First Edition: May 8, 2018

Kaiser Health News: Federal Officials Say No-Go To Lifetime Limits On Medicaid
This marked the first time the Trump administration has rejected a state’s Medicaid waiver request regarding who is eligible for the program. Critics of time limits, who say such a change would unfairly burden people who struggle financially throughout their lives, cheered the decision. “This is good news,” said Joan Alker, executive director of Georgetown University’s Center for Children and Families, a Medicaid advocate. “This was a bridge too far for this CMS.” (Galewitz, 5/7)

Kaiser Health News: How The Farm Bill Could Erode Part Of The ACA
Some Republican lawmakers continue to try to work around the federal health law’s requirements. That strategy can crop up in surprising places. Like the farm bill. Tucked deep in the House version of the massive bill — amid crop subsidies and food assistance programs — is a provision that supporters say could help provide farmers with cheaper, but likely less comprehensive, health insurance than plans offered through the Affordable Care Act. It calls for $65 million in loans and grants administered by the Department of Agriculture to help organizations establish agricultural-related “association” type health plans. (Appleby, 5/8)

Kaiser Health News: Medicare Beneficiaries Feel The Pinch When They Can’t Use Drug Coupons
Under the federal anti-kickback law, it’s illegal for drug manufacturers to offer people any type of payment that might persuade them to purchase something that federal health care programs like Medicare and Medicaid might pay for. The coupons can lead to unnecessary Medicare spending by inducing beneficiaries to choose drugs that are expensive. “The law was intended to prevent fraud, but in this case it also has the effect of prohibiting Part D enrollees from using manufacturer copay coupons … because using the coupon would be steering Medicare’s business toward a particular entity,” said Juliette Cubanski, associate director of the Program on Medicare Policy at the Kaiser Family Foundation. (Andrews, 5/8)

California Healthline: Gubernatorial Hopefuls Look To Health Care For Election Edge
California’s leading gubernatorial candidates agree that health care should work better for Golden State residents: Insurance should be more affordable, costs are unreasonably high, and robust competition among hospitals, doctors and other providers could help lower prices, they told California Healthline. What they don’t agree on is how to achieve those goals — not even the Democrats who represent the state’s dominant party. (Bartolone, 5/7)

Kaiser Health News: Use Of Psychiatric Drugs Soars In California Jails
The number of jail inmates in California taking psychotropic drugs has jumped about 25 percent in five years, and they now account for about a fifth of the county jail population across the state, according to a new analysis of state data. The increase could reflect the growing number of inmates with mental illness, though it also might stem from better identification of people in need of treatment, say researchers from California Health Policy Strategies (CHPS), a Sacramento-based consulting firm. (Gorman, 5/8)

Reuters: Trump Proposes $15 Billion Spending Cuts, Targets Children's Health Program
President Donald Trump will request a package of $15 billion in spending cuts from Congress on Tuesday, including some $7 billion from the Children's Health Insurance Program championed by Democrats, senior administration officials said on Monday. One official said the targeted cuts would cover "unobligated balances" or money that is not being spent. He said the cuts would not have an effect on the CHIP program itself. (Mason, 5/7)

The Associated Press: Trump Proposing Billions In Spending Cuts To Congress
The White House said it is sending the so-called rescissions package to lawmakers Tuesday. Administration officials, who required anonymity because they weren't authorized to speak publicly on the matter, said the package proposes killing $15 billion in unused funds. A senior official said about $7 billion would come from the Children's Health Insurance Program, or CHIP, which provides health care to kids from low-income families, though that official stressed the cuts won't have a practical impact on the popular program. (Taylor, 5/7)

The Wall Street Journal: Trump Seeks To Cut $15 Billion From Federal Spending By Rescinding Approved Funds
The plan is a shift from earlier discussions about rescinding funds that had been approved as part of a sweeping, $1.3 trillion spending bill enacted in March. This proposal would instead seek to rescind funds that had been authorized in previous fiscal years, but not spent. The official said Mr. Trump plans to propose rescinding money from the March deal in a future proposal, the official said. Mr. Trump had threatened to veto the March spending measure but decided to sign it and avoid shutting down the government. The senior administration official said Monday the rescissions proposal headed for Capitol Hill Tuesday would be the first in a series of proposals to cut funding. (Peterson, 5/7)

The Washington Post: Trump Made High Drug Prices His Issue. Democrats Think They Can Take It Back.
Democrats are trying to take back an issue Donald Trump effectively stole from them during the 2016 presidential campaign: the high cost of prescription drugs. Trump repeatedly railed against pharmaceutical companies during the campaign and after taking office, promising that prices would drop and accusing drug companies of “getting away with murder.” But more than a year into his tenure, Trump has taken only limited action, and drug prices continue to climb. (Werner and Johnson, 5/7)

Bloomberg: Drug Plans Drop After Trump Official Targets PBMs Ahead Of Speech
Shares of CVS Health Corp. and Express Scripts Holding Co. slipped Monday after one of the Trump administration’s top health-care officials said the companies’ roles as intermediaries between drugmakers and health plans was hurting patients. Known as pharmacy-benefit managers, or PBMs, the plans negotiate with drugmakers to put their products on lists of covered drugs in return for discounts, and steer patients toward options that they say save them and employers money. Those dual roles are in conflict, said Seema Verma, administrator of the Centers for Medicare and Medicaid Services. (Flanagan, 5/7)

Stat: CMS Chief Criticizes Medicare Drug Payments For 'Perverse' Incentives
The Trump administration on Monday offered a new critique of the way Medicare pays for drugs administered by doctors, hinting at potential changes that could draw broad ire from drug makers, hospitals, and doctors. Centers for Medicare and Medicaid Services Administrator Seema Verma said the payment structure for Medicare Part B, which covers chemotherapy treatments and other physician-administered drugs, “creates a perverse incentive for manufacturers to set higher prices, and for providers to pick drugs that are more expensive.” (Mershon, 5/7)

Bloomberg: Obamacare Premiums To Surge Next Year, Early Requests Show 
The first glimpse of what health-insurance companies plan to charge for Obamacare plans next year suggests there’s no relief ahead for consumers saddled with high premiums. Several insurers in Maryland and Virginia are seeking double-digit percentage increases in monthly costs for individual medical plans in 2019. The largest increases are being sought by CareFirst, which wants to nearly double the amount it charges on average for one coverage option in Maryland, and raise the cost of another in Virginia by 64 percent. (Tozzi, 5/7)

The Washington Post: CareFirst BlueCross BlueShield And Other Maryland Insurers Seek 30 Percent Premium Hikes For 2019
Insurers are proposing double-digit premium increases in Maryland's individual-health-plan market, a consequence of what the state’s health insurance commissioner called a “death spiral. ”CareFirst BlueCross BlueShield requested an 18.5 percent increase on the HMO plans used by the vast majority of its individual-plan members — and a whopping, 91.4 percent increase on its PPO plans. Kaiser Permanente requested a 37.4 percent increase on its HMO plans. The average rate increase requested, across insurers and plans, was 30 percent. (Johnson, 5/7)

The Hill: Maryland Insurers Asking For Double-Digit Premium Hikes 
Insurers have said a number of policies being promoted by the Trump administration are to blame for rising premiums and the departure of healthy people from the risk pool, including the repeal of ObamaCare’s individual mandate penalty. The administration also made it easier for insurers to sell cheaper, skimpier plans. (Weixel, 5/7)

Stat: With No Insurance, Amish Want Discount On Spark's Pricey Gene Therapy
The meeting could determine whether the two young siblings would keep going blind. The doctor knew that going in, but he was feeling good. He’d negotiated huge discounts before, allowing patients to get complex surgeries or budget-busting drugs they otherwise couldn’t afford. And his last two conversations with Spark Therapeutics had been promising. Then again, at $850,000 a person, Luxturna was more budget-busting than just about any other drug. Spark had proposed a few different ways of helping insurers to cover the gene therapy — but Dr. Kevin Strauss’ patients tend not to have insurance. As the medical director of the Clinic for Special Children, on the outskirts of Strasburg, Pa., he mostly sees members of the Plain community: Old Order Amish and Mennonite families, who believe that caring for the sick and the elderly is a community’s responsibility. (Boodman, 5/7)

The Hill: Trump Officials Reject Medicaid Lifetime Limits In Kansas 
“We have determined that we will not approve Kansas’ recent request to place a lifetime limit on Medicaid benefits for some beneficiaries,” Centers for Medicare and Medicaid Services Administrator (CMS) Seema Verma said Monday in a speech at a meeting of the American Hospital Association. “We seek to create a pathway out of poverty, but we also understand that people’s circumstances change, and we must ensure that our programs are sustainable and available to them when they need and qualify for them,” she added. (Sullivan, 5/7)

The Hill: New Hampshire Wins Approval For Medicaid Work Requirements
Medicaid beneficiaries in New Hampshire will have to work, attend school or perform community service to be eligible for benefits under a new waiver approved by the Trump administration. Under the program, adults aged 19 to 64 will be required to participate in 100 hours per month of “community engagement activities,” such as employment, education, job skills training or community service. (Weixel, 5/7)

The New York Times: Needle By Needle, A Heroin Crisis Grips California’s Rural North
The dirty needles can be found scattered among the pine and brush, littering the forest floor around Eureka, a town long celebrated as a gateway to the scenic Redwood Empire. They are the debris of a growing heroin scourge that is gripping the remote community in Northern California. While the state as a whole has one of the lowest overall opioid-related death rates in the country, a sharp rise in heroin use across the rural north in recent years has raised alarms. In Humboldt County, the opioid death rate is five times higher than the state average, rivaling the rates of states like Maine and Vermont that have received far more national attention. (Del Real, 5/8)

Politico: 'People Are Dying Every Day': Drug Distributors To Face Lawmakers
The nation's largest drug distributors spent millions on Washington lobbying last year. Now they're about to find out how much goodwill it has bought them in Congress. The House Energy and Commerce Committee is hauling in the executives of five drug distribution companies Tuesday after spending the last year investigating their role as middlemen between drugmakers and the hospitals and pharmacies that dispensed millions of pills in towns that are now ravaged by the opioid epidemic. (Meyer, 5/8)

The Associated Press: Hill Panel Probing Opioids Abuse Targets Distributor Firms
Congressional investigators say wholesale pharmaceutical distributors shipped hundreds of millions of prescription opioid pills to West Virginia, a state disproportionately ravaged by deaths caused by the addictive drugs. Now, lawmakers want executives of those companies to explain how that happened. Current and former officials from five distributor companies are set to give sworn testimony on the subject Tuesday to a House subcommittee. Their appearances come during an election-year push by Congress to pass largely modest legislation aimed at curbing a growing epidemic that saw nearly 64,000 people die last year from drug overdoses, with two-thirds of those deaths involving opioids. (Fram, 5/8)

Politico: 5 Unintended Consequences Of Addressing The Opioid Crisis
The crackdown on opioids is having unintended consequences. The push for fewer opioid prescriptions at lower doses and for shorter periods has increased suffering for some pain patients including those near the end of life. The emphasis on opioids has also overshadowed other forms of substance abuse that require attention. (Karlin-Smith and Ehley, 5/8)

The Hill: Walmart To Restrict Opioid Prescriptions At Its Pharmacies
Walmart pharmacies will soon limit the supply of first-time opioid prescriptions for acute pain to seven days, an effort aimed at clamping down on an epidemic killing more people per year than car crashes. The initiative will start within 60 days, the company announced Monday, and comes as an increasing number of states and entities in the health-care industry have placed limits on opioid prescriptions. (Roubein, 5/7)

Bloomberg: Opioid Judge Demands Review Of Litigation-Funding Deals 
The judge overseeing more than 600 lawsuits targeting opioid makers is demanding local governments’ lawyers turn over information about any litigation-funding agreements and provide assurance that lenders won’t gain control over legal strategy or settlements. U.S. District Judge Dan Polster in Cleveland issued the order Monday saying he wants to ensure the agreements don’t create conflicts of interest by affecting plaintiffs lawyers’ judgments in pursuing cases against opioid makers, such as Purdue Pharma LLP and Johnson & Johnson, and distributors such as McKesson Corp. and Cardinal Health Inc. (Feeley and Harris, 5/7)

The New York Times: Melania Trump Rolls Out ‘Be Best,’ A Children’s Agenda With A Focus On Social Media
Hours after President Trump took to Twitter on Monday to denigrate the special counsel’s investigation as a “Phony Witch Hunt” and the Iran deal as a “MESS,” Melania Trump stepped into the Rose Garden and said she would focus her official effort as first lady on teaching children to put kindness first in their lives, particularly on social media. In a speech delivered in front of her husband, Vice President Mike Pence, at least five cabinet secretaries and other senior officials, Mrs. Trump unveiled a program called “Be Best,” which she said would tackle opioid abuse, social media pressures and mental health issues among young people. (Rogers, 5/7)

The New York Times: States Turn To An Unproven Method Of Execution: Nitrogen Gas
Hamstrung by troubles with lethal injection — gruesomely botched attempts, legal battles and growing difficulty obtaining the drugs — states are looking for alternative ways to carry out the death penalty. High on the list for some is a method that has never been used before: inhaling nitrogen gas. Oklahoma, Alabama and Mississippi have authorized nitrogen for executions and are developing protocols to use it, which represents a leap into the unknown. There is no scientific data on executing people with nitrogen, leading some experts to question whether states, in trying to solve old problems, may create new ones. (Grady and Hoffman, 5/7)

Los Angeles Times: It's Not Just You, We're All Living In The United States Of Anxiety
Feeling more anxious these days? You've got plenty of company. A new survey from the American Psychiatric Assn. reveals that 39% of Americans feel more anxious now than they did a year ago. That's more than double the 19% of Americans who feel less anxious now than at this time last year. (Another 39% of survey respondents said their anxiety level is about the same, and 3% weren't sure.) (Kaplan, 5/8)

The New York Times: When A New Mother’s Joy Is Entwined With Grief
Every Mother’s Day, Maggie Nelson, her husband Mike, and their three young children head to the cemetery to take a family photo at the grave of their daughter, Emily. She was stillborn in 2010, but her twin, Mikey, now 7, survived. “People say, ‘That’s kind of sad,’ but I can say, ‘I’m a proud mom of four. Here I am with all of them,’” Ms. Nelson, 39, said of the photos of her and the kids gathered on the grass by Emily’s stone plaque. A Bloomington, Ill., kindergarten teacher, she is a member of an unofficial sorority of women who experienced acute grief while postpartum. (Zulkey, 5/8)

Stat: Stubborn Genes: New Research Looks At How Our Bodies Respond (Or Don’t) To Night Shift Work
In nursing, there is a rite of passage that nearly everyone goes through — night shifts. Sometimes, the shifts are clumped together, and sometimes, they are spaced apart, said Daniel Schweitzer, a nurse in Pittsburgh. But they always seem to have the same effect on his body clock. “When you do a few nights, you get this permanent jet lag, where you’re never quite truly awake,” he said. “Your sleep schedule gets truly messed up.” (Satyanarayana, 5/7)

Los Angeles Times: In Veterans, Even A Mild Case Of Traumatic Brain Injury Is Linked To An Increased Risk Of Dementia
Mild traumatic brain injury may sound like an oxymoron, along the lines of "jumbo shrimp" or "random order." But a new study shows that mild TBIs can have serious consequences for military veterans by raising their risk of dementia. Researchers who examined the medical records of more than 350,000 Americans who served during the wars in Iraq and Afghanistan found that men and women who experienced at least one mild TBI were more than twice as likely as their uninjured peers to develop dementia after they retired from the military. (Kaplan, 5/7)

The Hill: How Ebola Entered The American Consciousness: A Trump Tweet
Little did Trump know that his initial tweets came at the moment when the White House was most worried that the Ebola virus would, in fact, spread to the United States. The occasion was the African Leaders Summit, which brought heads of state from fifty African nations to the Mandarin Oriental Hotel, the State Department and the White House itself. The Obama administration worried that the summit, which included dozens of staff, hangers-on and members of the African media attached to each delegation, would inadvertently serve as the opportunity for Ebola to spread between delegations, or to civilians in the Washington area. (Wilson, 5/8)

The Associated Press: US Abortion Clinics Face Surge Of Trespassing And Blockades
America’s abortion clinics experienced a major upsurge in trespassing, obstruction and blockades by anti-abortion activists in 2017, according to an annual survey by an industry group. The National Abortion Federation report chronicled a litany of actions that ranged from coordinated trespassing efforts by abortion opponents, repeated brick-throwing at windows of a Cleveland clinic and an attempted bombing in Illinois. (Crary, 5/7)

The Associated Press: University Of California Workers Start 3-Day Strike Over Pay
Thousands of custodians, security guards, gardeners and other service workers at University of California campuses started a three-day strike Monday to address pay inequalities and demand higher wages. Strikers gathered at sunrise on the 10 campuses throughout the state, wearing green T-shirts and carrying signs that call for “equality, fairness, respect.” The strike was called last week by American Federation of State, County and Municipal Employees Local 3299, which represents 25,000 service workers, after the union and the university could not agree on a new contract and mediation efforts failed. Another 29,000 nurses, pharmacists, radiologists and other medical workers heeded the service workers’ call for a sympathy strike and will join the walkouts Tuesday and Wednesday, which is expected to disrupt thousands of surgeries and other appointments. (Rodriguez, 5/7)

Los Angeles Times: Massive UC Workers' Strike Disrupts Dining, Classes And Medical Services
UC's five medical centers hired contract workers to fill in during the strike and scrambled to reschedule exams and treatments. UC San Francisco rescheduled more than 12,000 appointments for surgeries and treatments, including chemotherapy and radiation. UC Davis rescheduled several hundred appointments, including more than 100 cancer surgeries and 150 radiology exams. But campus spokeswoman Kimberly Hale said 78% of UC Davis health workers showed up for work. UC San Diego directed emergency room patients to other hospitals. (Watanabe and Resmovits, 5/7)

The New York Times: M.I.T. Is Not Responsible For Student’s Suicide, Court Rules
In a legal case closely watched for its potential implications for universities nationwide, Massachusetts’s highest court ruled Monday that M.I.T. could not be held responsible for the 2009 suicide of one of its students. Broadly, the Supreme Judicial Court said in its 44-page ruling, “there is no duty to prevent another from committing suicide.” (Seelye, 5/7)

The Associated Press: California Judge Affirms Ruling For Coffee Cancer Warnings
A court ruling that gave coffee drinkers a jolt earlier this year was finalized Monday when a Los Angeles judge said coffee sold in California must carry cancer warnings. Superior Court Judge Elihu Berle said Starbucks Corp. and other roasters and retailers failed to show that benefits from drinking coffee outweighed any risks from a carcinogen that is a byproduct of the roasting process. He had tentatively made the same written decision in March. (Melley, 5/7)

The Associated Press: Court To Weigh Fallout Of Massachusetts Drug Lab Misconduct
Massachusetts’ highest court is set to consider whether to toss more convictions linked to a former chemist who authorities say was high almost every day she worked at a state drug lab for eight years. The Supreme Judicial Court will hear arguments on Tuesday in the case brought by the American Civil Liberties Union of Massachusetts and the state’s public defender agency. Prosecutors already have agreed to dismiss thousands of cases tainted by Sonja Farak, who pleaded guilty in 2014 to stealing cocaine from the lab. (5/8)

The Washington Post: Cleveland Clinic Doctor Treats Woman Having Allergic Reaction Midflight
Minutes into her flight, Ashley Spencer popped open a bag of chips and started to munch. For years, Spencer has been suffering from a rare autoimmune disorder, and she hoped new medication might be able to help. So the 28-year-old was traveling from Philadelphia to the renowned Cleveland Clinic on Saturday to see whether she might be a candidate. The aircraft was barely in the air when Spencer started to feel sick, she said. She told her mother she was going to the airplane bathroom to vomit. (Bever, 5/7)

The Associated Press: Several GOP Governor Candidates Urge Fallin To Sign Gun Law
Several Republican candidates for governor of Oklahoma urged GOP Gov. Mary Fallin Monday to sign legislation allowing adults to carry handguns without a permit amid growing opposition from some of the state's top law enforcement officials. Oklahoma currently requires a license to carry a handgun openly or concealed and charges handgun license applicants a fee of up to $200. But gun rights supporters, including GOP gubernatorial candidates Gary Richardson and Dan Fisher, a former state representative, said they believe the Second Amendment gives citizens the right to carry firearms without government interference. (Talley, 5/7)

The Associated Press: Parkland Survivor Urges Congress To Act To Curb Gun Violence
Seventeen-year-old Aalayah Eastmond hid beneath the lifeless body of a classmate as a gunman opened fire at her Parkland, Florida high school in February. "No student should have to literally dodge bullets to survive," Eastmond recalled Monday, "but I was that student. No student should have to have body matter of her classmate picked out of her hair, but I was that student." (Daly, 5/7)