First Edition: November 20, 2019

Kaiser Health News: HealthBent: The Case Of The ACA’s Disappearing Taxes
It was a moment of genuine bipartisanship at the House Ways and Means Committee in October, as Democratic and Republican sponsors alike praised a bill called the “Restoring Access to Medication Act of 2019.” The bill, approved by the panel on a voice vote, would allow consumers to use their tax-free flexible spending accounts or health savings accounts to pay for over-the-counter medications and women’s menstrual products. Assuming it ultimately finds its way into law, the measure would also represent the latest piece of the Affordable Care Act’s financing to be undone. (Rovner, 11/20)

Kaiser Health News: New California Law May Expand Use Of HIV Prevention Drugs, With Caveats
Kellen Willhite was 24 when he learned he’d been exposed to HIV. What followed was, as he describes it, a second trauma: trying to obtain the drugs that could save him before it was too late. In 2016, a day after Willhite and his then-boyfriend had engaged in unprotected sex, they visited the small offices of Golden Rule Services, a nonprofit community clinic about 7 miles south of the state Capitol. (Kreidler, 11/20)

The New York Times: Next Democratic Debate: The Top Four Vs. Everyone Else
Mayor Pete Buttigieg of South Bend, Ind., has recently emerged as a leader in some Iowa polls, and Senator Bernie Sanders of Vermont appears re-energized by the endorsement of Representative Alexandria Ocasio-Cortez of New York. But the two candidates at center stage remain the same: former Vice President Joseph R. Biden Jr. and Senator Elizabeth Warren of Massachusetts. Together, these four have separated themselves from the 2020 pack. The debate stage has shrunk since the October clash, with former Representative Beto O’Rourke of Texas quitting the race and the former federal housing secretary Julián Castro failing to qualify. (Goldmacher and Ramic, 11/20)

Reuters: Where Democratic Presidential Candidates Stand On 'Medicare For All' Ahead Of Next Debate
Perhaps no issue has divided the field of Democratic 2020 presidential hopefuls more than the debate over "Medicare for All." Progressive candidates favor the sweeping proposal, which would replace private health insurance with a single government-run plan. More moderate candidates have embraced less drastic measures they say would achieve universal healthcare coverage while allowing individuals to choose their plan. (11/19)

The Associated Press: 7 Key Questions Heading Into Wednesday’s Democratic Debate
No single issue has dominated the initial Democratic primary debates more than health care, and it’s safe to assume that will be the case again Wednesday night. And no one has more riding on that specific debate than Warren, who hurt herself last month by stumbling through questions about the cost of her single-payer health care plan. Given that policy specifics make up the backbone of her candidacy, she can’t afford another underwhelming performance on the defining policy debate of the primary season. (Peoples, 11/20)

The New York Times: The Issues That Got The Most Time At The Debates So Far
Over six nights of debates since June, the Democratic presidential candidates have spent a lot of time talking — 659 minutes in total, or nearly 11 hours. They’ve spent the most time discussing health care, which has become a proxy for the fight between the liberal and moderate wings of the party. Other topics, like climate change and reproductive rights, have received less attention, drawing some complaints. (11/20)

The Washington Post: Americans Have Questions About Medicare-For-All. Canadians Have Answers.
When Bryan Keith was diagnosed with prostate cancer three years ago, he underwent a blizzard of tests, specialist consultations, a month of radiation treatment and a surgical procedure. His out-of-pocket costs? Zero. “I’ve never had to reach into my wallet for anything other than my health-care card,” said Keith, 71, who is now in remission. In this picturesque mountain town of about 10,000 people, Keith’s experience is the norm — and the model often cited by Sens. Bernie Sanders and Elizabeth Warren as they promote Medicare-for-all as an antidote to some of the problems afflicting U.S. health-care consumers. (Abutaleb, 11/19)

The Hill: Majority Of Iowans Want Health Care Option That Isn't 'Medicare For All': Poll 
A majority of Iowans who will likely attend the state’s 2020 Democratic caucuses want a health care option other than “Medicare for All,” a new poll finds. More than a third of Democratic respondents in a CNN-Des Moines Register-Mediacom poll — 36 percent — support Medicare for All, but nearly as many others — 34 percent — want a public option to buy into, CNN reports. (Campisi, 11/19)

The Associated Press: Trump Says He Went Through ‘Very Routine Physical’
President Donald Trump said Tuesday he went through a “very routine physical” when he visited Walter Reed National Military Medical Center over the weekend. The president complained that first lady Melania Trump and some of his staff members expressed concern about his health based on media reports about Saturday’s trip to the hospital. He said it’s the media that’s “sick.” (Freking, 11/19)

Politico: Trump Says Media Panicked Melania Into Thinking He Had A Heart Attack
[Trump] told reporters that he was greeted by a panicked first lady and communications department when he arrived back at the White House due to media coverage of the trip. “I went for a physical. And I came back and my wife said, ‘Darling are you OK? … Oh they’re reporting you may have had a heart attack,’” Trump explained. “I said, ‘Why did I have a heart attack?’ ‘Because you went to Walter Reed Medical Center’ — that's where we go when we get the physicals.” (Oprysko, 11/19)

CNN: The White House Shifts Description Of Trump's Visit To Walter Reed
The White House has offered shifting descriptions of President Donald Trump's medical exam in the days since he made an unscheduled Saturday visit to Walter Reed National Military Medical Center. Trump and White House press secretary Stephanie Grisham initially billed Trump's visit as the first part of the President's annual physical. But two days later, the President's doctor described the hospital visit as an "interim checkup," a term physicians told CNN implies a separate visit that is not part of an annual physical. (Diamond, 11/19)

Politico: Contractor Proposed Glamour Magazine Profile For Medicaid Chief
Newly revealed correspondence shows that federal health officials discussed with contractors a publicity plan to feature President Donald Trump’s Medicare and Medicaid chief Seema Verma in magazines like Glamour, win recognition for her on “Power Women” lists and get her invited to attend prestigious events like the Kennedy Center Honors. The correspondence – emails between high-profile media consultant Pam Stevens, whose services cost hundreds of dollars per hour, and Verma and Brady Brookes, Verma’s deputy chief of staff — offers fresh insight into the Centers for Medicare and Medicaid Services’ use of federal funds to employ a range of communications contractors. (Diamond and Cancryn, 11/20)

NPR: Medicaid Funding In U.S. Territories Takes A Dive
Right now, there are dozens of patients — U.S. citizens — in New Zealand hospitals who are fighting the clock. They have only a few weeks to recover and get home to the tiny island of American Samoa, a U.S. territory in the South Pacific. "We have a cancer patient that is coming back in December," says Sandra King Young, who runs the Medicaid program in American Samoa. "We can only give him six weeks of chemo, radiation and surgery. He has a good chance of survival if he has the full year of treatment, but not six weeks. The patient and family understand, and since they have no money, they have agreed to come back." (Simmons-Duffin, 11/20)

The Associated Press: Fake Doctors, Misleading Claims Drive OxyContin China Sales
OxyContin is a dying business in the United States. Purdue Pharma, owned by the billionaire Sackler family, is collapsing under an avalanche of lawsuits that accuse the company of using false claims to push its blockbuster painkiller in the U.S., profiting as an unsuspecting nation slipped into a devastating drug crisis. Meanwhile, another company owned by the family in China has been promoting OxyContin with the same tactics Purdue was forced to abandon in the U.S. as opioid overdose deaths soared, according to interviews with four current and former employees and more than 3,300 pages of training and marketing material obtained by the Associated Press. (11/20)

The Associated Press: Oxy Sales In China Driven By Misleading Addiction Claims
Thousands of lawsuits across the United States have accused a drug company owned by the billionaire Sackler family of using false claims to push highly addictive opioids on an unsuspecting nation, fueling the deadliest drug epidemic in U.S. history. Yet, even as its U.S. drugmaker collapses under the charges, another company owned by the family has used the same tactics to peddle its signature painkiller, OxyContin, in China, according to interviews with current and former employees and documents obtained by the Associated Press. (Kinetz, 11/20)

The Washington Post: Pharmacy Chains Face October 2020 Trial Over Their Role In The Opioid Crisis
Seeking to kick-start the sprawling nationwide opioid litigation, a federal judge on Tuesday scheduled a trial against major pharmacy chains for next October and proposed sending three other cases back to other federal courts where they originated. Judge Dan Aaron Polster, the Ohio federal judge in charge of the nearly 2,500 lawsuits filed against the drug industry in federal courts across the country, said he would preside over a case that pits two Ohio counties, Summit and Cuyahoga, against some of the nation’s largest pharmacy chains. (Bernstein, 11/19)

The Wall Street Journal: States AGs Agree To Longer Halt On Purdue Family Claims
Purdue Pharma LP has convinced 24 states and the District of Columbia to comply with a bankruptcy court injunction halting opioid lawsuits against the company and the controlling Sackler family at least temporarily, Purdue’s lawyer said at a bankruptcy hearing. Last month, the judge presiding over Purdue’s bankruptcy enjoined lawsuits against the maker of the opioid OxyContin and the Sacklers. Roughly half of all state attorneys general and the District of Columbia had argued against the injunction, which extends until April 8. (Biswas, 11/19)

The Washington Post: Health Groups, Vaping Foes Renew Calls For Broad E-Cigarette Flavor Ban
The battle over youth vaping escalated Tuesday, with leading conservative women’s groups joining anti-tobacco groups to urge President Trump to make good on his September vow to ban flavored e-cigarettes. In addition, a House committee approved a bill that outlaws flavored tobacco products, and the New York attorney general sued the e-cigarette giant Juul Labs for allegedly targeting teens in its marketing, the day after California brought a similar suit. (McGinley, 11/19)

The Wall Street Journal: Massachusetts Lawmakers To Vote On Bill To Ban Flavored Tobacco, Menthol Cigarettes
Massachusetts lawmakers are expected to vote Wednesday on a bill that would be the most stringent state-level ban on flavored tobacco, including menthol cigarettes, as they seek to combat youth vaping and cut down on broader tobacco use. The menthol ban would take a restriction already imposed in some U.S. counties and cities to the statewide level for the first time. Convenience-store owners have been pushing back, arguing a menthol ban will fuel a black market and hurt business, but proponents say they don’t want to allow flavor options that could lure young users. (Kamp, 11/20)

The Wall Street Journal: New York Attorney General Sues Juul Labs For Alleged Deceptive Marketing
The New York state attorney general’s office sued Juul Labs Inc. on Tuesday, accusing the country’s largest e-cigarette maker of engaging in deceptive marketing of its products, which state officials blame for contributing to a youth vaping epidemic. The lawsuit, filed in New York Supreme Court, follows a similar one filed Monday in California and another filed in May by North Carolina. New York is seeking restitution, penalties and disgorgement of profits from the company. (West and Maloney, 11/19)

The Associated Press: AMA Calls For Total Ban On All E-Cigarette, Vaping Products
The American Medical Association on Tuesday called for an immediate ban on all electronic cigarettes and vaping devices. The group adopted the sweeping stance at a policy-making meeting in San Diego. It aims to lobby for state and federal laws, regulations or legal action to achieve a ban, but the industry is sure to fight back. (Tanner, 11/19)

Los Angeles Times: Juul Took A Page From Big Tobacco To Revolutionize Vaping
By the time Juul’s co-creator stood before a tech audience in April 2016, ads for the e-cigarette aimed to distance the product from a toxic past: “Our company has its roots in Silicon Valley, not in fields of tobacco.” But when James Monsees, a soon-to-be billionaire, projected a 30-year-old tobacco document on the screen behind him, he grinned. It was an internal memo from the research troves of R.J. Reynolds, the maker of Camel cigarettes. It was stamped “SECRET.” (Baumgaertner, 11/19)

The Associated Press: For Trans Activists, Recent Setbacks Temper Long-Term Hopes
Amid their annual vigils for transgender homicide victims, trans rights activists in the U.S. are trying to maintain long-term optimism even as many hard-won protections are under threat. Just a few weeks ago, President Donald Trump’s administration argued before the Supreme Court that employers should be allowed to fire workers because they are transgender. (Crary, 11/19)

The Hill: Schumer: Leadership Trying To Work Out Competing Surprise Medical Bill Measures 
Senate Minority Leader Charles Schumer (D-N.Y.) said Tuesday that congressional leadership is trying to work out differences between competing measures to protect patients from getting hit with massive, “surprise” medical bills. The effort is a rare area for possible bipartisan action this year, given that lawmakers in both parties and President Trump say that patients should be protected from getting medical bills for thousands of dollars when they go to the emergency room and one of the doctors in the facility happens to be outside their insurance network. (Sullivan, 11/19)

Politico: Ernst And Schumer Spar Over Violence Against Women Act
Sen. Joni Ernst is battling with Senate Minority Leader Chuck Schumer over the Violence Against Women Act, with Ernst suggesting Schumer is halting her bill to thwart her reelection campaign and Schumer charging that Ernst is "afraid of the NRA." The rare conflict between the Iowa Republican and New York Democrat underscored the political tension on legislation ahead of next year's election, when Ernst will be fighting to win a second term and Schumer will be leading the charge to defeat her. Ernst's seat is one of a half-dozen competitive seats being targeted by Democrats in 2020. (Levine and Everett, 11/19)

Stat: 12 Burning Questions For Stephen Hahn, Trump’s Pick To Lead FDA 
Stephen Hahn, President Trump’s nominee to helm the Food and Drug Administration, will today face his first real test in Washington — a confirmation hearing packed with hours of questions from senators on nearly every aspect of the agency’s sprawling portfolio, from mysterious vaping illnesses to the promise of gene therapies. Hahn, who currently serves as the chief medical executive of MD Anderson Cancer Center, is auditioning for the FDA’s top job at a transformational time for the agency. (Florko, 11/20)

The Wall Street Journal: Generic-Drug Approvals Soar, But Patients Still Go Without
Record numbers of generic drugs for cancer, heart ailments and other conditions have received U.S. approval in recent years, raising hopes that the new competition would reduce high drug costs. But many of the lower-price medicines haven’t hit the market, a Wall Street Journal review found. The result: Many patients are forced to take high-price medicines, and a widely touted remedy for reining in drug costs has failed to live up to its promise. (Hopkins, 11/19)

Stat: Mysterious Anti-Pharma Group Is Backed By Hospital Lobby And CVS Health
The dark-money group that has spent over $1 million on mysterious, pharma-bashing radio ads was formed by a top executive and a top lobbyist for the American Hospital Association and a former political consultant for CVS (CVS) Health, according to a 2018 tax filing released to STAT this week. The secretive group, known as Citizens for Truth in Drug Pricing, has blanketed airwaves with radio advertisements and sponsored commentary that sharply criticizes drug companies for high prices. (Facher, 11/20)

The New York Times: Guards Accused Of Napping And Shopping Online The Night Epstein Died
The night that Jeffrey Epstein hanged himself in a Manhattan jail, one of the guards on duty was catching up on sports news and looking at motorcycle sales on a government computer. The other spent time shopping online for furniture. For about two hours, they appeared to be asleep at a desk just 15 feet away from Mr. Epstein’s cell. Those details were revealed in an indictment unsealed on Tuesday against the two jail employees. The indictment said neither guard made the required rounds every 30 minutes to check on inmates. Yet they filed paperwork claiming they had. (Gold, Ivory and Hong, 11/19)

The Associated Press: As Epstein Died, Guards Allegedly Shopped Online And Slept
The indictment, leaning in part on images from security cameras on the cell block, also contains new details reinforcing the idea that, for all the intrigue regarding Epstein and his connections to powerful people, his death was a suicide and possibly preventable. “The defendants had a duty to ensure the safety and security of federal inmates in their care at the Metropolitan Correctional Center,” U.S. Attorney Geoffrey S. Berman said. “Instead, they repeatedly failed to conduct mandated checks on inmates, and lied on official forms to hide their dereliction.” (11/19)

The Associated Press: Hospital Psychiatric Wards Now Feel Like Prisons, Some Say
Hospitals have been overhauling facilities and procedures in psychiatric wards nationwide in response to new guidelines for suicide prevention. Some mental health advocates and officials say the changes have come at the expense of patient privacy and dignity, making mental health units feel more like correctional institutions. (11/19)

NPR: CRISPR For Sickle Cell Disease Shows Promise In Early Test
Doctors are reporting the first evidence that genetically edited cells could offer a safe way to treat sickle cell disease, a devastating, incurable disorder that afflicts millions of people around the world. Billions of cells that were genetically modified with the powerful gene-editing technique called CRISPR have started working, as doctors had hoped, inside the body of the first sickle cell patient to receive the experimental treatment, according to highly anticipated data released Tuesday. (Stein, 11/19)

The Wall Street Journal: Donors Pledge $2.6 Billion For Polio Eradication
Donors around the world are injecting another $2.6 billion into eradicating polio, a goal that remains elusive despite years of pursuit. The new money, from the Bill & Melinda Gates Foundation, Rotary International, the crown prince of Abu Dhabi and others, is to help the Global Polio Eradication Initiative, a group of public and private organizations, strengthen its activities as it confronts numerous challenges from antivaccine sentiment to outbreaks of a virus from a former polio vaccine. (McKay, 11/19)

The New York Times: The Brain Benefits Of Reading And Writing
People who never learned to read and write may be at increased risk for dementia. Researchers studied 983 adults 65 and older with four or fewer years of schooling. Ninety percent were immigrants from the Dominican Republic, where there were limited opportunities for schooling. Many had learned to read outside of school, but 237 could not read or write. (Bakalar, 11/19)

The New York Times: How The Brain Can Rewire Itself After Half Of It Is Removed
Shortly after the birth of her first son, Monika Jones learned that he had a rare neurological condition that made one side of his brain abnormally large. Her son, Henry, endured hundreds of seizures a day. Despite receiving high doses of medication, his little body seemed like a rag doll as one episode blended into another. He required several surgeries, starting when he was 3 1/2 months old, eventually leading to a complete anatomical hemispherectomy, or the removal of half of his brain, when he turned 3. (Sheikh, 11/19)

The New York Times: A High-Tech System To Make Homes More Healthy
Delos is what’s known as a “wellness real estate” brand. Founded in New York in 2012, it aims to make homes healthier places to live by installing a system that monitors and controls a property’s air and water quality and lighting. Delos introduced the technology, called Darwin Home Wellness Intelligence (Darwin), in Australia last fall. (Vora, 11/20)

The Washington Post: Ramping Up Exercise Tied To Lowered Heart Disease Risk In Older Adults, Study Says
Sedentary older adults can help lower their risk of heart disease if they start exercising, a new study confirms. Researchers examined data on more than 1.1 million people 60 and older without any history of heart disease who had two health screenings between 2009 and 2012. Most were physically inactive at the first screening, and almost 4 in 5 of these people remained sedentary throughout the study period. (Rapaport, 11/19)

The New York Times: Racist Manifesto Lands On Syracuse Students’ Phones, Deepening Crisis
It was an ordinary cram session, around midnight, when the screed appeared on students’ phones. A racist manifesto, sent to a small clutch of people sitting at a Syracuse University library on Tuesday morning, warned of “the great replacement,” a right-wing conspiracy theory that predicts white genocide at the hands of minority groups. (Randle and McKinley, 11/19)

The Associated Press: Maryland Auditors ‘Hindered’ In Medical Board Report
The University of Maryland Medical System, rocked by a self-dealing scandal this year involving board members that caused Baltimore’s mayor to resign, has repeatedly “delayed and hindered” the work of state auditors, according to a letter from the chief auditor made public Tuesday. Maryland Legislative Auditor Gregory Hook wrote to leading state lawmakers late last month that 37 employees in his office have spent a cumulative total of 600 days working on the audit, with fieldwork beginning April 16. He also wrote that the office has spent “countless days sifting and analyzing electronic records” it has received. (11/19)

The New York Times: More Time Granted For Texas Baby Before Life Support Halted
A Texas family that disagrees with a Fort Worth hospital’s plan to take a 9-month-old girl off life support has been given more time to find a facility to take her. Texas Right to Life, which represents Tinslee Lewis’ family, said a judge Tuesday extended a temporary restraining order against Cook Children’s Medical Center until Dec. 10. The hospital didn’t immediately comment. (11/19)

The Associated Press: Jury Awards $58M In Lawsuit Against Body Donation Firm
A civil jury has awarded $58 million Tuesday to 10 people who alleged a now-closed body donation facility mishandled the donated remains of their relatives and deceived them about how the body parts would be used. The trial against Stephen Gore, owner of the Biological Resource Center of Arizona, ended with jurors finding in favor of 10 of 21 plaintiffs, awarding $8 million in compensatory damages and $50 million in punitive damages. (11/19)

The Washington Post: D.C. Admits Lax Monitoring Of Mental Patient Accused In Unprovoked Killing
The District’s mental health agency acknowledged Tuesday that it failed to properly monitor a discharged psychiatric patient with a homicidal history before he allegedly killed a neighbor in an unprovoked shooting in March. But the agency assumed no blame for the attack, asserting that “any attempt” to link its lax supervision to the victim’s death “would require undue speculation.” (Duggan, 11/19)

Los Angeles Times: Poll: L.A. County Voters Want Homeless People Gone, Police Help
With tens of thousands of people sleeping outside every night in L.A. County, one of the most contentious debates is over what to do about homeless encampments and who should do it. A new poll conducted for the Los Angeles Times and the Los Angeles Business Council Institute found that a sizable majority of voters countywide think law enforcement should assume a larger role, despite court rulings and settlements limiting such involvement. (Oreskes, 11/19)