladies. Together, the new studies support the idea that exercise can be considered medicine, and potent medicine at that. But they also raise questions about whether we know enough yet about the types and amounts of exercise that might best treat different health problems and whether we really want to start thinking of our workouts as remedies. (Reynolds, 3/13)

The New York Times: Pillsbury Flour Cases Are Recalled Over Salmonella Trace
The producers of Pillsbury Unbleached All-Purpose Flour, used by many home bakers, have voluntarily recalled 12,245 cases sold to retailers, after a random inspection revealed traces of salmonella in one bag. The cases, each of which contains about eight five-pound bags, were mostly sold to the Publix supermarket chain and to Winn-Dixie markets, both of which have branches throughout the Southeast. The cases have best if used by dates of either April 19, 2020, or April 20, 2020. (Hoffman, 3/12)

The New York Times: Capturing The Highs And Lows Of Bipolar Disorder Through Photography
When the medical journal The Lancet asked Matthieu Zellweger to photograph any psychiatric condition that intrigued him, he thought of a close friend who has been living with bipolar disorder. He knew how his friend lamented that it was an “invisible handicap” that you couldn’t just snap out of, as some well-meaning but frustrated people would suggest. But Mr. Zellweger also recognized something in his friend that led him to propose a photo essay on bipolar disorder. (Zellweger, 3/13)

The Associated Press: City Drops Lawsuit Against DC Hospital Over Closure
The attorney general of Washington, D.C., has dropped a lawsuit against an area hospital and its owner that was meant to prevent the hospital from ending most services. The Washington Post reported Tuesday that a judge dismissed the case against Providence Hospital and Ascension Health last week after D.C. Attorney General Karl A. Racine filed a motion to dismiss it. Racine’s motion said his office was satisfied with plans submitted by the hospital. (3/13)

The Associated Press: New York, Feds Join To Get 100K Rape Kits Tested Around US
Languishing evidence in over 100,000 sexual assault cases around the country has been sent for DNA testing with money from a New York prosecutor and federal authorities, spurring over 1,000 arrests and hundreds of convictions in three years, officials say. It’s estimated that another 155,000 or more sex assault evidence kits still await testing, and thousands of results have yet to be linked to suspects. Many who have been identified can’t be prosecuted because of legal time limits and other factors. (Peltz, 3/12)

The Wall Street Journal: Pittsburgh Air-Quality Problem Recalls The Bad Old Days
The air above this city is raising alarms once again. People who live in Allegheny County, which surrounds Pittsburgh, have lodged more than 2,300 air-quality complaints this year. For most of January, county officials urged residents in 22 municipalities in the Mon Valley nearby to limit outdoor activities out of concern for high levels of sulfur dioxide, and U.S. Steel has begun offering free health screenings. (Maher, 3/12)

The Associated Press: States Weigh Bans On Shackling Jailed Moms During Childbirth
Michelle Aldana gave birth to her first child chained to a hospital bed. Then serving time at the Utah state prison on a drug charge, she says she labored through the difficult 2001 birth for nearly 30 hours, her ankles bleeding as the shackles on both her legs and one arm dug in. "I felt like a farm animal," she says. (3/13)

The Associated Press: Blue Cross Insurers In N. Carolina, Oregon To Mix Leadership
Two Blue Cross Blue Shield insurers on both U.S. coasts will invest jointly in high-cost management technology and share insights into improving health care in a long-term agreement that will leave the companies as separate entities. Blue Cross Blue Shield of North Carolina and Portland, Oregon-based Cambia Health Solutions said Tuesday that they will share top executives but will keep separate their assets and insurance policies. Cambia's new board will be mixed. (3/12)

The Washington Post: California Gov. Gavin Newsom To Impose Moratorium On Death Penalty
California Gov. Gavin Newsom (D) on Wednesday will impose an indefinite moratorium on carrying out the death penalty, arguing that the cost, finality and racial imbalance among death-row inmates make the punishment immoral and a public policy “failure,” according to planned remarks released by his office. Newsom will suspend the practice through an executive order that will give a reprieve from execution — though not release — to California’s 737 death row inmates, about a quarter of the nation’s population awaiting capital punishment. The order will also annul California’s lethal injection protocol and close the execution chamber at San Quentin State Prison, where the state’s most notorious criminals have been put to death. (Wilson and Berman, 3/12)

Los Angeles Times: Gov. Gavin Newsom To Block California Death Row Executions, Close San Quentin Execution Chamber
The order will prevent the state from putting prisoners to death by granting temporary reprieves to all 737 condemned inmates on California’s death row, the largest in the nation. It will immediately close the execution chamber at San Quentin State Prison and scuttle the state’s ongoing efforts to devise a constitutional method for lethal injection. No inmate will be released and no sentence or conviction will be altered, the order says. (Willon, 3/12)

Politico: Newsom To Sign Moratorium On Executions In California
California has the largest number of condemned prisoners in the nation, representing one out of every four Death Row inmates in the United States. “I do not believe that a civilized society can claim to be a leader in the world as long as its government continues to sanction the premeditated and discriminatory execution of its people,’’ Newsom, a Democrat, said in a statement released late Tuesday. “In short, the death penalty is inconsistent with our bedrock values and strikes at the very heart of what it means to be a Californian.” (Marinucci, 3/12)