First Edition: May 23, 2019

Kaiser Health News: Are Surprises Ahead For Legislation To Curb Surprise Medical Bills?
Surprise medical bills — those unexpected and often pricey bills patients face when they get care from a doctor or hospital that isn’t in their insurance network — are the health care problem du jour in Washington, with congressional lawmakers from both sides of the aisle and the White House calling for action. These policymakers agree on the need to take patients out of the middle of the fight over charges, but crafting a legislative solution will not be easy. (Bluth, 5/22)

Kaiser Health News: House Hagglers Zero In On Single-Payer And It All Comes Down To Two Little Words
Would single-payer severely weaken the economy, or drive doctors out of business? Would it result in better, more affordable care for all Americans, or even save lives? And, consistently, they were thwarted by two deceptively simple words. “It depends.” Deployed in various forms by three of Washington’s top number crunchers, that caveat underscored a point the same office made three weeks ago: “single-payer,” or “Medicare for All,” could play out in countless ways. And before policymakers can prognosticate about what such a shift would do, they need to answer some more basic questions. (Luthra, 5/22)

California Healthline: Heat And Violence Pose Twin Threats For Asylum-Seekers Waiting At Border
It wasn’t even May before thermometers hit 100 degrees in this Mexican border city. Tania was washing clothes for her two daughters when she started to feel queasy and weak. She lay down in a bed at the stifling migrant shelter where she’d taken refuge with her fiance and children. But the throbbing pain and nausea wouldn’t go away, and she fainted. She was taken to a Mexican Red Cross hospital, one of the few places where asylum-seekers like her, waiting at the U.S. border to plead their case, can go in an emergency. (Barry-Jester, 5/22)

The New York Times: Kirsten Gillibrand Proposes Huge Investments In Maternal Health, Child Care And Education
Senator Kirsten Gillibrand’s presidential campaign on Wednesday introduced a proposal aimed at investing heavily in maternal and child health, adoption and in vitro fertilization, paid family leave and universal prekindergarten. The proposal, which Ms. Gillibrand called the “Family Bill of Rights,” continued her campaign’s focus on women and families. On Tuesday, she was among several Democratic candidates who joined a rally outside the Supreme Court to protest new abortion restrictions that some states had recently adopted. (Saul, 5/22)

The Associated Press: Harris, Gillibrand Offer Plans To Bolster Maternal Care
[Sen. Kamala] Harris' bill, first introduced in 2018, would create a $25 million program to fight racial bias in maternal care. It would direct grants to medical schools, nursing schools and other training programs to improve care for black women, who are three to four times more likely than white women to die in childbirth. Her revived proposal also would allocate an additional $125 million toward identifying high-risk pregnancies and, according to her Senate office, provide mothers with the "culturally competent care and resources they need." (Summers and Weissert, 5/22)

The Hill: Harris Introduces Bill To Combat Racial Bias In Maternal Health Care
“Black mothers across the country are facing a health crisis that is driven in part by implicit bias in our health care system," Harris said in a statement Wednesday. "We must take action to address this issue, and we must do it with the sense of urgency it deserves." The U.S. has the highest rate of pregnancy-related deaths among industrialized countries, and black women are three- to four-times more likely to die from pregnancy-related issues than white women, according to the American College of Obstetricians and Gynecologists. (Hellmann, 5/22)

The New York Times: Canceled Fund-Raiser Prompts Question: Can A Democrat Oppose Abortion?
A top Democratic official on Wednesday canceled a planned fund-raiser for an anti-abortion congressman that had prompted an outcry among progressives, raising the question of whether there is room left in the party for lawmakers who oppose abortion at a moment when numerous Republican-controlled states are trying to effectively outlaw the procedure. The decision by Representative Cheri Bustos of Illinois, the head of the Democratic Congressional Campaign Committee, underscored the extent to which support for abortion rights has become a central litmus test for Democrats in the aftermath of President Trump’s two appointments to the Supreme Court. (Martin, 5/22)

The Washington Post: Top Democrat Cancels Event For Anti-Abortion House Colleague
Lipinski is one of the last congressional Democrats to oppose abortion rights. Normally, a top Democrat appearing at one of his fundraisers would be little noticed, but abortion issues are in­cred­ibly fraught as some conservative states move to outlaw abortion in an effort to overturn Roe v. Wade. With that backdrop, there’s little tolerance among those who want to protect abortion rights for a politician who doesn’t. “I’m proud to have a 100 percent pro-choice voting record and I’m deeply alarmed by the rapidly escalating attacks on women’s access to reproductive care in several states,” Bustos said in a statement Wednesday night. (Itkowitz, 5/22)

Politico: DCCC Chief Cancels Fundraiser In Snub To Anti-Abortion Democrat
Bustos stands by the policy and has given no indication that she will reverse course, which has continue to irritate the caucus's left flank, particularly lawmakers who, themselves, ousted more moderate incumbent Democrats. “It’s a smart move and I’m glad she listening to progressive voices,” Rep. Ro Khanna (D-Calif.), who has sharply criticized Bustos’ for her handling of the vendor policy. “I appreciate that Cheri has shown a willingness to listen and change. I hope she’ll take the same approach on the vendor blacklist issue. I remain committed to sitting down with her and seeking a principled compromise.” (Ferris and Barron-Lopez, 5/22)

Politico: Will The Supreme Court Take Up A Roe V. Wade Showdown In 2020?
The Supreme Court may well be headed for an election-year fight over abortion rights, but it’s not likely to be a blockbuster showdown over Roe v. Wade. Courtwatchers anticipate that the justices will agree to take one or more cases related to abortion restrictions in the coming term, drawing attention to the polarizing issue as the 2020 presidential campaign moves into a critical phase. (Gerstein, 5/22)

The New York Times: ‘Fetal Heartbeat’ Vs. ‘Forced Pregnancy’: The Language Wars Of The Abortion Debate
The new laws that prohibit abortion as early as the sixth week of pregnancy have been called “heartbeat” legislation by supporters, a reference to the flickering pulse that can be seen on ultrasound images of a developing embryo. But when the American Civil Liberties Union announced a legal challenge last week to one such law in Ohio, there was no mention of the word “heartbeat” in the news release, which referred to the law instead as “a ban on almost all abortions.” In Georgia, Stacey Abrams, a Democrat who narrowly lost the governor’s race last year, called the measure in her state a “forced pregnancy bill.” A sign at a protest against the law in Atlanta this week turned the idea into a slogan: “NO FORCED BIRTHS.” (Harmon, 5/22)

USA Today: Abortion Law: Republican And Conservative Women Don't All Agree
Do conservative women have abortions? The answer is, obviously, yes. But it's not often we hear from them. Nearly one in four women in the United States will have an abortion by age 45 — and they don't all share the same values and political views. Cultural stigma can make it difficult for any woman to talk about her abortion, but the particular pressures facing conservative women mean that stigma often equals silence.  (Dastagir, 5/22)

The Associated Press: Rallies For And Against Abortion Fire Up Around The South
Abortion opponents held a rally Wednesday at the Alabama Capitol, savoring victory after the state's governor signed the nation's most stringent abortion ban into law last week. Elsewhere in the South, abortion-rights supporters occupied much of a city block in New Orleans, chanting 'My body! My choice!" Standing in front of the banner, "Pro-Life Pro-Woman," speakers said the law passed in Alabama — and fetal heartbeat laws in others states — show they are gaining momentum in the fight against abortion. (Chandler, 5/22)

The Associated Press: Kansas Clinic Returns To Court Over Telemedicine Abortions
A Kansas clinic stopped providing telemedicine abortions months ago and returned to court Wednesday after concluding that the legal climate remains uncertain despite a judge's order late last year saying the state couldn't stop the procedures. The clinic in Wichita operated by the Trust Women Foundation also faces a complaint over its past telemedicine abortions filed with the state's medical board by officials from the anti-abortion group Kansans for Life. The state has enacted three laws in eight years to require physicians to be physically present when giving women pregnancy-ending medications. (5/22)

The Associated Press: Girl, 10, 6th Known Child To Die After US Border Detention
U.S. authorities say a 10-year-old girl from El Salvador died last year after being detained by border authorities in a previously unreported case. The death marks the sixth known case in the last year. The U.S. Department of Health and Human Services said Wednesday that she died on Sept. 29 at an Omaha, Nebraska, hospital of fever and respiratory distress. (5/22)

The Associated Press: House Hearing Grows Heated Over Migrant Children's Deaths
A Democratic lawmaker on Wednesday blamed the Trump administration's border policies for the deaths of migrant children, an accusation the acting head of the Homeland Security Department called "appalling." The brouhaha came at a House Homeland Security Committee hearing on the budget for the sprawling law enforcement department, which has seen major upheaval over the past two months following a White House-orchestrated shake-up. Kevin McAleenan, the head of U.S. Customs and Border Protection, was named to lead the department temporarily following the resignation of Secretary Kirstjen Nielsen. (Long, 5/22)

The Hill: CBO: Medicare For All Gives 'Many More' Coverage But 'Potentially Disruptive' 
Experts from Congress’s nonpartisan budget office testified Wednesday that a single-payer health care system would result in “many more” people with health insurance but would also be “potentially disruptive” and increase government control. The Congressional Budget Office (CBO) experts made the remarks at the second hearing on a single-payer, “Medicare for All” system that House Democrats have held this year, this time at the House Budget Committee. (Sullivan, 5/22)

The New York Times: Flu Outbreak Prompts Largest Border Detention Center To Stop Processing Migrants
Border Patrol officials temporarily stopped processing apprehended migrants at the agency’s largest detention center, in the South Texas city of McAllen, after nearly three dozen detainees there became ill with the flu. The halt was ordered late Tuesday, a day after the death of a 16-year-old Guatemalan boy who was sick with the flu and had been in custody at the center. The McAllen facility resumed full operations Wednesday afternoon. (Fernandez and Kanno-Youngs, 5/22)

The Associated Press: Flu Outbreak Sickens Over 30 Migrants At Border Center
The processing center is a converted warehouse that holds hundreds of parents and children in large, fenced-in pens that gained international attention last year when it held children separated from their parents. The government closed the facility after the flu outbreak, sent in cleaning crews to disinfect the building and plans to reopen it soon. The 32 sick children and adults have been quarantined at a smaller processing center, according to a U.S. Border Patrol official who spoke with reporters on condition of anonymity because there is an ongoing investigation. Their ages were unknown. (Long and Spagat, 5/22)

Los Angeles Times: This Immigrant Rights Champion Runs A Migrant Youth Home That Was Repeatedly Cited For Safety Violations
Los Angeles lawyer Peter Schey has long been a trailblazing courtroom defender of immigrant youth. He helped argue the Supreme Court case that ensured the right of children without legal status to attend public schools. He also helped secure the Flores settlement — a landmark 1997 agreement to safeguard migrant children held by the government, which gave his legal foundation the right to inspect those shelters. That case also inspired him to run his own shelter for homeless migrant youths. (Carcamo, 5/22)

Modern Healthcare: Fear Pushes Immigrants Out Of Medicaid, CHIP, Study Finds
An immigrant couple with two children recently asked Veronica Hernandez to write a letter for them canceling the family's Medicaid coverage because they feared that receiving public benefits would jeopardize the husband's legal status. Other patients at Mary's Center, a community health center in Washington, D.C., who are political asylum seekers are refusing to apply for public health insurance or the Supplemental Nutrition Assistance Program out of similar fears, said Hernandez, the center's program coordinator for bilingual health access. (Meyer, 5/22)

Politico: HUD Moves To Allow Discrimination Against Homeless Transgender People
The Department of Housing and Urban Development is moving to roll back protections for homeless transgender people by enabling HUD-funded providers of shelters to consider a person’s sex or gender identification in determining whether they can be admitted. The proposal, included in the department’s spring rule list out Wednesday, contradicts a pledge that HUD Secretary Ben Carson made to lawmakers just yesterday. (O'Donnell, 5/22)

The Washington Post: USDA Researchers Quit In Droves As Trump Administration Plans Relocation
A plan to move Agriculture Department researchers out of Washington has thrown two small but influential science agencies into upheaval. Federal employees at the Economic Research Service (ERS) and the National Institute of Food and Agriculture (NIFA) have quit in unusually large numbers since August, when Agriculture Secretary Sonny Perdue announced he would relocate the offices. ERS leadership has been conducting final site visits this week of candidate locations, and an “announcement Friday is very likely,” said Peter Winch, an organizer for the American Federation of Government Employees, a union that represents ERS workers. (Guarino, 5/22)

The Wall Street Journal: Former FDA Commissioner Gottlieb Returns To NEA As Venture Investor
The former commissioner of the Food and Drug Administration has returned to New Enterprise Associates to focus on health-care investing. Scott Gottlieb, who stepped down as FDA commissioner in March, will hold the title of special partner for the health-care investment team at NEA, where he previously worked as venture partner from 2007 to 2017. (Mack, 5/22)

The Washington Post: Congressional Report: Purdue Pharma Influenced World Health Organization’s Opioid Guidelines
A new congressional report claims that the World Health Organization’s guidelines on treating pain were directly influenced by the pharmaceutical industry, including a set of directions for prescribing powerful painkillers that appear to have been taken from opioid giant Purdue Pharma. The investigation, from the offices of Reps. Katherine M. Clark (D-Mass.) and Hal Rogers (R-Ky.), points to evidence that pharmaceutical companies and those who profited from the increased prescribing of opioids aimed to push the WHO into endorsing use of the drugs across the globe. The WHO provides health guidance worldwide. (Zezima, 5/22)

The Associated Press: US Lawmakers Demand UN Health Agency Change Opioid Guidance
The members of Congress say a 2011 manual and 2012 guidelines on opioids were influenced by people with financial connections to Purdue Pharma, the company that makes the powerful opioid painkiller OxyContin. “We have come to believe that Purdue has leveraged its financial ties to successfully impact the content of the WHO’s guidelines,” Reps. Katherine Clark, a Massachusetts Democrat, and Hal Rogers, a Kentucky Republican, say in a letter to the health arm of the United Nations. “As a result, the WHO is, in effect, promoting the chronic use of opioids.” (Mulvihill, 5/22)

Politico: How Joe Biden’s Drug Policies Supercharged The Opioid Crisis
In April, as he prepared to announce his presidential candidacy, Joe Biden went on an apology tour that noticeably stopped short of issuing any apologies. He called Anita Hill and, in the words of a campaign statement, shared “his regret for what she endured” at the confirmation hearings for Supreme Court Justice Clarence Thomas, which Biden chaired some 28 years ago. He recorded a video expressing regret for not being more “mindful” of the personal-space boundaries of women after several allegations of unwanted and nonconsensual touching. He then went on “The View” and argued that in neither of these instances did his actions warrant an apology. He did, however, half-apologize for one thing: His role in creating one of the most insidious aspects of the War on Drugs, even while minimizing his role in it. (Siegel, 5/23)

Modern Healthcare: Verma Exploring Outcome-Based Ideas To Tackle High Drug Costs
CMS Administrator Seema Verma said Wednesday there need to be "serious discussions" on how to pay for new and extremely pricey drug innovations but slammed the idea of giving Medicare negotiating power. Verma told reporters that Medicare and Medicaid's payment systems were not expected to deal with high costs for new and curative innovations. (King, 5/22)

The Associated Press: Lilly Selling Half-Price Version Of Popular Humalog Insulin
A half-price version of Eli Lilly's popular Humalog insulin is now available, following the company's promise in March to offer diabetics a more affordable option amid fierce criticism of soaring insulin prices. Lilly, one of the three top insulin makers, said Wednesday that it has begun selling its own generic version of Humalog U-100 under the chemical name insulin lispro. (Johnson, 5/22)

Stat: Did FDA Unfairly Treat Catalyst By Approving Jacobus' Similar Drug? 
Reeling from an unexpected move by regulators, Catalyst Pharmaceuticals (CPRX) is threatening to hit back. Until recently, the drug maker had been riding high. Last December, the Food and Drug Administration approved its medicine for treating adults with a rare neuromuscular disorder called LEMS, which meant Catalyst has seven years of marketing exclusivity. And despite controversy over its $375,000 price tag, the company appeared to have silenced some critics with assistance programs that kept patient out-of-pocket costs low. Meanwhile, its soaring stock price pleased investors. (Silverman, 5/23)

Stat: Microbiome Therapies Could Be The Next Frontier In Medicine. But How Exactly Do You Make Them?
Before any company can begin a clinical trial, the Food and Drug Administration has to know how they’re going to make their “drug.” For some microbiome companies, that’s not really a problem; to put it delicately, the active ingredient for their drug comes from the guts of willing volunteers. All that’s left to do is process it. But as more attention and hope is placed on bacteria specifically selected or designed to be therapeutic, the companies testing them may hit a roadblock that could cost them millions or slow their progress.The problem? Manufacturing bacteria for drugs is really hard. (Sheridan, 5/23)

The New York Times: ‘Battle Of The Thermostat’: Cold Rooms May Hurt Women’s Productivity
It is a truth universally acknowledged — or at least, much discussed on social media — that a woman who works in an office is in want of a sweater. Office air conditioning is often set at a temperature that women find chilly; the resulting water-cooler debate has been called the “battle of the thermostat.” One study even suggested that because women have slower metabolic rates, the formula used to set temperatures in workplaces, which was developed decades ago based on the comfort of men, may overestimate women’s body heat production by 35 percent. (Greenwood, 5/22)

The Associated Press: Faces Of Concussions: NHL’s Head-On Battle With An Epidemic
Wearing a black shirt with “Fight for your happiness” on the front and “Sick not weak” on the back, Daniel Carcillo eats an apple as his wife makes a cappuccino nearby and their oldest daughter scampers around the kitchen. This is the family he always wanted, just not the life he expected. Carcillo is hurting inside and out after seven documented concussions in the National Hockey League and what he believes could be literally hundreds of traumatic brain injuries. (Whyno, 5/23)

The Washington Post: Transgender Powerlifter Mary Gregory Stripped Of World Records: ‘Where Do We Draw The Line?'
When Mary Gregory filled out the registration form to compete in a local weightlifting event, she checked the box that read “female” without hesitation. “I mean, that’s my gender,” she said. “I didn’t even think about it. That’s who I am.” If there were any questions, Gregory didn’t notice, and on April 27, after months of training, she strode onto the platform at the Best Western hotel just east of Charlottesville and wowed the spectators and fellow powerlifters in attendance. That night she posted a picture on Instagram of herself holding a trophy, telling her 120 followers about the records she set for her age and weight class in the 100% Raw Powerlifting Federation, which organized the day’s competition. (Maese, 5/19)

USA Today: 'Safest' Sunscreens: Environmental Working Group Releases 2019 Review
With Memorial Day around the corner, sunscreens on the market today may be providing inferior sun protection or contain potentially harmful chemicals, an environmental advocacy organization says. In a review of more than 1,300 products with SPF in them, the Environmental Working Group found that about two-thirds did not meet its standard for protection or chemical safety. (Miller, 5/22)

The New York Times: There’s Evidence On How To Raise Children, But Are Parents Listening?
Does anything you do as a parent matter? This is a question that surely most parents have asked themselves, as they push through some of the harder parts of raising children — sleepless nights, tantrums, vomiting illnesses, harassing children to finish their homework. Given how much work parenting can be, most of us probably want to believe that, yes, it does matter. The evidence, however, is not always as clear. (Oster, 5/23)

The Washington Post: Her Two Sons Had A Rare Disease. After Their Deaths, Kathy Wales Left The Air Force To Become A Nurse.
Kathy Wales will perform the same tasks as her fellow nurses when she starts work, but she took a different path to wearing scrubs. The 15-year Air Force veteran stopped working in 2009 when her two young sons were diagnosed with a rare disease. She lost both in the years that followed — one to the illness, the other to suicide. Their deaths inspired her to build a new career that begins next month at a Virginia hospital, a path that involves working through grief, helping patients with their mental health and honoring the lives of her children. (Moyer, 5/22)

The Associated Press: Tougher Vaccine Rules Move Forward In California
California lawmakers moved ahead Wednesday with tougher rules that limit parents from choosing whether to vaccinate their schoolchildren as a handful of opponents shouted "We will not comply" inside the Senate. Senators sent the measure to the Assembly as the nation struggles to stem the highest number of measles cases in decades and as state efforts to strengthen vaccine requirements draw emotional opposition. (Thompson, 5/22)

Los Angeles Times: Controversial Vaccine Bill Clears California Senate Despite Opposition From Parents
The bill comes amid the worst measles outbreak in more than 20 years, with more than 750 people diagnosed with the disease this year nationwide. Of those, 44 cases have been in California. California has some of the strictest laws in the country requiring childhood immunizations in order to attend public or private schools. Since a 2015 law, the state has allowed for exemptions from required shots only if a doctor says there is a medical reason to skip some or all of them. Previously, parents could opt their children out of vaccinations by citing a personal or religious belief, as most states allow. (Gutierrez, 5/22)

The Hill: Measles Outbreak Spreads To Maine, Cases Now In Half The Country
The measles outbreak has now spread to half the country, as Maine became the 25th state to report a confirmed case of the disease. According to the Maine Centers for Disease Control and Prevention (CDC), the case was confirmed in a school-age child in Somerset County on Monday. It's the first confirmed measles case in the state since 2017. (Weixel, 5/22)

The Associated Press: Texas Moves To Arm More Teachers To Prevent School Shootings
Texas moved a big step closer to arming more teachers and school personnel as a way to help prevent future campus shootings, under a bill sent to Gov. Greg Abbott. The measure approved Wednesday night by the state Senate changes the 6-year-old school marshal program that had limited the number of armed marshals, and instead opens campuses to as many as local school districts feel they need. (Vertuno, 5/22)

Stat: California Names Former Google Scientist As The State’s ‘Mental Health Czar’
Noted psychiatrist and former Verily leader Dr. Tom Insel is going to be the “mental health czar” for the state of California, Democratic Gov. Gavin Newsom announced Tuesday. Insel, the former National Institute of Mental Health director, will also continue his work with Mindstrong, a startup that is working on a mental health app, a company spokesperson confirmed. Insel joined the company in 2017 after leaving Verily, Google’s life sciences arm. (Sheridan, 5/22)

The Associated Press: Claim Seeks $45M For Incapacitated Woman Who Gave Birth
Lawyers for an incapacitated woman who was raped and later gave birth at a Phoenix long-term care facility have filed a $45 million notice of claim against the state, saying she may have been impregnated before. The claim, which is a precursor to a lawsuit, also alleges the woman was raped repeatedly before giving birth last December. (5/22)

Los Angeles Times: After 2 Suspected Homophobic Killings, Audit Finds Broader Issues With L.A. Child Welfare
A long-awaited state audit of Los Angeles County’s troubled Department of Children and Family Services has uncovered shortcomings that often place vulnerable children in harm’s way. The audit found that the department’s social workers didn’t initiate or complete investigations of neglect accurately or quickly enough, used “inaccurate” assessments to determine child risk and didn’t always conduct criminal background checks of those living in homes where children were placed. (Fry and Stiles, 5/22)

The Associated Press: Mandatory Overtime For Nurses At Center Of Hospital Strike
A hospital strike now in its third week is putting a spotlight on staffing shortages at the same time Ohio lawmakers are debating legislation that would allow nurses to refuse mandatory overtime. Many of the nurses among the 2,200 workers on strike at Mercy Health St. Vincent Medical Center in Toledo say they are tired of repeatedly being on-call or forced to work beyond their regular shifts because of understaffing. (Seewer, 5/22)

The Washington Post: Family Of U-Md. Student Who Died Of Adenovirus Takes Step Toward Suing School
The family of an 18-year-old University of Maryland freshman who died of adenovirus in the fall has filed a notice of claim against the college, setting the stage for a possible lawsuit. Ian Paregol said the death of his daughter, Olivia Shea Paregol, could have been prevented had the university disclosed that the virus was spreading through the College Park campus. (Abelson, 5/22)