First Edition: September 22, 2017

California Healthline: A Nail-Biter: California Nervously Awaits U.S. Senate’s Verdict On Obamacare
Congressional Republicans are giving repeal of Obama’s signature health law one more try. They have until the end of the month to garner enough votes to pass the so-called Graham-Cassidy bill, which would fundamentally change how health care is funded nationwide. Its effects would be especially far-reaching in California and other states that bought heavily into the Affordable Care Act. (9/21)

California Healthline: FDA Approves Scope With Disposable Part Aimed At Reducing Superbug Infections
Seeking to prevent superbug outbreaks, federal health officials said they have approved the first gastrointestinal medical scope with a disposable cap for use in the U.S. The Food and Drug Administration said that the design of the new duodenoscope by Japanese device maker Pentax should make it easier to remove dangerous bacteria that can become trapped inside these reusable instruments. (Terhune, 9/22)

The New York Times: Latest Obamacare Repeal Effort Is Most Far-Reaching
For decades, Republicans have dreamed of taking some of the vast sums the federal government spends on health care entitlements and handing the money over to states to use as they saw best. Now, in an 11th-hour effort to repeal the Affordable Care Act, the party has come up with a way to repackage the funding for the law it loathes into a trillion-dollar pot of state grants. The plan is at the core of the bill that Senate Republican leaders have vowed to bring to a vote next week. It was initially seen as a long-shot effort by Senators Lindsey Graham and Bill Cassidy. But for all its ad hoc, last-minute feel, it has evolved into the most far-reaching repeal proposal of all. (Zernike, Abelson and Goodnough, 9/21)

The Wall Street Journal: Q&A: How The Graham-Cassidy Plan Would Change Health Coverage
The Graham-Cassidy bill would lump together the money spent on two ACA programs to expand health coverage: subsidies for private insurance and an expansion of the Medicaid program. That funding would be redistributed as block grants to states that could use it to fashion their own health systems. All of the bill’s health spending would end in 2027 and need to be reauthorized by Congress. The bill also makes structural changes to Medicaid by capping how much federal money states can get. A similar proposal, contained in the Republicans’ last effort to repeal parts of the ACA, would have resulted in 15 million people losing health coverage in a decade, according to the Congressional Budget Office. (Hackman, 9/21)

The Washington Post: How Many With Preexisting Conditions Would Be Priced Out Of Coverage Under Cassidy-Graham?
The easiest way to understand the debate over preexisting conditions in health-care coverage — a debate fueled this week by Jimmy Kimmel’s repeated disparagement of the new Republican plan to overhaul Obamacare — is to look at the Obamacare website. As of writing, Healthcare.gov explains what protections the Affordable Care Act provides to those with conditions that, before the bill’s passage, may have resulted in denial of coverage or sharply increased premiums. (Bump, 9/21)

The New York Times: The G.O.P. Bill Forces States To Build Health Systems From Scratch. That’s Hard.
In 2003, health care policy makers in Massachusetts agreed that the state should build a system to expand coverage to its uninsured residents. It took four years before Romneycare was fully up and running. In between, politicians had to think hard about how they wanted the system to work: how money would be raised and spent, what benefits would be offered, whether and how markets should be used to distribute coverage, whether people who didn’t buy coverage should be penalized. (Sanger-Katz, 9/21)

Politico: Last-Ditch Obamacare Repeal Bill Has ‘Worst Elements’ Of Earlier Plans
The last-ditch Obamacare repeal bill has almost every divisive proposal that doomed previous bills. The big difference: a Sept. 30 deadline to use a rule that allows Senate Republicans to pass a measure with just 50 votes. (Demko, 9/21)

The Washington Post: Federal Estimate Shows Big Win-Loss Gap Among States Under Cassidy-Graham Bill
An internal analysis by the Trump administration concludes that 31 states would lose federal money for health coverage under Senate Republicans’ latest effort to abolish much of the Affordable Care Act, with the politically critical state of Alaska facing a 38 percent cut in 2026. The report, produced by the federal Centers for Medicare and Medicaid Services, focuses on the final year of a block grant that states would receive under the Cassidy-Graham legislation. It shows that government funding for such health insurance would be 9 percent lower overall in 2026 under the plan than under current law. (Goldstein and Eilperin, 9/22)

NPR: Latest Senate Health Bill Would Cut Funds To Blue States
Senate Republicans' latest plan to overhaul the U.S. health care system ends with a massive shift of federal money from states that expanded Medicaid — and are largely dominated by Democrats — to those that refused to expand. Several analyses of the bill show the pattern. (Kodjak, 9/21)

The Hill: Which States Could Win And Lose From The New ObamaCare Repeal Bill
The ObamaCare repeal bill set for a possible vote next week in the Senate would create winners and losers among the 50 states that would be asked to implement their own health-care plans with block grants of federal funding. The bill, sponsored by Republican Sens. Lindsey Graham (S.C.) and Bill Cassidy (La.), ends federal funding for ObamaCare’s Medicaid expansion and the subsidies that help people afford coverage, as well as the law’s insurance mandate. (Hellmann and Weixel, 9/21)

The Hill: GOP ObamaCare Repeal Takes New Step In Nixing Medicaid Expansion
The Senate GOP's last-ditch effort to repeal ObamaCare goes farther than past bids to rein in the law’s Medicaid expansion, barring states from extending the expansion past 2019 even if they use their own money. An earlier GOP repeal bill would have let states keep the program, but that is eliminated under the legislation crafted by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), which could come up for a Senate vote next week. (Sullivan, 9/21)

The Associated Press: GOP Health Bill Offers Provisions Aimed At Helping 2 States
Provisions shoehorned into the Republican health care bill dangle extra money for Alaska and Wisconsin, home states of one GOP senator whose vote party leaders desperately need and another who co-sponsored the legislation, according to analysts who've studied the legislation. (Fram, 9/21)

The Washington Post: Cassidy-Graham Bill Provision Would Exempt Alaska, Montana From A Cap On Medicaid Spending
As GOP leaders continue to drum up support for the health-care proposal written by Republican Sens. Bill Cassidy (La.) and Lindsey O. Graham (S.C.), a provision buried deep in the 140-page bill benefiting Alaska has begun to draw greater scrutiny. Beginning on page 95, the bill has a provision that exempts low-density states whose block grants either decrease or stay flat between 2020 and 2026 from the Medicaid per capita cap. Under that scenario, Alaska and Montana would be exempted from the funding cap that applies to all other states during that period. (Eilperin, 9/21)

The Hill: Graham And Cassidy Go Into Overdrive To Win Murkowski Vote
Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) are going into overdrive to win over Alaska Sen. Lisa Murkowski (R), a pivotal vote for their bill to dismantle ObamaCare and give states more authority over healthcare. The two have seen Murkowski, one of three Republicans to sink the GOP’s last repeal bill, as a critical vote for some time. (Bolton, 9/22)

The Hill: Pence Urges Alaskans To Contact Murkowski, Sullivan For Repeal Bill
Vice President Pence urged Alaska residents on Thursday to contact the state's Sens. Lisa Murkowski and Dan Sullivan, who are among the Republicans undecided on the new ObamaCare repeal plan, and ask them to support the bill. Pence said in an interview with Anchorage radio host Mike Porcaro that "now is the time to reach out to Sen. Dan Sullivan and Sen. Lisa Murkowski and let them know that you'd be grateful if they'd stand with President Trump and they'd vote in favor of Graham-Cassidy when it comes to the Senate floor next week." (Delk, 9/21)

The Hill: Senate Dem: GOP Trying To 'Purchase Votes' For ObamaCare Repeal Bill With Alaska Changes
Sen. Chris Murphy (D-Conn.) on Thursday slammed Republicans for reportedly offering to make changes to their ObamaCare repeal bill that would benefit Alaska to win support from Sen. Lisa Murkowski (R-Alaska). "The outright purchasing of votes. Everyone involved in this moral and intellectual monstrosity should be ashamed of themselves," Murphy tweeted on Thursday. (Manchester, 9/21)

Politico: Trump Publicly Backs Healthcare Effort, Privately Harbors Doubts
In public, President Donald Trump is all-in on the Senate’s final chance to repeal Obamacare. But privately, there’s ambivalence in the White House about the bill’s contents and its chances of clearing the tightly divided chamber next week. Trump spent time between meetings at the United Nations calling senators and other senior White House officials about the Graham-Cassidy bill, asking for updated vote tallies and how to woo senators for the bill. White House officials have considered tweaking the state funding to win a vote from GOP Sen. Lisa Murkowski of Alaska — and others. Trump has also publicly excoriated Kentucky Sen. Rand Paul for voting against the legislation, telling aides he would go after other senators. (Dawsey and Everett, 9/22)

Politico: McConnell Lays It On The Line
He's been battered by President Donald Trump and had his vaunted legislative acumen called into question. Now, Mitch McConnell has a chance to put his cruel summer behind him. Over the next week, the Senate majority leader will try one last time to rescind the Democratic health care law. At the same time, he's put his political reputation on the line in Alabama, where his chosen candidate, incumbent Sen. Luther Strange, faces off against anti-establishment Roy Moore in a special Senate election on Tuesday. (Everett and Bresnahan, 9/21)

The Associated Press: Iowa Sen. Ernst Hopes, But Isn't Sure, Health Bill Has Vote
Republican Sen. Joni Ernst said Thursday she isn't sure her party's last-ditch effort to repeal Barack Obama's health care law has the votes to pass, as she faced tough questions from Iowa constituents about the political drive for the measure. "If it's brought up, I hope we have the votes to pass it," Ernst told reporters after a meeting with constituents in northern Iowa. "I hope there's consensus on the bill." (Beaumont, 9/21)

The Hill: Nevada GOP Gov Rips ObamaCare Repeal Bill: Flexibility It Promises 'A False Choice'
Nevada Gov. Brian Sandoval (R) on Thursday amped up his criticism of the new plan to repeal and replace ObamaCare, saying the GOP bill would “pit Nevadans against each other.” “Flexibility with reduced funding is a false choice,” Sandoval said in a statement to The Nevada Independent. “I will not pit seniors, children, families, the mentally ill, the critically ill, hospitals, care providers, or any other Nevadan against each other because of cuts to Nevada’s healthcare delivery system proposed by the Graham-Cassidy amendment.” (Carter, 9/21)

The Hill: Medicaid Directors Issue Warning On New ObamaCare Repeal Bill
The National Association of Medicaid Directors (NAMD) warned Republicans on Thursday that the Senate's latest ObamaCare repeal bill would place a massive burden on states. The bill, sponsored by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), would eliminate ObamaCare's Medicaid expansion and subsidies beginning in 2020, converting the funding to state block grants. (Hellmann, 9/21)

Los Angeles Times: Ads Target California's GOP House Members On New Healthcare Bill But It's Not Clear Who's Paying For Them
Five of California's House Republicans are being featured in new digital ads urging them to oppose the so-called Graham-Cassidy healthcare bill to roll back Obamacare. But the newly formed group that's running the ads isn't saying where it's getting the money for them. (Mai-Duc, 9/21)

The New York Times: Jimmy Kimmel Accused A Senator Of Lying About His Health Care Bill. Who’s Right?
Jimmy Kimmel, the talk show host who has become the unlikely face of opposition to Senate Republicans’ latest health care push, insisted he had done his homework. Mr. Kimmel spent a second straight night arguing against the proposal on Wednesday. Senator Bill Cassidy of Louisiana, a co-sponsor of the bill, responded by telling news outlets that “Jimmy doesn’t understand.” (Qiu and Victor, 9/21)

The Associated Press Fact Check: Kimmel’s Take On Health Care Harder To Refute
Who’s right — President Donald Trump and Sen. Bill Cassidy, or late-night host Jimmy Kimmel? None has really captured the complexity of the debate over who might lose insurance protections in the latest Republican health care bill. But of the three, the TV guy is the hardest to refute. Trump insists in a tweet that the bill covers pre-existing conditions, a point also made by Cassidy, a sponsor of the legislation. But there’s a catch. It allows states to get a waiver from “Obamacare” requirements that insurers charge the same to people with health problems as they do to healthy people. (Alonso-Zaldivar, 9/22)

The Associated Press: Jimmy Kimmel Transforms Debate, And Shows Comedy's New Role
If the latest Republican attempt to repeal Obamacare doesn't work, it may become known as the Jimmy Kimmel Non-Law. The comic's withering attacks this week have transformed the debate over the bill (sponsored by Sens. Lindsey Graham and Bill Cassidy) and, in the process, illustrated how thoroughly late-night talk shows have changed and become homes for potent points of view. (Bauder, 9/21)

Politico: Kimmel Tells Viewers: ‘We Have Until Sept. 30’ To Stop GOP Health Bill
Jimmy Kimmel on Thursday said it’s not his job to talk about health care — but he’s doing it anyway, until Senate Republicans’ last-ditch bill to repeal Obamacare is stopped. “I should not be the guy you go to for information on health care,” the late-night TV host said on Thursday’s show. “And if these guys … would tell the truth for a change, I wouldn’t have to.” (Diamond, 9/21)

The Hill: Jimmy Kimmel Becomes Thorn In The GOP's Side
Republicans racing against the clock to repeal ObamaCare are fighting against Democrats, angry patient advocates and a who’s-who of health industry groups. Yet one of the most formidable opponents they face is an unlikely wild card: the comedian Jimmy Kimmel. (Lillis, 9/21)

The Hill: CNN To Host Health-Care Debate With ObamaCare Repeal Sponsors
CNN will host a town hall-style debate Monday night where senators will face off over the new ObamaCare repeal bill. The network announced that Sens. Bernie Sanders (I-Vt.) and Amy Klobuchar (D-Minn.), opponents of the bill, will debate its co-sponsors, Sens. Bill Cassidy (R-La.) and Lindsey Graham (R-S.C.). (Concha and Sullivan, 9/21)

Los Angeles Times: The Push For Single-Payer Health Care Just Went National. What Does That Mean For The California Effort?
When Vermont Sen. Bernie Sanders visited Beverly Hills last May, he made a full-throated appeal for California to “lead the country” and pass a pending state proposal to establish single-payer health care. On Friday, he’ll return here for a San Francisco speech trumpeting his own higher-stakes plan — a bill to drastically overhaul the nation’s health-care system by covering everyone through Medicare. (Mason, 9/22)

The Washington Post: How Tom Price Decided Chartered, Private Jets Were A Good Use Of Taxpayer Money
After Tom Price was sworn in as health and human services secretary, the Georgia Republican faced an inconvenience known to millions of Americans: His flight was delayed, an aide said, and he was forced to spend hours at an airport. The delay left Price a no-show at an early public appearance his office helped plan. Price knew well the pain of flying to and from Washington as a member of Congress for 12 years. But now he was the head of a trillion-dollar federal agency and one of President Trump’s point men to fulfill the campaign promise of repealing the Affordable Care Act. Flight delays and no-shows would not do. (Davis, 9/22)

Politico: Price Traveled By Private Plane At Least 24 Times
Health and Human Services Secretary Tom Price has taken at least 24 flights on private charter planes at taxpayers’ expense since early May, according to people with knowledge of his travel plans and a review of HHS documents. The frequency of the trips underscores how private travel has become the norm — rather than the exception — for the Georgia Republican during his tenure atop the federal health agency, which began in February. The cost of the trips identified by POLITICO exceeds $300,000, according to a review of federal contracts and similar trip itineraries. (Pradhan and Diamond, 9/21)

Stat: HHS Hints At Major Changes To Medicare That Could Mean Higher Costs For Patients
The Trump administration is signaling it will pursue significant changes to Medicare that could put beneficiaries on the hook for higher costs. In an informal proposal on Wednesday, federal health officials hinted at several new pilot programs it may implement in the months ahead. One idea would give doctors more latitude to enter into so-called private contracts to charge Medicare beneficiaries more for certain services, if the patients were willing to pay. (Mershon, 9/21)

Stat: Without Congressional Action, Hospital Payments At Risk Of Expiring
Drive around this city long enough, and you’ll see the billboards that have become a staple of the skyline. They read: Atlanta can’t live without Grady. For many here, that’s indeed the case. Grady Memorial Hospital, a safety net hospital with more than 950 beds, is where people go if they come down with the flu or if they suffer a gunshot wound, but can’t afford care anywhere else. (Blau, 9/22)

Stat: To Advance Precision Medicine, NIH Turns To Long-Mistreated Communities
The National Institutes of Health would like six vials of your blood, please.Its scientists would like to take a urine sample, measure your waistline, and have access to your electronic health records and data from the wearable sensor on your wrist. And if you don’t mind sharing, could they have your Social Security number? It is a big ask, the NIH knows, and of an equally big group — the agency eventually hopes to enroll over 1 million participants in the next step of what four researchers referred to in a 2003 paper as “a revolution in biological research.” (Facher, 9/22)

Reuters: Death Toll From Overheated Florida Nursing Home Rises To 10
A 10th elderly patient at a Miami-area nursing home has died after she was exposed to sweltering heat in the aftermath of Hurricane Irma, police said on Thursday. The resident of the Rehabilitation Center at Hollywood Hills died on Wednesday, police in Hollywood, Florida, said in a statement, without giving details. (Simpson, 9/21)

The New York Times: Aaron Hernandez Found To Have Severe C.T.E.
The brain scan came as a surprise even to researchers who for years have been studying the relationship between brain disease and deaths of professional football players. Aaron Hernandez, the former New England Patriots tight end and a convicted murderer, was 27 when he committed suicide in April. Yet a posthumous examination of his brain showed he had such a severe form of the degenerative brain disease C.T.E. that the damage was akin to that of players well into their 60s. (Belson, 9/21)

Los Angeles Times: Disgraced Ex-Patriots Player Aaron Hernandez Found To Have CTE And Early Brain Atrophy
In an announcement Thursday, Boston University’s CTE Center said doctors diagnosed Hernandez with Stage 3 CTE. Stage 4 is the most serious. Both stages, usually found in much older former players, are associated with aggressiveness, impulsivity, depression and memory loss. The effort, led by Dr. Ann McKee, also found he had “early brain atrophy” and “large perforations” on a central membrane in his brain. (Fenno, 9/21)

Los Angeles Times: UC Irvine To Debut Brain Research Center With Advanced MRI Machine
UC Irvine’s Campus Center for Neuroimaging will have a grand opening next month for its new research center that aims to make breakthroughs in human brain research. The centerpiece of the center — dubbed FIBRE, or Facility for Imaging & Brain Research — is a $3-million Siemens Prisma 3T magnetic resonance imaging, or MRI, machine noted for its technology that collects higher-quality images in a shorter time. It came to UCI with help from Siemens and the National Institutes of Health. (Zint, 9/21)

Stat: Zapping The Brain For Stroke Rehab: Pivotal Clinical Trial Begins
Despite being forced by Hurricane Irma to close its outpatient facilities for several days, the Mayo Clinic in Jacksonville, Fla., is expected to forge ahead this month with a pivotal clinical trial testing whether an electrical implant can rewire the brains of stroke patients so they can use their arms and hands again. (Begley, 9/22)

Los Angeles Times: Two Top Candidates For California Governor Have Been Touting Their Healthcare Wins. Here's What They Really Did
Gavin Newsom and Antonio Villaraigosa are depicting themselves as Democratic healthcare visionaries as they campaign to become California’s next governor. To prove his healthcare mettle, Newsom points to Healthy San Francisco, a first-of-its-kind universal system adopted while he reigned as the city’s mayor in 2006. Newsom’s work on the program helped him land an endorsement from the influential California Nurses Association, and a boast or two will surely punctuate his speech at their convention on Friday as hyper-partisan politics intensify over efforts to repeal the Affordable Care Act and implement a national single-payer plan. (Willon, 9/22)

The Hill: Senate Health Committee Schedules Hearing On Opioid Crisis
The Senate Health Committee will hold a hearing on the opioid crisis next month. The committee will focus on the federal response to the crisis and conduct oversight of the Comprehensive Addiction and Recovery Act, a law passed in 2016 that supports efforts to address the issue. (Hellmann, 9/21)

The Associated Press: Opioid Epidemic Laws Lead Panel To Revisit Recovery Schools
A fire led to the eventual end of Phoenix — a groundbreaking Maryland public school program for children with addiction that closed in 2012 — but the state could see institutions like it rise again from the ashes. Recent spikes in the Maryland heroin and opioid epidemic have triggered calls for substantial changes in education systems statewide, and a state work group is weighing the return of recovery schools after a Sept. 7 meeting. (Slater, 9/21)

The New York Times: Air Pollution Tied To Kidney Disease
Add a new potential ill to the list of problems linked to air pollution: kidney disease. Previous studies have linked high levels of the fine particulate matter known as PM 2.5 to cardiovascular disease and stroke. A new analysis, in The Journal of the American Society of Nephrology, followed 2,482,737 veterans for an average of eight and a half years. The Department of Veterans Affairs database includes information on glomerular filtration rate, or G.F.R., a measure of kidney function. (Bakalar, 9/21)

NPR: Pee In The Pool Can Cause Breathing And Eye Irritation
Water parks can be fun, but they also can pose unexpected health risks – in this case, eye and respiratory problems. And that shower you never take before you get in the pool plays a role. In July 2015, patrons at an indoor water park resort in Ohio started to complain about eye and respiratory problems. Local health officials surveyed patrons and water park employees, who reported issues like eye burning, nose irritation, difficulty breathing and vomiting. The Centers for Disease Control and Prevention then stepped in to investigate. (Jochem, 9/21)

The Washington Post: She Chose To Die So She Could Give Birth. Now Her Newborn Is Dead, Too.
The headaches began in March. The couple didn’t think much of them — until Carrie DeKlyen began vomiting. An initial scan showed a mass in her brain. More tests showed that it was a form of cancer, possibly lymphoma, but treatable. But a pathology exam revealed a more grim diagnosis. The 37-year-old mother of five from Wyoming, Mich., had glioblastoma, an aggressive form of brain cancer. If lucky, she could live for five more years. (Phillips and du Lac, 9/21)

inewsource: Diabetes-Related Amputations Increase In California — And San Diego
Clinicians are amputating more toes, legs, ankles and feet of patients with diabetes in California — and San Diego County in particular — in a “shocking” trend that has mystified diabetes experts here and across the country. Though they often prolong lives, diabetes-related amputations deprive patients of independence, increase the need for social services and add to disability and medical costs.Explore the rate of amputations in California.Statewide, lower-limb amputations increased by more than 31 percent from 2010 to 2016 when adjusted for population change. In San Diego County, the increase was more than twice that: 66.4 percent. (Clark, 9/20)

Los Angeles Times: Multiple Cases Of West Nile Virus In Glendale Prompt Education Campaign
With eight cases of West Nile virus reported in Glendale so far this year, health officials took part in a door-to-door education campaign Wednesday, informing residents of what they can do to protect themselves from infection. Conducted by the Greater Los Angeles County Vector Control District, the effort informed residents in Glendale, Los Feliz and Atwater Village about the preventive measures they can take to reduce the risk of being bitten by mosquitoes. Levy Sun, a spokesman for vector control, said wearing insect repellent and dumping out any stagnant water near homes are measures people should take regularly. (Nguyen, 9/21)