First Edition: March 27, 2019

Kaiser Health News: Trump Administration And Democrats Return Health Law To Political Center Stage
Trump has repeatedly called for the law to be repealed and replaced, but when Republicans controlled Congress they could not muster the necessary votes. Just last week, the president lashed out Sen. John McCain (R-Ariz.), who died in August, for failing to support that effort. (Rovner, 3/26)

Kaiser Health News: Device-Safety Experts To FDA: Make Data Public
Medical device safety researchers are calling on the Food and Drug Administration to release hundreds of thousands of hidden injury and malfunction reports related to about 100 medical devices. A recent Kaiser Health News investigation revealed that the FDA granted device makers numerous “exemptions” from the standard rules of publicly reporting harm related to devices. One such program began about 19 years ago and allowed companies to file alternative summary reports about injuries or malfunctions into a database not visible to doctors, medical researchers or the public. (Jewett, 3/27)

Kaiser Health News: Medicaid Expansion Boosts Hospital Bottom Lines — And Prices
The Medicaid expansion promoted by the Affordable Care Act was a boon for St. Mary’s Medical Center, the largest hospital in western Colorado. Since 2014, the number of uninsured patients it served dropped by more than half, saving the nonprofit hospital more than $3 million a year. But the Grand Junction hospital’s prices did not go down. “St. Mary’s is still way too costly,” said Mike Stahl, CEO of Hilltop Community Resources, which provides insurance to about half of its nearly 600 employees and their families in western Colorado. (Galewitz, 3/27)

Kaiser Health News: Analysis: Why Should Americans Be Grateful For $137 Insulin? Germans Get It For $55
This month, Eli Lilly and Co. announced with some fanfare that it was manufacturing a generic version of its own best-selling insulin brand, Humalog, which it would sell for half off — $137.35 versus about $275. David Ricks, the chief executive of Lilly, said the company was making this seemingly beneficent gesture because “many patients are struggling to afford their insulin.”But they’re struggling, in large part, because since 2001 Lilly has raised the price of a vial of Humalog to about $275, from $35. Other insulin makers have raised prices similarly. (Elisabeth Rosenthal, 3/27)

The New York Times: Democrats Pivot Hard To Health Care After Trump Moves To Strike Down Affordable Care Act
The Trump administration’s decision to ask a federal appeals court to invalidate the Affordable Care Act has given House Democrats a new opening to pursue what they see as a winning political strategy: moving past talk of impeachment to put kitchen-table issues like health care front and center. The notice to the court, filed late Monday by the Justice Department, could not have come at a more opportune time for Democrats. The finding by Robert S. Mueller III, the special counsel, that there was no evidence of a criminal conspiracy between the Trump campaign and Russia, dashed the hopes of the most partisan Democrats that the House would impeach the president. (Stolberg and Pear, 3/26)

The Wall Street Journal: Democrats Signal Renewed Focus On Health Care After Mueller Findings
“We’ve never taken our focus off the for-the-people agenda,” House Speaker Nancy Pelosi (D., Calif.) told reporters on Tuesday after meeting with the Democratic caucus. She said the party would push to lower the cost of health care, build infrastructure and clean up government. Rep. James Clyburn (D., S.C.), the House majority whip, appeared to go a step further. “I believe that the Mueller report has been done. It’s a chapter that’s closed,” Mr. Clyburn said. Pointing to a filing by the Justice Department late Monday that asked a court to invalidate the Affordable Care Act, Mr. Clyburn said health care is “the No. 1 thing on people’s minds.” (Hughes and Peterson, 3/26)

The Washington Post: Trump Surprises Republicans — And Pleases Democrats — With Push To Revive Health-Care Battle
In a new court filing, the Justice Department argued that the ACA, also known as Obamacare, should be thrown out in its entirety, including provisions protecting millions of Americans with preexisting health conditions and allowing young adults to stay on their parents’ health-care plans. President Trump praised the move during a lunch with Senate Republicans, and suggested the GOP should embrace a new congressional battle over health-care policy ahead of the 2020 elections. “Let me tell you exactly what my message is: The Republican Party will soon be known as the party of health care,” he told reporters before the lunch. “You watch.” (Olorunnipa and Kim, 3/26)

Reuters: Trump Administration Steps Up Obamacare Attack, Asks Court To Overturn Law
Democrats said the move to overturn Obamacare would overshadow Republican President Donald Trump's claim of victory following the conclusion of Special Counsel Robert Mueller's probe of Russian interference in the 2016 presidential election. The legal filing gave Democrats a natural opening to focus on an issue they say is more important to voters than the Mueller investigation. "We always felt that the issues that affect average Americans - healthcare, climate change, jobs - (are) far more important to them, and to us, than what happens in an investigation," Senate Minority Leader Chuck Schumer told reporters. (3/26)

The Associated Press: Trump's Attack On 'Obamacare' Gives Democrats A Fresh Issue
"This is something that Americans care deeply about," said Sen. Amy Klobuchar of Minnesota, a White House hopeful. "I may not have been asked about the Mueller report at town hall meetings, but I was sure asked about health care." Other Democrats appeared to relish the chance to shift to health care. Asked if the Trump administration's court filing allowed Democrats to turn the page on Mueller, House Speaker Nancy Pelosi said she would have been talking about health care no matter what. "We have been dealing with health care constantly," the California Democrat said. "The public attention has been on the Mueller report, but we have been focused on health care." (3/26)

Los Angeles Times: Trump Reopens Obamacare Repeal Debate, And Democrats Are Thrilled
In a closed-door lunch with the senators, the president issued a vague call to them to address healthcare to lower costs, according to several lawmakers in the room. “He led off on that and he spent a good bit of time on it. It’s clearly on his mind, and it’s clear to me he wants us to take another run on it,” said Sen. John Kennedy of Louisiana. “I thought that he’d immediately start talking about the Mueller report or China,” the country at the center of Trump’s trade agenda. (Bierman, Haberkorn and Levey, 3/26)

Politico: White House Obamacare Reversal Made Over Cabinet Objections
The Trump administration’s surprising move to invalidate Obamacare on Monday came despite the opposition of two key cabinet secretaries: Health and Human Services Secretary Alex Azar and Attorney General Bill Barr. Driving the dramatic action were the administration’s domestic policy chief, Joe Grogan, and the acting director of the Office of Management and Budget, Russ Vought, according to three sources with direct knowledge of the decision. Both are close allies of White House acting chief of staff Mick Mulvaney, who helped to engineer the move. (Johnson and Everett, 3/26)

The New York Times: What Happens If Obamacare Is Struck Down?
The Affordable Care Act was already in peril after a federal judge in Texas invalidated the entire law late last year. But the stakes ramped up again this week, when President Trump’s Justice Department announced it had changed its position and agreed with the judge that the entire law, not just three pieces of it, should be scrapped. A coalition of states is appealing the ruling. If it is upheld, tens of millions more people would be affected than those who already rely on the nine-year-old law for health insurance. Also known as Obamacare, the law touches the lives of most Americans, from nursing mothers to people eating at chain restaurants. (Abelson, Goodnough and Pear, 3/26)

Bloomberg: Trump Turns Back To Health Care, But What Comes Next Is Unclear 
The failure by Republicans to overturn the Affordable Care Act has been a sore point for the president. In recent weeks, Trump has taken to Twitter to attack the late Senator John McCain, who in 2017 cast the decisive vote against a bill packaged as a “skinny repeal” of the health law. The following year, Republicans lost control of the House, as many Democrats campaigned on a promises to shield Obamacare from its GOP critics. (Tozzi and Wasson, 3/26)

Politico: White House, Pelosi In Talks On Drug Pricing Legislation
The Trump administration has held early-stage conversations with Speaker Nancy Pelosi's staff about drug-pricing legislation that could provide each side with a domestic policy victory, according to White House and congressional sources. Democrats and the Trump administration have made reducing drug costs a priority, but accomplishing anything could be difficult, especially since the administration has taken an aggressive stance to overturn Obamacare in federal court. (Karlin-Smith and Cancryn, 3/26)

Reuters: Trump Wants To Work With Democrats On Drug Prices, Infrastructure: Aide
U.S. President Donald Trump is willing to work with congressional Democrats to lower drug prices for Americans and on infrastructure funding, White House adviser Kellyanne Conway said on Tuesday. Conway said the Trump administration considered those two issues as areas of cooperation between Democrats and the Republican president. (3/26)

Reuters: Purdue Pharma Agrees To $270 Million Settlement In Oklahoma Opioid Case
OxyContin maker Purdue Pharma LP and members of the wealthy Sackler family that own the company reached a $270 million settlement to resolve a lawsuit brought by the state of Oklahoma accusing the drugmaker of fueling an opioid abuse epidemic. The settlement unveiled by Oklahoma Attorney General Mike Hunter on Tuesday was the first to result from a wave of lawsuits accusing Purdue of deceptively marketing painkillers, helping create a deadly crisis sweeping the United States. (3/26)

The New York Times: Purdue Pharma And Sacklers Reach $270 Million Settlement In Opioid Lawsuit
The payment, negotiated to settle a case brought by the state of Oklahoma, was far larger than two previous settlements Purdue Pharma had reached with other states. It could jolt other settlement talks with the company, including those in a consolidated collection of 1600 cases overseen by a federal judge in Cleveland. “Purdue appears to have concluded that it was less risky to settle the Oklahoma case than have the allegations publicly aired against it during a televised trial and face exposure to what could have been an astronomical jury verdict,” said Abbe R. Gluck, a professor at Yale Law School who directs the Solomon Center for Health Policy and Law. (Hoffman, 3/26)

The Washington Post: Purdue Pharma, State Of Oklahoma Reach Settlement In Landmark Opioid Lawsuit
Under the terms of the Oklahoma settlement, Purdue will immediately contribute $102.5 million to establish a new foundation for addiction treatment and research at Oklahoma State University. Members of the Sackler family, who own the company but were not defendants in the case, will pay an additional $75 million in personal funds over five years. Purdue also will provide $20 million worth of treatment drugs, pay $12 million to cities and towns and cover about $60 million in litigation costs. (Bernstein and Zezima, 3/26)

Politico: Purdue Pharma Agrees To $270M Opioid Settlement With Oklahoma
The $275 million for 6,700 Oklahoma deaths comes out to roughly $41,000 per death — which would mean Purdue and the Sacklers could end up paying a staggering $16 billion if these numbers were spread across the nation, although the settlements aren’t likely to follow a precise pattern. Purdue agreed to spend $102.5 million to create the center, located in the university's wellness and recovery department, and to donate $20 million worth of medicines to support treatment over the next five years. Purdue will also give $72.5 million to state and local governments combating the opioid crisis. Of that, $12.5 million is for local government and up to $60 million will be for costs and fees related to the litigation. (Goldberg, 3/26)

NPR: Purdue Pharma Settles Opioid Lawsuit In Oklahoma
"The agreement reached today will provide assistance to individuals nationwide who desperately need these services — rather than squandering resources on protracted litigation," the Sackler family said in a statement. "We have profound compassion for those who are affected by addiction and are committed to playing a constructive role in the coordinated effort to save lives." (Bebinger, 3/26)

The Associated Press: Oklahoma Attorney General's Statement On Opioids Settlement
Oklahoma Attorney General Mike Hunter confirmed at a news conference Tuesday that the state has reached a $270 million settlement with the company that produces the painkiller OxyContin, blamed in part for a local and national opioid crisis. Hunter also released a statement outlining how the money will be used to counter an opioid epidemic that claimed 400 lives in Oklahoma in 2017 — the same year the state sued Purdue Pharma and other drugmakers. (3/26)

The Associated Press: Anger, Hope From Families And Survivors Of Opioid Crisis
A multimillion-dollar settlement in the nation's deadliest drug crisis brought no relief to Jodi Barber, whose 19-year-old son died of a prescription drug overdose. He became addicted to painkillers after breaking his collarbone. "The pain is always going to be there as a parent," said Barber of Orange County, California. "Knowing that it was preventable really hurts. All these deaths are preventable and that hurts." (3/26)

The Associated Press: Vermont Sues 2 Prescription Opioid Distributors
Vermont filed a lawsuit Tuesday against two pharmaceutical distributors, accusing them of selling ever-increasing amounts of prescription opioids in the state while failing to effectively monitor and control the sales and acknowledge the quantity of pills was outpacing the need. The lawsuit alleges Cardinal Health, Inc. and McKesson Corporation committed unfair and deceptive acts and practices, were negligent, and that their behavior constitutes a public nuisance. (3/26)

The Washington Post: A Job-Scarce Town Struggles With Arkansas’s First-In-Nation Medicaid Work Rules
At the center of Court Square in this old Mississippi Delta town, the monument to the county’s Confederate dead is inscribed: “No braver bled for a brighter land. No brighter land had a cause so grand. ”It has been a long time since Marianna or surrounding Lee County could be described as bright. Along the square, a storefront funeral home sits empty, along with two former drugstores, a department store, a jeweler, a barber. Gone, too, is Ronny’s dollar store, which let customers buy clothes on layaway. The National Guard Armory closed down and became a senior center, until that also closed. (Goldstein, 3/26)

The Wall Street Journal: Senate Panel Considers ‘Red Flag’ Gun Laws In Aftermath Of Mass Shootings
A GOP-led Senate committee held a rare gun-control hearing Tuesday on measures aimed at temporarily blocking dangerous people from accessing firearms, following a wave of states’ decisions to allow such curbs. The Senate Judiciary Committee focused Tuesday on extreme-risk protection orders, also known as red-flag laws, aimed at allowing courts to temporarily take guns from people deemed dangerous. Extreme-risk protection orders are designed to generally let family members or law-enforcement officials petition a court for an order that would temporarily block that person from being able to buy a firearm, or enable officials to remove his or her weapons. (Peterson, 3/26)

The Associated Press: Panel To Review Indian Health System's Treatment Of Children
The Trump administration is creating a task force to investigate how an Indian Health Service doctor was able to sexually assault children in his care. The White House announced Tuesday that the Presidential Task Force on Protecting Native American Children in the Indian Health Service System will be co-chaired by President Donald Trump's domestic policy adviser and the U.S. attorney for the Northern District of Oklahoma. (3/26)

The Wall Street Journal: White House Launches Investigation Of Indian Health Service Failures Over Sexual Abuse
The team of law enforcement and other government officials will examine why the IHS failed to stop the doctor, Stanley Patrick Weber, and also how better to protect Native American children under the care of the federal health agency, senior administration officials said. The committee will be co-chaired by Trent Shores, U.S. attorney for the northern district of Oklahoma, and Joe Grogan, the White House’s domestic policy council chairman, the officials said. (Frosch and Weaver, 3/26)

The Washington Post: Puerto Rico Faces Food-Stamp Crisis As Trump Privately Vents About Federal Aid To Hurricane Maria-Battered Island
At the Casa Ismael clinic for HIV-positive men with severe health complications, the staff used to immediately change patients’ diapers after they were soiled. But last week, clinic administrator Myrna Izquierdo told the nurses that had to stop. To save money, the nonprofit clinic, which relies on its patients’ food-stamp money for funding, will ask patients to sit in diapers in which they have repeatedly urinated, sometimes for hours. The Casa Ismael clinic is short on funds in part because of cuts in food stamps that hit about 1.3 million residents of Puerto Rico this month — a new crisis for an island still struggling from the effects of Hurricane Maria in September 2017. (Stein and Dawsey, 3/25)

The Washington Post: Gilead Profits From Tuvada HIV Treatment Funded By Taxpayers And Patented By The U.S. Government
Thomas Folks spent years in his U.S. Centers for Disease Control and Prevention lab developing a treatment to block deadly HIV in monkeys. Then San Francisco AIDS researcher Robert Grant, using $50 million in federal grants, proved the treatment worked in people who engaged in risky sex. Their work — almost fully funded by U.S. taxpayers — created a new use for an older prescription drug called Truvada: preventing HIV infection. But the U.S. government, which patented the treatment in 2015, is not receiving a penny for that use of the drug from Gilead Sciences, ­Truvada’s maker, which earned $3 billion in Truvada sales last year. (Rowland, 3/26)

Reuters: U.S. Expands Abortion 'Gag Rule,' Cuts Funding To Regional Bloc: Pompeo
The Trump administration on Tuesday expanded its anti-abortion policies, cutting funding to the Organization of American States (OAS) and prohibiting the use of U.S. tax dollars to lobby for or against abortion rights. Trump in 2017 reinstated a policy known as the "Mexico City Policy," requiring foreign nongovernmental organizations (NGOs) that receive U.S. family planning funds to certify they do not provide abortions or give abortion advice. (3/26)

The New York Times: U.S. Expands Anti-Abortion Policies With New Overseas Funding Rules
“We will enforce a strict prohibition on backdoor funding schemes and end-runs around our policy,” Mr. Pompeo said. “American taxpayer dollars will not be used to underwrite abortions.” The move builds on a 2017 announcement by the Trump administration that it was reinstating and expanding the so-called Mexico City policy. The executive action dating to 1984 — and described by critics as the “global gag rule” — requires foreign nongovernmental organizations to refuse to perform abortions in exchange for receiving American funding. (Wong, 3/26)

The Wall Street Journal: Trump Administration Expands Global Anti-Abortion Policy
The policy has been a political football for decades, with presidents of opposing parties reversing course at the start of their administrations, twice on the anniversary of the Supreme Court’s Roe v. Wade decision, the 1973 ruling that recognized abortion as a woman’s constitutional right. President Obama shelved the policy in 2009, though opting not to do so on the day chosen by some of his predecessors. President Trump reinstated the “Mexico City policy” shortly after taking office in January 2017, doing so the day after the ruling’s anniversary. (McBride, 3/26)

The Associated Press: North Carolina's 20-Week Abortion Ban Ruled Unconstitutional
A federal judge has declared unconstitutional a North Carolina law banning women from having abortions after the 20th week of pregnancy except in an urgent medical emergency. The decision Monday by U.S. District Judge William Osteen in Greensboro gave state legislators 60 days before his ruling takes effect to allow them to amend abortion restrictions or appeal his ruling to a higher court. (3/26)

The Washington Post: North Carolina’s 20-Week Abortion Ban Is Unconstitutional, A Federal Judge Rules
Under the ruling — which will take effect in 60 days, pending an appeal from the state or revised legislation — women will be able to seek abortions at any point before a doctor determines the fetus is “viable” and could be able to survive outside the womb. Those pushing for greater access to abortions cheered the decision, which comes amid a swell of new restrictions from GOP-led statehouses elsewhere. (Thebault and Wax-Thibodeaux, 3/26)

The Associated Press: Utah Bans Abortions After 18 Weeks, Teeing Up Legal Showdown
Utah Gov. Gary Herbert has signed a law banning most abortions after 18 weeks of gestation, setting the stage for a legal showdown. Though the Republican governor said the measure signed late Monday strikes a balance, opponents said it is unconstitutional and promised to sue. The law is expected to take effect in May. (3/26)

The Associated Press: Abortion Flap Could Cost Kansas Governor Her Commerce Chief
Democratic Gov. Laura Kelly could be forced to replace Kansas' top business development official because of two small grants to a nonprofit group he previously managed from a fund tied to a late physician known nationally for doing late-term abortions. Acting state Commerce Secretary David Toland has no role in regulating abortion providers, but the state's most influential anti-abortion group has joined an effort by some Republican legislators to oust him. (3/26)

The New York Times: New York Suburb Declares Measles Emergency, Barring Unvaccinated Children From Public
An executive order pulled close to 6,000 unvaccinated children out of schools. Nearly 17,000 doses of the measles-mumps-rubella (M.M.R.) vaccine were given in 26 weeks. There was a public health campaign in which community officials, doctors and rabbis testified to the importance of immunizations. None of those efforts stemmed the severe measles outbreak that has been plaguing Rockland County in New York since October. (Gold and Pager, 3/26)

The Associated Press: County Bans Unvaccinated Minors In Public As Measles Spreads
"It's an attention grab, there's no question about it," Rockland County Executive Ed Day said at a news conference, noting that he didn't believe such a drastic step has ever been tried in the U.S. before. Day said he was taking the action in hopes of reversing a recent uptick in cases amid disturbing reports that health workers were encountering resistance when investigating cases. Rockland's outbreak has most heavily affected Orthodox Jewish communities, in which vaccination rates tend to be lower. (3/26)

The Wall Street Journal: County In New York Facing Measles Outbreak Bans Unvaccinated Minors From Public Spots
As health inspectors have tried to vaccinate children, Mr. Day said, they’ve faced “increasing resistance” from unvaccinated families. Some parents have hung up their phones on inspectors calling to ask about vaccinations, and unvaccinated children have been seen in public places. “It endangers the health and well-being of others, and displays a shocking lack of responsibility and concern for others in our community,” he said. (Honan, 3/27)

The Wall Street Journal: This Old Mouse: ‘Golden Girls’ Unlock The Mysteries Of Aging
Grace and Blanche, two old mice who were second cousins, reached relative fame before dying within months of each other at their home in Bar Harbor, Maine. Known fondly as the Golden Girls at Jackson Laboratory, a nonprofit that specializes in research and mouse production, the two were believed to be the oldest living mice in the world just before their passing in 2016. (Ansberry, 3/26)

The New York Times: What Your Exercise Habits Might Say About How Long You’ll Live
A new study offers both hope and a subtle nudge to anyone who has slacked off on exercise in recent years. It finds that if people start to exercise in midlife, even if they have not worked out for years, they can rapidly gain most of the longevity benefits of working out. But the reverse is also true, the study finds. Stop exercising and those longevity benefits shrink or evaporate. (Reynolds, 3/27)

The Associated Press: Hospital Using Drones To Fly Blood Samples Between Buildings
A pioneering use of drones to fly blood samples across a North Carolina hospital campus launched Tuesday in the latest move to expand their roles in business and health care. The short trips between WakeMed buildings in Raleigh mark the first time the Federal Aviation Administration has allowed regular commercial flights of drones carrying products, according to UPS and drone company Matternet, which partnered with the hospital on the program. (3/26)

The Washington Post: United Medical Center Needs $40 Million Taxpayer Bailout, D.C. Officials Say
The District’s only public hospital will require a $40 million taxpayer subsidy to stay afloat, city officials have determined, the latest and largest in a series of government bailouts for the struggling facility over the last several years. United Medical Center — the only hospital east of the Anacostia River and a key provider of medical services for low-income residents of Southeast Washington — is running a projected annual operating deficit of tens of millions of dollars, hospital officials testified at a D.C. Council health committee hearing Tuesday. (Jamison, 3/26)

The Wall Street Journal: Mayor De Blasio’s Wife Defends Mental-Health Initiative
ThriveNYC officials defended the funding and effectiveness of the city’s mental-health initiative during a New York City Council hearing Tuesday, as lawmakers pushed to understand how the sprawling program is structured and if it reaches the seriously mentally ill. Chirlane McCray, wife of New York City Mayor Bill de Blasio, said her signature three-year-old initiative with a $250 million annual budget is designed to “fill the gaps” in the city’s mental-health programs, as well as introduce innovations. (West, 3/26)

Los Angeles Times: L.A. County Expands Smoking Ban To Vaping Tobacco And Smoking Pot In Public
It's about to get harder to find a place to vape and smoke cannabis in Los Angeles County. The Board of Supervisors updated the county’s legal definition of "smoke" and "smoking" on Tuesday, expanding an existing ban on using tobacco products at beaches, parks and government buildings to include electronic cigarettes and pot. The supervisors also clamped down with new restrictions on smoking at beach parking lots, bus stops, outdoor bars and some common areas of county-owned golf courses in unincorporated areas. (Stiles, 3/26)