First Edition: October 23, 2018
Today's early morning highlights from the major news organizations.
Kaiser Health News:
Fixing Obamacare’s ‘Family Glitch’ Hinges On Outcome Of November Elections
Last Christmas Eve, Justine Bradford-Trent slipped on ice, slamming to the ground. Her elbow swelled. Was it broken? She couldn’t tell. Because Bradford-Trent was uninsured, she weighed her options. She could go to the emergency room, the immediate but more costly option. The urgent care center cost less, but it was closed for the holiday. The Idaho resident decided to wait and, once the swelling subsided, she concluded it was just a bad bruise. (Luthra, 10/23)
Kaiser Health News:
Marketplace Subsidies May Be Option In 2020 For Plans That Skirt Obamacare
Earlier in the year, the administration also approved a rule allowing businesses to band together in “associations” to buy health insurance to offer insurance to members. Critics fear that rule could expose consumers to coverage gaps or higher out-of-pocket costs because these plans would be classified as “large-group plans” and not have to meet some ACA requirements. The changes unveiled on Monday do not affect people who get their coverage through their jobs. (Galewitz and Appleby, 10/22)
California Healthline:
Gavin Newsom Is Bullish On Single-Payer — Except When He’s Not
Twenty minutes before the only scheduled 2018 California’s gubernatorial debate, Lt. Gov. Gavin Newsom rolled into the San Francisco parking garage in a black SUV. Through the tinted windows, a soft overhead light slightly illuminated the front-runner’s chiseled features and slicked-back hair. In a well-tailored blue suit and matching tie, Newsom strode to the elevator and casually leaned his tall frame against the corner, emerging on KQED radio’s third floor to banter with waiting reporters — the picture of a polished and confident front-runner. (Rinker, 10/22)
The New York Times:
Trump Officials Make It Easier For States To Skirt Health Law’s Protections
The Trump administration announced a new policy on Monday making it easier for states to circumvent coverage requirements and consumer protections in the Affordable Care Act. States could, for example, use federal funds to subsidize short-term insurance plans with skimpy benefits and fewer protections for people with pre-existing conditions. Coming two weeks before Election Day, the new policy appeared to be a political gift to Democrats, who are making health care a potent campaign theme. (Pear, 10/22)
The Washington Post:
Trump Administration Allows ACA Subsidies For Leaner Health Plans
Under guidance issued Monday by the Centers for Medicare and Medicaid Services (CMS), states seeking federal waivers to run their insurance marketplaces will be given much more leeway. That includes the ability to apply ACA subsidies to short-term and association health plans — two types of coverage the administration has expanded as a way of making cheaper plans available to those who want them. These plans don’t include coverage of certain “essential” benefits like mental-health services and prenatal care and they can refuse to cover people with preexisting conditions. (Winfield Cunningham, 10/22)
Los Angeles Times:
Trump Administration Takes Another Step To Allow Health Plans That Don't Cover Preexisting Conditions
The new proposal from the Department of Health and Human Services and the Treasury Department would not explicitly scrap the law’s protections, which bar health plans from denying coverage to people with preexisting medical conditions. But the administration plan would dramatically reshape rules established by the 2010 law that were designed to prevent states from weakening these protections. (Levey, 10/22)
The Hill:
Trump Administration Loosens Restrictions On ObamaCare Waivers
Health advocates say the new policy is the latest example of the Trump administration allowing states to wiggle around ObamaCare requirements. While Congress was unable to repeal the law, the waivers will allow states to enact policies that advocates say counter the law’s intentions. During a call with reporters, Verma said she has received “numerous” requests from states for a more flexible waiver policy. The new guidance will take effect immediately, Verma said, but will only impact health plans in 2020 and later. Open enrollment for 2019 begins Nov. 1. (Weixel, 10/22)
Politico:
Trump Administration Widens Obamacare Escape Hatch For Red States
Red states have expressed interest in skirting Obamacare requirements. Iowa, facing an exodus of insurers, last year proposed a waiver that would have reduced financial support to lower-income health insurance shoppers and created new aid for middle-income individuals. Iowa Gov. Kim Reynolds withdrew the plan last October, complaining that the waiver rules were "inflexible." Verma declined to comment on whether specific states would seek waivers under the new policy. Conservative health policy experts hailed the administration's announcement. (Goldberg, 10/22)
The Wall Street Journal:
States Are Cleared To Allow Less-Comprehensive Health Plans
Democrats said the move contradicted Republicans’ claims that they want to protect people with pre-existing medical conditions from high premiums. “The American people should look at what Republicans are doing, rather than what they’re saying, when it comes to health care,” said Senate Minority Leader Chuck Schumer (D., N.Y.). “Just weeks before the election, Republicans are once again undermining protections for people with pre-existing conditions and sabotaging our health-care system.” (Hackman, 10/22)
The Hill:
Dems Blast Trump Rule Changes On ObamaCare
Vulnerable Republicans across the country have been scrambling to say that they support pre-existing condition protections to try to fend off a potent line of Democratic attack, but Schumer and other Democrats argued Monday that the new rules undermined those claims. “The American people should look at what Republicans are doing, rather than what they’re saying, when it comes to health care,” Schumer said. The Democratic Senatorial Campaign Committee added that every Republican Senate candidate “should be forced to answer for this.” (Sullivan, 10/22)
The Associated Press:
Trump Administration Unveils Health Options For Small Firms
The Trump administration is rolling out new options for small employers to use tax-free accounts for providing health coverage to workers, officials said Monday. The idea is to expand so-called "health reimbursement arrangements" to allow employees to buy their own individual health insurance policies. Employers could also pair the accounts with workplace health plans, allowing workers to use the money for additional benefits such as dental care. (10/22)
The Hill:
Trump Administration Plans To Revamp Employer-Based Health Care
HRAs allow workers to purchase coverage using tax-free dollars. Currently, an HRA can only be used to reimburse an employee or dependents for certain qualified medical expenses. The Obama administration prohibited HRAs for large- and mid-sized companies, and the IRS previously said HRAs did not comply with ObamaCare coverage requirements. HRA contributions can only be tax-free if they are coupled with a health plan that meets ObamaCare’s coverage protections. (Weixel, 10/22)
The New York Times:
At Rallies And Online, Transgender People Say They #WontBeErased
L.G.B.T. activists mobilized a fast and fierce campaign that included a protest outside the White House on Monday to say transgender people cannot be expunged from society, in response to an unreleased Trump administration memo that proposes a strict definition of gender based on a person’s genitalia at birth. The existence of the draft memo, the administration’s latest effort to roll back the recognition and protection of transgender people under federal civil rights law, was reported by The New York Times on Sunday morning. (Mervosh and Hauser, 10/22)
The Associated Press:
Fury Over Reported Federal Plan Targeting Transgender People
"I feel very threatened, but I am absolutely resolute," Mara Keisling, executive director of the National Center for Transgender Rights, said at a news conference convened by more than a dozen activist leaders. "We will stand up and be resilient, and we will be here long after this administration is in the trash heap." The activist leaders, speaking amid posters reading "#Won'tBeErased", later addressed a protest rally outside the White House. (Crary and Alonso-Zaldivar, 10/22)
Politico:
Trump Administration Proposal On Transgender Protections Spurs Protests
“I am livid, but clear-headed,” said Mara Keisling, executive director of the National Center for Transgender Equality, who spoke during a press conference at the headquarters for the Human Rights Campaign in Washington, D.C., before the march. “We will be here long after this administration is in the trash heap.” (Emma, 10/22)
Los Angeles Times:
Transgender Advocates Decry Trump Administration Proposal To Define Gender As Fixed At Birth
L.A.’s LGBTQ leaders see the potential policy change as an effort to systematically undermine a national recognition of transgender people ushered in by the Obama White House. And while they aren’t surprised by the Trump administration’s effort to establish a strict legal definition of sex, they say they are still alarmed. Advocates fear the sweeping change would breed an increase in hate and violence toward transgender people, lead to new barriers in obtaining adequate healthcare and education, and induce a greater sense of hopelessness and isolation in a community that already exists on the farthest margins of society. (Newberry, 10/22)
The Washington Post:
Trump Administration Considering ‘Different Concepts’ Regarding Transgender Rights, With Some Pushing Back Internally
Trump confirmed Monday that a policy change toward transgender people was under consideration but said that there is more than one way to approach the issue. He was not specific about the potential alternatives. “We’re looking at it. We have a lot of different concepts right now. They have a lot of different things happening with respect to transgender right now,” Trump said. “And we’re looking at it very seriously.” Asked about his promise to protect LGBT people, he replied: “You know what I’m doing? I’m protecting everybody.” (Meckler, Schmidt and Sun, 10/22)
The Associated Press:
Science Says: Sex And Gender Aren't The Same
Anatomy at birth may prompt a check in the "male" or "female" box on the birth certificate — but to doctors and scientists, sex and gender aren't always the same thing. The Trump administration purportedly is considering defining gender as determined by sex organs at birth, which if adopted could deny certain civil rights protections to an estimated 1.4 million transgender Americans. (Neergaard, 10/23)
Stat:
Scientists See A Problem With Trump Plan On Defining Sex: Biology
A new report that the Trump administration hopes to legally define a person’s sex at birth — an unchangeable condition determined by genitalia — has prompted an outcry among the transgender community. But beyond the political implications — and fears that any such change could ultimately mean the end of civil rights protections for transgender people — the proposal raises fundamental questions about something else: biology. The proposal is “highly inaccurate and just an insult to science. Basic science,” said Rachel Levin, a Pomona College neuroscientist who studies the development of sex. (Thielking, 10/22)
The New York Times:
Anatomy Does Not Determine Gender, Experts Say
Researchers who have studied gender issues and provided health care to people who do not fit the typical M/F pigeonholes said that the Trump administration’s latest plan to define gender goes beyond the limits of scientific knowledge. “The idea that a person’s sex is determined by their anatomy at birth is not true, and we’ve known that it’s not true for decades,” said Dr. Joshua D. Safer, an endocrinologist and executive director of the Center for Transgender Medicine and Surgery at Mount Sinai Health System in New York. He is also president of the United States Professional Association of Transgender Health. (Grady, 10/22)
The Washington Post Fact Checker:
Are Republicans Seeking To ‘Get Rid Of Medicare, Medicaid And Social Security’?
Democrats have seized on recent comments by Senate Majority Leader Mitch McConnell (R-Ky.) in a round of media interviews after the Treasury Department reported that the federal budget deficit increased 17 percent year over year, to $779 billion in fiscal 2018. “It’s disappointing, but it’s not a Republican problem,” McConnell told Bloomberg News on Oct. 16 when asked about the deficit announcement. “It’s a bipartisan problem: unwillingness to address the real drivers of the debt by doing anything to adjust those programs to the demographics of America in the future.” He added that by “entitlement reform,” he was “talking about Medicare, Social Security and Medicaid.” Cue the immediate outrage from the left. (Glenn Kessler, 10/23)
Politico:
HHS Reviews Refugee Operations As Trump Calls For Border Crackdown
The Trump administration is eyeing a shake-up of its refugee operation — and scrutinizing its controversial director — as President Donald Trump steps up his call for another crackdown along the U.S.-Mexico border. A top official at the Department of Health and Human Services, which runs the refugee resettlement program, is conducting what she called a “top to bottom” review of the program, three months after the migrant crisis paralyzed the agency last summer. (Diamond, 10/23)
Reuters:
Hundreds Of Migrant Children Held In U.S. Tent City For Months: Filings
U.S. authorities have held some immigrant children who entered the country illegally and without a parent in a temporary "tent city" in Texas for months, violating a 20-year-old court order on how long minors can be detained, according to court filings by civil rights lawyers and immigration advocates. More than 500 children have been housed in tents near Tornillo, Texas since August, and 46 have been held there since June, according to a Friday court filing in Los Angeles federal court by civil rights organizations and advocacy groups representing migrant children. (Hals and Cooke, 10/22)
Stat:
Is A Recent Fall In Overdose Deaths Temporary Or A Sign Of A Corner Turned?
The number of fatal drug overdoses nationwide has fallen for six consecutive months, fueling hopes that the downturn marks not just a reprieve but a long-lasting shift in the tide of the addiction crisis. Annual U.S. drug overdoses have been tracking upward for nearly four decades, and the rate of growth increased sharply in the last few years with the onset of the opioid epidemic. (Joseph, 10/23)
The Wall Street Journal:
No Benefit Seen From Antipsychotics Used In Delirious Hospital Patients
New research found no benefit from two antipsychotic drugs used by hospitals to treat delirium in critically ill patients, the latest study to call into question a common but unproven medical practice. Delirious intensive-care patients who were treated with the drugs haloperidol and ziprasidone didn’t emerge from their confusion any sooner than those given a placebo, according to the study published online Monday in the New England Journal of Medicine. (Evans, 10/22)
NPR:
Haloperidol And Other Antipsychotics No Better Than Placebo For ICU Delirium, Study Finds
"In some surveys up to 70 percent of patients [in the ICU] get these antipsychotics," says Dr. E. Wesley "Wes" Ely, an intensive care specialist at Vanderbilt University Medical Center. They're prescribed by "very good doctors at extremely good medical centers," he says. "Millions of people worldwide are getting these drugs to treat their delirium. "But the drugs can have serious side effects. And Ely says there is no solid research showing that they are effective at treating delirium. (Harris, 10/22)
The New York Times:
What’s Life Like After Depression? Surprisingly, Little Is Known
A generation ago, depression was viewed as an unwanted guest: a gloomy presence that might appear in the wake of a loss or a grave disappointment and was slow to find the door. The people it haunted could acknowledge the poor company — I’ve been a little depressed since my father died — without worrying that they had become chronically ill. (Carey, 10/22)
Stat:
Ebola Response Teams Struggling To Track Those Who Need To Be Vaccinated
The Ebola response teams in the Democratic Republic of the Congo are having increasing trouble keeping track of where the virus is spreading, a problem that threatens containment efforts and undermines the effectiveness of the vaccination program there. Public health officials had been hopeful that an experimental vaccine could help curb the spread of the outbreak. But, for that to happen, response teams must be able to identify people who have been in contact with Ebola patients. Persistent violence in the outbreak zone has made that hard to do. (Branswell, 10/23)
The New York Times:
Microplastics Find Their Way Into Your Gut, A Pilot Study Finds
In the next 60 seconds, people around the world will purchase one million plastic bottles and two million plastic bags. By the end of the year, we will produce enough bubble wrap to encircle the Equator 10 times. Though it will take more than 1,000 years for most of these items to degrade, many will soon break apart into tiny shards known as microplastics, trillions of which have been showing up in the oceans, fish, tap water and even table salt. Now, we can add one more microplastic repository to the list: the human gut. (Quenqua, 10/22)
Los Angeles Times:
Can Organic Food Help You Reduce Your Risk Of Cancer? A New Study Suggests The Answer May Be Yes
To reduce your risk of cancer, you know you should quit smoking, exercise regularly, wear sunscreen, and take advantage of screening tests. New research suggests another item might be added to this list: Choose organic foods over conventional ones. A study of nearly 70,000 French adults who were tracked for an average of 4.5 years found that those who ate the most organic foods were less likely to develop certain kinds of cancer than the people who ate the least. (Kaplan, 10/22)
The New York Times:
Lavender’s Soothing Scent Could Be More Than Just Folk Medicine
Lavender bath bombs; lavender candles; deodorizing lavender sachets for your shoes, car or underwear drawer; lavender diffusers; lavender essential oils; even lavender chill pills for humans and dogs. And from Pinterest: 370 recipes for lavender desserts. Take a deep breath. Release. (Klein, 10/23)
The Wall Street Journal:
Take Two Aspirin—And A Serving Of Kale
Some hospital patients are heading home with a sheaf of prescriptions—and a bag of spinach and spaghetti squash. Invoking the mantra that food is medicine, hospitals across the country are taking measures to prevent and treat illness through diet. To nudge patients into eating well at home, they have opened food pantries that offer nutrition counseling and healthful fare. They are growing their own produce, adding farmers to the payroll and hosting greenmarkets. A few are even tiptoeing into the grocery business. (Lagnado, 10/22)
The New York Times:
A Centennial Of Death: The Great Influenza Pandemic Of 1918
Flu season is coming and flu shot season is here. I teach in a journalism institute, and when I was doing my stint as director, welcoming the new graduate students in the fall, I always used to urge they get flu shots: You’ll be wandering all over the city, I would tell them, you’ll be interviewing people, you’ll be using communal keyboards — whatever else you do, get a flu shot. (Klass, 10/22)
Reuters:
U.S. Judge Affirms Monsanto Weed-Killer Verdict, Slashes Damages
A U.S. judge on Monday affirmed a verdict against Bayer AG unit Monsanto that found its glyphosate-based weed-killers responsible for a man’s terminal cancer, sending the German company's shares down 8 percent. In a ruling by San Francisco's Superior Court of California, Judge Suzanne Bolanos said she would slash the punitive damages award to $39 million from $250 million if lawyers for school groundskeeper Dewayne Johnson agreed. (10/23)
The Associated Press:
Judge Upholds Monsanto Verdict, Cuts Award To $78 Million
Monsanto spokesman Daniel Childs said that the company was pleased with the reduced reward but still planned to appeal the verdict. Childs said there’s no scientific proof linking Roundup to cancer. The jury awarded punitive damages after it found that the St. Louis-based agribusiness had purposely ignored warnings and evidence that its popular Roundup product causes cancer, including Johnson’s lymphoma. Punitive damages are designed to punish companies that juries determine have purposely misbehaved and to deter others from operating similarly. (Elias, 10/22)
The Wall Street Journal:
Judge Reduces Jury Award Against Bayer’s Roundup To $78.5 Million
Bayer inherited thousands of Roundup-related lawsuits in its recently closed acquisition of Monsanto Co. and has worked to assuage investor concerns about potential liability from the litigation. The decision is the latest turn in the first Roundup case to go to trial, which resulted in an August verdict in favor of a groundskeeper who said prolonged use of glyphosate-based herbicides caused his non-Hodgkin lymphoma. (Randazzo and Bunge, 10/23)
The Associated Press:
Thousands Strike University Of California Hospitals
Thousands of University of California medical workers began a three-day strike Tuesday against hospitals, clinics and campuses that prompted the rescheduling of thousands of surgeries and outpatient appointments. Picket lines were called for the five UC medical centers in Los Angeles, San Francisco, San Diego, Irvine and Davis. (10/23)
Los Angeles Times:
Gavin Newsom Slashed Welfare Checks To The Homeless, With The Goal Of Housing More People. Did It Work?
When San Francisco’s homelessness problem swelled in the early 2000s, Gavin Newsom endorsed a radical plan for the famously liberal city. Then a San Francisco supervisor on the rise, Newsom proposed slashing the amount of welfare for single homeless adults and instead using the funds on shelters, housing and services. Called Care Not Cash, the program sought to stop welfare recipients from spending their monthly checks on heroin or alcohol. (Smith, 10/23)