First Edition: October 8, 2019

Kaiser Health News: As Medicare Enrollment Nears, Popular Price Comparison Tool Is Missing
Millions of older adults can start signing up next week for private policies offering Medicare drug and medical coverage for 2020. But many risk wasting money and even jeopardizing their health care due to changes in Medicare’s plan finder, its most popular website. For more than a decade, beneficiaries used the plan finder to compare dozens of Medicare policies offered by competing insurance companies and get a list of their options. Yet after a website redesign six weeks ago, the search results are missing crucial details: How much will you pay out-of-pocket? And which plan offers the best value? (Jaffe, 10/8)

Kaiser Health News: Trump’s New Order For Medicare Packs Potential Rise In Patients’ Costs
Vowing to protect Medicare with “every ounce of strength,” President Donald Trump last week spoke to a cheering crowd in Florida. But his executive order released shortly afterward includes provisions that could significantly alter key pillars of the program by making it easier for beneficiaries and doctors to opt out. The bottom line: The proposed changes might make it a bit simpler to find a doctor who takes new Medicare patients, but it could lead to higher costs for seniors and potentially expose some to surprise medical bills, a problem from which Medicare has traditionally protected consumers. (Appleby, 10/7)

California Healthline: Vapers Accuse Officials Of Overreach As Investigation Into Deadly Lung Illness Lags
On Sept. 16, Tulare County in California announced the nation’s seventh death from vaping-related illness. Its advisory warned about “the dangerous effects of using electronic cigarettes, or e-cigarettes.” Like so many of the official warnings coming out around the country, it lacked details about the specific products involved in the vaping death. But by the time of the announcement, the family of the man who died had been in touch with Gregory Conley, president of the American Vaping Association, which advocates for vaping products. (Barry-Jester and Gold, 10/7)

The New York Times: Supreme Court Opens New Term With Argument On Insanity Defense
In the first argument of its new term, the Supreme Court on Monday considered whether states may abolish the insanity defense, a question that seemed to puzzle several of the justices, who drew conflicting lessons from history, moral philosophy, constitutional law and the brutal crimes at the heart of the case. James Kahler of Kansas was sentenced to death in 2011 for killing four family members, but his lawyers said he had severe depression that made it impossible for him to understand reality or to distinguish right from wrong. (Liptak, 10/7)

SCOTUSblog: Argument Analysis: Justices Open New Term With Questions And Concerns About Insanity Defense
Arguing for Kahler, attorney Sarah Schrup began by emphasizing that, for centuries, a defendant’s culpability hinged on his ability to distinguish between right and wrong. The insane, she stressed, lack that capacity. Justice Ruth Bader Ginsburg asked whether a state could decide that it wanted to “rethink” the insanity defense, creating the prospect that someone could be found guilty but nonetheless insane and then committed to a psychiatric hospital instead of prison. Would that violate the Constitution, she asked? Schrup pushed back, arguing that someone who is insane historically would not have been subject to prosecution at all. And a conviction, she added, could carry a stigmatizing effect. (Howe, 10/7)

The Washington Post: Supreme Court’s New Term Opens With Arguments Over Unanimous Juries, Insanity As A Criminal Defense
Justice Stephen G. Breyer said the case raised “quite deep” questions. He wondered about one “crazy” defendant who killed someone because he believed the person was a dog, and another who killed someone he knew was a person but did it because he believed a dog had told him to do it. “Why does Kansas say one is guilty, the other is not guilty?” Breyer asked. Kagan also found the case raised deep questions but said she doubted the outcome will mean much for Kahler. In no state, Kagan told Kahler’s lawyer Sarah Schrup, “would your client be found insane.” (Barnes, 10/7)

The Wall Street Journal: Trump’s Federal Hiring Emphasizes Border Control, Veterans, Military
The White House has reshaped the federal workforce to advance President Trump’s priorities, emphasizing border control, veterans and the military while shrinking the size of the education, labor and housing-and-urban-development agencies, an analysis by The Wall Street Journal shows. Compared with the political difficulties of the federal-budget process, strategic hiring is a quieter way to advance a presidential policy agenda and a practice employed by all White Houses to varying degrees. (Butchireddygari, 10/7)

The New York Times: Juul Is Sued By School Districts That Say Vaping Is A Dangerous Drain On Their Resources
With school districts across the United States scrambling to reverse the rise of vaping among teenagers, three of them on Monday filed suit against Juul, the e-cigarette manufacturer, accusing it of endangering students and forcing educators to divert time and money to fight an epidemic of nicotine addiction. The school systems in St. Charles, Mo., Olathe, Kan., and on Long Island were believed to be the first in the United States to sue Juul, which dominates the e-cigarette market with devices that look like thumb drives and that have become wildly popular with American teenagers. (Hassan, 10/7)

Reuters: Two School Districts Sue Juul Over Vaping 'Epidemic'
As a result of "youth-targeted product design and marketing, and years of misstatements and omissions regarding its products, Juul succeeded in addicting a generation of youth to nicotine," the St. Charles district said in its lawsuit, which was filed in federal court in St. Louis. The Olathe district, which sued Juul in federal court in Kansas City, Kansas, similarly accused the company of creating a nationwide "epidemic of vaping" and said it had been "forced to expend significant resources combating this public nuisance." (Pierson, 10/7)

The Washington Post: E-Cigarettes Add To Fire Dangers On Planes, And FAA Has Little Direction
When an e-cigarette battery started smoldering on a flight to Los Angeles in July 2017, a SkyWest flight attendant threw it into an ice bucket before shoving it into a fire containment bag. In Denver, two months later, a carry-on bag with four vaping batteries “caught fire on the boarding bridge,” and firefighters were called to put it out, according to the Federal Aviation Administration. In March, Southwest Airlines employees had to pull a smoking suitcase containing e-cigarette batteries from a plane’s cargo hold in San Diego. Adjacent bags were damaged, as was the plane, which was temporarily taken out of service, according to the FAA. (Laris, 10/7)

Reuters: Democrat Lawmaker Introduces Bill To Cap Nicotine Content In Vapes
A U.S. lawmaker on Monday introduced a bill that seeks to regulate e-cigarette makers by capping the amount of nicotine in the vapes they manufacture to make them less addictive. The bill, introduced by Illinois Congressman Raja Krishnamoorthi, is the latest effort by lawmakers to clamp down on e-cigarette use, given a spike in underage vaping. (10/7)

The Associated Press: First Lady Calls For End Of E-Cigarette Marketing To Youth
Melania Trump said Monday that companies "must stop" marketing e-cigarettes to children, saying they are addictive and dangerous. Marketing tobacco products to kids is already prohibited in the United States, and Juul Labs Inc., the nation's largest maker of electronic cigarettes, has said it will cease advertising them in the U.S. Still, some believe Juul's early online marketing of e-cigarettes contributed to an explosion in vaping among youth. (Superville, 10/7)

The Hill: First Lady Calls For End Of Marketing E-Cigarettes To Youth 
"It is important to me that we all work to educate children and families about the dangers associated with this habit," she said. "Marketing this addictive product to children must stop." Melania Trump was one of the driving forces behind President Trump's crackdown on flavored vaping products. (Weixel, 10/7)

The Associated Press: Kroger, Walgreens To Stop Selling E-Cigarettes In US
Two major retailers say they will no longer sell e-cigarettes in the U.S. amid mounting health questions surrounding vaping. Supermarket chain Kroger and drugstore chain Walgreens announced Monday they would discontinue sales of e-cigarettes at their stores nationwide, citing an uncertain regulatory environment. (10/7)

Cincinnati Enquirer: U.S. Lab Seeking Possible Links Between Vaping And Lung Disease Is In Cincinnati
The search for answers to the mysterious lung disease apparently related to vaping goes through a low-slung building in an industrial park in a northern Cincinnati neighborhood. The Forensic Chemistry Center in Cincinnati operates under the authority of the U.S. Food and Drug Administration. As a result, it’s a secretive place, and FDA officials declined repeated requests to tour the lab or speak with its leadership. An agency spokeswoman answered questions that The Enquirer submitted by email. In the vaping investigation, the laboratory has received more than 400 samples of vaping products from 18 states, “and those numbers continue to increase,” the FDA said. (Saker, 10/7)

Los Angeles Times: Mice Who ‘Vaped’ Nicotine For A Year Had Big Spike In Tumor Growth
New research in mice suggests that long-term exposure to vaping liquids that contain nicotine greatly increases the risk of cancer. After breathing in the vapor for 20 hours a week for more than a year, 22.5% of the mice had cancerous tumors in the lining of the lungs, and 57.5% developed growths in their bladder tissue that can be precursors to cancer. Meanwhile, only 5.6% of mice in a control group that breathed only filtered air wound up with lung tumors, and none of them had growths in their bladders. (Baumgaertner, 10/7)

The Wall Street Journal: Majority Of New Yorkers Support Ban On Sale Of E-Cigarettes
New Yorkers think the use of e-cigarettes is a serious public health problem and support a ban on flavored e-cigarette products, according to a poll released Monday. The Siena College Research Institute found that 78% of the 589 New Yorkers surveyed in late September believe that vaping is a somewhat serious or very serious public health problem. Sixty-one percent of those polled supported a temporary ban on the sale of flavored e-cigarette and vaping products, while 52% said they supported banning the sale of all e-cigarettes and vaping devices in New York. (West, 10/7)

The Wall Street Journal: Sanders’s Heart Attack Brings Age To 2020 Forefront
Bernie Sanders’s recent heart attack and hospitalization are bringing to the forefront an issue the Democratic party’s three leading presidential candidates have actively tried to minimize: their age. At 78, the Vermont senator is the oldest in the party’s field. Former Vice President Joe Biden is 76, and Massachusetts Sen. Elizabeth Warren is 70. All three—who have consistently occupied the trio of top slots in public polls of the Democratic contest—are much older than the median age of about 55 years for a U.S. president at inauguration. They are competing to face President Trump, who is 73. (Parti, 10/7)

Politico: Sanders Heart Attack Casts Cloud Over His Candidacy
Bernie Sanders has been sidelined for nearly a week — after failing for almost three days to disclose that he had a heart attack. It's unclear when the 78-year-old senator will return to the stump. His campaign has yet to divulge the severity of his heart attack. And that sequence of events unfolded as he's been eclipsed in the polls by the other progressive icon in the race, Elizabeth Warren. (Otterbein and Siders, 10/7)

CNN: How Bernie Sanders' Heart Attack Changes The 2020 Race
Bernie Sanders' heart attack suffered on the campaign trail last week thrusts a tough issue to the front of the 2020 presidential race: How old is too old to be president? Sanders is the obvious focus of that question, after having two stents placed into an artery following a campaign appearance in Nevada -- and being forced to pull out of a CNN-sponsored town hall on LGBT issues in California later this week. But he's not the only candidate in the Democratic field who will be affected by Sanders' heart attack in the race. (Cillizza, 10/7)

Stat: Buttigieg Wants Lower Drug Prices — Even As He Hopes Drug Makers ‘Thrive’
Just hours after he released an aggressive plan to lower prescription drug prices, South Bend, Ind., Mayor Pete Buttigieg shared his counterintuitive message for drug makers: “We want you to thrive. ”Thrive, that is, in a way that is “compatible with a decent life for Americans,” he explained during a Monday interview with STAT. Buttigieg, long seen as one of the most moderate candidates vying for the Democratic presidential nomination, released a sweeping plan Monday that included ideas once seen as radical, even among Democrats, like levying heavy fines against drug makers and seizing patents. (Florko, 10/7)

Stat: Public Citizen Urges FDA To Withdraw Drug For Preventing Premature Birth
As an Oct. 29 regulatory meeting nears to review the Makena treatment for preventing premature births, a consumer advocacy group is urging the Food and Drug Administration to immediately withdraw the controversial drug because it failed a confirmatory study. In a citizen’s petition being filed with the FDA on Tuesday, Public Citizen pointed to a required followup effectiveness study that was released in March, showing Makena is no better than a placebo in preventing preterm birth or major complications from preterm birth. (Silverman, 10/8)

Stat: With A New Lobbying Group And A Day At The White House, Synthetic Biology Looks For Footing In Washington
Synthetic biology, the industry built around using back-end technologies to engineer the life sciences, has long prided itself on having a quirky, countercultural ethos — and having more fun than those stuffy suits in biotech and pharma. It was just two years ago, after all, that a biohacker CRISPR’d himself on stage at the industry’s big annual conference. Now, though, the industry is trying to establish its footing here in a town with a culture utterly unlike its own. (Florko and Robbins, 10/8)

The Associated Press: US Official: Research Finds Uranium In Navajo Women, Babies
About a quarter of Navajo women and some infants who were part of a federally funded study on uranium exposure had high levels of the radioactive metal in their systems, decades after mining for Cold War weaponry ended on their reservation, a U.S. health official Monday. The early findings from the University of New Mexico study were shared during a congressional field hearing in Albuquerque. Dr. Loretta Christensen — the chief medical officer on the Navajo Nation for Indian Health Service, a partner in the research — said 781 women were screened during an initial phase of the study that ended last year. (Hudetz, 10/7)

The Associated Press: Hospital Where 3 Preemies Died Seeking Source Of Bacteria
A Pennsylvania hospital is racing to determine the source of a waterborne germ that appears to have infected at least eight infants in the neonatal intensive care unit, three of whom have died, officials said Monday. Geisinger Medical Center in Danville has begun sending very premature newborns and some expectant mothers to other facilities while officials investigate, the hospital said. (10/7)

The New York Times: 3 Babies Die At Pennsylvania Hospital After Bacterial Infection
The bacterium — Pseudomonas aeruginosa — is very common, likes moist environments and grows in water. Pseudomonas infections have been a particular problem for neonatal intensive care units because underdeveloped babies have compromised immune systems. “It’s often very harmless,” Dr. Frank A. Maffei, Geisinger’s chief of pediatrics, said at the news conference. “However, it can cause diseases, and it can cause diseases in very fragile patients. Certainly, premature and tiny babies are among our most fragile and vulnerable patients we care for here.” (Zaveri, 10/7)

WOSU Radio: Gov. DeWine Introduces 'STRONG Ohio' Bill To Reduce Gun Violence
Two months after the mass shooting in Dayton spurred Gov. Mike DeWine to take action against gun violence, the governor has released details about the official bill he's presenting to lawmakers. The legislation won't include two significant gun control measures DeWine previously supported, however. DeWine in August said he wanted two major elements in his gun violence bill: a version of a “red flag” gun seizure law, and enhanced background checks for private gun purchases. Neither element appears in the version DeWine unveiled Monday. (Kasler and Ingeles, 10/7)

Cincinnati Enquirer: Dayton Shooting: Ohio Governor Decides Against 'Red Flag' Gun Law
Instead of a red flag or extreme risk protection order law that would remove guns from people deemed dangerous, DeWine proposed expanding the state's "pink slip" system, which places mentally ill Ohioans in hospitals for up to 72 hours. Under DeWine's proposed changes, those dealing with chronic alcoholism or drug dependency could be "pink-slipped," too. After a hearing in probate court, a judge or magistrate could determine that the person should be separated from his or her firearms. The person could give guns to someone who doesn't live with him or her, sell them or give them to law enforcement. (Balmert and Borchardt, 10/7)

Dayton Daily News: Gov. Mike DeWine Lays Out Gun Plan
DeWine is also wants a clear path for police to enforce existing laws that allow seizure of firearms from people under a “weapons disability” because of mental illness, drug use or alcoholism. Additionally, the governor wants people with drug dependency or chronic alcoholism and are deemed to be dangerous to be held in hospitals for up to 72 hours — as is the process for people with mental illnesses who exhibit signs they’re a danger to themselves or others. “The STRONG Ohio bill will give hospitals and courts a better ability to help those who are legally declared to be a danger to themselves or others due to drug dependency or chronic alcoholism,” the DeWine administration said. (Bischoff, 10/7)

Modern Healthcare: Gun Control Could Reduce Suicide More Than Boosting Mental Health Staffing
Gun control measures may be more effective at reducing firearms suicides in the U.S. than increasing behavioral health capacity, a new study suggests. The study, published in Health Affairs, found that a 10% increase in behavioral health workers per state was associated with a modest 1.2% reduction in the gun suicide rate from 2005 to 2015. (Meyer, 10/7)

The New York Times: Players With C.T.E. Doubled Their Risk With Every 5.3 Years In Football
Former tackle football players with chronic traumatic encephalopathy, the degenerative brain disease linked to repeated head hits, doubled their risk of developing the worst forms of the disease for each 5.3 years they played, according to a new study. Scientists have known that more years playing tackle football is associated with thinking and memory deficits later in life. This study builds on that research and, for the first time, calculated the number of years played with levels of measurable disease in the brain. (Belson, 10/7)

NPR: Acute Flaccid Myelitis May Be Caused By A Virus, Research Shows
The condition strikes young children. It can start with run-of-the-mill virus symptoms, like fever or sniffles. But, then the kids lose control of their limbs, may have trouble swallowing or breathing, or even end up paralyzed. This terrifying experience happened to more than 570 families since 2014, whose children were struck with an illness called acute flaccid myelitis, or AFM. "It was really scary," says Susan Coyne, the mother of a son, Evan Mazanec, who developed AFM back in 2014 when he was 7 years old. "When this first started, no one really knew what it was," she says. (Aubrey, 10/7)

NPR: Smartphone App Can Help Detect Leukocoria, A Sign Of Eye Cancer
It's hard for doctors to do a thorough eye exam on infants. They tend to wiggle around — the babies, that is, not the doctors. But a new smart phone app takes advantage of parents' fondness for snapping pictures of their children to look for signs that a child might be developing a serious eye disease. The app is the culmination of one father's the five-year quest to find a way to catch the earliest signs of eye disease, and prevent devastating loss of vision. (Palca, 10/7)

The New York Times: The Government Says Rainbow Crosswalks Could Be Unsafe. Are They Really?
Ahead of an annual L.G.B.T.Q. festival in Ames, Iowa, members of the City Council decided to liven up a pedestrian crosswalk near the downtown shopping district by painting stripes in colors evoking the gay, nonbinary and transgender pride flags. “Who would have thought, 50 years ago, that a small town in central Iowa would be saying this: We see you, we hear you, we welcome you,” Reginald Stewart, vice president for diversity and inclusion at Iowa State University, said of the kaleidoscopic markings. (Rueb, 10/7)

The New York Times: Stress Can Make You Sick. Take Steps To Reduce It.
Not long ago Dr. Rangan Chatterjee had a patient with Type 2 diabetes who was struggling to lower his blood sugar levels despite following an intense diet and exercise program. Dr. Chatterjee counseled him to focus on the root cause of his problem: Chronic stress. The patient, a 53-year-old businessman, had been putting in long hours at the office, working late into the night and skimping on sleep. (O'Connor, 10/8)

NPR: Lawmakers Seek Protections For Workers Against Lung Damage Tied To Making Countertops
Lawmakers in Congress are calling on the Department of Labor to do more to protect workers who may be unsafely cutting "engineered stone" used for countertops. The material contains high levels of the mineral silica, and breathing in silica dust is dangerous. While silica is found in natural stones, like granite, engineered stone made of quartz can be more than 90% silica. This type of artificial stone has become increasingly popular among Americans for kitchen and bathroom countertops in recent years. (Greenfieldboyce, 10/7)

The New York Times: Pregnant? Try Not To Sleep On Your Back
During pregnancy, sleeping on your back may be a bad idea. Previous studies have found that sleeping in a supine position causes compression of veins and arteries that can lead to a reduction in blood flow to the placenta severe enough to double the risk for stillbirth after 28 weeks of gestation. (Bakalar, 10/8)

The Wall Street Journal: Sleepovers Have Parents Worried About Midnight Gadget Use
Kids’ sleepovers have gotten complicated. The days of flashlights, Ouija boards and prank calls are over. Now, some parents are worried their children could be exposed to porn, violent videogames or the pressure to post inappropriate photos in the wee hours. (Jargon, 10/8)

The Associated Press: California OKs Pharmacists To Dispense HIV Prevention Meds
Pharmacists in California will be able to dispense HIV prevention pills to patients without a doctor's prescription after Gov. Gavin Newsom signed legislation Monday that supporters say will greatly reduce the spread of infection. Advocates of Senate Bill 159 say California is the first state to authorize pre-exposure prophylaxis, also called PrEP, and post-exposure prophylaxis, known as PEP, without prescriptions. California is already considered a leader in AIDS prevention, they say. (10/7)

Los Angeles Times: HIV Prevention Drugs Will Be Available Without A Prescription In California
Senate Bill 159 by Sen. Scott Wiener (D-San Francisco) and Assemblyman Todd Gloria (D-San Diego) allows pharmacists to dispense pre-exposure prophylaxis, known as PrEP, and post-exposure prophylaxis, known as PEP, in a way similar to birth control and emergency contraceptives. The law will also bar insurance companies from requiring prior authorization before the HIV prevention drugs are provided. “Recent breakthroughs in the prevention and treatment of HIV can literally save lives,” Newsom said in a statement. “All Californians deserve access to PrEP and PEP, two treatments that have transformed our fight against HIV and AIDS. I applaud the Legislature for taking action to expand access to these treatments and getting us close to ending HIV and AIDS for good.” (Gutierrez, 10/7)

The Wall Street Journal: New York City Boosts Homeless Outreach After Four Men Are Killed
New York City will increase its mental-health outreach to the homeless in Manhattan’s Chinatown after four homeless men were bludgeoned to death in the neighborhood, Mayor Bill de Blasio said Monday. Psychiatrists and clinicians from the city’s Department of Health and its Thrive mental-health program will perform street evaluations and provide substance-abuse resources to the homeless as part of the new push, officials said. (Honan and Blint-Welsh, 10/7)

Los Angeles Times: $600,000 For Homeless Housing? Audit Suggests Spending Money On Shelters Instead
With the costs of building housing on the rise, Los Angeles City Controller Ron Galperin is recommending that some projects be reevaluated to see if their budgets can be cut to use less of the city’s $1.2-billion homeless housing bond. In an audit that will be released Tuesday, Galperin found that more than 1,000 units of housing approved for funding through Proposition HHH could top $600,000 apiece. (Smith, 10/7)

The Washington Post: D.C. May Approve One Of The Highest Soda Taxes In The Country.
A majority of the D.C. Council wants to impose one of the highest taxes on sugary drinks in the nation, driving up the cost of a soda in the capital city. A bill announced Monday would levy a 1.5 cent-per-ounce excise tax on sweetened beverages, adding one dollar to the price of a two-liter bottle. The tax applies to sugary drinks with any “natural common sweeteners,” sweeping up beverages such as Ga­tor­ade, sweetened iced coffee and orange juice with added sugar. (Nirappil, 10/7)

The Washington Post: Secretly-Recorded Prison Film Shows The Gruesome Reality Of Life Inside
With a camera hidden in a hollowed-out Bible, peeking through the “O” of the word “Holy,” and a pair of rigged reading glasses, Scott Whitney secretly filmed the world behind bars, inside one of Florida’s notoriously dangerous prisons. For four years, the 34-year-old convicted drug trafficker captured daily life on contraband cameras at the Martin Correctional Institution. He smuggled footage dating back to 2017 out of the prison and titled the documentary “Behind Tha Barb Wire.” The video — given to the Miami Herald — allows the public to see with their own eyes the violence, rampant drug use and appalling conditions inside the prison. (Paul, 10/7)

The Associated Press: Iowa Board Approves Payment For Student Suicide Jury Verdict
A state panel that signs off on legal settlements for the state of Iowa has approved payment of $315,000 to the parents of an Iowa State University student who died by suicide in November 2015. A jury in August found the state partially liable for the death of Dane Schussler. (10/7)

The Washington Post: ‘A Way To Find The Peace I Lost’: This Maryland Nonprofit Is Teaching People With Disabilities How To Sail Boats
[April] Schrock is one of more than 600 people with disabilities (and hundreds of their family members and friends) who have benefited from CRAB’s programming this year, said Paul Bollinger Jr., the group’s executive director. In the roughly 30 years since CRAB’s founding, that number probably stretches “easily” into the tens of thousands, though 2019 will set an annual record, he said. Plus, Bollinger added, the group is poised to significantly expand and diversify its fleet of sailboats (currently around a half-dozen, with a bonus canoe). (Natanson, 10/4)