First Edition: March 26, 2018

Kaiser Health News: Trump Immigration Policies Put Immigrant Caregivers And Their Elderly Patients At Risk
After back-to-back, eight-hour shifts at a chiropractor’s office and a rehab center, Nirva arrived outside an elderly woman’s house just in time to help her up the front steps. Nirva took the woman’s arm as she hoisted herself up, one step at a time, taking breaks to ease the pain in her hip. At the top, they stopped for a hug.“Hello, bella,” Nirva said, using the word for “beautiful” in Italian. (Bailey, 3/26)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Health Law Fix Misses The Spending Bill Train
Congress passed a bill to fund much of the federal government for the remainder of the fiscal year just hours before its March 23 deadline. But not included in that legislation is a bipartisan bill aimed at stabilizing premiums for individuals who buy their own health insurance. That proposal collapsed in partisan rancor after lawmakers were unable to resolve a fight over abortion and other issues. (3/23)

The Wall Street Journal: Health-Insurance Premiums Loom As Election Issue
Health-insurance premiums are likely to jump right before the November elections, a result of Congress’s omission of federal money to shore up insurance exchanges from its new spending package. Lawmakers from both parties had pushed to include the funding in the $1.3 trillion spending law signed Friday, but they couldn’t agree on details. A battle has already begun over how to cast the blame for the expected rate increases. Democrats blame GOP lawmakers for the failure of negotiations over the funding, saying Republican leaders demanded the inclusion of abortion restrictions they knew would be unacceptable to Democrats. Republicans say that they negotiated in good faith and that Democrats rejected reasonable rules on abortion. (Armour, 3/25)

Bloomberg: Why Some Americans Are Risking It And Skipping Health Insurance 
Across America there are thousands of people like the Buchanans, the Owenses and the Bobbies making the same hard decision to go without health insurance, despite the benefits. They’re risking it—betting that they’ve got enough savings, enough of a back-up plan, or enough luck to get them through a twisted knee, a cancer, or a car wreck. Bloomberg is following a dozen of these families this year in an effort to understand the trade-offs when a dollar spent on health insurance can’t be spent on something else. Some are financially comfortable. Others are scraping by. (Tozzi, 3/26)

The Associated Press: AP Sources: Trump Plans To Oust Shulkin As VA Secretary
President Donald Trump is planning to oust embattled Veterans Affairs Secretary David Shulkin amid an extraordinary rebellion at the agency and damaging government investigations into his alleged spending abuses, three administration officials told The Associated Press on Sunday. Two officials said an announcement on Shulkin could happen this week, subject to Trump's final decision as the White House hones in on possible replacements to head the Department of Veterans Affairs. (Yen and Thomas, 3/25)

The Washington Post: Trump May Be Preparing To Make More Administration Personnel Changes
At his coastal resort here, Trump told associates he wants to oust Veterans Affairs Secretary David Shulkin. Christopher Ruddy, the chief executive of Newsmax, talked to the president Saturday and then said on television Sunday that Shulkin is “likely to depart the Cabinet very soon.” Ruddy, who speaks to Trump frequently, said on ABC News’ “This Week” that the president thinks the White House is operating “like a smooth machine” and that he has been “perplexed” by news reports of chaos. “He did say that he’s expecting to make one or two major changes to his government very soon,” Ruddy said. (Wagner and Dawsey, 3/25)

The New York Times: Trump Approves New Limits On Transgender Troops In The Military
Transgender troops who are currently in the United States military may remain in the ranks, the White House said late Friday, but the Pentagon could require them to serve according to their gender at birth. The policy recommendation that President Trump approved flatly states that “transgender persons who require or have undergone gender transition are disqualified from military service.” But it also largely gives the Pentagon the ability to make exceptions where it sees fit. (Cooper and Gibbons-Neff, 3/24)

The Associated Press: Trump Order Would Ban Most Transgender Troops From Serving
"This new policy will enable the military to apply well-established mental and physical health standards — including those regarding the use of medical drugs — equally to all individuals who want to join and fight for the best military force the world has ever seen," White House Press Secretary Sarah Huckabee Sanders said Friday. The new policy was promptly assailed by congressional Democrats and civil rights groups. House Democratic leader Nancy Pelosi tweeted, "No one with the strength & bravery to serve in the U.S. military should be turned away because of who they are. This hateful ban is purpose-built to humiliate our brave transgender members of the military who serve with honor & dignity." (Thomas, 3/24)

The Wall Street Journal: Trump Allows Current Transgender Troops But Bans Future Recruits
The administration decision comes amid federal court rulings requiring the Pentagon to maintain a policy of open transgender service. The Justice Department was expected to file at least one motion Friday evening in U.S. District Court in the Western District of Washington state to argue the court should lift an injunction that prevented the Pentagon from banning transgender service members. The Trump administration faces a number of court orders that require the Pentagon to maintain the previous policy until they are reversed. “DoD will continue to comply with court rulings and continue to assess and retain transgender service members,” said Maj. Dave Eastburn, a Pentagon spokesman. (Lubold, 3/24)

NPR: Spending Bill Lets CDC Study Gun Violence; But Researchers Are Skeptical It Will Help
Government health agencies have spent more than two decades shying away from gun violence research, but some say the new spending bill, signed by President Trump on Friday, will change that. That is because, in agency instructions that accompany the bill, there is a sentence noting that the Centers for Disease Control and Prevention has the authority to conduct research on the causes of gun violence. "I think this is a huge victory for our country and our communities and our children. This is one step in many to help stop gun violence in this country," says Rep. Stephanie Murphy, a Democrat from the Orlando, Fla., area, where a mass shooting left 49 dead at a gay nightclub in 2016. But researchers who study gun violence are unimpressed. (Greenfieldboyce, 3/23)

The Hill: Funding Bill Won't Prompt New CDC Gun Research, Experts Say
Public health experts and former CDC officials say that, unless Congress actually appropriates money for that research, no progress will be made. Democrats have frequently railed against the fact that a 1996 amendment has effectively stopped CDC from researching gun violence. The mass shooting at a Florida high school in February reignited the debate in Congress. Democrats had pushed for a full repeal of the so-called Dickey Amendment, which prohibits the use of federal funding to promote or advocate for gun control, but Republicans did not agree. (Weixel, 3/25)

The Hill: Top Appropriators Say They See No Need To Specify Funding For Gun Research
Top appropriators in the House and Senate on Thursday said they are not interested in funding new federal research into the causes of gun violence. Sen. Roy Blunt (R-Mo.) and Rep. Tom Cole (R-Okla.) said in separate interviews they don’t see the need to give federal research agencies like the Centers for Disease Control and Prevention (CDC) additional money meant to study the causes of gun violence. (Weixel, 3/22)

The Washington Post: Tenacious New Gun Researchers Are Determined To Break Cycle Of Mass Shootings
Yifan Zhang was finishing her PhD in biostatistics at Harvard five years ago when news broke of the Sandy Hook Elementary School shooting. As a graduate student from China, specializing in highly technical design of clinical drug trials, she had little connection to America’s long-running debate over gun violence. But even now, she said, the anguished faces of those parents she saw on television remain seared in her memory.So when she heard about a gun-violence research project at Stanford University that could use the statistical skills she had honed on pharmaceuticals, she jumped at the chance. (Wan, 3/24)

The Associated Press: States: Federal Money For Opioid Crisis A Small Step Forward
The federal government will spend a record $4.6 billion this year to fight the nation's deepening opioid crisis, which killed 42,000 Americans in 2016. But some advocates say the funding included in the spending plan the president signed Friday is not nearly enough to establish the kind of treatment system needed to reverse the crisis. A White House report last fall put the cost to the country of the overdose epidemic at more than $500 billion a year. (Mulvihill, 3/25)

Stat: Trump Opioid Plan Writes In Favoritism To Vivitrol Over Other Medications
The White House’s national strategy to combat the opioid crisis, unveiled last week, would expand a particular kind of addiction treatment in federal criminal justice settings: a single drug, manufactured by a single company, with mixed views on the evidence regarding its use. Federal prisons should “facilitate naltrexone treatment and access to treatment” to inmates as they transition out of incarceration, according to a fact sheet circulated by the administration. A White House spokesman later confirmed to STAT that the document referred specifically to naltrexone in its injectable form. (Facher, 3/26)

The New York Times: Why Can’t Dying Patients Get The Drugs They Want?
At first glance, a bill passed by the House of Representatives this week seems like the kind of thing anyone could get behind. Known as the “Right to Try” legislation, it would allow terminally ill patients access to experimental drugs without the approval of the Food and Drug Administration. But the bill and a similar one passed last summer by the Senate do little to address the main barrier that patients face in getting unapproved treatments: permission from the drug companies themselves. (Thomas, 3/23)

Politico: California's Drug Transparency Law Yields Early Surprises
California’s first-in-the-nation drug pricing transparency law is beginning to kick in — and to spur copycats, with Oregon’s governor last week signing a law that requires drug companies to disclose cost components they have long considered proprietary. Whether they’ll actually reduce prices is a crapshoot. (Colliver, 3/25)

The Associated Press: Benefits Of Lobbying Evident For Small Drugmaker
Tucked in the massive congressional budget bill is a provision that props up the price Medicare pays for a handful of medications, costing taxpayers millions at a time when the Trump administration is vowing to reduce the cost of prescription drugs. Lawmakers acted after a lobbying campaign by a small Washington state pharmaceutical company called Omeros. Its main product is a drug called Omidria, used by hospitals in cataract surgery, which had recently lost a coveted Medicare reimbursement status. Individuals associated with the company also stepped up their political contributions. (3/24)

NPR: Patients' Comment About Drug Side Effects On Social Networks
When Allison Ruddick was diagnosed with stage 3 colorectal cancer in October 2014, she turned to the world of hashtags. After her initial diagnosis it wasn't clear if the cancer had metastasized, so she was in for a nerve-wracking wait, she says. She wanted outside advice. "But they don't really give you a handbook, so you search kind of anywhere for answers," Ruddick says. "Social media was one of the first places I went." (Wilhelm, 3/23)

Stat: Cancer Immunotherapy Implants Get Boost By Novartis Licensing
Cancer immunotherapy — the process of activating a patient’s own immune system to fight a tumor — is a booming field in drug development. But it faces certain hurdles. Fewer than a quarter of cancer patients benefit from leading drugs in the class known as “checkpoint inhibitors.” And personalized cellular therapies are costly and complicated to create and deliver. To help solve those challenges, scientists at Harvard have developed an implantable device that would pull immune cells into the implant, train them to recognize pieces of the patient’s tumor, and then release these cells — with the end goal of creating a sustained attack against the cancer. (Cooney, 3/26)

The New York Times: When The Elderly Call For Help, A ‘Chain’ Immigrant Often Answers
Irma Mangayan was lathering and rinsing a 92-year-old woman in Room 413 one recent afternoon when she received a page from another room. An incontinent resident had an accident, and Ms. Mangayan would have to clean it up. Before her shift was over at Belmont Village Senior Living, Ms. Mangayan would hoist women and men into their wheelchairs, escort residents using walkers downstairs to the dining room and then back and perform myriad other tasks that they once could do for themselves. (Jordan, 3/25)

The New York Times: American Adults Just Keep Getting Fatter
American adults continue to put on the pounds. New data shows that nearly 40 percent of them were obese in 2015 and 2016, a sharp increase from a decade earlier, federal health officials reported Friday. The prevalence of severe obesity in American adults is also rising, heightening their risks of developing heart disease, diabetes and various cancers. According to the latest data, published Friday in JAMA, 7.7 percent of American adults were severely obese in the same period. (Richtel and Jacobs, 3/23)

The Wall Street Journal: Why Do Some People Get Sick Less Often?
You know who you are: the person who had perfect attendance, the one who never gets the nasty cold going around the office. Some people seem to be immune to whatever’s taking hold of their friends and neighbors, while others move from one bout of cold to another with little reprieve. Two experts, Sheldon Cohen, a professor of psychology at Carnegie Mellon University in Pittsburgh, and Robert Atmar, a professor of medicine in the Section of Infectious Diseases at Baylor College of Medicine in Houston, explain how your family’s home ownership during early childhood may come into play and why loners may fare worse. (Mitchell, 3/24)

The Washington Post: Why It's Good To Talk 'Baby Talk' To Your Child
All around the world, parents talk differently to babies than they do to adults. With their young kids, parents switch into a mode of communication known to linguists as “motherese” or infant-directed speech, and known more commonly as baby talk, a form of speech featuring long pauses and a roller coaster of pitch changes. For example, picture the upward swing in pitch that our voices take toward the end of a question (“Do you want to go to the park today?”): It’s much more dramatic when we address young children than adults. (Piazza, 3/25)

NPR: Apps Selling Prescription Birth Control Do Well In 'Contraception Deserts'
Rachel Ralph works long hours at an accounting firm in Oakland, Calif., and coordinates much of her life via the apps on her phone. So when she first heard several months ago that she could order her usual brand of birth control pills via an app, and have them delivered to her doorstep in a day or two, it seemed perfect. She was working 12-hour days. "Food was delivered, dinner was often delivered," Ralph says. "Anything I could get sent to my house with little effort — the better." (McClurg and Lopez, 3/26)

The Washington Post: Wellness Is Made Easier With Some Simple Tips
What’s wellness?Sure, it involves your physical form and your ability to deal with disease and other challenges. But wellness also has a lot to do with how you approach the world. Your relationships, your physical surroundings and your habits all affect your body and mind. (Blakemore, 3/25)

Stateline: Family Members Fight For Right To Visit Ailing Relatives
Experiences like [Toby] Davidow’s have prompted at least 11 states to enact laws that would provide a legal remedy, besides seeking guardianship, which can be costly and complicated, for relatives who have been prevented from seeing infirm or disabled family members. Under the laws, relatives can seek a court order permitting visitation and communication. The order must be granted, unless the ailing relative is found to be mentally competent and objects to contact. (Ollove, 3/26)

The Wall Street Journal: New Jersey Venture Aims To Stop ‘Exodus’ Of Medical Students
Years in the making, Hackensack Meridian School of Medicine at Seton Hall University is finally ready for students. The school, located at the former Hoffmann-La Roche campus in Nutley, N.J., is a joint venture of Seton Hall University and Hackensack Meridian Health. The college began accepting applications this week for its first class of 55 students, who will begin studies this July. (West, 3/24)