First Edition: May 9, 2019

Kaiser Health News: Needle Exchanges Find New Champions Among Republicans
Once repellent to conservative politicians, needle exchanges are now being endorsed and legalized in Republican-controlled states. At least four legislatures have considered bills to allow hypodermic needle exchanges, and two states, Georgia and Idaho, made them legal this year. In each of these states, the House and Senate are controlled by Republicans and the governor is a Republican. Florida, Missouri, Iowa and Arizona have introduced bills this legislative session that would allow needle exchanges in their state. The measures were all sponsored or co-sponsored by Republicans. (Knight, 5/9)

Kaiser Health News: Addiction Medicine Mostly Prescribed To Whites, Even As Opioid Deaths Rose Among Blacks
White drug users addicted to heroin, fentanyl and other opioids have had near-exclusive access to buprenorphine, a drug that curbs the craving for opioids and reduces the chance of a fatal overdose. That’s according to a study out Wednesday from the University of Michigan. It appears in JAMA Psychiatry. Researchers reviewed two national surveys of physician-reported prescriptions. From 2012 to 2015, as overdose deaths surged in many states so did the number of visits during which a doctor or nurse practitioner prescribed buprenorphine, often referred to by the brand name Suboxone. The researchers assessed 13.4 million medical encounters involving the drug but found no increase in prescriptions written for African Americans. (Bebinger, 5/8)

The New York Times: Drug Prices Will Soon Appear In Many TV Ads
The Trump administration for the first time will require pharmaceutical companies to include the price of prescription drugs in television advertisements if the cost exceeds $35 per month. The move, announced on Wednesday by Alex M. Azar II, the health and human services secretary, is the most visible action the administration has taken so far to address the rising cost of prescription drugs. It has been a key issue for American voters and one that both Republicans and Democrats have vowed to address. (Thrush and Thomas, 5/8)

The Associated Press: TV Pitches For Prescription Drugs Will Have To Include Price
Health and Human Services Secretary Alex Azar said Wednesday the Trump administration has finalized regulations requiring drug companies to disclose list prices of medications costing more than $35 for a month's supply. "What I say to the companies is if you think the cost of your drug will scare people from buying your drugs, then lower your prices," Azar said. "Transparency for American patients is here." In a tweet, President Donald Trump celebrated the announcement, saying: "Historic transparency for American patients is here. If drug companies are ashamed of those prices lower them!" (Alonso-Zaldivar, 5/8)

NPR: New Rule For Drugmakers: Disclose Drugs' List Prices In TV Ads
Industry groups have fought this move since it was announced in October. They adopted voluntary rules, that would have directed ad viewers to a website with more detailed cost information. Today, in a statement, the Pharmaceutical Research and Manufacturers of America (PhRMA) wrote that the list price is confusing since that's not what most people pay. The rule addresses that by requiring an additional statement that reads, "If you have health insurance that covers drugs, your cost may be different." PhRMA also said that the rule raises "First Amendment and statutory concerns." Court challenges may be coming. The legal authority given by the White House is based on the laws that require Medicare and Medicaid to be run in a cost-effective manner, according to the rule. (Simmons-Duffin, 5/8)

The Wall Street Journal: Drug Prices To Be Disclosed In TV Ads Soon
Drugmakers have opposed the mandate, saying the rule could improperly limit free speech and that providing only the list price would confuse and mislead consumers who might think they have to pay more than they actually would. The list price is the figure initially set by the drugmaker, but it is different than what consumers generally pay, because it doesn’t take into account rebates, discounts and insurance payments. “While we are still reviewing the administration’s rule, we believe there are operational challenges, particularly the 60-day implementation timeframe, and think the final rule raises First Amendment and statutory concerns,” said Stephen Ubl, president and chief executive of the Pharmaceutical Research and Manufacturers of America, in a written statement. PhRMA is an industry trade group. (Armour, 5/8)

The New York Times: Elizabeth Warren, Unveiling Opioid Plan, Says She Will Give Sackler Family’s Donations To Charity
Senator Elizabeth Warren of Massachusetts escalated her criticism of the pharmaceutical industry, announcing she would donate the campaign contributions she has received from the family of the pharmaceutical magnate Raymond Sackler, and calling on Harvard University to remove the Sackler name from all campus buildings where it appears. Ms. Warren, who is running for the Democratic presidential nomination, made the announcement as she unveiled a plan on Wednesday to fight the opioid crisis raging in the United States. (Herndon, 5/8)

The Associated Press: Warren Releases $100 Billion Plan To Combat Opioid Epidemic
Warren's new opioids measure is modeled on a 1990 law passed to help fight the spread of AIDS and would be paid for using her proposed tax on the wealthiest American households. The Massachusetts senator released her new plan Wednesday ahead of a campaign trip to Ohio and West Virginia, where she'll visit a town that sued drug companies. Warren ties the opioid epidemic to the influence of drug companies' "money and power" in America. Drug companies have largely denied that their distribution practices contributed to the nation's rising opioid overdose rate. (Schor, 5/8)

The Wall Street Journal: Elizabeth Warren To Offset Donations From Family Tied To OxyContin Maker
Ms. Warren, writing in a post on the website Medium—as she often does when announcing policy positions—takes aim at the Sacklers, noting that OxyContin is a powerful opioid painkiller that caused widespread addiction after hitting the U.S. market in 1996. Purdue and other companies are facing more than 1,600 lawsuits from cities, counties and states over their alleged role in sparking the opioid crisis through deceptive and aggressive marketing. The Sacklers have broadly denied the allegations. In 2007, a federal investigation of Purdue led the company and three of its executives to plead guilty in federal court to criminal charges of misleading the public about OxyContin’s addiction risks between 1995 and 2001, and to pay $634.5 million in government penalties and costs to settle civil litigation. (Jamerson, 5/8)

The New York Times: As States Race To Limit Abortions, Alabama Goes Further, Seeking To Outlaw Most Of Them
Amid a flurry of new limits on abortion being sought in states around the nation, Alabama is weighing a measure that would go further than all of them — outlawing most abortions almost entirely. The effort in Alabama, where the State Senate could vote as soon as Thursday, is unfolding as Republicans, emboldened by President Trump and the shifting alignment of the Supreme Court, intensify a long-running campaign to curb abortion access. (Williams and Blinder, 5/8)

The Washington Post: House Democrats Seek To Block Trump’s Faith-Based Protections For Health Workers
The House Appropriations Committee on Wednesday voted to block a new Trump administration rule allowing health workers to refuse services that violate their religious beliefs. The measure by Rep. Barbara Lee (D-Calif.) would prevent spending to implement the new rule, which Trump announced last week during a speech before faith leaders. The broad new rule allows health-care providers, insurers and employers to refuse to provide or pay for services that violate their religious or moral beliefs, such as abortion or assisted suicide. (Werner, 5/8)

The Associated Press: Wisconsin Republicans To Vote On Killing Medicaid Expansion
Wisconsin Republicans planned to scrap expanding Medicaid, legalizing medical marijuana, raising the minimum wage and a host of other priorities of Democratic Gov. Tony Evers on Thursday, as they begin dismantling his two-year budget plan. Evers and Democrats remain defiant, saying the public is on their side in support of expanding Medicaid. They ran on their promise to expand the health program for the poor and believe their victories in 2018 were due in large part to that position. Polls also show broad public support. (5/9)

ProPublica/Mississippi Center For Investigative Reporting: Trump Hailed This State’s Prison Reforms As A National Model — But The Numbers Reflect A Grim Reality
Last November, as he rallied support for federal prison reform, President Donald Trump visited Gulfport, Mississippi, touting the legislation and what Mississippi had accomplished. Trump talked about the “fantastic job” that Mississippi Corrections Commissioner Pelicia Hall was doing of turning the state’s prisons into places that train inmates for jobs. The following month, Trump signed the First Step Act, whose goal is to reduce the federal prison population and better prepare offenders for life outside bars. (Mitchell, 5/9)

The Associated Press: Teen’s Death Raises New Questions About US Care Of Migrants
Juan de León Gutiérrez told his mother he was calling from a warehouse in Mexico, hidden by a human smuggler who had been paid to take the teenager into the United States. “He told me he had something of a headache, perhaps because he was hungry and had not been able to sleep,” said his mother, Tránsito Gutiérrez de León. The 16-year-old died on April 30 after officials at a Texas youth detention facility noticed he was sick, becoming the third Guatemalan child to die in U.S. custody since December. (Merchant and Perez D., 5/9)

The New York Times: Brother And Sister Of Robert F. Kennedy Jr. Accuse Him Of Spreading Misinformation On Vaccines
A brother, sister and niece of Robert F. Kennedy Jr. on Wednesday chastised him for campaigning against vaccines, saying he has been disseminating “dangerous misinformation” that discourages immunization even as measles spreads throughout the United States. They declared that they love him and praised his work to protect the environment. “However, on vaccines he is wrong,” they wrote in a column published in Politico under the headline “RFK Jr. Is Our Brother and Uncle. He’s Tragically Wrong About Vaccines.” (Rabin, 5/8)

The Washington Post: Robert F. Kennedy, Jr., Is Called Out By His Own Family For His Anti-Vax Conspiracy Theories
On Wednesday, Kennedy’s siblings Kathleen Kennedy Townsend and former congressman Joseph P. Kennedy II (D-Mass.), as well as niece Maeve Kennedy McKean, published an article in Politico Magazine accusing him of being “complicit” in a misinformation campaign. “Robert F. Kennedy Jr. … is part of this campaign to attack the institutions committed to reducing the tragedy of preventable infectious diseases,” they wrote. “He has helped to spread dangerous misinformation over social media and is complicit in sowing distrust of the science behind vaccines.” (Epstein, 5/8)

The Wall Street Journal: San Francisco Investigates Doctor Over Measles Vaccination Exemptions
City officials here are investigating whether a pediatrician illegally gave medical exemptions to parents seeking to not vaccinate their children for school entry, as the U.S. struggles to get control of a growing measles outbreak. A subpoena by City Attorney Dennis Herrera requests the patient records of Dr. Kenneth Stoller, an outspoken opponent of vaccination requirements. The patients’ names were redacted. California is one of three states in which only certain medical exemptions—such as having an allergy to a vaccine or undergoing chemotherapy—can be used to allow a child to attend school without inoculation against measles and other communicable diseases. West Virginia and Mississippi are the others. (Carlton, 5/8)

Los Angeles Times: Bill To Stiffen California’s Vaccine Law Must First Get Past Single-Issue Voters
Some bills are just more trouble than they’re worth for nervous legislators who must worry about voter support. One such bill is a current measure to tighten the requirement that children be vaccinated against contagious diseases — like measles — before being admitted to school for the first time. Kids can be excused from that edict for medical reasons, such as having a weak immune system caused by leukemia. But a few unscrupulous doctors are peddling medical exemptions for phony reasons to parents who obsessively fear vaccinations. Many of these parents get very hostile when lobbying lawmakers and attacking vaccine advocates. (Skelton, 5/9)

The Associated Press: Student Who Sued Over Chickenpox Vaccination Has The Disease
The lawyer for a Kentucky high school student who wasn't allowed to participate in school activities because he wasn't vaccinated for chickenpox says his client has now contracted the illness. Attorney Christopher Wiest of Covington told The Kentucky Enquirer that 18-year-old Jerome Kunkel came down with chickenpox last week. Wiest says Kunkel is "fine" and "a little itchy." (5/8)

The Washington Post: Jonathan Stickland Attacks Vaccine Scientist Peter Hotez, Accusing Him Of 'Sorcery'
A Texas state legislator unleashed a vilifying attack on a leading vaccine scientist Tuesday, accusing the doctor of “sorcery.” It started with a report published Monday by the Texas Department of State Health Services that noted the state recorded a 14 percent rise in parents opting out of their children’s vaccinations. It was a new statistic that alarmed Peter Hotez, professor and dean of the National School of Tropical Medicine at Baylor College of Medicine. (Paul, 5/8)

The New York Times: Walmart Raises Minimum Age To Buy Tobacco Products To 21
Starting in July, people under the age of 21 will no longer be able to buy tobacco products from Walmart or Sam’s Club stores in the United States. Walmart Inc. announced on Wednesday that it would be raising the minimum age for buying the products on July 1, making it the latest retailer to make changes regarding tobacco sales to minors. Walmart’s move comes after a letter from the Food and Drug Administration last month that requested it to submit a plan to end illegal tobacco sales to minors. (Garcia, 5/8)

The Hill: Walmart Raises Age To Buy Tobacco To 21
“We unequivocally acknowledge that even a single sale of a tobacco product to a minor is one too many, and we take seriously our responsibilities in this regard,” Walmart’s U.S. Chief Ethics and Compliance Officer John Scudder said in the letter. The retailer said it would double down on disciplinary action against employees who fail to verify customers’ ages, including possible termination. Walmart also said it would employ virtual reality technology in its age-verification training to allow employees to train under a variety of possible scenarios on the job. (Axelrod, 5/8)

The Hill: Dem Senator Calls On McConnell To Endorse Bipartisan Bill To Raise Smoking Age To 21 
The lead Democratic sponsor of bipartisan legislation to raise the minimum age to purchase tobacco to 21 called on Senate Majority Leader Mitch McConnell (R-Ky.) on Wednesday to co-sponsor the bill rather than introduce his own. Sen. Brian Schatz (D-Hawaii) said the legislation, which is supported by many major public health groups, is the best way to ensure minors are protected from the harms of tobacco. (Weixel, 5/8)

The New York Times: Elizabeth Holmes’s Possible Defense In Theranos Case: Put The Government On Trial
The trial of Elizabeth Holmes, the former Theranos chief executive, and Ramesh Balwani, its chief operating officer, is setting up to be the most extensive corporate prosecutions since executives at Enron were tried in 2006. And if the case gets to trial, one intriguing question is how Ms. Holmes and Mr. Balwani will defend themselves. A recent filing by Ms. Holmes, which was joined by Mr. Balwani, who goes by Sunny, outlines a possible defense: put the government on trial by claiming that regulators improperly brought actions against the company for its blood analysis technology. (Henning, 5/8)

The Associated Press: Health Claim Rejected? Some Steps To Appeal A Denial
Patients are often shocked when their insurance company denies coverage for a procedure or treatment, especially if that leads to a bigger-than-expected bill. These rejections can be fairly common, and people may not put up their best fight to get the decision reversed. Odds are tough, but denials can be resolved with phone calls or a formal appeal, which health care experts see as more of a last resort. Here's a look at the issue. (5/8)

The New York Times: Colorado School Shooting Victim Died Trying To Stop The Gunman
It was three days before the last day of school, and the students inside Ms. Harper’s English classroom were whiling away the last period of the day watching “The Princess Bride” when one of their classmates walked in late and pulled out a gun. “The only thing he said out loud to the students was, ‘Don’t you move,’” said Nui Giasolli, an 18-year-old senior who was in the class at the time. (Turkewitz, Healy and Mazzei, 5/8)

The Washington Post: Colorado Shooting Updates: Heroic Details Emerge About Incident At School
He was a high school senior, set to graduate this week. But instead of celebrating Kendrick Castillo’s graduation, the family of the 18-year-old will be mourning his death. Castillo, a senior at STEM School Highlands Ranch in suburban Denver, was killed in a classroom Tuesday in a shooting that police say was carried out by a pair of his classmates: 18-year-old Devon Erickson and a younger classmate who has not been identified because she is a juvenile. Eight other students were injured. (Schaneman, Svrluga and Balingit, 5/8)

The Associated Press: Florida Governor Signs Bill Allowing More Armed Teachers
More Florida teachers will be eligible to carry guns in the classroom under a bill Republican Gov. Ron DeSantis signed Wednesday that immediately implements recommendations from a commission formed after a mass shooting at a high school in Parkland. DeSantis signed the bill in private and didn't issue a statement afterward. But he previously made it clear he supports the changes made to the law enacted after a rifle-toting former student walked into Marjory Stoneman Douglas High School and killed 17 people in February 2018. (Farrington, 5/8)

The New York Times: In This Doctor’s Office, A Physical Exam Like No Other
To scientists like Michael Snyder, chair of the genetics department at Stanford University, the future of medicine is data — lots and lots of data. He and others predict that one day doctors won’t just take your blood pressure and check your temperature. They will scrutinize your genome for risk factors and track tens of thousands of molecules active in your body. (Zimmer, 5/8)

NPR: Genetically Modified Viruses Help Save A Patient With A 'Superbug' Infection
For the first time, scientists have used genetically modified viruses to treat a patient fighting an antibiotic-resistant infection. Isabelle Carnell-Holdaway, 17, began the experimental treatment after doctors lost all hope. She was struggling with a life-threatening infection after a lung transplant. With the new treatment, she has not been completely cured. But the Faversham, England, teenager has recovered so much that she has resumed a near-normal life. (Stein, 5/8)

The Associated Press: California Governor To Reveal Updated Spending Plan
California is flooded with money and Gov. Gavin Newsom will outline how he thinks the nation's most populous state should spend it Thursday when he releases a revised version of his $200 billion-plus state budget. The Democratic governor has already proposed new spending to expand health care for young immigrants living in the country illegally, prevent and fight wildfires, spur more housing and boost early child care programs. (5/9)

The Washington Post: Obesity Epidemic Is Led More By Rural Than Urban Populations
As the rate of obesity around the world has climbed steadily for decades, public health efforts to combat it have largely focused on people in cities. With growing numbers of people living in cities, the assumption by public health officials was that urbanization — with its sedentary lifestyle and easy access to highly processed foods — was driving much of the weight gain. But a growing body of research suggests that the bigger problem is in rural areas. (Wan, 5/8)

The New York Times: Despite Eric Garner’s Death And A $35 Million Program, Chokeholds Still Used By Police
In the Bronx, a man was choked from behind as an officer frog-marched him to a squad car. In Manhattan, a detective responding to a noise complaint wrapped his arm around a man’s neck and squeezed for 22 seconds. And in Brooklyn, a plainclothes officer pinned an 18-year-old up against a lamp post, his forearm choking off the teenager’s air supply while he was patted down. (Winston, 5/9)

The Washington Post: California To Ban Controversial Pesticide, Citing Effects On Child Brain Development
California, one of the nation’s largest agricultural states, announced plans Wednesday to ban the widely used pesticide chlorpyrifos linked to neurological problems in infants and children even as federal regulators have allowed the product to remain on the market. State health officials said their decision came amid growing evidence that the pesticide, which is used on crops such as oranges, grapes and almonds, “causes serious health effects in children and other sensitive populations at lower levels of exposure than previously understood.” California Gov. Gavin Newsom (D) also has proposed $5.7 million to support the transition to “safer, more sustainable alternatives,” according to the California Environmental Protection Agency. (Dennis and Eilperin, 5/8)