First Edition: October 30, 2017

Kaiser Health News: Flurry Of Federal And State Probes Target Insulin Drugmakers And Pharma Middlemen
With the price of a crucial diabetes drug skyrocketing, at least five states and a federal prosecutor are demanding information from insulin manufacturers and the pharmaceutical industry’s financial middlemen, seeking answers about their business relationships and the soaring price of diabetes drugs. Attorneys general in Washington, Minnesota and New Mexico issued civil investigative demands this year and are sharing information with Florida and California, according to various corporate financial filings. (Tribble, 10/30)

Kaiser Health News: Big Gains In Latino Coverage Poised To Slip During Chaotic Enrollment Season
Latinos, who just a year ago were highly sought customers for the Affordable Care Act’s marketplace plans may not get the same hard sell this year. The Trump administration’s laissez-faire approach toward the upcoming enrollment period for the health law’s insurance marketplaces could reverse advances made in the number of Latinos with coverage, fear navigators and community activists. (Andalo, 10/30)

Kaiser Health News: Money For Health Law Navigators Slashed — Except Where It’s Not
Despite all the efforts in Congress to repeal the health law this summer and fall, the Affordable Care Act is still the law of the land. People can start signing up for health insurance for 2018 starting Nov. 1. But the landscape for that law has changed a lot. Take navigators. Those are specially trained people who help consumers sign up for coverage. The federal government cut navigator funding by 41 percent. But that’s not an across-the-board cut. Some groups and states are dealing with far deeper cuts, while others will have dollars close to what they had last year. (Olgin, 10/30)

Kaiser Health News: Rural Areas — Already Short On Health Resources — Face Enrollment Hitches
Ms. Stella’s, a home-cooking restaurant in Milledgeville, Ga., serves roast beef, grilled pork chops, chicken wings and oxtails with 24 sides from which to choose. Last spring, owners Jeri and Lucious Trawick opened a second restaurant in Eatonton, about 20 miles away, and Jeri decided to leave her full-time job to help shepherd the expansion. But she needed to update the couple’s health insurance and went shopping on the Affordable Care Act’s online marketplace. Trawick, 43, who considers herself nearly as skilled with a computer as she is with a skillet, found the Obamacare website daunting. (Anderson, 10/27)

The Associated Press: Health Law Sign-Ups Start, And Some See A 'Hostile Takeover'
It's sign-up season for the Affordable Care Act, but the Trump administration isn't making it easy — cutting the enrollment period in half, slashing advertising and dialing back on counselors who help consumers get through the process. Many people already faced fewer choices and higher premiums. But President Donald Trump's decision to cancel a subsidy to insurers that lowers consumer costs compounded the turmoil, pushing premiums even higher. (Alonso-Zaldivar, 10/30)

Politico: Confusion Clouds Open Enrollment With Republicans Still Eager To Dismantle Obamacare
Obamacare is about to have its worst open-enrollment season ever — and that’s no accident. President Donald Trump and Republicans in Congress still aim to dismantle the 2010 law. Making it look bad helps their cause, even as they’ve failed repeatedly to repeal or replace Obamacare. The new theory for Republicans: If fewer people enroll in Obamacare, there will be less of a constituency to save it. (Demko, Pradhan and Cancryn, 10/29)

The Hill: ObamaCare Heads Into Crucial First Sign-Ups Under Trump 
ObamaCare made it through nearly 10 months of repeal attempts with Republicans in full control of Washington. It now faces another crucial period starting Wednesday. It’s the first test of how the Trump administration will handle enrollment under the law it claims is “imploding.” With the president making no secret of his desire to kill the law completely, Democrats accuse the administration of "sabotage" and say the number of new enrollees is likely to drop as a result. (Sullivan, 10/29)

NPR: Less Money, Less Time To Enroll In 2018 Health Plans Poses Challenges
Starting next week, Americans will again be able to shop for health plans on the Affordable Care Act marketplaces. Open enrollment in most states runs from Nov. 1 through Dec. 15. But a lot of people don't know that because the Trump administration slashed the marketing budget for Affordable Care Act, also known as Obamacare. So states, municipalities, community groups, insurers and others are strengthening their outreach efforts. In Texas, some cities and local governments are doing their best to get the word out, but it will be hard to reach the more rural communities. (Lopez and Dembosky, 10/28)

The Associated Press: Trump Administration Proposes Health Law Benefit Changes
The Trump administration on Friday proposed new health insurance regulations that could affect basic benefits required by the Affordable Care Act, but not for a couple of years. Loosening "Obamacare" benefit requirements was a major sticking point for congressional Republicans in thus-far fruitless efforts to repeal the law. The complex new plan from the administration would give states a potential path to easing some requirements. (Alonso-Zaldivar, 10/27)

The New York Times: The Governor Blocked Medicaid Expansion. Now Maine Voters Could Overrule Him.
Night after night, in the sharp autumn air, canvassers are knocking on doors across Maine in hopes of getting tens of thousands of poor adults insured through Medicaid. Gov. Paul LePage, a Republican, has five times vetoed expanding access to the program under the Affordable Care Act. Next month, voters here will be the first in the nation to decide the issue by referendum. But even in this liberal city, canvassers have encountered resistance from some as they stood on creaky porches and leaf-strewn steps to argue, as Lily SanGiovanni did the other night, that “health care is a human right.” (Goodnough, 10/27)

The Associated Press: Kansas Proposes Work Requirement In New Version Of Medicaid
A proposed change to Kansas' privatized Medicaid program would compel about 12,000 adults to work to obtain benefits, making the state the first in the country to have such a requirement. Gov. Sam Brownback's administration said Friday requiring some Medicaid recipients to work would improve their lives and increase their self-esteem. Advocates for Medicaid recipients said requiring work for Medicaid is illegal. (10/27)

The New York Times: Opioids On The Quad
As other college students head out to party on a Saturday night, Julie Linneman, a sophomore at Villanova University, rides the subway to a small rowhouse in West Philadelphia to meet with “her people,” a posse of students who understand what it’s like to be taken down by opioids. Ms. Linneman is a bespectacled 22-year-old who favors shredded jeans. She is a fan of cooking shows, fantasy fiction and Paul McCartney. She spent her first attempt at sophomore year — the one at Northern Kentucky University — in her dorm room, high on heroin. (Spencer, 10/30)

The Associated Press: Opioid Epidemic Shares Chilling Similarities With The Past
While declaring the opioid crisis a national public health emergency Thursday, President Donald Trump said: "Nobody has seen anything like what's going on now." He was right, and he was wrong. Yes, this is the most widespread and deadly drug crisis in the nation's history. But there has been a long string of other such epidemics, each sharing chilling similarities with today's unfolding tragedy. (10/28)

The Wall Street Journal: Trump Administration Relaxes Medical Privacy Rule For Overdoses
The Trump administration announced Friday it is relaxing a federal privacy rule that prevents health providers from notifying family members about a drug overdose, one of the administration’s most significant policy shifts to combat the nation’s opioid crisis. The new rule will explicitly permit health-care providers to share information with family members, friends and legal representatives about a patient’s medical condition if the patient is in crisis or incapacitated, such as during an opioid overdose. (Hackman, 10/27)

The Associated Press: Ky. Advocates Ask Trump Official For More Opioid Resources
Advocates and doctors in opioid-ravaged Kentucky urged President Donald Trump's acting chief health official to spend more money on fighting the drug epidemic one day after he signed an order declaring the crisis a national public health emergency. Acting Health and Human Services Secretary Eric Hargan toured a clinic in Lexington, Kentucky, on Friday that specializes in treating pregnant women and their babies addicted to opioid-based drugs like heroin and prescription painkillers. (10/27)

USA Today: Opioid Victims Say Donald Trump's Declaration Is Good, But Not Enough
Parents of children who overdosed on opioids have waited patiently for President Trump to declare the epidemic a "national emergency," as he twice promised he would. On Thursday, some were disappointed. To some survivors, the declaration instead of a public health emergency is too little, too late. (O'Donnell and DeMio, 10/26)

The Hill: Drug Exec Accused Of Bribing Doctors To Prescribe Opioid Drug 
The billionaire founder and top executive of a drug company that manufactures a prescription opioid has been arrested and charged with bribing doctors to overprescribe the drug, CNN reports. John Kapoor, 74, of Insys Therapeutics, was arrested Thursday in Arizona. Authorities say his company had been giving illegal kickbacks to doctors to encourage prescriptions of the powerful painkiller Subsys, which is typically only used for end-stage cancer patients. (Delk, 10/27)

The New York Times: Florida Sheriff Posts Graphic Overdose Video To Combat Opioid Crisis
It’s a video that might elicit a lingering sense of dread and, perhaps, déjà vu. A sheriff’s deputy approaches a dark blue Nissan with its door ajar in a darkened convenience store parking lot. A man and a woman are passed out in the front seats, their bodies gaunt and motionless. In the back, a baby girl, 8 months old, is asleep, strapped in a car seat. (Ugwu, 10/26)

The Washington Post: A Shocking Overdose Photo Exposed Her Addiction — And May Have Saved Her Life
Erika Hurt had become the face of drug addiction. The young mother was captured in a photograph by police, passed out in the driver's seat of her car outside a Dollar General store in Hope, Ind. — an empty syringe still resting between the 25-year-old addict's fingers. The snapshot captured yet another horrifying moment in the worsening U.S. opioid epidemic. What was not seen that Saturday afternoon last October was her 10-month-old son, buckled into his car seat in the back. (Bever, 10/27)

NPR: Baltimore Needs More Funds To Buy Opioid Overdose Drug To Save Lives
As deaths from opioid overdoses rise around the country, the city of Baltimore feels the weight of the epidemic. "I see the impact every single day," says Leana Wen, the city health commissioner. "We have two people in our city dying from overdose every day." As part of Baltimore's strategy to tackle the problem, Wen issued a blanket prescription for the opioid overdose drug naloxone, which often comes in a nasal spray, to all city residents in 2015. (Aubrey, 10/27)

The Washington Post: Even This Puppy Wasn’t Safe From America’s Opioid Crisis
Like most puppies, Zoey is energetic and insatiably curious. When she’s outside, the 3-month-old yellow Labrador keeps her nose pointed to the ground, sniffing things, tackling flowers and chewing on random objects without hesitation. Such was the case on a recent morning, when owner Peter Thibault took Zoey out for a walk on their wooded neighborhood street in Andover, Mass. At some point, he noticed Zoey had lunged toward an empty cigarette box that had been discarded near a tree — and then put it in her mouth. He bent down to try to take the package away from her. (Wang, 10/28)

Politico: Backed By UnitedHealth, HHS Nominee Would Now Help Oversee It
Five months after President Donald Trump nominated Stephen Parente to be an assistant secretary for Health and Human Services, the nation's largest health insurer quietly gave a $1.2 million gift to a tiny academic research center that Parente helped found and served as director over the past decade. Parente, who is still awaiting confirmation as HHS’ assistant secretary of planning and evaluation, for which he was nominated in April, would head an office that often assesses policies that affect the insurance industry. It is currently researching the impact of Obamacare on the insurance market. (Diamond, 10/30)

USA Today: Speaking The Language Of Science In Administration That Often Eschews It
He joined a Republican administration last month that's often accused of downplaying or disregarding science, but the new surgeon general says he's "nonpartisan" and will let science and data drive his approach to the opioid epidemic. "It's more important than ever to have that objective voice," physician Jerome Adams said in his first sit-down interview since taking office. "Everyone's got their own opinion (but) make no mistake, the science does matter."  (O'Donnell, 10/28)

Los Angeles Times: CVS-Aetna? Expect More Strange Bedfellows As Competition From Amazon Grows
If CVS Health’s reported $66-billion bid to acquire health insurer Aetna is approved, it could give the retail pharmacy chain an infusion of customers through Aetna’s members and more leverage when it negotiates drug prices. But beyond that, the tie-up could help prepare the two companies for what analysts believe will be the industry-rattling arrival of Amazon into the pharmacy business. (Pierson, 10/27)

Bloomberg: CVS-Aetna Deal Could Mean End Of Era In How Drugs Are Paid For
If Aetna Inc. is eventually swallowed by CVS Health Corp., an important part of the health-care business will be changed -- perhaps for good. For years, pharmacy benefits were largely carved out from the rest of a medical coverage plan. But increasingly the two services are being combined, a move that in theory will make it easier to verify whether expensive drugs are worth the cost. A merger of the third-biggest health insurer with the largest U.S. drugstore chain, which also operates a pharmacy-benefit management company, could speed the process. (Langreth and McLaughlin, 10/27)

The Washington Post: Study Shows How High Fever In Early Pregnancy Miy Cause Birth Defects
Certain birth defects of the face and heart can occur when babies’ mothers have a fever during the first trimester of pregnancy, a crucial time in an embryo’s development. Now scientists have figured out the molecular players that make it so. In an experiment with chicken embryos, a temporary rise in incubation temperature — meant to mimic feverlike conditions — was enough to produce defects to the face and heart. Such an elevation in temperature, called hyperthermia, affects the activity of heat-sensitive channels in cells necessary for an embryo’s development, researchers report online in the journal Science Signaling. (Cunningham, 10/28)

The Washington Post: She Signed Up To Be A Surrogate Mother — And Unwittingly Gave Her Own Child Away
Jessica Allen was already the mother of two boys when she decided to become a surrogate. The pay she would receive to carry another woman’s child to term — $30,000 — would allow Allen to become a stay-at-home mom, as well as save for a new house. It would also be her “chance to give a family the blessing of a child,” her partner, Wardell Jasper, told her, according to the New York Post, which first reported the story. (Wang, 10/28)

The Washington Post: High Blood Pressure In Pregnancy -- Preeclampsia -- Can Be Dangerous
It has been nearly seven years since Sarah Hughes had pre­eclampsia, but she still remembers the anguish of missing her newborn’s first three days of life when this pregnancy complication sent her back to the hospital with dangerously high blood pressure. Hughes said she could tolerate the gasping for breath and intense headache as well as the painful, intravenous magnesium sulfate she received to reduce the chances of a seizure, but she could not stand being away from her new child, who was at home being cared for by relatives. (Neumann, 10/28)

The Washington Post: Preterm Birth Rate Increases, But Many Women Can't Get Treatment To Prevent It.
There are two medications that prevent preterm birth, the most common cause of perinatal death in the United States. One costs 16 cents a week, one $285 a week. Poor black women aren’t getting either. Why? In 2015, for the first time in eight years, the rate of preterm birth in the United States rose, despite increased understanding of preventive measures. Preterm births cost Americans an estimated $26 billion per year. (Abbott, 10/29)

Los Angeles Times: Argentina Bans Abortion In Most Cases. So Why Is Its Abortion Rate Far Higher Than That Of The U.S.?
The woman stumbled into a public hospital late one night, her stomach turning as she approached the lobby. She was bleeding. Dr. Damian Levy ushered her into a room. Like many of his patients at Hospital Alvarez in Buenos Aires, she was young and poor. At first, she refused to tell him why she was there.Then she burst into a tearful confession. She had tried to perform her own abortion at home and used 40 tablets of the drug misoprostol — nearly three times the suggested dosage for inducing a miscarriage. She was worried that the hospital would report her to police. (Parvini, 10/29)

The Washington Post: Closure Of Two D.C. Maternity Wards Hurts Low-Income Women Most
In the days and weeks before Providence Hospital closed its maternity ward, Caitlin Givens, a midwife, explained to pregnant patients what they needed to do to continue their prenatal care. She talked to them about scheduling appointments with a different provider, how many visits they would need before their delivery. She reminded them they needed their blood pressure checked regularly. (Itkowitz, 10/28)

NPR: Parenting In The Age Of Alexa, Are Artificial Intelligence Devices Safe For Kids?
Earlier this month, the toy-giant Mattel announced it had pulled the plug on plans to sell an interactive gadget for children. The device, called Aristotle, looked similar to a baby monitor with a camera. Critics called it creepy. Powered by artificial intelligence, Aristotle could get to know your child — at least that was how the device was being pitched. (Doucleff and Aubrey, 10/30)

The New York Times: Underweight Women At Risk Of Early Menopause
Underweight women are at increased risk for early menopause, a new study has found. This study, in Human Reproduction, followed 78,759 premenopausal women ages 25 to 42 beginning in 1989. Over the following 22 years, 2,804 of them reported natural menopause before age 45. (Bakalar, 10/26)

The Washington Post: Who Should Get The Shingrix Shingles Vaccine
Barbara Campbell has twice had shingles. Each time, one side of her body was covered in “thousands of these horrid blisters.” She could only wear the lightest silk blouse. Anything else touching her skin hurt too much. “I’m in terror of having it happen again,” said Campbell, 79, of Fort Lauderdale, Fla., describing the painful rash that will affect almost 1 out of 3 people in their lifetime. Because of allergies, she couldn't get the Zostavax vaccine, which is made with live, albeit weakened virus. (Sun, 10/28)

The Washington Post: Nonalcoholic Fatty Liver Disease If Fast-Growing Reason For Liver Failure--And Transplants--In Young People.
Nonalcoholic fatty liver disease and its more aggressive form, nonalcoholic steatohepatitis, have become the fastest-growing reasons for liver transplants in young Americans, according to a recent study. Typically, older adults experience the slow progression of fatty liver disease that is not related to alcohol but can lead ultimately to liver cirrhosis. As a result of increasing childhood obesity, hypertension and diabetes, however, more young adults are reaching end-stage liver disease early in life, researchers say. (Crist, 10/29)

The Associated Press: Nursing Homes Struggled With Choice To Evacuate In Hurricane
Murky water started seeping into a Port Arthur, Texas, nursing home four days after administrators decided to shelter in place. Volunteers — one even brandishing a gun — demanded relocation of the elderly residents, at least two of whom died in the days after police ultimately ordered the evacuation. The deaths of elderly residents at Lake Arthur Place and other Texas and Florida facilities after hurricanes made landfall in August and September have heightened scrutiny of the evacuation procedures at nursing homes and assisted living facilities. (Lauer and Spencer, 10/29)

The Associated Press: Florida Governor Loses In Court Battle Over Nursing Homes
Florida Gov. Rick Scott's push to force nursing homes to add generators in the aftermath of Hurricane Irma could be blocked after a judge ruled there was no pressing danger that justifies the order. Scott called for the rules after residents at the Rehabilitation Center at Hollywood Hills died in the days after Irma wiped out power to much of South Florida. (Fineout, 10/27)

The Wall Street Journal: Florida Judge Rules Against Emergency Nursing-Home Generator Measures
The new rules were issued in September, days after the death of eight patients from a Broward County nursing home that lost central air conditioning when Hurricane Irma hammered the state. Under direction from Gov. Rick Scott, two state agencies demanded nursing homes and assisted-living facilities quickly add generators and fuel to maintain safe temperatures for at least four days during a power outage. The industry balked, with three groups representing elder-care facilities mounting legal challenges focused in part on what they argued was an impossible schedule. (Kamp, 10/27)

The Washington Post: A Death At United Medical Center, The District's Only Public Hospital, Prompts New Questions About Patient Safety At The Troubled Facility
The cries began shortly before 5 a.m., echoing down the almost empty corridors of United Medical Center’s nursing home. From his bed in Room 704, Warren Webb’s moans cohered into words: “Help! I can’t breathe!” A registered nurse appeared and adjusted the height of his bed. But the nurse quickly began arguing with Webb’s wheelchair-bound roommate, who was pleading for her to do more to help. Webb rolled out of bed and landed on the floor, his diaper coming loose. (Jamison, 10/29)

The Associated Press: Arkansas Poised To Execute Man Amid Fight Over Mental Health
Jack Greene’s lawyers say he’s severely mentally ill. The Arkansas death row inmate says they’re lying. As Greene approaches a Nov. 9 execution date, his lawyers are raising questions about who should determine his mental competency. Arkansas gives considerable weight to its prison director’s opinion in deciding whether a condemned inmate has the mental capacity to understand his execution; Greene’s lawyers want doctors to have a greater say. (Kissel, 10/29)

Los Angeles Times: L.A. County Death Toll From West Nile Virus Climbs To 17
Amid a heat wave that could make West Nile virus more likely to spread, the number of people infected with the disease in Los Angeles County continued to climb this week. At least 230 people in L.A. County have fallen sick with West Nile this year, and 17 of them have died, health officials said Friday. The number of people infected is already the third-highest ever in the county, according to health officials — and the season has yet to end. (Karlamangla, 10/27)