First Edition: November 9, 2018

Kaiser Health News: Montana’s Legislature Could Decide Medicaid Expansion’s Fate
A ballot initiative that would have continued funding Montana’s Medicaid expansion beyond June 2019 has failed. But advocates say they’ll continue to push for money to keep the expansion going after that financial sunset. “We now turn our attention to the legislature to maintain Montana’s bipartisan Medicaid expansion and protect those enrolled from harmful restrictions that would take away health insurance coverage,” said a concession statement Wednesday from Chris Laslovich, campaign manager with the advocacy group Healthy Montana, which supported the measure. (Whitney, 11/9)

Kaiser Health News: Deadly Shootings Are Rising In U.S. After Steady Declines
After steadily declining for more than two decades, deadly shootings are rising across the country, according to a new government report. The researchers also said that the number of suicides involving a firearm grew 21 percent between 2006 and 2016. The report, published Thursday by the Centers for Disease Control and Prevention, looked at gun deaths around the country and in 50 major metropolitan areas. The researchers found a rise in gun homicides in 2015 and 2016, reversing a downward trend and bringing them to a level comparable to a decade ago. (Heredia Rodriguez, 11/9)

Kaiser Health News: New Contractor For Food Stamps Upsets Cart For Farmers Markets
When the woman stopped by Phil Munson’s stall at a Rochester, N.Y., farmers market recently, he noticed a change. A regular customer, she browsed his Fisher Hill Farm vegetables as usual and selected a few to buy. But this time, instead of offering cash for her produce, the woman paid with the wooden tokens available for people using Supplemental Nutrition Assistance Program (SNAP) benefits, formerly known as food stamps. (Andrews, 11/9)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Split Decision On Health Care
Voters on Election Day gave control of the U.S. House to the Democrats but kept the U.S. Senate Republican. That will mean Republicans will no longer be able to pursue partisan changes to the Affordable Care Act or Medicare. But it also may mean that not much else will get done that does not have broad bipartisan support. (Rovner, 11/8)

The Wall Street Journal: Election Shifts Health-Care Landscape Across The U.S.
The midterm elections abruptly shifted the health-care landscape across the country, strengthening the position of the Affordable Care Act while resulting in a divided Congress that could mean most changes unfold on the state level. Health care was the No. 1 issue among voters this election, according to an AP survey of about 90,000 people. The voting results suggested a rebuke to repeated Republican efforts to roll back the health law, and that many Americans care deeply about issues such as coverage for pre-existing medical conditions. (Armour, 11/8)

Modern Healthcare: Medicaid Expansion In Alaska, Montana Threatened By Midterm Results
Medicaid expansion in Alaska and Montana potentially could be rolled back or repealed as a result of Tuesday's midterm election results. If that happens, it would be the first time the extension of coverage to low-income adults under the Affordable Care Act was ever reversed. (Meyer, 11/8)

The New York Times: Gretchen Whitmer Of Michigan Was Overlooked. Not Any Longer.
There is a tendency for people to define Gretchen Whitmer by who she is not. Ms. Whitmer was not one of the surprising, insurgent Democratic nominees for governor this cycle, as her campaign for Michigan’s governorship was flush with money and key endorsements from the outset. She did not have the up-from-nothing background story of some other Democratic candidates; after all, a building in downtown Detroit is named for her father, the former chief executive of Blue Cross Blue Shield. She was not Abdul El-Sayed, the fiery leftist whose campaign for governor captured national attention, but who lost badly to Ms. Whitmer in the primary. ... Mr. El-Sayed consistently chided Ms. Whitmer on health care. Though Ms. Whitmer was integral in helping Michigan expand Medicaid in 2013, she refused to back the Medicare-for-all proposal that Mr. El-Sayed and other progressive stalwarts attributed to her close connection with the health care industry and companies like Blue Cross Blue Shield. (Herndon, 11/8)

The Associated Press: Health Insurers Riding Postelection Wave
Health insurers are extending their postelection streak before the opening bell thanks to several ballot initiatives and the increased chance that a divided Congress that may not repeal the Affordable Care Act. Shares of Centene Corp., WellCare Health Plans Inc. and Humana Inc., up between 7 percent and 9 percent this week, all edged higher in premarket trading, defying the broader markets which are retreating Thursday. The hospital chain HCA Healthcare Inc., up 5 percent for the week, is rising again. (11/8)

Stat: Elijah Cummings Sparred With Martin Shkreli And Mylan’s CEO. Now He’s Got A Gavel To Take On Pharma
He accused Valeant Pharmaceuticals of obstructing a congressional investigation into its pricing practices. He called out Biogen for charging so much for a multiple sclerosis drug that the government holds a patent on. And he famously scolded a smirking Martin Shkreli during a hearing, saying, “It’s not funny, Mr. Shkreli. People are dying.” For years, Elijah Cummings has been a persistent, if forceless, thorn in the pharmaceutical industry’s side. Now, though, Congress’ pharma critic-in-chief will be armed with the authority of a powerful committee chairmanship at a time when lawmakers in both parties are squeezing drug companies more than ever before. (Joseph, 11/9)

The Hill: Dem Overtures To Trump On Drug Pricing Worry Pharma 
The Democratic takeover of the House is giving new life to efforts to fight high drug prices with bipartisan action, a worrying prospect for the pharmaceutical industry. It’s a top priority for House Democrats, who now have powers to press the issue and put the drug industry on the hot seat. It’s also an issue where Democrats believe there is potential to reach a deal with President Trump. (Sullivan, 11/8)

The Hill: House Dems Plan Key Vote On Pre-Existing Conditions 
House Democrats are planning to hold a vote to protect people with pre-existing conditions, a key issue that powered their victory on Tuesday, quickly after taking the majority next year. A House Democratic aide said the vote would be on a measure to have the House of Representatives formally intervene in an anti-ObamaCare lawsuit to defend the health law. (Sullivan, 11/8)

Politico: House Democrats Weigh Joining Obamacare Suit
The move would come soon after the next Congress is sworn in and marks an early attempt to make good on campaign pledges to protect the Affordable Care Act, House sources told POLITICO. Bringing up a resolution to intervene in the case also would force an early vote that puts chamber's Republicans on record about protecting the law and its popular preexisting condition protections.(Ollstein and Cancryn, 11/8)

The Hill: Federal Panel Warns Of People Losing Health Coverage In Arkansas From Work Requirement
A nonpartisan government commission on Medicaid is calling on the Trump administration to pause the practice of revoking Medicaid coverage for people in Arkansas who fail to meet the state’s new work requirements. The letter from the Medicaid and CHIP Payment and Access Commission (MACPAC) states that the commission is “highly concerned” that 8,462 people have lost their health coverage through Medicaid this year for failing to meet the state’s new work requirement.  (Sullivan, 11/8)

The New York Times: A Look At California Gun Laws, Among The Toughest In The Nation
California, where a gunman killed 12 people in a bar in Thousand Oaks on Wednesday night, has some of the strictest gun laws in the country. It was the first state to ban assault weapons in 1989 after a shooting at a Stockton elementary school left five students dead. In the wake of several recent mass shootings — including one in February in Parkland, Fla., where a gunman killed 17 students and employees at a high school — state legislators put forward at least nine new gun control bills in response. Here’s a look at the state of gun regulations in California. (Urbina, 11/8)

The Associated Press: California Gunman Was Volatile But Passed Mental Assessment
Neighbors of Ian David Long described the man who shot and killed 12 people at a country music bar as distant in public but combative with his mother inside the suburban Los Angeles home the two shared. One ruckus in April was so extreme that they called law enforcement. Authorities brought in a mental health specialist who concluded that Long could not be involuntarily committed for psychiatric observation but worried the 28-year-old Marine veteran might have post-traumatic stress disorder. (Ronayne and Pritchard, 11/9)

The Wall Street Journal: Police Probe Motive In Southern California Bar Massacre
From Las Vegas to Parkland, Fla., Pittsburgh to Santa Fe, Texas, the nation has been shaken by the frequency of mass shootings over the past two years. The Federal Bureau of Investigation says 30 active-shooter incidents in 2017 left in 138 people dead—both the highest totals since the FBI began keeping track in 2000. The FBI defines an active shooter as someone actively engaged in killing or attempting to kill people in a populated area. (Lovett, Frosch and Elinson, 11/8)

The Wall Street Journal: California Bar Shooter Had Domestic-Disturbance History After Serving In Afghanistan
Ian David Long, identified as the gunman in a mass shooting here, was a high-school baseball player remembered as a perfectionist who dropped the sport his senior year in part to focus on joining the military. When Long’s baseball coach sat down to write about him in a yearbook, one word came to mind: “Intensity!” (Berzon and Randazzo, 11/8)

The Washington Post: ‘A Surreal Shock’: Las Vegas Shooting Survivors Live Through California Massacre
When the first shots were fired at Borderline Bar & Grill, David Anderson immediately knew he was in the middle of a mass shooting. He had lived through one last year. Anderson survived the attack at a country music festival in Las Vegas in October 2017 that left 58 people dead. On Wednesday, he again survived a gunman indiscriminately firing at people enjoying country music, this time at college night at a well-loved bar. Twelve people were killed. (Zezima and Mettler, 11/9)

The Washington Post: Thousand Oaks Parents: ‘I Don’t Want Prayers. I Don’t Want Thoughts. I Want Gun Control.’
Marc and Susan Orfanos awoke at 2 a.m. on Thursday in Thousand Oaks, Calif., to a call from a relative in New York. The groggy-eyed couple stumbled into a ritual that is familiar to parents in Columbine, Blacksburg, Aurora, Newtown, Orlando, Parkland — and, as of this week, also in the quiet outpost of Los Angeles. They waited to find out if their child, who had survived the deadliest gun massacre in modern American history last year in Las Vegas, had perished in another mass-casualty shooting. (Stanley-Becker, 11/9)

Los Angeles Times: 'We Have Been Drawn Into This Terror': At Vigils, Thousand Oaks Grieves For 12 Victims Of Mass Shooting
The wind that roared through Thousand Oaks on Thursday night threatened to drown out their voices, but the mourners still sang, channeling their grief, shock and anger into a familiar melody. More than 100 people fell silent as the strains of “Amazing Grace” wafted through the crowd and the light-wrapped trees on the lawn outside the Thousand Oaks Civic Arts Plaza. (Gerber, Karlamangla, Newberry and Greene, 11/8)

The Washington Post: Ventura Shooting: Guard, Officer Killed, Stoking Debate About Active-Shooter Defenses
The gunman began his rampage by shooting an unarmed security guard outside a country-music bar in California, police said. After the attacker began firing on patrons inside, a sergeant with the sheriff’s office charged into the building to confront him and was cut down by gunfire. The Ventura County mass shooting that left 12 dead Wednesday became a grim test case in a persistent debate about how places such as schools, nightclubs and houses of worship should steel themselves against shooters and how police should respond to them. (Jouvenal and Horton, 11/8)

The Associated Press: Mother On A Mission: Gun Control Advocate Wins US House Race
In a campaign ad pierced by the sound of gunfire, Lucy McBath earlier this year laid out the story of her 17-year-old son's shooting death and how his loss propelled her to activism. The story resonated with voters, who elected her Tuesday to fill a long-red House seat that Georgia Republicans held onto just last year. (Martin and Santana, 11/8)

Politico: How An All-Woman, Pro-Gun Control Ad Crew Is Flipping Republican Seats
When Sen. Chris Murphy of Connecticut gave his now-famous filibuster in the aftermath of the 2016 Pulse nightclub shooting, his impassioned plea for increased gun control galvanized liberals across the country. One of them, all the way on the other coast in Los Angeles, was Sarah Ullman. The 30-year-old had once interned for Murphy and relocated to pursue a career as a filmmaker, but she was moved deeply enough that she launched a special undertaking, separate from but related to her primary career. She began to make political ads for progressive, pro-gun control candidates across the country with her super PAC, One Vote at a Time. (Flores and Robertson, 11/9)

The New York Times: F.D.A. Plans To Ban Most Flavored E-Cigarette Sales In Stores
The Food and Drug Administration plans to ban sales of most flavored e-cigarettes in retail stores and gas stations around the country, in an effort to reduce the popularity of vaping among young people. The agency also plans to require age-verification measures for online sales to try to ensure that minors are not able to buy the flavor pods. (Kaplan, 11/8)

Reuters: U.S. To Restrict E-Cigarette Flavors To Fight Teenage Vaping 'Epidemic'
The ban means only tobacco, mint and menthol flavors can be sold at these outlets, the agency official said, potentially dealing a major blow to Juul Labs Inc, the San Francisco-based market leader in vape devices. The FDA also will introduce stricter age-verification requirements for online sales of e-cigarettes. The FDA’s planned restrictions, first reported by The Washington Post and confirmed to Reuters by the official, do not apply to vape shops or other specialty retail stores. (Reuters, 11/9)

The Washington Post: FDA Plans Curbs On E-Cigarette Sales Over Concerns About Surge In Teen Vaping
The FDA’s initiatives on vaping are spurred by preliminary government data that show ­e-cigarette use rose 77 percent among high schoolers and nearly 50 percent among middle schoolers in 2018. That means 3.5 million children were vaping in early 2018, up 1 million from 2017. Gottlieb, who once served on the board of a North Carolina vaping company, was at one time viewed as an ally of the e-cigarette industry, and he delayed some critical e-cigarette rules shortly after becoming commissioner in 2017. He has also said his first priority is protecting children from tobacco-related disease. Most vaping products are flavored, and studies show teenagers are attracted to the flavors. (McGinley, 11/8)

The Wall Street Journal: New York Eyes Ban Of Flavored E-Cigarettes
The Cuomo administration is planning to ban the sale of flavored e-cigarettes as soon as next year—putting New York at the forefront of growing efforts around the country to rein in the products. The state Department of Health posted regulations on Wednesday banning the sale or possession of flavored e-cigarettes, citing an “alarming increase of e-cigarette use among New York’s youth” and a desire to “protect our youth from a lifetime addiction to nicotine.” (Vielkind, 11/8)

Politico's Pulse Check: FDA Commissioner Scott Gottlieb
The FDA commissioner explains why he's cracking down on e-cigarettes, how he views science in the Trump administration and the reaction to his infamous "almonds don't lactate" line, and much more. (11/8)

The Associated Press: FDA Approves Return Of Popular Primatene Mist Asthma Inhaler
A new version of the once-popular asthma inhaler Primatene Mist will soon return to U.S. stores. The Food and Drug Administration approved the over-the-counter aerosol inhaler late Wednesday. It's for temporary relief of mild, intermittent asthma symptoms in people ages 12 and up. (11/8)

The Associated Press: Medicare Expands Access To In-Home Support For Seniors
In a harbinger of potentially big changes for Medicare, seniors in many states will be able to get additional services such as help with chores, safety devices and respite for caregivers next year through private "Medicare Advantage" insurance plans. The shift reflects a growing recognition that simple help at home can have a meaningful impact on patients' well-being — and reduce some costs for taxpayers. A couple of hundred dollars to install grab bars in the shower can prevent a fall leading to a broken hip, a life-changing injury. (Alonso-Zaldivar, 11/9)

The Wall Street Journal: Google Picks Geisinger CEO To Oversee Health-Care Initiatives
Google is expected to name a prominent hospital-system chief executive to a newly created role overseeing the technology company’s health-care efforts. David Feinberg is moving to the new Google health-care post after leading the Geisinger health system, which includes a health plan and hospital system operating in Pennsylvania and New Jersey. (Hopkins and Wilde Mathews and MacMillan, 11/8)

Stat: HHS Recommended That The DEA Ban Kratom, Documents Show 
The Department of Health and Human Services has recommended a ban on the chemicals in kratom that would make the popular herbal supplement as illegal as heroin or LSD, according to documents obtained by STAT. HHS asserted in a letter to the Drug Enforcement Administration that two chemicals in kratom should be classified as Schedule I substances, meaning that the chemicals have “a high potential for abuse” and that there is “no currently accepted medical use” for them. The letter was accompanied by a supporting analysis. (Swetlitz, 11/9)

Reuters: U.S. Regulators Snip Red Tape For Medical Devices To Curb Opioid Crisis
Laura Perryman expected her medical company, Stimwave Technologies Inc, would have to wait several years for its painkilling device to win U.S. approval as a treatment for chronic migraines. She now thinks it could be done in months, thanks to a new initiative by the U.S. Food and Drug Administration to use medical device-based treatments, diagnostic tests and mobile medical apps to address the country's opioid crisis. (11/9)

The Associated Press: Group Challenges Kansas Ban On Telemedicine Abortions
A group that supports abortion rights on Thursday filed a lawsuit challenging a Kansas ban on telemedicine abortions, a practice that allows women in rural areas to get abortion pills without an in-office consultation in a city clinic. The Center for Reproductive Rights contends the anti-abortion section in the Kansas Telemedicine Act is unconstitutional because it treats women seeking abortions differently from other patients seeking medical care through telemedicine. (11/8)

The Associated Press: Kentucky Abortion Battle Shifts To Second-Trimester Ban
Kentucky’s protracted legal fight over abortion is entering a new round involving the same combatants, but this time they’ll be arguing over a second-trimester procedure to end pregnancies. Lawyers for Kentucky’s only abortion clinic will argue in federal court next week that a new state law amounts to an unconstitutional ban on a procedure they term the “safest and most common method” of second-trimester abortions. Critics called the procedure a form of dismemberment of a live fetus. (Schreiner, 11/8)

The New York Times: Under 40 With High Blood Pressure? Be Wary Of Heart Risks
Adults under 40 with high blood pressure are at increased risk for cardiovascular disease later in life, researchers have found. A prospective study published in JAMA included 4,851 American adults whose average age was 36. They had their blood pressure measured on two occasions at the start and were followed for an average of 19 years. Over the period, there were 228 instances of coronary heart disease, stroke, heart failure or peripheral artery disease. (Bakalar, 11/8)

Stat: Animal Rights Group To Drug Makers: End Test That 'Traumatizes' Rodents
A leading animal rights group wants four big drug makers to abandon a decades-old test that has been used for antidepressant research, over concerns the testing may traumatize rodents while failing to yield any reliable outcomes for drug development. At issue is the so-called forced swim test in which mice, rats, guinea pigs, and gerbils are placed in beakers filled with water and forced to swim in order to keep from drowning. The test has been used to gauge the effectiveness of antidepressants on the theory that an animal will swim or struggle longer, and spend less time floating, after being given one of these pills. (Silverman, 11/8)

The New York Times: The Ecosystem In Immigrants’ Guts Is Shaped By The Place They Call Home
Bodies that migrate across borders undergo tremendous change. Immediately, feet alight on alien terrain, ears channel novel sounds and noses breathe in unfamiliar scents. More gradually, daily routines fall into new rhythms, cultural norms hybridize and dreams evolve. Another transformation occurs deep within the body, two recent studies from the Netherlands and United States find, as the trillions of microbes that live in the human digestive system shift in composition. (Yin, 11/8)

The New York Times: Crossing From Asia, The First Americans Rushed Into The Unknown
Nearly 11,000 years ago, a man died in what is now Nevada. Wrapped in a rabbit-skin blanket and reed mats, he was buried in a place called Spirit Cave. Now scientists have recovered and analyzed his DNA, along with that of 70 other ancient people whose remains were discovered throughout the Americas. The findings lend astonishing detail to a story once lost to prehistory: how and when humans spread across the Western Hemisphere. (Zimmer, 11/8)

NPR: Sadness Circuit Found In Human Brain
Scientists may have caught a glimpse of what sadness looks like in the brain. A study of 21 people found that for most, feeling down was associated with greater communication between brain areas involved in emotion and memory, a team from the University of California, San Francisco reported Thursday in the journal Cell. "There was one network that over and over would tell us whether they were feeling happy or sad," says Vikaas Sohal, an associate professor of psychiatry at UCSF. (Hamilton, 11/8)

The Associated Press: Lawyers: Cops Didn't Have Key As Women Drowned In Police Van
Two women drowned in the back of a locked cage while being taken for involuntary commitment to a mental hospital because the police van they were in took an unsafe route and rolled over, and deputies lacked a key or bolt cutters to get them out, a lawyer for one of the women's families told South Carolina lawmakers Thursday. The deputies, who drove around barricades and a manned checkpoint and ignored the safer route they had been given to avoid floodwaters from Hurricane Florence, bear plenty of responsibility for the deaths of Wendy Newton and Nicolette Green, said Tommy Brittain, a lawyer for Newton's family. (Collins, 11/8)

The Associated Press: Harvard Medical School Receives 'Transformational' Gift
Harvard has received a $200 million gift that officials say is the largest in its medical school's 236-year history. The gift announced Thursday is from Len Blavatnik and the Blavatnik Family Foundation. Officials say the gift will allow the medical school to accelerate research and develop new tools to diagnose, prevent and treat disease. (11/8)

The Associated Press: 1 Death Linked To Ongoing Turkey Salmonella Outbreak
Federal health officials on Thursday reported the first death in an ongoing salmonella outbreak linked to raw turkey. The Centers for Disease Control and Prevention said the death was in California but didn't have any immediate details. Since last November, the agency said 164 people have fallen ill in 35 states, with the most recent case being reported on Oct. 20. (11/8)