First Edition: Oct. 18, 2023

KFF Health News: Covid Relief Payments Triggered Feds To Demand Money Back From Social Security Recipients 
As the nation reeled from covid-19, the federal government sent many Americans a financial lifeline. But some recipients say the covid relief payments have triggered financial distress by jeopardizing their Social Security benefits. The government has demanded they repay much larger amounts — thousands of dollars in benefits for the poor and disabled distributed by the Social Security Administration. (Hilzenrath and Fleischer, 10/18)

KFF Health News: Pregnant And Addicted: Homeless Women See Hope In Street Medicine 
Five days after giving birth, Melissa Crespo was already back on the streets, recovering in a damp, litter-strewn water tunnel, when she got the call from the hospital. Her baby, Kyle, who had been born three months prematurely, was in respiratory failure in the neonatal intensive care unit and fighting for his life. The odds had been against Kyle long before he was born last summer. Crespo, who was abused as a child, was addicted to fentanyl and meth — a daily habit she found impossible to kick while living homeless. Crespo got a ride to the hospital and cradled her baby in her arms as he died. (Hart, 10/18)

KFF Health News: Abortion Coverage Is Limited Or Unavailable At A Quarter Of Large Employers, KFF Survey Finds 
About a quarter of large U.S. employers heavily restrict coverage of legal abortions or don’t cover them at all under health plans for their workers, according to the latest employer health benefits survey by KFF. The findings demonstrate another realm, beyond state laws, in which access to abortion care varies widely across America since the Supreme Court overturned the constitutional right to abortion last year in Dobbs v. Jackson Women’s Health Organization. (Pradhan, 10/18)

KFF Health News: Listen To The Latest 'KFF Health News Minute' 
This week on the KFF Health News Minute: Some physicians worry we’re about to see rising numbers of teen pregnancies after decades of progress, and some addiction experts say states are wasting opioid settlement money on ineffective drug prevention programs for young people. (10/17)

AP: Gaza's Doctors Struggle To Save Hospital Blast Survivors As Middle East Rage Grows 
Doctors in Gaza City faced with dwindling medical supplies performed surgery on hospital floors, often without anesthesia, in a desperate bid to save badly wounded victims of a massive blast that killed civilians sheltering in a nearby hospital amid Israeli bombings and a blockade of the territory. ... “We need equipment, we need medicine, we need beds, we need anesthesia, we need everything,” said hospital director Mohammed Abu Selmia. He warned that fuel for the hospital’s generators would run out within hours, forcing a complete shutdown, unless supplies enter the Gaza Strip. (Jobain, Kullab, Nessman and Lee, 10/18)

Reuters: Attack On Gaza Hospital 'Unprecedented' In Scale, WHO Says
"This attack is unprecedented in scale," said Richard Peeperkorn, WHO Representative for the West Bank and Gaza. "We have seen consistent attacks on healthcare in the occupied Palestinian territory." Peeperkorn said there so far have been 51 attacks against healthcare facilities in Gaza, with 15 health workers killed and 27 injured. "The hospital was one of 20 in the north of the Gaza Strip facing evacuation orders from the Israeli military," he said. "The order for evacuation has been impossible to carry out given the current insecurity, critical condition of many patients, and lack of ambulances, staff, health system bed capacity, and alternative shelter for those displaced," he added. (Tetrault-Farber, 10/18)

The New York Times: World Leaders Express Horror Over Deadly Gaza Hospital Blast
World leaders issued statements of condemnation and condolence on Tuesday after an explosion killed hundreds at a hospital in Gaza City, a staggering loss of civilian life in Israel’s 10-day-old war with Hamas that rapidly became enmeshed in competing assertions of blame. Virtually all stressed the horrific nature of the devastation. ... King Abdullah II of Jordan called the explosion “a heinous war crime that cannot be ignored." (Stack, 10/17)

Euronews: Total Siege Of Gaza Not In Line With International Law, Says European Council President
A total siege of Gaza is “not in line with international law”, European Council President Charles Michel said on Tuesday after EU heads of state met online to iron out their stance on the Israel-Hamas war. ... “A total siege, when you cut basic infrastructure, when you cut access to water, when you cut electricity, when you don’t allow food to enter: this is not in line with international law." His counterpart at the Commission, Ursula von der Leyen, whose hesitation in calling on Israel to spare civilians in its attacks on the Gaza strip has generated unease in many EU capitals, also told reporters she had explained to the Israeli authorities that "providing water to Gaza is essential." "This is a basic human right," she added.

The Washington Post: Al-Ahli Hospital In Gaza Is Run By The Anglican Communion
The al-Ahli Hospital in Gaza City — where authorities suspect an airstrike killed hundreds of people Tuesday — is owned and operated by a branch of the Anglican Communion, one of the largest Christian groups in the world. The 80-bed hospital normally sees about 3,500 outpatient visits a month, according to the website of the Diocese of Jerusalem, the local branch of the Anglican Communion that runs al-Ahli. It handles about 300 surgeries and roughly 600 radiological visits a month. (Boorstein and Brasch, 10/17)

Bloomberg: US Health Insurance Premiums Now Cost $24,000 A Year, Survey Says
Health insurance premiums jumped this year amid a post-pandemic spike in costs of care, adding to the burden on employers and workers as inflation erodes broader buying power. The average employer-sponsored health insurance premium for US families rose 7% to almost $24,000 this year, according to an annual KFF survey of more than 2,000 US companies, compared with a 1% increase last year. Premiums for individual employer coverage rose at the same rate. (LaPara, 10/18)

The Wall Street Journal: Surge In Health-Insurance Costs Pose Next Challenge For Finance Chiefs 
Accelerated increases in health-insurance costs are driven by factors including higher labor costs in hospitals and elsewhere across the healthcare system, an uptick in elective care that dipped during the pandemic and demand for new and expensive drugs. Workers tend to enroll for health insurance starting in the fall, so are learning now or will soon find out what their coverage options are for 2024. Executives, meanwhile, are starting to think about coverage for 2025. (Williams-Alavarez, 10/16)

The Wall Street Journal: Health Inflation’s Big Hike This Year, In Charts 
Inflation came for your healthcare this year. Next year is looking to be just as bad. The cost of employer health insurance rose this year at the fastest clip since 2011, according to an annual survey from KFF, a healthcare research nonprofit. The 7% jump in the cost of a family plan brought the average tab to nearly $24,000—more than the price for some small cars. Workers’ average payment of $6,575 for those plans was nearly $500 more than last year. (Mathews and Ulick, 10/18)

The Washington Post: Primary Care Saves Lives. Here’s Why It’s Failing Americans
Without patients having access to primary care, minor complaints evolve into chronic illnesses that demand complex long-term treatment plans. Addressing basic patient problems in the emergency room costs up to 12 times what it would in a primary-care office, resulting in billions of additional dollars each year. But even as evidence mounts that access to primary care improves population health, reduces health disparities and saves health-care dollars, the field is attracting fewer and fewer medical students. The remaining small-group medical practices are being replaced by concierge offices with steep annual membership fees. (Sellers, 10/17)

Stat: Medicare Reduced Heart Disease By Changing How It Pays Doctors
Doctors lowered the incidence of heart disease and strokes among their patients when Medicare rewarded them for focusing on sicker patients, according to research of a pilot program released Tuesday in the Journal of the American Medical Association. The pilot program didn’t increase overall costs at all. (Wilkerson, 10/17)

Axios: Insurers Bash Biden's Mental Health Parity Proposal
Insurers and some employers contend the Biden administration's recent proposal to bolster coverage of mental and behavioral care could actually backfire and make it more difficult for patients to access quality care. The health care payers are urging the administration to drop major features of its plan, including a new formula to determine whether insurers are improperly limiting patient access to mental health care. And a leading health insurer trade group called on the administration to scrap the whole thing. (Goldman, 10/18)

Axios: NIH Nominee Gets Her Day Before Sanders' Panel
After five months of waiting, President Biden's pick for National Institutes of Health director, Monica Bertagnolli, today will get a confirmation hearing before the Senate health committee. And drug development and pricing is likely to loom large. (Sullivan and Bettelheim, 10/18)

Roll Call: Democratic Women Set Abortion Access As Key To NDAA Support 
Members of the House Democratic Women’s Caucus warned defense committee leaders Tuesday that including provisions that limit abortion access in the fiscal 2024 defense authorization bill would make it impossible for them to support the bill’s final passage. (Coudriet, 10/17)

The Colorado Sun: Federal Judge Questions Colorado’s Abortion Pill “Reversal” Law
After hundreds of pages of court filings and more than two hours of legal argument Tuesday, U.S. District Court Judge Daniel D. Domenico arrived at the simplest possible way to tame the sprawling debate around Colorado’s new law banning so-called medication abortion “reversal” treatment and to decide whether the first-of-its-kind law should stand — at least for now. The case, he said, wouldn’t be decided by whose science is most correct. It’s about whose standard is. (Ingold, 10/18)

The Texas Tribune: San Antonio Faces Suit Over “Reproductive Justice Fund” 
The city of San Antonio is facing a lawsuit after budgeting $500,000 to support reproductive health services, including, potentially, transportation and lodging for people seeking abortions outside Texas. A group of anti-abortion organizations filed the lawsuit Tuesday in Bexar County, asking a state district judge to prohibit taxpayer dollars from going to organizations that help Texans travel out of the state for abortion. (Klibanoff, 10/17)

Reuters: Bankrupt Rite Aid Resolves Drug Supply Dispute With McKesson
Pharmacy chain Rite Aid has settled a critical dispute with drug supplier McKesson Corp to ensure that customers' prescriptions will continue to be filled during Rite Aid's bankruptcy, attorneys said on Tuesday. Rite Aid, which filed for Chapter 11 bankruptcy on Sunday night in New Jersey, sued McKesson the following morning, seeking to stop it from terminating a drug supply agreement that accounts for 98% of the pharmacy chain's prescription drug sales. (Knauth, 10/17)

AP: Rite Aid's Bankruptcy Plan Stirs Worries Of New 'Pharmacy Deserts'
Rite Aid’s plan to close more stores as part of its bankruptcy process could hurt access to medicine and care, particularly in some majority Black and Hispanic neighborhoods and in rural areas, experts say. ... When drugstore chains shutter stores, they often target locations in lower-income, Black and Latino neighborhoods with people covered through government-funded insurance programs like Medicaid, said Dima Qato, a University of Southern California associate professor who studies pharmacy access. (Murphy, 10/17)

Roll Call: CDC Sees Inconsistent Gains In HIV Prevention Prescriptions 
The Centers for Disease Control and Prevention published preliminary data Tuesday showing that more than one-third of individuals eligible for a commonly used HIV prevention drug received a prescription, as funding for a critical HIV program grew 16-fold between fiscal years 2019-2023. But the reach of this strategy is highly inconsistent among racial groups. (Raman, 10/17)

The Boston Globe: Biotech Investors Push To Extend Time Before Pills Are Subject To Price Negotiations
A group called the Incubate Coalition, comprising the venture capital firms that bankroll most biotech startups, is pressing US lawmakers to extend by four years the time that pills can be on the market before they become subject to price negotiations with Medicare. Such an extension could mean billions of dollars in extra profits to biopharma companies and their investors over time — and billions in additional costs to Medicare and its recipients. (Weisman, 10/17)

Modern Healthcare: Walgreens, Alignment Health To Launch Medicare Advantage Plans In 2024
Health insurance startup Alignment Health and Walgreens Boots Alliance have signed an agreement to jointly market Medicare Advantage plans for 2024. The Medicare Advantage insurer and retail giant have agreed to offer $0 premium co-branded plans in some counties in Arizona, California, Florida and Texas, pending regulatory approvals. They said the effort will reach 1.6 million Medicare-eligible enrollees. (Tepper, 10/17)

Axios Columbus: Columbus Hospitals Forgiving Medical Debt Totaling $335 Million 
Four regional hospitals are relieving medical debt accrued by hundreds of thousands of Columbus residents, local officials announced yesterday. Medical debt is a leading cause of bankruptcy in America, with major physical and emotional tolls on patients' health. (Buchanan, 10/17)

Modern Healthcare: Home Healthcare Turns To AI To Fill Staffing Gaps
More home healthcare providers are turning to artificial intelligence-powered tools to improve efficiency and close care gaps. An estimated $265 billion in services for Medicare beneficiaries is projected to move into the home over the next few years as more older adults age in place, according to business consulting firm McKinsey and Company. To meet the demand amid a caregiver shortage, home health agencies, hospital-at-home providers and home care companies are starting to rely more heavily on AI technology. (Eastabrook, 10/17)

Kansas City Star: Ex-Saint Luke’s Employee Said Rusty Tools, Roaches, Found In OR 
Several former employees of Saint Luke’s Hospital of Kansas City are alleging the hospital, part of the Saint Luke’s Health System, failed to properly clean and repair operating room instruments, used rusty instruments during operations and failed to address an ongoing problem with cockroaches and other bugs in and around the operating room. (Spoerre, 10/18)

AP: Maryland Medical Waste Incinerator To Pay $1.75M Fine For Exposing Public To Biohazardous Material 
A medical waste processing company has pleaded guilty to dozens of environment-related charges and agreed to pay $1.75 million in fines after state prosecutors in Maryland accused a south Baltimore incineration plant owned by the firm of exposing the public to biohazardous material. The waste comes from hospitals, laboratories and other medical settings. It’s supposed to be burned into ash before being transported to landfills, a process that prevents disease transmission, state officials said Tuesday at a news conference announcing the settlement agreement involving the nation’s largest medical waste incinerator. (Skene, 10/17)

Modern Healthcare: California Healthcare System Preps For Undocumented Immigrant Coverage
Starting in January, California will accept Medicaid enrollments from all low-income undocumented immigrants who qualify for benefits, and 700,000 people are projected to sign up. California gradually has been opening Medi-Cal, as Medicaid is known in the state, to undocumented immigrants since 2016, starting with low-income children and adults younger than 26 or older than 49, and is poised to lift age restrictions next year. The full expansion will cost an estimated $2.1 billion a year. (Hartnett, 10/17)

The Philadelphia Inquirer: Mayor Jim Kenney Protects Gender-Affirming Care In Philadelphia
Philadelphia joined a growing number of Democratic-led cities calling themselves places of refuge for transgender people when Mayor Jim Kenney signed Tuesday an executive order protecting those who come here for gender-affirming care. ... The newly signed executive order prohibits the city from using any resources to assist states that seek to investigate or punish someone for providing or receiving gender-affirming care in Philadelphia. (Gutman, 10/17)

San Francisco Chronicle: SF Drug Overdose Deaths Drop In September, But Worst Year Still Likely
Overdose deaths in San Francisco dropped to 54 in September from a high of 84 in August, a 36% decrease, according to the public health department. ... At the current pace, San Francisco is on track to see more than 800 overdose fatalities this year, topping 2020’s 725. “While we are thankful that those numbers are down compared to last year, that still represents more than two people a day in San Francisco dying largely from fentanyl overdose-related deaths,” Colfax said. (Toledo, 10/17)

NPR: As Teen Fentanyl Deaths Rise, Colleges Grapple With Their Role
Test strips and naloxone are becoming more and more common on college campuses, and at least one health department has recommended they be added to school packing lists. For students who didn't bring their own, many campuses are handing them out at welcome fairs, orientation events or campus health centers. ... "If you are in the position where you have had to give someone naloxone, they've almost died." "Naloxone is what I call an anti-funeral drug," explains Nabarun Dasgupta, a research scientist at UNC-Chapel Hill's school of public health. (Nadworny and Schlemmer, 10/18)

The New York Times: Body Count At Colorado Funeral Home With Decaying Remains Grows To 189 
The number of bodies found at a rural Colorado funeral home has grown to at least 189, officials said Tuesday, two weeks after they reported that a foul odor had led investigators to the decaying remains of 115 people there. It is unclear if the additional bodies were also decaying. (Carballo, 10/17)

AP: Breast Cancer Is Deadlier For Black Women. A Study Of Mammograms Could Help Close The Gap
Are 3D mammograms better than standard 2D imaging for catching advanced cancers? A clinical trial is recruiting thousands of volunteers — including a large number of Black women who face disparities in breast cancer death rates — to try to find out. People like Carole Stovall, a psychologist in Washington, D.C., have signed up for the study to help answer the question. (Johnson, 10/17)

The Washington Post: Many Americans Have Weak Bones, But Don’t Know It 
Molly Giles was standing in her kitchen one spring night in 2019, musing about whether to do the dishes or leave them until the morning, when a bone in her left leg snapped and she crashed to the ground, breaking her hip. “I passed out, and I’m pretty sure I would have died if my partner hadn’t been there and called 911,” the Northern California novelist recalls. Giles, now 81, had “bones like meringue,” her doctor rather glibly later told her. A scan several years earlier had revealed osteopenia, a precursor to the “silent” disease of bone density loss known as osteoporosis. But neither Giles nor her doctors followed up, and her bones grew increasingly weak until her femur “melted,” as she later described it. (Ellison, 10/17)

The New York Times: More Than a Third of Women Under 50 Are Iron-Deficient
Roughly 35 percent of women of reproductive age in the United States don’t have sufficient amounts of iron in their bodies. And yet the nutritional deficiency, which can affect multiple functions, from immunity to cognition, often goes undiagnosed, said Dr. Malcolm Munro, professor of obstetrics and gynecology at the David Geffen School of Medicine at the University of California, Los Angeles. This oversight is partly because symptoms can be difficult to pin down but also because iron deficiency is rarely recognized as an urgent condition with short- and long-term consequences, he said. (Gupta, 10/17)

The Wall Street Journal: Bosses Have A Problem: People Are Actually Using Sick Days
The bar for taking a sick day is getting lower, and some bosses say that’s a problem. U.S. workers have long viewed an unwillingness to take sick days as a badge of honor. That’s a laurel workers care much less about these days. The number of sick days Americans take annually has soared since the pandemic, employee payroll data show. Covid-19 and a rise in illnesses such as RSV, which can require days away from work, are one reason. Managers and human-resources executives also attribute the jump to a bigger shift in the way many Americans relate to their jobs.  (Chen, 10/17)