First Edition: March 26, 2019

Kaiser Health News: Bill Of The Month: A Knee Brace With A Big Markup
Last October, Esteban Serrano wrenched his knee badly during his weekly soccer game with friends. Serrano, a software engineer, grew up playing soccer in Quito, Ecuador, and he has kept up his sport since moving to the United States two decades ago. He hobbled off the field and iced the knee. But the pain was so severe, he made an appointment with Rothman Orthopaedic Institute, a network of orthopedists practicing in Greater Philadelphia, New Jersey and New York. (Andalo, 3/26)

The New York Times: Trump Officials Broaden Attack On Health Law, Arguing Courts Should Reject All Of It
The Trump administration broadened its attack on the Affordable Care Act on Monday, telling a federal appeals court that it now believed the entire law should be invalidated. The administration had previously said that the law’s protections for people with pre-existing conditions should be struck down, but that the rest of the law, including the expansion of Medicaid, should survive. If the appeals court accepts the Trump administration’s new arguments, millions of people could lose health insurance, including those who gained coverage through the expansion of Medicaid and those who have private coverage subsidized by the federal government. (Pear, 3/25)

The Washington Post: Trump Administration Backs Full Repeal Of Affordable Care Act In Legal Reversal
[The Justice Department] divulged its position in a legal filing Monday with the U.S. Court of Appeals for the 5th Circuit in New Orleans, where an appeal is pending in a case challenging the measure’s constitutionality. A federal judge in Texas ruled in December that the law’s individual mandate "can no longer be sustained as an exercise of Congress’s tax power” and further found that the remaining portions of the law are invalid. He based his judgment on changes to the nation’s tax laws made by congressional Republicans the previous year. (Stanley-Becker, 3/26)

Politico: In Shift, Trump Administration Backs Judge’s Ruling That Would Kill Obamacare
Regardless of the outcome, legal experts anticipate that the 5th Circuit's ruling will be appealed to the Supreme Court. If the courts ultimately strike down Obamacare — over the objections of a group of Democrat-led states, which have spent more than a year defending the health law in court — the consequences could be substantial for patients, health care organizations and other groups that have adapted to the nine-year-old law. (Diamond, 3/25)

The Associated Press: 11.4M Sign Up For Obama-Era Health Plans This Year
The government says 11.4 million people have signed up for coverage this year under former President Barack Obama's health law. That's just a slight dip from 2018. Despite the Trump administration's ongoing hostility to "Obamacare," a report from the Centers for Medicare and Medicaid Services released on Monday found remarkably steady enrollment— down only about 300,000 consumers. (3/25)

Reuters: Obamacare Enrollments Drop Marginally For 2019
The agency also said it was issuing guidance to allow issuers to continue certain health plans, often referred to as "grandmothered" plans, by one year. Such plans do not meet all the rules under the Obamacare laws. "Not extending the grandmothered plan policy would ... force people to decide between buying coverage they cannot afford on the individual market or going uninsured," CMS Administrator Seema Verma said. (3/25)

The Wall Street Journal: Affordable Care Act Sign-Ups Total 11.4 Million For This Year
Average rates for popular health plans sold on the exchanges fell about 1.5% this year, according to the Trump administration, the first such drop and a sign that the insurance markets are gaining firmer traction despite tumult in the past two years. The majority of people who obtain coverage on the exchanges get tax credits to reduce premium costs. Headed into the 2020 campaign, Democrats are divided over pursuing legislation now to shore up the exchanges or pushing for Medicare for All, a government-run health system. House Speaker Nancy Pelosi’s office said Democrats will release health-care legislation Tuesday focused on curbing costs and protecting people with pre-existing conditions. (Armour, 3/25)

The New York Times: House Democrats To Unveil Plan To Expand Health Coverage
Democrats won control of the House in large part on the strength of their argument that Congress needs to protect people with pre-existing medical conditions and to lower the cost of health care. On Tuesday, Democratic leaders, including Speaker Nancy Pelosi, will put aside, at least for now, the liberal quest for a government-run “Medicare for all” single-payer system and unveil a more incremental approach toward fulfilling those campaign promises. Building on the Affordable Care Act, they would offer more generous subsidies for the purchase of private health insurance offered through the health law’s insurance exchanges while financing new efforts to increase enrollment. (Pear, 3/25)

The Washington Post: Obama Cautions Freshman House Democrats About The Price Tag Of Liberal Policies
Former president Barack Obama gently warned a group of freshman House Democrats Monday evening about the costs associated with some liberal ideas popular in their ranks, encouraging members to look at price tags, according to people in the room. Obama didn’t name specific policies. And to be sure, he encouraged the lawmakers — about half-dozen of whom worked in his own administration — to continue to pursue “bold” ideas as they shaped legislation during their first year in the House. But some people in the room took his words as a cautionary note about Medicare-for-All and the ambitious Green New Deal, two liberal ideas popularized by a few of the more famous House freshmen, including Rep. Alexandria Ocasio-Cortez (D-N.Y.). (Bade, 3/26)

The Hill: House Dems To Hold Hearing On Preventing Surprise Medical Bills 
House Democrats will hold a hearing on protecting patients from surprise medical bills next week, according to a congressional aide. A subcommittee of the Education and Labor Committee will convene the hearing April 2. Witnesses have not yet been announced. The hearing, which has not yet been publicly announced, was first reported by Vox. (Weixel, 3/25)

Stateline: Trump Greenlights Major Medicaid Changes 
In a stark departure from past administrations, the Trump administration is allowing states to enact new Medicaid rules that will curtail benefits and reduce, rather than expand, the number of people eligible for the federal-state health program for the poor. New work requirements have received most of the attention. This year, the administration has granted permission to Arizona and Ohio to impose work requirements of 80 hours a month for most able-bodied adults. (Ollove, 3/26)

The New York Times: Women At Breast Implant Hearing Call For Disclosure Of Safety Risks
Women with illnesses linked to breast implants challenged plastic surgeons, regulators and implant makers at an emotionally charged meeting on Monday at the Food and Drug Administration, demanding more information about the risks of the implants and calling for a ban on one that is associated with an unusual type of cancer. They asked implant makers to disclose the materials used in the devices and also called for a “black box” warning — a label that the F.D.A. can require, noting heightened problems with a drug or device. (Grady and Rabin, 3/25)

The Washington Post: ‘I Was Not Warned’ - Women Who Say They Were Sickened By Breast Implants Demand FDA Action
Telling searing stories about broken health, disrupted families and lost careers, the women pressed an FDA advisory panel to recommend more long-term research, bans or restrictions on certain products and a beefed-up informed consent process so that women have a clear understanding of the risks and benefits of the devices before they opt for surgery. “I was not warned" about the risks of implants, Jamee Cook, an advocate and former ER paramedic, told the FDA’s expert committee. Cook, who lives near Dallas, said that after getting implants in 1998, she suffered for years from swollen lymph nodes, chronic fatigue, migraines and a low-grade fever. She said she eventually had the devices removed, after which many, but not all, of her symptoms eased. (McGinley, 3/25)

The Wall Street Journal: Patients Continue To Report Problems With Breast Implants
Jamee Cook, head of a women’s group called Breast Implant Victim Advocacy, said she was a paramedic and active when she got implants in 1998. Since then, she said, she experienced chronic fatigue, numbness and migraines—symptoms that were resolved when she had them taken out. “Women are still complaining of the exact same issues” they complained of in 1992 when silicone implants left the U.S. market, she said. “The FDA has not fulfilled its responsibility to protect patients.” Nearly three decades after the FDA first pulled silicone breast implants off the U.S. market and then allowed some back on, women continue to report debilitating conditions to the agency. The FDA is revisiting the issue again this year and is grappling with efforts to study which issues are proven and which not proven. (Burton, 3/25)

The Associated Press: US Experts: Too Soon To Pull Breast Implants Tied To Cancer
Government medical advisers said Monday it's too soon to ban a type of breast implant that has recently been linked to a rare form of cancer, saying more information is needed to understand the problem. The Food and Drug Administration panel didn't recommend any immediate restrictions on breast implants after a day reviewing the latest research on the risks of the devices, which have been subject to safety concerns for decades. (3/25)

The New York Times: Bayer And Johnson & Johnson Settle Lawsuits Over Xarelto, A Blood Thinner, For $775 Million
Johnson & Johnson and Bayer said on Monday that they had agreed to pay $775 million to settle about 25,000 lawsuits involving the blood thinner Xarelto, which they jointly sell. The settlement, which will be split evenly between the two companies, resolves state and federal cases in which patients sued the companies for failing to warn about potentially fatal bleeding episodes when patients took the drug. (Thomas, 3/25)

Stat: J&J And Bayer To Pay $775M To Settle Thousands Of Xarelto Lawsuits 
In a statement, the Janssen unit at J&J explained the company wanted to avoid the “enormous” time and resources to defend the lawsuits. But the health care giant also maintained the company “always appropriately informed physicians of the information that they need to make treatment decisions” and continues to “stand behind” Xarelto. (Silverman, 3/25)

Reuters: Duke University Pays $112.5 Million In Fake Research Case Sparked By Whistleblower
Duke University agreed to pay $112.5 million to settle claims by a whistleblower that a former research technician knowingly submitted fake data in applications for federal research grants, the U.S. Department of Justice said on Monday. The accord resolves claims by a former Duke laboratory research analyst who said the Durham, North Carolina-based university knew that Erin Potts-Kant used fraudulent data to obtain grants from the National Institutes of Health, the Environmental Protection Agency and other agencies. (3/25)

The New York Times: Duke University To Pay $112.5 Million To Settle Claims Of Research Misconduct
“Taxpayers expect and deserve that federal grant dollars will be used efficiently and honestly,” Matthew G.T. Martin, United States attorney for the Middle District of North Carolina, said in a statement. “May this serve as a lesson that the use of false or fabricated data in grant applications or reports is completely unacceptable.” The allegations were initially made in a whistle-blower lawsuit brought by Joseph Thomas, a research analyst who worked in Duke’s pulmonary division. He claimed that another researcher, Erin Potts-Kant, had fabricated data linked to as much as $200 million in federal research grants. (Kaplan, 3/25)

The Wall Street Journal: Duke University Agrees To Pay $112.5 Million In Whistleblower Suit Over Grants
The settlement “demonstrates that the Department of Justice will pursue grantees that knowingly falsify research and undermine the integrity of federal funding decisions,” Assistant Attorney General Jody Hunt for the Justice Department’s civil division said in a statement. The suit, brought by a former employee, alleged that the university was aware biologist Erin Potts-Kant included fraudulent data in a number of grant applications and reports, including for some work done with Duke pulmonary researcher William Michael Foster, who was named as a defendant in the civil lawsuit. (Korn, 3/25)

Stat: Many Leading Universities Still Failing To Report Clinical Trial Results 
Results from nearly one-third of hundreds of clinical trials have not been disclosed over the past two years by several of the most prestigious research universities in the U.S., despite federal law requirements, a new analysis has found. Specifically, findings were not posted for 31 percent — or 140 —of 450 studies that were to have been disclosed in public registries as a result of transparency requirements in the FDA Amendments Act, according to Universities Allied for Essential Medicines, a student-led organization concerned with access to medicines, and TranspariMED, a nonprofit research advocacy group. (Silverman, 3/25)

Stat: Tufts Taps Former U.S. Attorney To Investigate Ties To Purdue Pharma 
Tufts University announced Monday it had hired a former U.S. attorney to investigate its relationship with Purdue Pharma and the billionaire Sackler family that owns the maker of OxyContin and other opioid painkillers, following allegations that Purdue sought to gain influence at the school through donations. ...Scrutiny of the ties has been building amid the growing opioid crisis — which critics say OxyContin and Purdue’s aggressive marketing of its drugs helped trigger. It came to a head when a lawsuit filed last year by Massachusetts Attorney General Maura Healey against Purdue and members of the Sackler family revealed that the company allegedly influenced educational and research programs at Tufts and sought to use the Tufts brand to bolster the company’s. (Joseph, 3/25)

The New York Times: Museums Cut Ties With Sacklers As Outrage Over Opioid Crisis Grows
In London this weekend, visitors to the Old Royal Naval College headed to its reopened “painted hall,” an ornate masterpiece called Britain’s answer to the Sistine Chapel, and then went to the Sackler Gallery to learn its story. In Paris, at the Louvre, lovers of Persian art knew there was only one place to go: the Sackler Wing of Oriental Antiquities. Want to find the long line for the Temple of Dendur at the Metropolitan Museum of Art? Head for the soaring, glass-walled Sackler Wing. (Marshall, 3/25)

The Hill: Oklahoma Supreme Court Rejects Request To Delay Opioid Trial 
The Oklahoma Supreme Court on Monday denied a request by drugmakers to delay the start of an upcoming trial against them in the state for allegedly helping to fuel the opioid epidemic. Oklahoma’s case is expected to be the first state lawsuit against opioid manufacturers to go to trial. (Weixel, 3/25)

The New York Times: Two Top Medical Groups Call For Soda Taxes And Advertising Curbs On Sugary Drinks
Two of the country’s leading medical groups on Monday issued a call to arms against the soda industry, urging legislators and policymakers to embrace taxes, warning labels and advertising restrictions to deter young people from consuming the sugary beverages that are increasingly linked to the nation’s crisis of obesity and chronic disease. Describing sweetened drinks as “a grave health threat to children and adolescents,” the American Academy of Pediatrics and the American Heart Association issued a set of bold policy recommendations they say are necessary to stem the epidemic of Type 2 diabetes, cancer, cardiovascular disease and other diet-related illnesses responsible for tens of thousands of premature deaths and billions of dollars in annual health care costs. (Jacobs, 3/25)

The Hill: Health Groups Back Proposals Taxing Sugary Drinks, Limiting Marketing To Kids 
“For children, the biggest source of added sugars often is not what they eat, it’s what they drink,” said Natalie Muth, a physician and lead author of the policy statement. "As a pediatrician, I am concerned that these sweetened drinks pose real — and preventable — risks to our children’s health, including tooth decay, diabetes, obesity and heart disease. We need broad public policy solutions to reduce children’s access to cheap sugary drinks.” (Hellmann, 3/25)

Stat: The Measles Virus Was Down And Out. Now It's Primed For A Comeback
Back near the start of this century, before the full damage of Andrew Wakefield’s debunked study linking measles vaccine and autism became clear and social networking sites turbo-charged the disruptive power of vaccine opponents, some experts believed the world was ready to rid itself of measles once and for all. These days, with massive outbreaks in the Philippines and Ukraine, more than 80,000 cases in the past year in Europe, and ongoing epidemics in New York, Washington, Texas, Illinois, and California, measles does not feel like an endangered virus. (Branswell, 3/26)

The Wall Street Journal: The Autism Diagnosis That Isn’t Always Permanent
A growing body of evidence demonstrates that some children diagnosed with autism spectrum disorder, or ASD, can outgrow their diagnosis. This isn’t unqualified good news: Experts caution that those children often continue struggling with other conditions. The latest evidence was published this month in the Journal of Child Neurology. It demonstrated that among 569 children diagnosed with autism between 2003 and 2013, 38 children—or about 7%—no longer met the diagnostic criteria. (Reddy, 3/25)

Stat: Asthma Takes A Toll On African-Americans. Can Precision Medicine Help?
Geneticist Dr. Esteban Burchard was studying asthma at Brigham and Women’s Hospital in Boston years ago when, he recalled, “a black teenager died of an asthma attack right outside the hospital entrance. Which is ridiculous. There are 20 hospitals in Boston!” The death reflected a harsh reality in the United States: Asthma hits African-Americans particularly hard, and the health care system often fails them. An estimated 15.3 percent of black children have the disease compared with 7.1 percent of white children, according to the Centers for Disease Control and Prevention. Overall, African-Americans are nearly three times as likely to die from asthma as white people. (McQuaid, 3/26)

NPR: Questions Mount About 'Sonic Attacks' On U.S. Embassy In Havana
The claim was extraordinary. More than 20 U.S. diplomats in Cuba had "suffered significant injuries" in a series of attacks that seemed to target the brain. Or at least that's what State Department officials told reporters during a briefing in September 2017. A couple of weeks later, President Trump went even further. "I do believe Cuba is responsible," he said during a Rose Garden news conference. (Hamilton, 3/25)

The Associated Press: What My DNA Told Me: Avoid Fast Food, Eat Vegetables
Avoid fast food, eat vegetables and exercise. It sounds like generic health advice, but they're tips supposedly tailored to my DNA profile. The suggestions come from 23andme, one of the companies offering to point you toward the optimal eating and exercise habits for your genetics. As with most dieting schemes, the idea is appealing because it implies there's an elusive reason why you can't get in shape — in this case, your genes. (3/25)

The New York Times: Americans Are Having Fewer Heart Attacks
Older Americans are having fewer heart attacks and surviving them longer than ever before. For a study published in JAMA Open Network, researchers analyzed records of 4.3 million Medicare beneficiaries hospitalized for heart attacks from 1995 through 2014 in 5,680 hospitals across the country. The number of people hospitalized declined by 38 percent over the period, 30-day mortality decreased by 38 percent, and recurrent heart attacks within a year declined by 28 percent. (Bakalar, 3/26)

Reuters: Father Of Sandy Hook Victim Found Dead In Apparent Suicide: Police
The father of one of the children killed in the 2012 mass shooting at Sandy Hook Elementary School was found dead of an apparent suicide on Monday morning at his office in Newtown, Connecticut, police said. Jeremy Richman, 49, was the father of Avielle Richman, one of 20 children, all 6 or 7 years old, killed along with six adult staff members by a man with a semi-automatic rifle at the school in Newtown. It stands as one of the deadliest mass shootings in U.S. history. (3/25)

The New York Times: Sandy Hook Victim’s Father Dies In Apparent Suicide In Newtown
In the more than six years since his daughter Avielle was killed in the massacre at Sandy Hook Elementary School, Jeremy Richman had devoted his life to preventing families from experiencing the kind of tragic loss he did. With his wife, Jennifer Hensel, he created the Avielle Foundation to support research into brain abnormalities that could be linked to violent behavior. In this endeavor, he stressed mental health education and compassion. (Gold and Pager, 3/25)

The Associated Press: In Parkland, Worry Increases After Student Suicides; In Newtown, Father Of 1st-Grade Victim Found Dead
The community of Parkland, Fla., is focusing attention on its suicide prevention programs after two survivors of the Florida high school massacre killed themselves in a week. Parkland Mayor Christine Hunschofsky said Monday that community leaders, government officials, parents, police and others held an emergency meeting Sunday after a second Marjory Stoneman Douglas High School student apparently killed himself over the weekend. That came a week after a recent graduate, who was close friends with victim Meadow Pollack, killed herself. Her family said she suffered from survivor’s guilt. (3/25)

The Washington Post: Parkland Suicides: Marjory Stoneman Douglas Community Faces Tragedy Again
The Parkland parents were insistent. They would not leave without a plan. It was Sunday afternoon, one year, one month and 10 days since their children had been among the 17 people killed at Marjory Stoneman Douglas High School. Now their Parkland community was again coping with loss — this time death by suicide. (Rozsa, Epstein and Mettler, 3/26)

The Hill: Parkland Students Call Suicide Deaths Of Classmates 'Another Failure By America' 
Current and former Marjory Stoneman Douglas high school students are speaking out about the mental health services they received after a mass shooting in the wake of some fellow students' recent suicide deaths. Kyra Parrow, who was a senior when a gunman killed 17 students at the school in Parkland Fla., tweeted on Sunday that the suicides represented another "failure" from America. (Wise, 3/25)

Politico: Flood Of Products Containing Marijuana Extract Puts FDA In A Bind
Even by the superhyped standard of internet cures, the marijuana and hemp extract cannabidiol is unique, touted as everything from a hair conditioner to a sleep aid and a way to help manage diabetes and fight cancer. The CBD boom is also giving regulators fits, blurring the line between a drug and a dietary supplement and testing how much the government can police health claims. (Owermohle, 3/26)

The New York Times: Marijuana Edibles May Pose Special Risks
Pot brownies and other cannabis “edibles” like gummy bears that are sold online and where marijuana is legal may seem like harmless fun, but new research indicates that edibles may be more potent and potentially more dangerous than pot that is smoked or vaped. The new study analyzed thousands of cannabis-triggered emergency room visits in the greater Denver area, and found that edibles induced a disproportionate number of pot-related medical crises. (Rabin, 3/25)

The Associated Press: Marijuana ER Visits Climb In Denver Hospital Study
Five years after Colorado first legalized marijuana, a new study shows pot's bad effects are sending more people to the emergency room. Inhaled marijuana caused the most severe problems at one large Denver area hospital. Marijuana-infused foods and candies, called edibles, also led to trouble. Patients came to the ER with symptoms such as repeated vomiting, racing hearts and psychotic episodes. (3/25)

The Associated Press: More Aging Americans Are Using Pot To Soothe What Ails Them
The group of white-haired folks — some pushing walkers, others using canes — arrive right on time at the gates of Laguna Woods Village, an upscale retirement community in the picturesque hills that frame this Southern California suburb a few miles from Disneyland. There they board a bus for a quick trip to a building that, save for the green Red Cross-style sign in the window, resembles a trendy coffee bar. The people, mostly in their 70s and 80s, pass the next several hours enjoying a light lunch, playing a few games of bingo and selecting their next month’s supply of cannabis-infused products. (Rogers, 3/25)

The Associated Press: Audit: Slow Legionnaires' Response At Illinois Veterans Home
A state audit released Monday contradicted former Gov. Bruce Rauner's claim that his administration had done everything federal experts recommended to remedy a deadly 2015 Legionnaires' disease crisis at an Illinois veterans' home. Auditor General Frank Mautino reported that the Centers for Disease Control and Prevention had recommended in December 2015 that filters be put on every water spigot. Despite Rauner's claim, the audit found that only shower and bathtub heads were outfitted with filters before 2018. (3/25)

The Associated Press: Murphy To Sign Bill Allowing Medically Assisted Suicide 
New Jersey Gov. Phil Murphy said Monday he will sign legislation allowing terminally ill patients to seek life-ending medication. New Jersey will join six other states and the District of Columbia that have similar laws once the bill is signed. “Allowing terminally ill and dying residents the dignity to make end-of-life decisions according to their own consciences is the right thing to do. I look forward to signing this legislation into law,” Murphy, a Democrat, said in a statement after the Democrat-led Assembly and Senate passed the measure in close votes. (3/25)

The Associated Press: Judge Cautions Lawyers To Watch Language In Abortion Case
A federal judge in Kentucky has cautioned lawyers to watch their language in their bitter legal feud over abortion — this time over a lawsuit challenging two new state laws aimed at putting more restrictions on the procedure. U.S. District Judge David J. Hale set a Friday hearing on a motion for a preliminary injunction requested by attorneys for EMW Women's Surgical Center in Louisville — the only abortion clinic in Kentucky. (3/26)

Los Angeles Times: California Lawmakers Will Consider Banning Cosmetic Genital Surgery On Intersex Children
River Gallo has prosthetic testes he says he never asked for and never wanted. Alice Alvarez says she should have been able to decide for herself before a doctor removed her testicles, which one did when she was an infant. Both are part of a group supporting a bill in the California Legislature that would ban cosmetic surgeries on children born with atypical genitals until they’re old enough to consent. California would be the first state to enact such a ban. (Gutierrez, 3/25)

The Associated Press: Northam Plans Spending To Rebuild Psychiatric Hospital
Virginia Gov. Ralph Northam is proposing a new budget amendment to replace an aging psychiatric hospital in the central part of the state. Northam took a tour of Central State Hospital outside of Petersburg on Monday before announcing plans to ask lawmakers to approve adjustments to the state’s capital budget to spend more than $300 million to rebuild the hospital. The Democratic governor says there is bipartisan support to address the urgent need to upgrade the hospital, which is a collection of several buildings spread out on a sprawling campus in Dinwiddie County. (3/25)