First Edition: March 16, 2023

KHN: The US Remains A Grim Leader In Preterm Births. Why? And Can We Fix It? 
Tamara Etienne’s second pregnancy was freighted with risk and worry from its earliest days — exacerbated by a first pregnancy that had ended in miscarriage. A third-grade teacher at an overcrowded Miami-Dade County public school, she spent harried days on her feet. Financial worries weighed heavy, even with health insurance and some paid time off through her job. (Varney, 3/16)

KHN: Listen To ‘Tradeoffs’: Medical Debt Delivers ‘A Shocking Amount Of Misery’
The numbers that tell the story of medical debt in the U.S. are staggering: Around 100 million Americans have health care debt, and together they owe at least $140 billion. And research suggests this debt can have striking consequences on people’s financial, physical, and mental health. In this episode of the “Tradeoffs” podcast, Dan Gorenstein talks about the pain and possible solutions to medical debt with KHN senior correspondent Noam N. Levey and UCLA researcher Wes Yin. (Levey, 3/16)

Axios: Biden Admin Lays Out Medicare Drug Negotiation Process
The Biden administration on Wednesday began fleshing out how it will implement drug-pricing provisions in the Inflation Reduction Act, including a multi-step negotiation process for selected Medicare drugs starting next year. (Bettelheim, 3/16)

Reuters: Biden Says 'More Coming' On Drug Pricing After Inflation Fines
U.S. President Joe Biden on Wednesday said his administration would subject 27 drugs to inflation penalties, a move that will reduce out-of-pocket costs for Medicare recipients by as much as $390 per dose, and he pledged more drug price cuts were coming. ... Drugmakers hiked the price for 27 drugs last quarter higher than the rate of inflation, and will have to pay the difference on those medicines to Medicare, the government healthcare program for those age 65 and older and the disabled. (Aboulenein and Holland, 3/15)

AP: Biden Says He's Focused 'Intensely' On Lowering Drug Costs 
President Joe Biden on Wednesday said his administration was focused “intensely” on lowering health care costs and took aim at “MAGA” Republicans who he said are intent on dialing back Medicare coverage for millions of Americans. Biden used a speech in Las Vegas where he was wrapping a three-day Western swing to make the case there are stark differences in how Democrats are tackling skyrocketing drug prices compared to their Republican counterparts. (Seitz and Miller, 3/15)

The Hill: Biden Administration Names First Round Of Drugs To Face Medicare Rebate Penalties 
In a press briefing, Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure said her agency will invoice the drugmakers for these rebates beginning in 2025. “The Medicare prescription drug inflation rebate program is strengthening Medicare by making prescription drugs affordable for millions of people and discouraging drug companies from increasing prices faster than inflation,” Brooks-LaSure said. “It’s also protecting Medicare for our children and grandchildren.” (Choi, 3/15)

Stat: Medicare Explains How It Will Choose Drugs For Negotiation
Medicare laid out Wednesday in the greatest detail yet how it will choose which drug prices it will negotiate in its brand-new program, and how it will figure out what the government’s opening offer will be. (Cohrs, 3/15)

NerdWallet: When Will Medicare Cover Medical Marijuana? 
One in five Medicare recipients currently uses medical marijuana, according to an April 2022 poll by the Medicare Plans Patient Resource Center, an organization that provides Medicare guidance and information. And nearly a quarter have used it in the past. Two-thirds of Medicare recipients think Medicare should cover it, the poll found. But Medicare doesn’t cover medical marijuana because it’s not federally legal and not approved by the Food and Drug Administration. Here’s where the situation stands. (Ashford, 3/15)

The Washington Post: Texas Judge Seems Open To Claim Abortion Drug Was Not Properly Vetted
The federal judge who could upend access to a key abortion medication seemed open on Wednesday to the argument that the drug had not been properly vetted and could be unsafe — claims the Food and Drug Administration and leading health organizations strongly contest. While the antiabortion group challenging the drug acknowledged there is no precedent for a court to order the suspension of a long-approved medication, U.S. District Judge Matthew Kacsmaryk questioned whether mifepristone has met the rigorous federal standard necessary to be prescribed to patients in the United States. He asked a lawyer for the group whether the court could unilaterally withdraw FDA approval for a drug, and engaged with attorneys for both sides about whether mailing the pills should be prohibited because of a 19th-century law that bans sending articles “for any indecent or immoral use” through the Postal Service. (Stein, Kitchener and Marimow, 3/15)

NBC News: Judge Appears Sympathetic To Abortion Pill Challenge In Texas Hearing
During the four-hour hearing, U.S. District Judge Matthew Kacsmaryk appeared sympathetic to arguments from the lawyers for a coalition of anti-abortion groups called the Alliance for Hippocratic Medicine. Their goal in filing the suit was to overturn the Food and Drug Administration’s approval of the pills used to terminate pregnancies, which account for more than half of abortions in the U.S. (Victoria Lozano, Burns, Bendix and Siemaszko, 3/15)

The New York Times: Texas Judge Hears Case To End Federal Approval Of Abortion Pill 
Toward the end of the court hearing, which lasted more than four hours, Judge Kacsmaryk asked a lawyer for the plaintiffs, a coalition of anti-abortion groups and doctors, if they expected that “the court itself can order a withdrawal or suspension.” When the lawyer, Erik Baptist, said yes, the judge replied, “What gives the court that authority?” At another point in the session, the judge asked a Justice Department lawyer representing the defendant in the case, the Food and Drug Administration, if the fact that 22 conservative states had written a brief supporting the plaintiffs’ case showed that revoking the abortion pill would be beneficial for public policy. The lawyer, Julie Straus Harris, replied, “An injunction here would interfere with every state in the country” and could make abortion access difficult even in cases of nonviable pregnancies and rape. That seemed to make an impression on the judge, who noted, “This isn’t a case where we’re comparing 22 versus 28 states, but rather, all 50 states, especially in some of those other circumstances, right?” (Belluck and McCann, 3/15)

Salt Lake Tribune: Abortion Clinic Ban Signed By Utah Gov. Cox; Abortion Still Legal Up To 18 Weeks
Abortion clinics will be banned in Utah starting next year after Gov. Spencer Cox signed a bill Wednesday. The law will also impose other restrictions on abortion as the state’s trigger ban is held up in court. Rep. Karianne Lisonbee’s, R-Clearfield, HB467, was among the more controversial bills passed this legislative session. It passed out of both the Utah House and the Senate along party lines. (Anderson Stern, 3/16)

AP: Tennessee GOP Advance New Narrow Abortion Exemption Bill 
Tennessee Republican lawmakers on Wednesday took another swing at adding a narrow exemption to one of the strictest abortion bans in the United States. Nearly a month ago, a Republican legislative panel defied political threats made by the state’s influential anti-abortion lobbying group and advanced legislation clarifying situations where abortion could be allowed in Tennessee. (Kruesi, 3/15)

The Wall Street Journal: U.S. Maternal Mortality Hits Highest Level Since 1965
The number of women who died during pregnancy or shortly after rose 40% to 1,205 in 2021, compared with 861 in 2020 and 754 in 2019, the National Center for Health Statistics said Thursday. The increase pushed the maternal-mortality rate to 33 deaths per 100,000 live births, the highest since 1965, compared with 24 in 2020 and 20 in 2019. (Toy, 3/16)

USA Today: Why Maternal Mortality Rate Surged By 40% When Deaths Are Preventable
Experts say COVID-19 likely contributed to the increases, but that the sobering rates continue to reveal deep flaws in health systems, such as structural racism, implicit bias and communities losing access to care. “A roughly 40% increase in preventable deaths compared to a year prior is stunning news,” Dr. Iffath Abbasi Hoskins, president of the American College of Obstetricians and Gynecologists, said in a statement to USA TODAY. (Hassanein, 3/16)

The New York Times: Pregnancy And Covid: What Women Need To Know
Pregnant women are particularly vulnerable to Covid-19, and new government data show that maternal mortality rose sharply in 2021, the second year of the pandemic. Here’s what women need to know to keep themselves safe. (Rabin, 3/16)

CIDRAP: COVID-Related Stress During Pregnancy Tied To Later Distress For Moms And Babies 
Women who experience COVID-related stress during pregnancy have worse mental health 1.5 years after giving birth, and their babies show more distress and irritability, finds a follow-up study published yesterday in JAMA Network Open. (Van Beusekom, 3/15)

Stat: FDA Stays Mum On Question Of Spring Boosters For Covid
Are you six months out from your Covid-19 bivalent booster and wondering when you’ll be able to get another shot? If you live in the United Kingdom or Canada, you already have your answer. The Canadian and U.K. governments, acting on recommendations from expert committees, plan to offer spring booster shots for people at highest risk of getting severely sick from Covid. But in the United States, there’s been radio silence from the Food and Drug Administration on the question of spring boosters, creating frustration among a small but determined group of people who are keen not to have to wait until the autumn to get another dose of Covid vaccine. (Branswell, 3/16)

The Boston Globe: As Public Health Emergency Ends, COVID Vigilance Should Remain, Public Health Experts Say 
Governor Maura Healey announced on Wednesday that she would end the state’s public health emergency, marking the beginning of what public health officials say is the next phase of life with COVID-19. The move takes effect May 11, which aligns with the lifting of the federal public health emergency. (Bartlett, 3/15)

Axios: Unwinding Of COVID Emergency Brings Hurdles For Gender-Affirming Care
The end of the COVID-19 public health emergency could bring new barriers to trans men undergoing hormone therapy, in the way it would eliminate telehealth prescribing of controlled substances including testosterone. (Gonzalez, 3/15)

NBC News: New Double Lung Transplant Technique Is Successful In Two Late-Stage Cancer Patients
A novel treatment for certain late-stage lung cancers has succeeded in the first two patients to undergo the operation. Using knowledge learned during the Covid pandemic, surgeons at Northwestern Medicine in Chicago successfully performed double lung transplantations in two patients with stage 4 cancer. Both patients are alive and well. (Sullivan and Snow, 3/15)

Axios: Nearly 1 In 3 Patients Don't See Primary Care Doc
Nearly 30% of all patients who received medical services between 2016 and 2022 did not see a primary care physician, a FAIR Health analysis provided first to Axios shows. Primary care providers are supposed to manage patients' day-to-day health needs and provide preventative care, and evidence shows it can drive down costs and improve outcomes. But many people are clearly getting their care elsewhere — if they're getting it at all. (Reed, 3/15)

AP: In Nursing Homes, Impoverished Live Final Days On Pennies
New pants to replace Alex Morisey’s tattered khakis will have to wait. There’s no cash left for sugar-free cookies either. Even at the month’s start, the budget is so bare that Fixodent is a luxury. Now, halfway through it, things are so tight that even a Diet Pepsi is a stretch. “How many years do I have left?” asks 82-year-old Morisey, who lives in a Philadelphia nursing home. “I want to live those as well as I can. But to some degree, you lose your dignity.” Across the U.S., hundreds of thousands of nursing home residents are locked in a wretched bind: Driven into poverty, forced to hand over all income and left to live on a stipend as low as $30 a month. In a long-term care system that subjects some of society’s frailest to daily indignities, Medicaid’s personal needs allowance, as the stipend is called, is among the most ubiquitous, yet least known. (Sedensky, 3/15)

The Washington Post: One Of Largest Fertility Clinic Mishaps In U.S. Settled Out Of Court
An appeal of a landmark jury verdict that awarded nearly $15 million to five people who lost embryos and eggs in a fertility clinic mishap has settled out of court. The amount of the agreement is confidential, according to a court filing. ... More than 2,500 embryos and 1,500 eggs belonging to more than 400 people were in the cryo-preservation tank at Pacific Fertility Center in San Francisco when it malfunctioned in March 2018, according to a court filing. It is unclear how many of those people will share in what may be a substantial monetary settlement. (Bernstein, 3/15)

Modern Healthcare: Bright Health Under Florida Regulatory Supervision
Bright Health Group's financial headaches are worse than previously known, as Florida regulators revealed the company has been under supervision for six months and unable to spend money without clearance from the Sunshine State. (Tepper, 3/15)

Stat: HHS Chooses A Location For ARPA-H — Sort Of
Officials at the Advanced Research Projects Agency for Health are moving ahead with plans to set up an office in the Washington, D.C. area — though they aren’t saying whether that means the city proper or somewhere in Maryland or Virginia. The choice, however vague, all but guarantees the location will be a quick drive from the headquarters of the National Institutes of Health campus in Bethesda, Md., despite explicit instructions from Congress not to house the new, multi-billion-dollar health agency on the actual campus. (Owermohle and Cohrs, 3/15)

Stat: Would The Federal Government Defer To States To Regulate PBMs?
After years of struggling to regulate the drug middlemen that create pharmacy networks, the federal government could lean on states to rein them in — even, potentially, in Medicare. The Department of Justice has until next month to tell a federal appeals court where the administration stands on the issue. (Wilkerson, 3/15)

NPR: CRISPR Gene-Editing Success For Sickle Cell Raises New Questions
Victoria Gray was wandering through the British Museum in London last week when she spotted a small wooden cross hanging on the wall. "It's nice seeing all the old artifacts, especially the cross," Gray said. "Religion is something that I hold close to my heart, and my faith is what brought me this far." (Stein, 3/16)

Los Angeles Times: Industrial Chemical May Be Linked To Parkinson's Disease
A cancer-causing chemical that is widely used to degrease aviation components and heavy machinery could also be linked to Parkinson’s disease, according to a new research paper that recommends increased scrutiny of areas long contaminated by the compound. (Briscoe, 3/15)

Stat: Scientist Who Discovered Likely Top Cause Of MS Wants To Tackle ALS
Alberto Ascherio began his career as a young doctor treating tropical diseases in South American rainforests and parts of Africa. Over the next quarter-century, he made his way to what is now his wheelhouse: studying the links between viruses and neurodegenerative diseases. (Cueto, 3/16)

The Atlantic: The Rogue Theory That Gravity Causes IBS 
Bad things happen to a human body in zero gravity. Just look at what happens to astronauts who spend time in orbit: Bones disintegrate. Muscles weaken. So does immunity. “When you go up into space,” says Saïd Mekari, who studies exercise physiology at the University of Sherbrooke, in Canada, “it’s an accelerated model of aging.” (Wapner, 3/15)

Stat: Momentum Grows To Subject Medical Devices To Placebo Treatment
It’s the gold standard in medicine: taking a treatment, and putting it head-to-head against a placebo to confidently declare whether it actually works. But for most medical devices, placebo trials have never been done. (Lawrence, 3/16)

Modern Healthcare: Medicaid Redeterminations By State: How Many Will Lose Coverage?
Medicaid enrollees and the health insurance companies that cover them face major disruptions in the coming months as states resume removing people who no longer qualify from the program. (Tepper and Broderick, 3/15)

AP: Arkansas Lawmakers Send Gov. Sanders School Bathroom Bill
Transgender people at Arkansas public schools would not be able to use restrooms that correspond with their gender identity under a bill lawmakers sent to Gov. Sarah Huckabee Sanders on Wednesday. The bill approved by the majority-Republican House applies to multi-person restrooms and locker rooms at public schools and charter schools serving prekindergarten through 12th grades. The House, which approved an earlier version of the bill last month, passed the bill on a 77-15 vote without any debate. (DeMillo, 3/15)

Des Moines Register: Kim Reynolds' Education Bill May Make HPV Instruction Optional In Iowa
Folded into versions of the governor's broad education bill are changes to schools' health curriculum that would remove the requirement to teach students about certain sexually transmitted infections, including HPV. Iowa school districts would still need to maintain a health curriculum that includes "age-appropriate and research-based information regarding the characteristics of sexually transmitted diseases." (Ramm, 3/15)

The New York Times: 7 Virginia Deputies Charged With Murder In Death Of Man At Hospital 
Seven sheriff’s deputies in Virginia have been charged with second-degree murder in the death of a Black man with a history of mental illness who died after the officers smothered him as he lay on the ground in handcuffs and leg shackles at a hospital, his family’s lawyer and a county prosecutor said on Wednesday. The man, Irvo Otieno, 28, of Henrico County, Va., whose family emigrated from Kenya when he was 4 years old, appeared to have died from asphyxiation, or oxygen deficiency, on March 6 at Central State Hospital in Dinwiddie County, his family’s lawyer, Mark Krudys, said in an interview. His family says Mr. Otieno was deprived of medication while in jail that he needed for his mental illness. (Medina, 3/15)

AP: 8 Children Sickened At LA School After Eating Marijuana
Eight children were sickened at a Los Angeles school on Wednesday after eating marijuana gummies, authorities said. (3/15)

AP: Fentanyl Testing Materials Will Be Legalized In Mississippi 
Mississippi will decriminalize materials that allow people to test illegal drugs to detect if they are spiked with fentanyl, a highly powerful synthetic opioid painkiller. Republican Gov. Tate Reeves signed House Bill 722 on Monday, and it becomes law July 1. (3/15)

Fox News: Texas Senate Unanimously Passes Bill Allowing Fentanyl Distributors To Be Charged With Murder
The Texas Senate passed a "Combating Fentanyl" bill Wednesday that would open the door for state prosecutors to charge fentanyl distributors with murder. Senate Bill 645, introduced by Sen. Joan Huffman, a Republican representing the Houston area, would change the classification of drug overdoses to "poisonings," according to the Texas Tribune. (Richard, 3/16)

AP: Mexican President Floats Fentanyl Ban, Faults US Drug Policy 
Mexico’s president called anti-drug policies in the U.S. a failure Wednesday and proposed a ban on using fentanyl in medicine — even though little of the drug crosses from hospitals into the illegal market. President Andrés Manuel López Obrador has grappled in recent days with the issue of fentanyl, which has become a major security concern. López Obrador has denied that Mexico produces fentanyl, which causes about 70,000 U.S. overdose deaths per year. (3/15)

The Washington Post: For Depression, Exercise May Work As Well As Drugs Or Therapy, Study Finds
Exercise as a treatment for severe depression is at least as effective as standard drugs or psychotherapy and by some measures better, according to the largest study to date of exercise as “medicine” for depression. The study pooled data from 41 studies involving 2,265 people with depression and showed that almost any type of exercise substantially reduces depression symptoms, although some forms of exercise seemed more beneficial than others. (Reynolds, 3/15)

Dallas Morning News: This ‘Electronic Tattoo’ From UT Austin Can Tell When You’re Stressed Out
Researchers at the University of Texas at Austin have developed a temporary “e-tattoo” for the palm that can track excitement and stress using the skin’s electrical conductivity. The e-tattoo could be a reliable way for people with conditions such as anxiety or depression to track their emotions. (Ramakrishnan, 3/16)

CIDRAP: Study Finds Most Mpox Videos On TikTok Are Incomplete, Inaccurate
An analysis of mpox-related TikTok videos found the quality was low and the information provided was frequently incomplete and inaccurate, researchers reported yesterday in BMJ Global Health. Using a hashtag-based search strategy, the researchers identified 2,462 mpox-related videos from January 1 to August 11, 2022, and analyzed 85, evaluating them for content on features and treatment of mpox. (Dall, 3/15)

The New York Times: Scientists Investigate A Bird Flu Outbreak In Seals
Last summer, the highly contagious strain of avian influenza that had been spreading through North American birds made its way into marine mammals, causing a spike in seal strandings along the coast of Maine. In June and July, more than 150 dead or ailing seals washed ashore. Now, a study provides new insight into the outbreak. Of the 41 stranded seals tested for the virus, nearly half were infected with it, scientists reported on Wednesday in the journal Emerging Infectious Diseases. It is likely that wild birds introduced the virus to seals at least twice, the researchers concluded. In several seals, the virus had mutations that are associated with adaptation to mammals. The risk to humans remains low, and the seal outbreak waned quickly, the scientists said. (Anthes, 3/15)