First Edition: November 7, 2019

Kaiser Health News: The Air Ambulance Billed More Than His Surgeon Did For A Lung Transplant
Before his double lung transplant, Tom Saputo thought he had anticipated every possible outcome. But after the surgery, he wasn’t prepared for the price of the 27-mile air ambulance flight to UCLA Medical Center — which cost more than the lifesaving operation itself. (Almendrala, 11/6)

Kaiser Health News: When Caring For A Sick Spouse Shakes A Marriage To The Core
For a dozen years, Larry Bocchiere, 68, didn’t find it especially difficult to care for his wife, Deborah, who struggled with breathing problems. But as her illness took a downward turn, he became overwhelmed by stress. “I was constantly on guard for any change in her breathing. If she moved during the night, I’d jump up and see if something was wrong,” he said recently in a phone conversation.  “It’s the kind of alertness to threat that a combat soldier feels. I don’t think I got a good night’s sleep for five years. I gained 150 pounds.” (Graham, 11/7)

Kaiser Health News: Rural Seasonal Workers Worry About Montana Medicaid’s Work Requirements 
People on Medicaid who work rural seasonal jobs in Montana are wondering about the future of their access to health coverage. Montana recently passed a law that, if it gains federal approval and goes into effect as planned in January, would require many Medicaid recipients to prove they work a set number of hours each month. Kate Clyatt is one of those seasonal workers. She’s 28 and works as a ranch hand in the unincorporated community of Helmville, Mont., where there’s a saloon, rodeo grounds, two churches, a K-8 public school and a post office. (Cates-Carney, 11/7)

Kaiser Health News: Watch: When Insurance Doesn’t Cover A Mental Health Crisis
Arline Feilen of Carol Stream, Ill., spent five days in the hospital undergoing psychiatric care and ended up with a bill of more than $21,000 that her insurance would not pay. CBS This Morning interviewed Feilen and Kaiser Health News Editor-in-Chief Elisabeth Rosenthal about the latest KHN-NPR “Bill of the Month” installment on Wednesday. (11/6)

Politico: Why Democrats Keep Winning On Health Care
Voters in Virginia and Kentucky sent a clear message on health care Tuesday night: Medicaid expansion and preexisting conditions are winning issues for Democrats, even as President Donald Trump and his allies try to undercut Obamacare. And strident GOP attacks on abortion weren’t enough to stave off Republican losses. Democrat Andy Beshear, who claimed victory in Kentucky’s tight gubernatorial race, and Virginia Democrats who took back control of the state legislature promised to defend Obamacare’s popular insurance protections for preexisting conditions, and they railed against Republican plans to contract the law’s expansion of Medicaid to millions of poor adults. (Pradhan, 11/6)

The Hill: ObamaCare Enrollment Reaches 177,000 In First Two Days Of Enrollment Period 
More than 177,000 people signed up for ObamaCare plans during the first two days of open enrollment, according to numbers released Wednesday by the Trump administration. Nov. 1 marked the first day of open enrollment on healthcare.gov, the federal government’s enrollment platform used by 38 states. Of the 177,082 people who selected plans on healthcare.gov Friday and Saturday, nearly 49,000 were new customers. (Hellmann, 11/6)

The New York Times: Judge Voids Trump-Backed ‘Conscience Rule’ For Health Workers
A federal judge on Wednesday voided the Trump administration’s “conscience rule,” which would have made it easier for health care workers to avoid assisting with abortion or other medical procedures on religious or moral grounds. Hospitals, insurance companies or local governments that violated their employees’ rights under the rule could have faced a loss of federal funds. (Weiser and Sanger-Katz, 11/6)

Reuters: Trump's 'Conscience' Rule For Healthcare Workers Struck Down By U.S. Judge
U.S. District Judge Paul Engelmayer in Manhattan said the "conscience" rule was unconstitutionally coercive because it would let the U.S. Department of Health and Human Services (HHS) withhold billions of dollars of funding from hospitals, clinics, universities and other healthcare providers that did not comply. "Wherever the outermost line where persuasion gives way to coercion lies, the threat to pull all HHS funding here crosses it," Engelmayer wrote in a 147-page decision. (Stempel, 11/6)

The Wall Street Journal: Federal Judge Strikes Down Rule On Conscience Provisions For Medical Providers
“The court’s finding that the rule was promulgated arbitrarily and capriciously calls into question the validity and integrity of the rulemaking venture itself,” U.S. District Judge Paul Engelmayer wrote in his decision. “Indeed, the Court has found that HHS’s stated justification for undertaking rulemaking in the first place—a purported ’significant increase’ in civilian complaints relating to the conscience provisions—was factually untrue.” (Armour, 11/6)

The Washington Post: Trump’s ‘Conscience Rule’ For Health Providers Blocked By Federal Judge
Many physician and health advocacy groups contended that the rule would have disproportionately harmed certain groups of patients, including LGBTQ patients. “We are heartened by today’s ruling, and we will not stop fighting to prioritize patients’ need for standard medical care over health-care personnels’ personal religious or moral beliefs,” the National Family Planning and Reproductive Health Association said in a statement. (Abutaleb, 11/6)

Politico: New York Judge Tosses Trump Administration's Conscience Rule
The ruling is part of an ongoing series of legal battles as administration officials boost socially conservative policies in federally funded health programs. The most high-profile example is the Title X family planning program, where Planned Parenthood is fiercely fighting new restrictions that have prompted the clinics to withdraw from the program. HHS spokesperson Caitlin Oakley said the agency along with the Justice Department is reviewing the court's opinion, "so will not comment on the pending litigation at this time." Backers of the rule say it protects health care workers from having to violate their personal beliefs. (Luthi, 11/6)

NPR: Judge Scraps 'Conscience' Rule Protecting Doctors Who Deny Care For Religious Reasons
Complaints of such violations are relatively rare — for a decade, the office would receive an average of one complaint like this each year. Severino frequently pointed to a jump in those complaints to 343 last year as proving the need for this rule. He attributed that increase to a strong message from his office that they were "open for business" when it came to issues of religious freedom. However, that increase in the number of complaints is "demonstrably false," according to Engelmayer's ruling. Nearly 80% of all the complaints given to the court were about vaccinations — unrelated to health care workers and their religious beliefs in providing care. (Simmons-Duffin and Dwyer, 11/6)

The New York Times: U.S. Must Provide Mental Health Services To Families Separated At Border
A federal judge has ruled that the government must provide mental health services to thousands of migrant parents and children who experienced psychological harm as a result of the Trump administration’s practice of separating families. The decision, issued late Tuesday, marks a rare instance of the government being held legally accountable for mental trauma brought about by its policies — in this case, border security measures that locked thousands of migrant parents in detention while their children were placed in government shelters or foster homes. (Jordan, 11/6)

USA Today: Fed Ban On Flavored Vapes Imminent, Menthol And Vape Stores May Be Spared
Federal regulators are expected to announce a ban on electronic cigarette flavors other than tobacco and menthol within days, although it's unclear if mint flavors will be allowed or reformulated as menthol. Another possible exemption could be vaping products sold in vape stores rather than convenience stores, which is where the under-aged youth who are the focus of the ban often shop. (O'Donnell, 11/6)

The New York Times: Early Problems As Trump’s Signature Veterans’ Health Plan Rolls Out
A health program for veterans that President Trump heralds as a triumphant success is struggling to make its network of doctors as large as required to meet an aggressive expansion of care outside the Department of Veterans Affairs health facilities, officials said. The company managing the new program in a majority of the states said it would probably need millions of dollars more to meet the plan’s coverage goals. Under a new law, known as the Mission Act, veterans who need to drive for at least 30 minutes to a government-operated veterans hospital — rather than 40 miles under old standards — can receive primary care and mental health services outside the department’s traditional system. (Steinhauer, 11/6)

Reuters: Apple Rolls Out Health Records On IPhones For U.S. Military Veterans
Apple Inc on Wednesday said that U.S. military veterans who use its iOS devices and get medical care from the Veterans Health Administration will be able to access their health records on the devices. The Department of Veterans Affairs runs the largest integrated healthcare system in the United States, with 9 million veterans enrolled and more than 1,200 facilities. Apple began working with the department this summer to allow access to health records from the system on iPhones and other Apple mobile devices running its iOS operating system. (11/6)

The New York Times: Trump Administration Sues Gilead, Maker Of H.I.V.-Prevention Drugs
The Trump administration on Wednesday sued Gilead Sciences, a pharmaceutical company that sells H.I.V.-prevention drugs that can cost patients up to $20,000 a year, accusing the company of earning billions from research funded by taxpayers without paying taxpayers back. The government said the company infringed upon patents owned by the Department of Health and Human Services, and had refused attempts by the department to license its patents and collect royalties. The company sells two drugs, Truvada and Descovy, that can be taken once daily to prevent H.I.V. infection, a strategy called pre-exposure prophylaxis, or PrEP. (Victor, 11/7)

The Washington Post: U.S. Sues Drugmaker Gilead Sciences Over Patent On Truvada For HIV Prevention
In a news release Wednesday night, HHS said Gilead had ``willfully and deliberatively induced infringement of the HHS patents.’’ The department said as a result, ``Gilead has profited from research funded by hundreds of millions of taxpayer dollars and reeped billions from PrEP’’ through the sale of Truvada and a newer Gilead drug, Descovy. Despite efforts by the government to reach an agreement, the department said, ``Gilead has repeatedly refused to obtain licenses for the use of the HHS patents.’’ (Rowland, 11/6)

Politico: How The FDA And EPA’s Failure To Communicate Could Put Patients In Danger
For decades a chemical used to sterilize medical devices and surgery tools has been the only option to ensure safe devices for billions of critical health care procedures. But the chemical, ethylene oxide, has been shown to cause cancer, and growing panic among people living near plants that sterilize medical devices has led to a major crackdown and the shutdown of the factories in several states. (Karlin-Smith, Snider and Owermohle, 11/7)

The Washington Post: Deep Brain Stimulation Is Being Tested To Treat Opioid Addiction
A surgeon has implanted electrodes in the brain of a patient suffering from severe opioid use disorder, hoping to cure the man’s in­trac­table craving for drugs in the first such procedure performed in the United States. The device, known as a deep brain stimulator, is designed to alter the function of circuits in the man’s brain. It has been used with varying degrees of success in the treatment of Parkinson’s disease, dystonia, epilepsy, obsessive-compulsive disorder and even depression. It is seen as a last-resort therapy after the failure of standard care, such as medication that reduces the craving for drugs. (Bernstein, 11/6)

The Wall Street Journal: Bankruptcy Scholars Seek Probe Of Purdue Pharma’s Owners
Bankruptcy scholars on Tuesday called for an independent probe of the Sackler family’s dealings with OxyContin maker Purdue Pharma LP, which sought court protection from an avalanche of lawsuits over the opioid epidemic. “The extraordinary public interest in these cases warrants a targeted bankruptcy examination,” law professors Jonathan Lipson, Adam J. Levitin and Stephen J. Lubben wrote in a letter to federal watchdogs overseeing the drugmaker’s bankruptcy. (Brickley, 11/6)

The Washington Post: China Touts Crackdown On Fentanyl, Urged By Trump, As It Sentences Drug-Ring Members
Chinese authorities on Thursday handed severe sentences to members of a fentanyl production ring in an overt show of commitment toward tackling an issue at the heart of President Trump’s criticisms of China. Central government officials invited foreign media to a court in northern Hebei Province where officials announced the arrest of 20 people and the closure of two online shops selling the synthetic opioid, which U.S. public health officials say is responsible for killing more Americans in overdoses than any other drug. (Shih, 11/7)

The New York Times: Crispr Takes Its First Steps In Editing Genes To Fight Cancer
Doctors have for the first time in the United States tested a powerful gene-editing technique in people with cancer. The test, meant to assess only safety, was a step toward the ultimate goal of editing genes to help a patient’s own immune system to attack cancer. The editing was done by the DNA-snipping tool Crispr. (Grady, 11/6)

The Associated Press: Doctors Try CRISPR Gene Editing For Cancer, A 1st In The US
The treatment deletes three genes that might have been hindering these cells' ability to attack the disease, and adds a new, fourth feature to help them do the job. "It's the most complicated genetic, cellular engineering that's been attempted so far," said the study leader, Dr. Edward Stadtmauer of the University of Pennsylvania in Philadelphia. "This is proof that we can safely do gene editing of these cells." (11/6)

NPR: CRISPR To Fight Cancer Looks 'Promising' In 1st Safety Test
Stadtmauer stresses that the trial was not designed to determine whether the approach actually works — only whether it is safe and feasible. "This treatment is not ready for prime time," he says. "But it is definitely very promising."Other researchers agree. "I'm just so excited about this," says Jennifer Doudna of the University of California, Berkeley, who contributed to the discovery and development of CRISPR techniques. (Stein, 11/6)

The Associated Press: CVS Gets A 3Q Booster Shot From Aetna As Revenue Soars
CVS Health revenue surged in the third quarter as the drugstore chain and pharmacy benefits manager added health insurance and pushed ahead with a plan to change how many of its stores operate. The company said Wednesday its roughly $69 billion acquisition of the insurer Aetna helped its top line climb 36% in the quarter while earnings rose 10%. (11/6)

Reuters: CVS Quarterly Profit Beats Expectations; Shares Rise As It Eyes Growth
CVS Health Corp reported higher-than-expected third-quarter profit on Wednesday as medical costs in its Aetna health insurance business came in below forecasts, and the company said its new strategy of using in-pharmacy clinics would contain healthcare spending going forward. Shares of CVS, which runs a national drugstore chain, rose more than 5%, as its pharmacy benefits business also posted better-than-expected operating profit. (11/6)

The Wall Street Journal: CVS Beats Revenue Expectations, Raises Earnings Outlook
CVS said its pharmacy-services business, which offers pharmacy benefit services to employers, health plans and employee groups, recorded revenue of $36.02 billion in the quarter, up about 6% versus a year ago. Its retail business, filling prescription medications and selling a range of merchandise, saw revenue increase 3% to $21.47 billion. Prescription volumes grew 6.4% from a year earlier. (Thomas, 11/6)

The Wall Street Journal: Google Counts On Fitbit To Make Imprint In Health Market
Behind Google’s $2.1 billion deal for wearables maker Fitbit Inc. FIT -0.42% is the search giant’s dream to become a major player in health data after a failed attempt to establish a foothold in it years ago. Big technology companies have long been tantalized by the promise of devices like smartwatches and wireless earbuds to collect a wealth of real-time user data on heart rates, body temperature and the like. Makers of these wearable products sometimes share that data, though they aren’t particularly transparent with whom. Fitbit’s privacy policy says it works with unnamed “partners who provide us with analytics and advertising services” as well as third-party apps. (Needleman and Copeland, 11/6)

The Wall Street Journal: How To Use The HSA, For Medical Or Retirement Savings
The health savings account, or HSA, can be a powerful savings tool—if you approach it the right way. These accounts, which Congress authorized in 2003, are more than just a simple savings tool for medical emergencies. Retirement planners laud the HSA’s triple tax advantage and its use as a complementary savings vehicle to 401(k) plans. Oftentimes when people first hear of HSAs, it is during this time of year. For companies with policies that start in January, open enrollment typically happens in the fall. During this period, many employees are already stressed about choosing and selecting other benefits. (Carpenter, 11/7)

The New York Times: The Loneliness Of Frontotemporal Dementia
At 66, Bob Karger was losing language. It was not the tip-of-the-tongue feeling that melts when you recall a sought-after word. He had lost the connection between sounds and meaning — the way ba-na-na recalls a soft, yellow fruit or ea-gle calls to mind a large bird of prey. In a recent conversation, he had thought acorns grew on pine trees. Mr. Karger did not know how to use items around the house, either. When he picked up a can opener, he would not realize it could remove the top from a tin. If he held a hammer, he might grasp it by the head, turning it around in his palm, not knowing he could swing it into a nail. His world was filled with incomprehensible items. (Peskin, 11/7)

The Wall Street Journal: A New Strain Of HIV Is Recorded Under Group That Caused Pandemic
Scientists using advanced DNA sequencing technology have documented a previously unidentified strain of HIV under the group that is responsible for the vast majority of human infections. The previous strain in that group was documented in 2000. The latest strain was found in just three people, but the findings by Abbott Laboratories ABT 0.95% —a maker of HIV tests—are expected to strike up a broader conversation about how to classify new viral strains that could surface. The company described its findings on Wednesday in an academic journal. (Rana, 11/6)

The New York Times: Avoid Burnout Before You’re Already Burned Out
According to the World Health Organization, burnout is a workplace issue. But just because burnout can happen at work or because of work, doesn’t mean how you use your time outside of work can’t help prevent it. As a time management coach, I’ve seen that at the core, burnout prevention is about living out what is true about your body, your personality and your reality. You don’t need a dream job. But in your overall life, you do need to find time to take care of your health, do things you find refreshing and have a sense of purpose. The closer you are to living your truth, the less likely you are to burnout. (Saunders, 11/6)

The New York Times: How To Feel Nothing Now, In Order To Feel More Later
Everything was going really well for the men of Tennessee Street. Women wanted to talk to them, investors wanted to invest, their new site got traffic, phones were buzzing, their Magic: The Gathering cards were appreciating. This all was exactly the problem. They tried to tamp the pleasure. They would not eat for days (intermittent fasting). They would eschew screens (digital detox). It was not enough. Life was still so good and pleasurable. (Bowles, 11/7)

The New York Times: Flint’s Children Suffer In Class After Years Of Drinking The Lead-Poisoned Water
Nakiya Wakes could not understand how her wiry, toothy-grinned 6-year-old had gone from hyperactive one school year to what teachers described as hysterical the next. Then, in 2015, the state of Michigan delivered a diagnosis of sorts: Ms. Wakes’s neighborhood’s water — which her son, Jaylon, had been drinking and bathing in for more than a year — was saturated with lead, at some of the highest levels in the city. Jaylon would cycle through two schools, receive 30 suspensions and rack up 70 unexcused absences. (Green, 11/6)

The Washington Post: D.C. Offers Financial Aid For Residents To Replace Lead Water Pipes
Some District residents qualify for financial assistance from the city to cover part or all of the cost of replacing their lead water pipes under a new program aimed at completing lead service line replacements in about 12,000 homes. The program covers homes where D.C. Water already has replaced the part of the lead service line, which connects homes to the water main, on public property. Those residents may apply for financial aid to replace the rest of the lead line between the property line and their home with safer copper pipe, D.C. Water officials said Wednesday. (Shaver, 11/6)

The Washington Post: In Virginia, Newly Empowered Democrats Test The Blue Depths
Gun control in the home state of the National Rifle Association. Passage of the Equal Rights Amendment in a legislature that used to run like an old boys’ club. Climate legislation, in a state once defined by coal. A day after winning control of the General Assembly for the first time in a generation, Virginia Democrats were making big plans to use the new power they will consolidate with Gov. Ralph Northam (D). (Schneider and Vozzella, 11/6)

The New York Times: Why $4.5 Billion From Big Tech Won’t End California Housing Crisis
A mile from Apple’s headquarters in Cupertino lies the sun-faded carcass of the Vallco Shopping Mall. At the moment it consists of empty, buff-colored buildings, acres of black asphalt and a pile of rubble where the parking garage used to be. About a year ago, a developer submitted a proposal to build 2,400 apartments on the site, half of them subsidized to put rents below the market rate. The city approved the plan reluctantly, and afterward a community group sued. The project is stuck in court. (Dougherty, 11/6)

Los Angeles Times: L.A. Losing Homeless Housing In Closed Board And Care Homes
The news came in September: Long Beach Residential, a 49-bed home for adults who are mentally ill, was being sold. The residents of the converted apartment building, some of whom had lived there for decades, would have 60 days to move. It’s a scenario that is becoming increasingly common across California, brought on by a combination of an inadequate state funding system and California’s red hot real estate market. (Smith, 11/6)

The Associated Press: Mother Of Brain-Damaged Boy Wins $50M In Malpractice Suit
A jury awarded $101 million to the mother of a severely brain-damaged boy who sued a Chicago-area hospital for medical malpractice, but an agreement between the parties cut the amount to $50 million, a lawyer said Tuesday. Attorneys told a Cook County jury that medical staff at West Suburban Medical Center in Oak Park ignored ultrasound results that indicated the unborn baby didn't move for six hours during labor in 2014. (11/6)