First Edition: March 15, 2019

Kaiser Health News: Nursing Home Fines Drop As Trump Administration Heeds Industry Complaints
The Trump administration’s decision to alter the way it punishes nursing homes has resulted in lower fines against many facilities found to have endangered or injured residents. The average fine dropped to $28,405 under the current administration, down from $41,260 in 2016, President Barack Obama’s final year in office, federal records show. The decrease in fines is one of the starkest examples of how the Trump administration is rolling back Obama’s aggressive regulation of health care services in response to industry prodding. (Rau, 3/15)

Kaiser Health News: Judge Vows To Rule On Medicaid Work Requirements By End Of March
U.S. District Judge James Boasberg, who last year blocked Kentucky’s work requirement, heard testimony on a revised federal approval. He also had a hearing on Arkansas’ Medicaid work requirement — which took effect last July and has led to 18,000 Medicaid enrollees losing coverage. After the court hearings in Washington, Boasberg said he would rule on both states’ programs by April 1, which is when the next round of Arkansas enrollees could be kicked off the program. Kentucky plans to implement its work requirement this summer. (Galewitz, 3/14)

Kaiser Health News: Broker Websites Expand Health Plan Shopping Options While Glossing Over Details
Some websites consumers use to buy their own health insurance don’t provide full information on plan choices or Medicaid eligibility, and appear to encourage selection of less comprehensive coverage that provides higher commissions to brokers, according to a report released Friday by the left-leaning Center on Budget and Policy Priorities. These direct-enrollment broker websites — including eHealth, ValuePenguin, GetInsured.com and some named after the insurance carriers they represent — are not the state-based marketplaces or the federal exchange, known as healthcare.gov. (Appleby, 3/15)

California Healthline: Students With Disabilities Call College Admissions Cheating ‘Big Slap In The Face’
For Savannah Treviño-Casias, this week’s news about the college admissions cheating scandal was galling, considering how much red tape the Arizona State University senior went through to get disability accommodations when she took the SAT. “It felt like such a big slap in the face,” said Treviño-Casias, 23, who was diagnosed in sixth grade with dyscalculia, a disability that makes it more difficult to learn and do math. “I was pretty disgusted. It just makes it harder for people who actually have a diagnosed learning disability to be believed.” (Feder Ostrov and Ibarra, 3/14)

The Associated Press: O'Rourke Begins 2020 Bid With Big Crowds, Centrist Message
Democrat Beto O'Rourke jumped into the 2020 presidential race Thursday, shaking up the already packed field and pledging to win over voters from across the political spectrum as he tries to translate his sudden celebrity into a formidable White House bid. The former Texas congressman began his campaign by taking his first ever trip to Iowa, the state that kicks off the presidential primary voting. In tiny Burlington, in southeast Iowa, he scaled a counter to be heard during an afternoon stop at a coffee shop. (3/14)

The New York Times: Where Beto O’Rourke Stands On The Issues
Mr. O’Rourke arguably first made his name when, after the shooting at the Pulse nightclub in Orlando in 2016, he live-streamed the sit-in he and other Democratic representatives were holding on the House floor in support of stricter gun laws. The Republican-controlled Congress did not pass any gun control legislation then, but Mr. O’Rourke continues to support similar policies, including universal background checks, magazine size limits and restrictions on some semiautomatic weapons. ... While Mr. O’Rourke supports universal health care — increasingly a litmus-test position for Democratic candidates — he hasn’t committed to a specific way to get there. During his Senate campaign, he suggested that universal health care could take the form of a single-payer system or “a dual system,” in which a government-run program would coexist with private insurance. He has given conflicting messages on the most prominent proposal, “Medicare for all.” (Astor, 3/14)

The Wall Street Journal: Beto O’Rourke’s Past GOP Ties Could Complicate Primary Run
Before becoming a rising star in the Democratic Party, Beto O’Rourke relied on a core group of business-minded Republicans in his Texas hometown to launch and sustain his political career. To win their backing, Mr. O’Rourke opposed Obamacare, voted against Nancy Pelosi as the House Democratic leader and called for a raise in the Social Security eligibility age. (Epstein, 3/14)

The Hill: Trump Officials Defend Medicaid Work Requirements In Court
The debate over Medicaid work requirements played out in a federal courtroom Thursday as the Trump administration defended its policies against opponents who say the measures are designed to prevent poor people from participating in the health care program. D.C. District Court Judge James Boasberg heard oral arguments in two separate cases challenging the administration’s approval of programs in Kentucky and Arkansas requiring people to work or volunteer 80 hours a month to keep their coverage. (Hellmann, 3/14)

The Hill: Trump Health Chief Reveals Talks With States On Medicaid Block Grants 
“We have discussions with states where they will come in and suggest ideas,” Azar said at a Senate hearing in response to questions from Sen. Bob Casey Jr. (D-Pa.). “There may be states that have asked about block granting, per capita, restructurings around especially expansion populations ... It's at their instigation.” (Sullivan, 3/14)

The Washington Post: Trump Pledges Support For Health Programs But His Budget Takes ‘Legs Out From Underneath The System’
As President Trump stood before a joint session of Congress for his State of the Union address in February, he urged Republicans and Democrats alike to support the audacious goal of stopping the spread of HIV within a decade. “Together, we will defeat AIDS in America and beyond,” he declared. The White House’s 2020 budget request, issued this week, does propose an additional $291 million as a down payment for a new HIV initiative. Yet the $4.7 trillion budget also calls for sharp spending reductions to Medicaid, the public insurance program for the poor on which more than 2 in 5 Americans with the virus depend. (Goldstein, McGinley and Sun, 3/14)

The Washington Post Fact Checker: Democrats Engage In ‘Mediscare’ Spin On The Trump Budget
The game is played this way: When the president’s budget is released, claim that any difference over 10 years between anticipated Medicare spending (what is known as the “baseline”) and changes in law intended to reduce spending are devastating “cuts” that will harm seniors who rely on the old-age program. But here’s the problem: Most of these anticipated savings are wrung from health providers, not Medicare beneficiaries. Hospitals and doctors may object, sometimes vehemently, but often these are good-government reforms intended to make the program run more efficiently and with lower costs. Let’s check out the Democrats’ Mediscare spin. (Kessler, 3/15)

Modern Healthcare: Azar Calls Out ‘Absurdity' In Medicare Wage Index
HHS Secretary Alex Azar on Thursday acknowledged "absurdity" in the Medicare wage index after several senators complained about wide disparities in payments between states. During a Senate Finance Committee hearing, Azar said HHS is seeking comments on a revision to the entire wage index system but cautioned that HHS can only change the index so much on its own. (King, 3/14)

The New York Times: Tobacco, E-Cigarette Lobbyists Circle As F.D.A. Chief Exits
Dr. Scott Gottlieb became commissioner of the Food and Drug Administration in 2017 with an ambitious plan to reduce cigarette smoking, a habit that kills nearly half a million Americans each year, by shifting smokers to less harmful alternatives like e-cigarettes. But he was quickly embroiled in an unexpected crisis: the explosion of vaping among millions of middle and high school students, many of whom were getting addicted to nicotine. (Kaplan and Richtel, 3/15)

The Hill: FDA Faces Test Under New Chief
The newly named acting commissioner of the Food and Drug Administration (FDA) is poised to take over at a crucial time for the agency, as outgoing Commissioner Scott Gottlieb leaves an ambitious legacy largely unfinished. President Trump’s decision to tap Norman Sharpless as acting commissioner of the FDA is drawing praise from health advocates, who see it as an opportunity for the agency to continue its work uninterrupted. (Weixel, 3/14)

The New York Times: How Big Tobacco Hooked Children On Sugary Drinks
What do these ads featuring Joe Camel, Kool-Aid Man and the maniacal mascot for Hawaiian Punch have in common? All three were created by Big Tobacco in the decades when cigarette makers, seeking to diversify their holdings, acquired some of America’s iconic beverage brands. They used their expertise in artificial flavor, coloring and marketing to heighten the products’ appeal to children. That tobacco companies once sold sugar-sweetened drinks like Tang, Capri Sun and Kool-Aid is not exactly news. But researchers combing through a vast archive of cigarette company documents at the University of California, San Francisco stumbled on something revealing: Internal correspondence showed how tobacco executives, barred from targeting children for cigarette sales, focused their marketing prowess on young people to sell sugary beverages in ways that had not been done before. (Jacobs, 3/14)

The New York Times: Sandy Hook Massacre: Remington And Other Gun Companies Lose Major Ruling Over Liability
The Connecticut Supreme Court dealt a major blow to the firearms industry on Thursday, clearing the way for a lawsuit against the companies that manufactured and sold the semiautomatic rifle used by the gunman in the massacre at Sandy Hook Elementary School. The lawsuit mounted a direct challenge to the immunity that Congress granted gun companies to shield them from litigation when their weapons are used in a crime. The ruling allows the case, brought by victims’ families, to maneuver around the federal shield, creating a potential opening to bring claims to trial and hold the companies, including Remington, which made the rifle, liable for the attack. (Rojas and Hussey, 3/14)

The Associated Press: Court Rules Gun Maker Can Be Sued Over Newtown Shooting
In a 4-3 decision, justices reinstated a wrongful death lawsuit against Remington and overturned the ruling of a lower court judge, who said the entire lawsuit was prohibited by the 2005 federal law. The majority said that while most of the lawsuit's claims were barred by the federal law, Remington could still be sued for alleged wrongful marketing under Connecticut law. "The regulation of advertising that threatens the public's health, safety, and morals has long been considered a core exercise of the states' police powers," Justice Richard Palmer wrote for the majority, adding he didn't believe Congress envisioned complete immunity for gun-makers. (3/14)

The Wall Street Journal: Manufacturer Of AR-15 Can Be Sued Over Sandy Hook Massacre, Court Rules
The plaintiffs alleged that Remington unlawfully promoted the rifle to young, civilian men as a weapon with awesome power and ideal for combat. A representative for Remington didn’t respond to requests for comment. Remington had argued the claims were barred by a 2005 federal law that grants the gun industry expansive immunity from liability claims over gun violence. That law, however, has an exception, under which manufacturers may be liable for injuries resulting from violations of state laws dealing with the marketing of their products. (Gershman and McWhirter, 3/14)

The Washington Post: Families Of Sandy Hook Shooting Victims Can Sue Gunmaker Remington Over 2012 Attack, Court Says
The court’s decision was narrow, with the liability for gunmakers based on how they advertise their weapons rather than on the sale of them to third parties who then commit horrible crimes. In its ruling, the court said companies that market military-style guns to civilians as a way of killing enemies could be violating state fair trade laws. (Barbash, 3/14)

The Washington Post: ‘Our Friends Are Dying, So We March’: Students Rally To Fight Gun Violence
On Thursday morning, a curious scene emerged on Pennsylvania Avenue: Between the throngs of tourists snapping photos of the Washington Monument and commuters rushing to work, high school students pushed their way toward the White House. At 9 a.m., hundreds of teenagers from the District and suburban Maryland and Northern Virginia left their classrooms and headed to the U.S. Capitol to protest gun violence. “No more!” students chanted while holding signs that read, “I should be writing my college essay, not my will” and “Am I next?” (Smith, 3/14)

CNN: FDA Fast-Tracks OxyContin Manufacturer's Overdose Drug
The company whose drugs are at the center of America's deadly opioid epidemic was given a green light Wednesday to accelerate the development of a new opioid antidote. The US Food and Drug Administration granted Purdue Pharma's experimental opioid overdose drug fast-track designation. According to Purdue, its drug, nalmefene hydrochloride injection, has a longer effect than naloxone, another opioid antagonist that is approved to reverse overdoses. The FDA's fast-track designation facilitates the development and expedites the review of drugs that treat serious conditions and fill an unmet medical need. (Kounang, 3/14)

The Associated Press: 25 Nurses Cited Over High Doses For Patients Who Died
Nurses who helped administer excessive and possibly fatal painkillers to dozens of Ohio hospital patients should have questioned an intensive-care doctor's order for those high doses, the state attorney general said Thursday. Officials are pursuing potential discipline against 25 nurses who worked in the Columbus-area Mount Carmel Health System with the doctor, William Husel, who was fired in December. (3/14)

The Associated Press: Maine Bill Pitches Abortions By Nurses, Physician Assistants
Democratic Gov. Janet Mills wants to expand access to abortions by allowing nurse practitioners, physician assistants and certified nurse-midwives to perform procedures in Maine. Mills said Thursday her bill would expand access to abortions, particularly for women in rural areas. Democrats won the Legislature in November and promised to expand women's health access. (3/14)

The Associated Press: Georgia Senate Committee Hears Testimony On Abortion Bill
A Georgia Senate committee listened to emotional testimony Thursday over a proposal that would ban most abortions after a fetal heartbeat can be detected. The committee did not take a vote, and it was unclear when they might. Women in Georgia can currently seek an abortion during the first 20 weeks of a pregnancy. A fetal heartbeat is generally detectable at around six weeks, before many women know they are pregnant — especially women who aren't trying to conceive. (3/14)

The Associated Press: Arkansas Senate OKs New Requirement For Abortion Doctors
Senators in Arkansas approved a measure Thursday that imposes a new requirement on doctors who perform abortions, the latest in a series of restrictions on the procedure in the state that are moving quickly through the Legislature. The Senate voted 29-5 in favor of the proposal, which would require doctors who perform abortions to be board-certified or board-eligible in obstetrics and gynecology. The measure now heads to the House. (3/14)

The Associated Press: ACLU Files Lawsuit Challenging Kentucky Anti-Abortion Bill
Kentucky’s legal feud with abortion-rights defenders expanded on Thursday as the Republican-dominated legislature voted to ramp up the state’s restrictions on the procedure. Hours after the American Civil Liberties Union filed a lawsuit aimed at blocking one abortion bill, the group vowed to return to court to challenge Kentucky’s newest and most restrictive measure — which would ban most abortions once a fetal heartbeat is detected. A fetal heartbeat can be detected as early as six weeks into pregnancy. (Schreiner, 3/14)

The New York Times: Early Detection Is Possible For Pancreatic Cancer
Pancreatic cancer has a bad reputation. It is a terrible disease, but most people do not realize there are ways that early detection can help. When the “Jeopardy!” host, Alex Trebek, announced last week that he had Stage 4 pancreatic cancer, many people assumed that it was an automatic death sentence. Not Mr. Trebek. (Simeone, 3/15)

The New York Times: With Measles Outbreaks On The Rise, A Concern Over The Connection To Air Travel
Measles isn’t only in the headlines these days; it may also be on your airplane. An adult contagious with the disease flew from Asia to San Francisco in February, infecting two others — one adult and one child — during the flight, California health departments said this month. It’s an inauspicious development in a year that has already seen 228 cases of the serious and potentially lethal disease in 12 states, including six outbreaks of at least three people. (Schwartz, 3/14)

The New York Times: Flashing Lights And Sounds Improve Memory And Learning Skills In Mice
Could people’s eyes and ears help fix the damage Alzheimer’s disease does to the brain? Just by looking at flashing light and listening to flickering sound? A new study led by a prominent M.I.T. neuroscientist offers tantalizing promise. It found that when mice engineered to exhibit Alzheimer’s-like qualities were exposed to strobe lights and clicking sounds, important brain functions improved and toxic levels of Alzheimer’s-related proteins diminished. (Belluck, 3/14)

Reuters: Cuba Says USA, Not Canada, Manipulating Diplomat Health Incidents
Cuba denounced the Trump administration on Thursday for continuing to refer to health incidents among their diplomats in Havana as "attacks" without presenting any evidence, saying it was part of a broader campaign to damage bilateral relations. Both Canada and the United States have cut back their embassies in Havana to skeletal staffing after diplomats there began complaining about mysterious bouts of dizziness, headaches and nausea two years ago. (3/14)

The New York Times: Did Dietary Changes Bring Us ‘F’ Words? Study Tackles Complexities Of Language’s Origins
Thousands of years ago, some of our ancestors left behind the hunter-gatherer lifestyle and started to settle down. They grew vegetables and grains for stews or porridge, kept cows for milk and turned it into cheese, and shaped clay into storage pots. Had they not done those things, would we speak the languages and make the sounds that we now hear today? Probably not, suggests a study published Thursday in Science. (Klein, 3/14)

The Wall Street Journal: The Science Behind Why We Use ‘F’ Words
Modern humans communicate in roughly 7,000 different languages, a compilation of diverse sounds and gestures. Their origins involve a mixture of cultural, historical and social factors that come together to create the way we speak and connect. Biology and physiology, however, have largely stayed out of the linguistic picture, partially because it is challenging to collect both biological and linguistic evidence from the ancient past. In the new study, the research team from the University of Zurich tested an idea put forth in 1985 by linguist Charles Hockett. (Abbott, 3/14)

The New York Times: Mushrooms May Reduce The Risk Of Memory Problems
Eating mushrooms may reduce the risk for mild cognitive impairment, or M.C.I., a type of memory impairment that is often a precursor of Alzheimer’s disease. Researchers in Singapore used data on 663 Chinese men and women over 60. None had memory or thinking problems at the start of the study. In one-on-one interviews, they recorded diet information, including questions about six types of commonly consumed mushrooms. They assessed cognitive function with detailed structured interviews and widely used tests of mental acuity. Over the six-year study, 90 in the group developed M.C.I. (Bakalar, 3/14)

The Washington Post: Birth Order May Not Shape Personality After All
Birth order, according to conventional wisdom, molds personality: Firstborn children, secure with their place in the family and expected to be the mature ones, grow up to be intellectual, responsible and conformist. Younger siblings work harder to get their parents’ attention, take more risks and become creative rebels. That’s the central idea in psychologist Frank J. Sulloway’s “Born to Rebel,” an influential book on birth order that burst, like a water balloon lobbed by an attention-seeking third-born, onto the pop psychology scene two decades ago. (Guarino, 3/14)

The Washington Post: U.S. Hopes To Send More Experts To Congo As Ebola Outbreak Rages
The Centers for Disease Control and Prevention hopes to send experts to Congo in the next few weeks to train international and local personnel in the fight against a raging Ebola outbreak that has killed nearly 600 people and is far from under control, the CDC director said Thursday in an interview. Because of the worsening security situation, the CDC experts would not be based in the epicenter of the outbreak, in conflict-ridden parts of eastern Congo. Armed attacks against Ebola treatment centers in North Kivu province have increased in recent weeks. (Sun, 3/14)

The New York Times: Yoga For Incontinence? Evidence Is Lacking
Yoga exercises are often recommended to help control urinary incontinence in women, but there is no solid scientific evidence to show yoga works. Incontinence affects up to 15 percent of middle-aged and older women, and although there are medications and surgeries to treat it, the first approach is usually bladder training and exercise. Some find an appealing treatment in the relaxation, bodily postures and breath control of yoga. (Bakalar, 3/14)

The Washington Post: Mental Health Problems Rise Significantly Among Young Americans
Over the past decade or so, rates of depression, psychological distress, and suicidal thoughts and actions have risen significantly among people age 26 and younger, with some of the highest increases among women and those at higher income levels, according to a study of a broad swath of young Americans. The report, published Thursday in the American Psychological Association’s Journal of Abnormal Psychology, looked at survey data from more than 600,000 adolescents and adults. (Bahrampour, 3/14)

Los Angeles Times: Mental Health Problems Are On The Rise Among American Teens And Young Adults
A study published Thursday finds that U.S. teens and young adults in 2017 were more distressed, more likely to suffer from major depression, and more prone to suicide than their counterparts in the millennial generation were at the same age. Researchers also found that between 2008 and 2017, Gen Z’s emotional distress and its propensity toward self-harm grew more than for any other generation of Americans during the same period. By 2017, just over 13% of Americans between the ages of 12 and 25 had symptoms consistent with an episode of major depression in the previous year – a 62% increase in eight years. (Healy, 3/14)

NPR: Can Too Much Time Online Make You Depressed?
Understanding exactly why these trends are on the rise is always a challenge, says Twenge, since researchers can only point out correlations, not causes. But, she says, since the trends are "pretty large in a fairly short period of time, that helps us narrow what the likely cause might be. "She thinks the rise in smartphone and social media use is a significant factor. By 2012, smartphones had become widespread, she says, and it's around that same time that social media began to dominate young people's lives. For example, in 2009 about half of high school seniors visited social media sites every day. That's climbed to about 85 percent today, with Instagram and Snapchat replacing Facebook as the main "go to social media site," she says. (Neighmond, 3/14)

The New York Times: Florida Surgeon Resigns Over Instagram Photos Of Transgender Patients’ Genitals
A well-known Florida surgeon who specializes in transgender health care has resigned from his position at the University of Miami amid an uproar over pictures he posted on Instagram that showed surgical procedures and patients’ genitals alongside captions and hashtags that mocked transgender people and Asians. The surgeon, Dr. Christopher Salgado, 50, worked at the L.G.B.T.Q. Center for Wellness, Gender and Sexual Health at the University of Miami Health System until last month. Interspersed with photos of himself smiling with friends and colleagues, he posted images and text on his Instagram account, @sexsurgeon, that many people found disturbing. He deleted the account last month. (Stack, 3/14)

The Associated Press: Surgeon Denies Posting Homophobic Comments On Social Media
Salgado, a 50-year-old section chief for the hospital's LGBTQ Center for Wellness, Gender and Sexual Health, told the AP in an email Thursday that he had posted various photos of gender-reassignment patients' genitalia and that all of the patients had given their consent. But he said the hashtags, which "I had never seen in my life," were added by someone who had hacked his account. Salgado said the petition was sent by a patient with gender dysphoria who was going through a difficult time in life. Salgado said he loves the transgender population and has spent years caring for them. (3/14)

ProPublica: Head Of Rhode Island’s 911 System Is Removed From Post
The acting director of Rhode Island’s 911 emergency system has been removed from his post after state police learned he’d been training 911 call takers in CPR without proper certification. The revelation came less than 48 hours after The Public’s Radio requested verification of Gregory M. Scungio’s Red Cross certifications in an email to Rhode Island State Police. The inquiry was part of an ongoing examination of emergency medical services in Rhode Island, in conjunction with ProPublica’s Local Reporting Network. (Arditi, 3/14)

The Baltimore Sun: Bill Would Use Tax Returns To Identify And Help Marylanders Without Health Insurance 
Maryland would use state tax forms to identify uninsured residents and refer them to options for no-cost or low-cost health care under a bill moving forward in the General Assembly. The bill, if approved, would add a question on state tax returns asking taxpayers if they have health insurance. Those who answer that they don’t have health insurance would be referred to the state's Medicaid program or the health exchange, where individuals can buy health insurance plans. (Wood, 3/14)

The Washington Post: D.C.’s Mayor Went To The White House And Asked President Trump For A New VA Hospital
D.C. Mayor Muriel E. Bowser (D) made a surprise visit to the White House on Wednesday to discuss judicial vacancies and urged President Trump to replace the city’s troubled hospital for veterans. Bowser joined a scheduled meeting between senior adviser Beverly Perry, Deputy Mayor for Public Safety and Justice Kevin Donahue and the mayor’s top lawyer, Ronald Ross; and White House Counsel Pat Cipollone. Bowser said that after the meeting, the White House counsel offered to take her and her aides for an impromptu visit with the president in the Oval Office. (Nirappil, 3/14)

The Associated Press: Northam Announces Advancements In Mental Health Treatment
Virginia Gov. Ralph Northam said the state’s 40 mental health centers are now all offering walk-in mental evaluations. Northam said Thursday that the a person in need of a mental health assessment can get one at the state’s Community Services Boards without an appointment instead of waiting days or weeks for an appointment. Last year lawmakers and the governor approved extra funding to make sure every Community Services Board could offer same-day assessments. (3/15)

Medpage Today: Doddering Doctors: Hospitals Take A Stab At Weeding Them Out
Interventional cardiologist Jerrold Glassman, MD, spent the first week of March schussing down Park City's powdery slopes. He even braved black diamond runs, belying the fact that this July, he'll be 69 years old. "A 60-year-old today is not the 60-year-old of three decades ago," he said proudly. "Skiing is my passion and I'm going back up tomorrow." He and his ski buddies, older physicians like himself, dodge moguls some 30 days a year. A new app tracks his stats, like altitude, speed and distance, and said he did 25 downhill miles that day. (Clark, 3/14)