First Edition: September 13, 2019

Kaiser Health News: Despite Repeated Calls For Unity, Democrats Throw Some Debate Punches On Health Plans
“Everyone on this stage is well-intentioned,” said Sen. Kamala Harris of California. But she also issued a reminder that Trump has worked aggressively to fight the ACA — even taking it to court — and listed some of its most popular provisions, such as its protections for people with preexisting conditions and the ability to stay on your parents’ insurance until you turn 26. “If we don’t get Donald Trump out of office, he’s going to get rid of all of it,” she said. (Huetteman, 9/13)

Kaiser Health News: Vapers Seek Relief From Nicotine Addiction In — Wait For It — Cigarettes
Lucas McClain started smoking cigarettes in high school but switched to vaping after he heard e-cigarettes were a safer alternative. His vape of choice became the Juul, the king of electronic cigarettes — which comes with a king-size nicotine hit.Now 21, McClain wants to quit so badly that he’s turning back to the problem he fled in the first place: good old-fashioned cigarettes. (Ibarra, 9/13)

Kaiser Health News: A Dubious Product: A Rape Kit For Home Use
Alongside other “essential” household supplies for sale on Amazon, there’s now a product offered that might give consumers pause: an at-home rape kit. The “PRESERVEkit,” listed for $29.95, is intended for those who have been sexually assaulted. It is advertised as “containing all of the tools and step-by-step directions needed for the proper collection of evidence if going to the police or medical facility is not an option.” (Knight, 9/13)

Kaiser Health News: UVA Suspends Medical Lawsuits In Wake Of KHN Investigation
Under pressure after Kaiser Health News reported Monday that it sues thousands of patients a year and sends many into bankruptcy, University of Virginia Health System suspended about a dozen patient lawsuits Thursday and said it will announce changes to its billing and collections policy Friday. At a weekly session at the Albemarle County Courthouse often dominated by UVA hospital litigation, UVA lawyer Melissa Riley said cases due to be heard Thursday would be withdrawn while the system takes a broader look at its long-standing practice of aggressive debt collection. (Hancock and Heredia Rodriguez, 9/12)

Kaiser Health News: KHN’s ‘What The Health?’: Despite Booming Economy, Uninsured Rate Ticks Up
The annual report from the Census Bureau, released this week, found that 27.5 million Americans were without health insurance last year, an increase of nearly 2 million from 2017. The 0.5 percentage point increase in the uninsured rate — to 8.5% — was the first in a decade and came as unemployment and other economic indicators have been good. Meanwhile, the Trump administration signaled that it is moving to ban flavored vaping liquid used in e-cigarettes. Companies making the products have been accused of marketing to underage users with flavors like mango and bubble gum. (9/12)

The Washington Post: September Democratic Debate Highlights: Democrats Argue Over Health Care, Guns, Immigration
Biden, Warren and Sanders opened the debate with a clash over health care that was a proxy argument over the future of the Democratic Party. Warren and Sanders arguing that Medicare-for-all would save Americans money and Biden, joined by the more moderate candidates, made a case against a wholesale overhaul of the health-care insurance industry as too expensive and unpopular. It was part of a broader divide onstage, between candidates who favor less sweeping but more attainable goals and those calling for huge structural change. (Sonmez, Wootson and Viser, 9/13)

The Wall Street Journal: Top 2020 Democratic Candidates Spar Over Health Care In Third Debate
The candidates largely agreed on what they see as the most important issues facing the country—a lack of universal health care, income inequality, the threat of climate change and the prevalence of mass shootings—but they diverged on how to address them. Mr. Biden, who has been atop the polls, drew fire from several candidates, but they saved the sharpest words for President Trump over his rhetoric and trade policies. (Day, Collins and Glazer, 9/13)

The New York Times: Attacks On Biden In Debate Highlight Divide Over The Obama Legacy
Facing all of his closest competitors for the first time in a debate, Mr. Biden, the Democratic front-runner, repeatedly invoked President Barack Obama’s name and policy record as a shield against rivals who suggested his own record was flawed, or implied his agenda lacked ambition. On health care, immigration, foreign wars and more, Mr. Biden’s central theme was his tenure serving under Mr. Obama. By constantly invoking Mr. Obama, a popular figure among Democrats, Mr. Biden sought to mute the ideological and generational divisions that have left him vulnerable in the primary race. (Martin and Burns, 9/12)

Reuters: Some Democrats Snipe, Others Unite In Third Presidential Debate
An anticipated fiery matchup between Biden, the moderate former vice president, and Elizabeth Warren, a liberal senator who has gained the No. 2 spot in recent opinion polls, did not quite materialize. U.S. Senator Bernie Sanders, running a close third, sounded hoarse as he expounded on his favorite progressive topics, including healthcare, political corruption and income inequality. (9/13)

Reuters: Biden Attacks Warren, Sanders Over Cost Of Healthcare Plans In Democratic Debate
Biden, who served as vice president for eight years under Barack Obama, said he would build on Obama's landmark 2010 Affordable Care Act, popularly known as Obamacare. He accused Warren and Sanders of wanting to tear it down with Medicare for All, a proposed government-run healthcare program that would eliminate private insurance. "I know that the senator says she's for Bernie. Well I'm for Barack. I think Obamacare worked," Biden said, asking Warren and Sanders to explain how they would pay for their plans. "This is about candor, honesty, big ideas." (9/13)

The Wall Street Journal: The Moments That Mattered In Thursday’s Democratic Debate
The former vice president was backed up by Sen. Amy Klobuchar of Minnesota. “It says that we will no longer have private insurance as we know it,” she said of the Sanders bill. “That means that 149 million Americans will no longer be able to have their current insurance. That’s in four years. I don’t think that’s a bold idea, I think it’s a bad idea.” Ms. Warren responded that her policies would be paid for by the wealthiest. “Costs are going to go up for wealthier individuals and costs are going to go up for giant corporations,” she said. “But for hardworking families across this country, costs are going to go down.” (Parti and McCormick, 9/13)

The Associated Press: Key Takeaways From The Democratic Candidates' Debate
Sanders took heavy fire on his single-payer health insurance proposal, with Biden and others hammering the Vermont senator for the cost and the political palatability of effectively eliminating the existing private insurance market. (9/12)

The Washington Post: Democrats Clash Over Health Care And More In Debate That Started With Calls For Unity
Several other candidates were more than willing to take on their fellow Democratic contenders directly, despite beginning the debate saying they wanted to unify the country and highlight the party’s broad unanimity on public policy. “I don’t think it’s a bold idea, I think it’s a bad idea,” Sen. Amy Klobuchar (Minn.) said of Sanders’s health-care bill. “For a socialist, you’ve got a lot more confidence in corporate America than I have,” Biden said to Sanders, scoffing at the idea that companies would pay workers more if they had fewer health-care costs. (Olorunnipa, Kinskey and Viser, 9/13)

Los Angeles Times: Biden Clashes With Warren And Sanders At The Democratic Debate Over The Party’s Future
“We all owe a huge debt to Barack Obama, who fundamentally transformed healthcare in this country,” Warren said. “Now, the question is how can we best improve that? Those at the very top, the richest individuals, the biggest corporations, are going to pay more and middle-class families are going to pay less,” Warren said. “That is how this is going to work.” (Halper and Mehta, 9/12)

Reuters: Democratic Debate Highlights: Democrats Spar Over Healthcare, Opponent Attacks
Sanders acknowledged the cost of his signature plan – but said studies show the status quo will cost Americans $50 trillion over the same time period. "I wrote the damn bill, if I may say so," he said, repeating his main applause line from the second debate in July. Biden emphasized again that his plan would allow people who like their private insurance to keep it, a key point of distinction from Sanders' and Warren's approach. (9/13)

The New York Times: Fact-Checking The Democratic Debate
WHAT MR. CASTRO SAID: “I also worked for President Obama, Vice President Biden, and I know that the problem with your plan is that it leaves 10 million people uncovered.” Later, he added, “The difference between what I support and what you support, Vice President Biden, is that you require them to opt in, and I would not require them to opt in — they would automatically be enrolled.” This is mostly true. (9/12)

The Associated Press Fact Check: Dems Draw Link Between Trump, El Paso Murders
Democrats routinely accuse Trump of using cages for children without acknowledging the same enclosures were employed when Biden was vice president. The Obama administration also separated migrant children from families under certain limited circumstances, like when the child's safety appeared at risk or when the parent had a serious criminal history. But family separations as a matter of routine came about because of President Donald Trump's "zero tolerance" enforcement policy last year. (9/12)

The Washington Post: Fact Check Of The Third Democratic Debate
“We didn’t lock people up in cages; we didn’t separate families.”— Former vice president Joe Biden. Contrary to Biden’s claim, the Obama administration did use caged enclosures beginning in 2014 to hold families apprehended along the southern border by U.S. authorities. There is photographic evidence showing the cages in 2014. (Kessler, Rizzo and Kelly, 9/12)

The Washington Post: Liberal, Moderate Divide On Display In Democratic Debate
Those in the second tier, after Biden, Warren and Sanders, are under increasing pressure to break out of the pack. They all assailed Trump. New Jersey Sen. Cory Booker called Trump a racist. Former Texas Rep. Beto O’Rourke called him a white supremacist. And Kamala Harris, a California senator, said Trump’s hateful social media messages provided “the ammunition” for recent mass shootings. (Barrow and Peoples, 9/13)

Politico: Democrat Debate Highlights: Biden At Center Stage And Focus Of Attacks
ABC debate moderator David Muir asked Harris about her proposal, if she were elected president, to take executive action on guns, including banning the imports of AR-15 tactical rifles. Biden, Muir pointed out, said Harris’s proposal wasn’t constitutional. “Does the vice president have a point there?” Muir asked Harris. Biden cut in before she could answer, saying of executive actions that “some things you can. Many things you can't.” Harris then leaned over her lectern, looked at Biden and smiled.“Hey, Joe, instead of saying, ‘No we can't,’ let's say yes, we can,” she smiled, repeating the Obama-Biden 2008 campaign slogan. (Caputo and McCaskill, 9/12)

Los Angeles Times: Beto O'Rourke: ‘Hell, Yes, We’re Going To Take Your AR-15’
When the Democratic presidential debate turned to gun control, former Texas Rep. Beto O’Rourke became emotional as he told of meeting a woman who watched her daughter bleed to death after a mass shooting. There were too many victims, he said, and not enough ambulances after the attack in Odessa, Texas. He talked of the devastation wrought by high-velocity rifle rounds that cause massive internal injuries when they smash into their human targets, including victims in the attacks in Odessa and in his hometown of El Paso. (Pearce, 9/12)

The New York Times: Marathon Democratic Debate Includes No Questions About Women’s Issues
In a nearly three-hour debate, the Democratic candidates clashed on health care policy differences, offered varying plans to combat the scourge of gun violence and even discussed whether Americans should switch to a vegan diet to help mitigate the effect of farming on climate change (short answer: no). But questions on the gender pay gap and reproductive rights were entirely absent. Candidates quickly took to Twitter after the debate to note the omission, including Senator Kamala Harris of California and former Representative Beto O’Rourke of Texas. (Corasaniti and Stevens, 9/13)

The Washington Post: Julian Castro Questioned Joe Biden’s Acuity. But Did Castro Get It Right?
To many, it was the most loaded question at Thursday night’s Democratic presidential debate. “Are you forgetting what you said two minutes ago?” Julián Castro asked Joe Biden in a heated exchange over health care. The crowd inside the debate hall reacted with a collective gasp, as if they had witnessed a scandalous twist on an afternoon talk show. Then, Castro repeated himself. Twice. (Sullivan, 9/13)

Politico: From Vaping To Opioids: Trump Redefines Health Care For 2020 Run
The Trump administration’s assault on e-cigarettes is the latest move by the White House to salvage Donald Trump’s health care agenda ahead of the 2020 elections. Turning away from the bitter Obamacare debates that have been a disaster for Republicans, Trump’s been building his disease-by-disease agenda all year, aimed at suburban voters who may be put off by the Democrats’ left turn on health care. (Kenen and Diamond, 9/12)

The Wall Street Journal: Juul Debates Pushing Back On E-Cigarette Ban
Juul Labs Inc. is debating internally whether to embrace or push back on part of the Trump administration’s plan to pull most e-cigarettes from the market, according to people familiar with the matter. The policy—affecting sweet and fruity vaping products along with mint and menthol—would be a crippling hit to the startup, which generates more than 80% of its sales from flavors that would be banned. But Juul insiders agree that the move could help curb underage vaping and avert an even bigger threat to the market-leading e-cigarette maker: the possibility that the Food and Drug Administration could take Juul off the market altogether. (Maloney, 9/12)

The New York Times: A Ban On Flavored E-Cigarettes Would Sharply Cut Sales
A ban on flavored e-cigarettes would not only severely dent sales of Juul Labs’ popular vaping products, but also have a chilling effect on the little regulated $2.6 billion industry of roughly 20,000 vape and smoke shops that sprung up across the country in the past few years. But a day after Alex M. Azar II, the health and human services secretary, said the Food and Drug Administration would draft a plan within weeks that would remove flavored e-cigarettes and nicotine pods from the market, there were already signs that some companies were considering legal challenges or lobbying efforts to keep two flavors safe — mint and menthol. (Creswell and Kaplan, 9/12)

The Associated Press: US Officials Revise Vaping Illness Count To 380 In 36 States
The U.S. government has refined how it is measuring an outbreak of breathing illnesses in people who vape, now counting only cases that are most closely linked to electronic cigarette use. Health officials on Thursday said 380 confirmed cases and probable cases have been reported in 36 states and one U.S. territory. That marks a decrease from the 450 cited last week, when officials were also including "possible" cases. (9/12)

Reuters: U.S. Cuts Vaping-Related Illness Total Under Refined Case Definition
Six people have died from vaping-related illness, a number that remains unchanged, the CDC said. The deaths were reported in California, Illinois, Indiana, Kansas, Minnesota, and Oregon. As of Sept. 11, an additional three states have reported cases of the severe lung illness linked to vaping, raising the total to 36 states plus the U.S. Virgin Islands, the agency said. (9/12)

The Wall Street Journal: Vaping-Related Lung Ailments Puzzle Doctors
The Food and Drug Administration has received more than 120 product samples linked to vaping illness for analysis. Many of the samples tested so far have contained tetrahydrocannabinol, or THC, a chemical in marijuana known for its psychoactive effects, rather than nicotine. Most samples with THC also contained added vitamin E acetate, an oil sometimes found in dietary supplements and skin products, the agency said. But no one product or device has been associated with all of the cases, according to the CDC and the FDA. (Abbott, 9/12)

Reuters: New Jersey Expected To Announce Vaping Restrictions Within Weeks
Within weeks, New Jersey could become the latest state to restrict e-cigarette use, with the governor on Thursday launching a task force to find ways to curb vaping, linked by U.S. health officials to hundreds of respiratory illnesses and a half-dozen deaths. "As of this moment, there is no safe vape," Governor Phil Murphy said at a media briefing, adding he was concerned about both teen use and the recent illnesses. "The only safe alternative to smoking is not smoking." (9/12)

The New York Times: Partisans Dig In As Executives Call For Action On Guns
When a letter signed by about 150 leaders of some of the nation’s most recognizable companies called on Thursday for tighter gun control measures, the reactions cut largely along partisan lines. Democrats like Senator Richard Blumenthal of Connecticut said the letter, which was signed by companies including Levi Strauss, Yelp and the Gap, pointed to a “groundswell” of support for restrictions on firearms. “The letter reflects a seismic political dynamic that is really sweeping the country,” he added. (Corkery, 9/12)

The Associated Press: Trump Vows To Protect 2nd Amendment After Gun Briefing
President Donald Trump pledged Thursday to protect the Second Amendment, hours after huddling with top advisers to discuss gun control measures he might be willing to publicly stand behind. Speaking to reporters before flying to Baltimore for a Republican retreat, Trump insisted "a lot of progress" had been made on background checks "and various things having to do with guns" during Thursday's discussion. But he also made clear that he's weary of angering gun proponents, suggesting Democrats' push for new gun control measures following a summer of mass shootings might be nothing more than "a ploy." (9/12)

Politico: Inside The Gun Lobby’s Push To Sway Trump
President Donald Trump talked about expanding background checks, then wavered. He was considering a “red flag” bill to let authorities take guns away from dangerous people, but has now “cooled” on the prospect, according to three people involved in the discussions. The whole time, the gun rights lobby was there to nudge the president along. Advocates bombarded the White House with calls and petitions. Representatives scored meetings with senior officials. And the industry even has a former staffer working in the West Wing on legislation. Meanwhile, groups pushing for more restrictions on gun purchases haven’t been able to get in the door. (Kumar, 9/13)

The Washington Post: Trump’s Proposals To Tackle California Homelessness Face Local, Legal Obstacles
President Trump’s emerging plan to address California’s homeless crisis includes ideas that have been tried unsuccessfully before, namely the mass housing of people living on the streets, and proposals that have been ruled illegal by federal courts. The White House effort has taken state officials by surprise, as the president has shifted from criticizing California’s management of homelessness on social media to proposals that would insert the federal government directly into the crisis, including relocating homeless people living on the street and in tent camps to a federal facility. (Wilson, 9/12)

The Wall Street Journal: Purdue Pharma Made, Then Ditched, Plans For Opioid-Treatment Nonprofit
OxyContin maker Purdue Pharma LP nixed plans earlier this year to launch a foundation to fund opioid-addiction treatment and research as the company rethought its strategy amid hundreds of lawsuits and a possible bankruptcy filing. Purdue staff pitched the foundation concept several years ago, and the drugmaker’s owners and executives spent several months developing the latest version, according to people familiar with the matter and internal company emails viewed by The Wall Street Journal. (Hopkins, 9/12)

Stat: Historians Seek Public Archive Of Documents From Opioid Litigation
In settling lawsuits against them, companies often insist that all of the documents and depositions gathered as part of the cases be locked away or destroyed. To head that off — and to ensure a full accounting of the origins of the prescription opioid crisis — a group of historians is asking that any settlement in the massive opioid litigation require all collected documents be preserved and made public. In a court brief Thursday, the experts called for “full and permanent access to the records” for scholars, policymakers, journalists, and the public, and for the defendants to cover the costs of creating an archive. (Joseph, 9/12)

The Associated Press: Chaotic Talks Show Challenge Of Reaching Opioid Settlement
For months, the judge overseeing national litigation over the opioids crisis urged all sides to reach a settlement that could end thousands of lawsuits filed by state and local governments. But the chaotic developments this week in the case against OxyContin maker Purdue Pharma underscore how difficult that goal is. By Thursday, half of the nation’s state attorneys general said they would reject a tentative deal crafted by the other half, and many criticized the terms as grossly insufficient. (Mulvihill, 9/13)

Stat: Right To Try 'Remains A Bust,' As Many Drug Makers Prefer FDA Reviews
Despite the hubbub over the “right-to-try” law, a recent survey found that nearly half of drug makers indicated they would require regulators to review a decision to provide an experimental treatment to a person with a life-threatening disease. Specifically, 13 of 29 drug companies indicated they want a relevant regulatory authority to review requests that are granted to such people. Of these, six specified they would ask the Food and Drug Administration to conduct a review and five stated they require a research ethics committee or institutional review board, according to a report from the Government Accountability Office. (Silverman, 9/12)

ProPublica: Thousands Of Poor Patients Face Lawsuits From Nonprofit Hospitals That Trap Them In Debt
Over the past few months, several hospitals have announced major changes to their financial assistance policies, including curtailing the number of lawsuits they file against low-income patients unable to pay their medical bills. Investigative reports have spurred the moves, and they prompted criticism from a top federal official. “We are learning the lengths to which certain not-for-profit hospitals go to collect the full list price from uninsured patients,” Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, told board members of the American Hospital Association on Tuesday, according to published remarks. (Miller and Raghavendran, 9/13)

Los Angeles Times: Americans' Struggles With Medical Bills Are A Foreign Concept In Other Countries
In France, a visit to the doctor typically costs the equivalent of $1.12. A night in a German hospital costs a patient roughly $11. And in the Netherlands — one of the few wealthy nations other than the U.S. where patients face a deductible — insurers usually must cover all medical care after the first 385 euros, roughly $431. (Levey, 9/12)

The Associated Press: Attorneys General Warn About 'At-Home Rape Kit' Companies
Two companies are under fire for saying they want to sell do-it-yourself rape kits to sexual assault survivors. Attorneys general in several states have sent cease-and-desist letters to the MeToo Kits Company, based in New York City, and the New Jersey-based The Preserve Group, saying the evidence-collection kits are no substitute for a professional forensic exam. (9/12)

The New York Times: How Far Would You Go To Avoid Vaccinating Your Child?
When Jenni Mahnaz started a business consulting parents who wanted to remove their children from the traditional school system seven years ago, there seemed to be little obvious need for what she would deliver. Unlike groovy precincts of the West Coast or Evangelical communities in the South, New York — cynical, status-obsessed, frantically scheduled — is not an obvious place for the expansion of at-home education. Her business, NY Homeschool Help, has grown steadily, but these past several weeks have been something else entirely. (Bellafante, 9/13)

The New York Times: New York City Is Ending A Ban On Gay Conversion Therapy. Here’s Why.
Nearly two years ago, the New York City Council celebrated when it passed a far-reaching ban on conversion therapy, a discredited practice to change a person’s sexual orientation or gender identity. On Thursday, Corey Johnson, the Council speaker, who is gay, said the Council would act swiftly to repeal the ban. (Mays, 9/12)

The Wall Street Journal: New York City Moves To Repeal Ban On Conversion Therapy In Effort To Protect Such Bans Elsewhere
City Council Speaker Corey Johnson introduced legislation to repeal a citywide ban on conversion therapy, in a move designed as a legal tactic to protect such bans elsewhere. New York City faces a lawsuit filed in January by the Alliance Defending Freedom, challenging the constitutionality of the law that was passed in 2017. The religious freedom advocacy group is based in Arizona. Mr. Johnson, who is openly gay, called a repeal of the ban “painful,” but said he is accommodating leading LGBT rights organizations that are worried the lawsuit could undermine efforts to ban conversion therapy in other states. (Blint-Welsh and West, 9/12)

The Associated Press: Woman: Ants Bit Father, Covered The Walls At Georgia VA Home
A Georgia woman says her father was bitten more than 100 times by ants at a government veterans' home where his room was full of insects. Laquna Ross found her father Joel Marrable with swollen, red bumps all over his body when she visited him at the nursing home near Atlanta last week before his death, she told WSB-TV. (9/12)

The Washington Post: Veteran Joel Marrable Died At Atlanta VA Medical Center After Being Bitten 100 Times By Ants, Daughter Laquna Ross Says
Ross claimed that hospital staff told her they thought their patient died when they found him covered in the insects days earlier, according to WSB-TV. Within a day of Ross’s visit — she had just gotten back from a trip, she says — he had. Ross, who says her father served in the Air Force during the Vietnam War, told WSB-TV that Marrable “deserved better” than what he got in his final days at Eagle’s Nest Community Living Center, part of Atlanta VA Medical Center in Decatur, Ga. (Knowles, 9/12)