First Edition: September 7, 2018

Kaiser Health News: The High Cost Of Hope: When The Parallel Interests Of Pharma And Families Collide
A desperate but determined group of parents raised millions through golf tournaments and cocktail parties to support research for drugs to fight cystinosis, a rare, fatal childhood disease. They were ecstatic when a pill called Procysbi was approved in 2013. The twice-a-day medicine was a breakthrough because it supplanted an existing drug with debilitating side effects that had to be taken every six hours around the clock — a missed dose could permanently damage a child’s kidneys. (Kopp and Hancock, 9/7)

Kaiser Health News: Insulin’s High Cost Leads To Deadly Rationing
Diabetic ketoacidosis is a terrible way to die. It’s what happens when you don’t have enough insulin. Your blood sugar gets so high that your blood becomes highly acidic, your cells dehydrate, and your body stops functioning. Nicole Smith-Holt lost her son to diabetic ketoacidosis, three days before his payday, because he couldn’t afford his insulin. (Sable-Smith, 9/7)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Health Policy Goes To Court
A federal judge in Texas seemed sympathetic to the argument by GOP state officials that the Affordable Care Act soon will no longer be constitutional, since Congress eliminated the penalty for not having insurance. The case was filed by 18 state attorneys general and two governors. (9/6)

California Healthline: California: A Health Care Laboratory With Mixed Results
California’s expansion of Medicaid under the Affordable Care Act enabled many low-income HIV patients to get health insurance previously denied to them. Still, those with mental health needs, who had been receiving coordinated care through a separate federal program, suddenly faced gaps in treatment, payment disputes and doctors who had little understanding of life with HIV. A report on HIV patients is one example in a special California edition of the journal Health Affairs showing that though the state is often a national beacon in health care, some of its innovations fall short of expectations. (Gorman, 9/5)

The New York Times: Newly Revealed Emails Raise Fresh Objections To Kavanaugh Confirmation
The disclosure on Thursday of dozens of previously secret emails involving Judge Brett M. Kavanaugh provoked pointed new questions on the third day of his Supreme Court confirmation hearings, as Democrats pressed him to explain fresh disclosures on abortion rights, affirmative action and previous testimony to the Senate. Much of the tumult surrounded one quotation from an email that Judge Kavanaugh wrote as a lawyer in George W. Bush’s White House concerning the landmark abortion decision Roe v. Wade: “I am not sure that all legal scholars refer to Roe as the settled law of the land at the Supreme Court level since Court can always overrule its precedent, and three current Justices on the Court would do so.” (Savage and Stolberg, 9/6)

The Wall Street Journal: Kavanaugh Weathers Raucous Hearing
The nominee told senators at the hearing that in the email he was evaluating how the Supreme Court might view a particular issue, not providing his own viewpoint on Roe. Judge Kavanaugh established a strongly conservative record on the D.C. Circuit Court. If he is confirmed to replace the retiring Justice Anthony Kennedy, it is expected by Republicans and Democrats alike to shift the Supreme Court’s jurisprudence sharply to the right. (Bravin and Tau, 9/7)

Politico: Kavanaugh Faces New Scrutiny Over Abortion After Leaked Email
But his 2003 email pointed out what he hasn’t acknowledged in testimony on Roe — that the Supreme Court could reverse precedent. “To be very clear, Judge Kavanaugh personally highlighted that precedent can be overturned,” Sen. Patty Murray (D-Wash.), the ranking member of the health committee, said in a press conference Thursday. “And he was literally counting the number of judges who stand ready to overturn Roe v. Wade.” (Cancryn and Roubein, 9/6)

Politico: Partisan Brawl Erupts After Booker Releases Kavanaugh Docs
Democrats have fumed for weeks over the withholding of hundreds of thousands of pages of documents from Kavanaugh’s years in the George W. Bush White House, including a massive tranche of records that lawyers working for Bush had limited only to Judiciary Committee senators. That secrecy collapsed in dramatic fashion Thursday as Democratic senators vowed to begin releasing records they said were unfairly withheld and highly relevant to the confirmation. (Schor, 9/6)

The New York Times: Here’s What Happened On Day 3 Of The Kavanaugh Confirmation Hearing
Judge Kavanaugh’s abortion views created a stir outside the hearing room. Adding to the concerns of abortion rights advocates was a Kavanaugh reference to contraceptives as “abortion-inducing drugs.” He was answering a question from Senator Ted Cruz, Republican of Texas, about his dissent in a case involving Priests for Life, a religious organization that objected to a regulation under the Affordable Care Act requiring many employers to provide free insurance coverage for contraception to their female workers. The group had objected to an accommodation offered by the Obama administration that allowed it to obtain a waiver by completing a form. (Stolberg, Savage and Liptak, 9/6)

Politico: Murkowski, Collins Face New Abortion Pressure On Kavanaugh
A newly released email by Brett Kavanaugh, weighing in on the future of abortion rights, is putting new pressure on two moderate Republicans who hold the keys to his confirmation. But Lisa Murkowski of Alaska and Susan Collins of Maine aren’t raising concerns yet. (Everett, 9/6)

The Washington Post: Trump And Questions Of Presidential Power Dominate Third Day Of Kavanaugh Hearings
Members of the Senate Judiciary Committee, including some Republicans, pressed Kavanaugh about the judge’s expansive views of presidential power and past writings that concluded civil suits and criminal investigations of presidents would be better delayed until the chief executive left office. Democratic senators said it was crucial to have an independent Supreme Court in what Sen. Richard J. Durbin (D-Ill.) called “the age of Trump.” (Barnes, Kim, Marimow and Berman, 9/6)

Los Angeles Times: New Documents Released About Kavanaugh, But Trump's High Court Pick Is On Track For Confirmation
With Republicans in control of the Senate, Kavanaugh now appears on track to be confirmed by the end of the month. “You’re gonna get confirmed,” Sen. Lindsey Graham (R-S.C.) told him. “You’re gonna make it.” (Haberkorn, Savage and Wire, 9/6)

The New York Times: The Future Of Abortion Under A New Supreme Court? Look To Arkansas
When a patient arrived this spring at the only abortion clinic in western Arkansas, the doctor had startling news: A new state law had gone into effect, and clinics could no longer perform abortions via medication in the state. “Wait — all of Arkansas?” the patient asked her doctor, Stephanie Ho. “Yes,” Dr. Ho remembered replying. (Tavernise, 9/7)

The New York Times: Democrats Grilling Kavanaugh Have Their Eyes On 2020
The questioning of Judge Brett M. Kavanaugh had not even begun Thursday morning when Senator Cory Booker, Democrat of New Jersey, threatened to release secret emails — even if it meant being expelled from the Senate. “This is about the closest I’ll ever come in my life to an ‘I am Spartacus’ moment,” the senator declared with a flourish. (Stolberg, 9/6)

The Washington Post: Potential 2020 Candidates Use Kavanaugh Hearings To Show Resistance To Trump
Sen. Cory Booker (N.J.) on Thursday portrayed himself as a rebel willing to face expulsion from the Senate for releasing confidential documents from Kavanaugh, describing it as his “I am Spartacus” moment. In reality, the documents had already been cleared for release. Sen. Kamala D. Harris (Calif.) hinted that she might have hard evidence that Kavanaugh spoke about the special counsel investigation with someone at the law firm founded by Trump’s personal attorney. But she offered no such details when pressed. Booker and Harris, two of the Democratic Party’s most prominent African Americans, took the headline-grabbing but shaky steps to put their opposition to Trump and Kavanaugh on full display for the country. (Sullivan, 9/6)

The Associated Press: Data Show Big Let-Up In 'Obamacare' Premiums
Millions of people covered under the Affordable Care Act will see only modest premium increases next year, and some will get a price cut. That's the conclusion from an exclusive analysis of the besieged but resilient program, which still sparks deep divisions heading into this year's midterm elections. (Hoyer and Alonso-Zaldivar, 9/7)

The New York Times: Trump Administration Moves To Sidestep Restrictions On Detaining Migrant Children
The Trump administration moved on Thursday to remove court-imposed time limits on the detention of migrant children, proposing to end 20 years of judicial oversight and allow families to be held indefinitely in secure facilities as their cases wend through the immigration courts. The proposed new regulation reflects President Trump’s frustration that thousands of families from Central America and elsewhere are continuing to stream across the southwest border, assured in part by guarantees in the current legal process that migrants who arrive with children will not be held for long periods in detention. (Dickerson, 9/6)

The Wall Street Journal: Trump Administration Wants To Detain Migrant Children Longer
Department of Homeland Security and Health and Human Services officials said Thursday that they want to circumvent the so-called Flores agreement, a 1997 court settlement that prevents authorities from detaining children for more than 20 days. The proposal, announced as a rule change in the Federal Register, signals that officials are looking for ways to detain families together until their immigration cases are decided amid the administration’s efforts to crack down on illegal border-crossers. The proposal is almost certain to face legal challenges. The administration earlier this year asked a federal judge in California to let officials detain families together beyond the 20-day limit and was denied. (Caldwell and Gurman, 9/6)

Politico: Trump Family Detention Plan Challenges Court Settlement
"Legal loopholes significantly hinder the Department’s ability to appropriately detain and promptly remove family units that have no legal basis to remain in the country," Homeland Security Secretary Kirstjen Nielsen said in a written statement. "This rule addresses one of the primary pull factors for illegal immigration and allows the federal government to enforce immigration laws as passed by Congress." (Hesson, 9/6)

The Associated Press: Group: Reports Of Sex Abuse At Kids' Shelters Need Inquiry
A group formed in the wake of outrage over the separation of immigrant families at the Mexico border criticized an investigation by the state of Arizona into reports that some of those children were sexually abused at shelters. The group Uncage and Reunite Families, composed of elected officials, community activists and religious leaders called on Gov. Doug Ducey to launch an independent investigation after the one conducted by the state health services department only found issues with personnel records and delayed background checks. (Galvan, 9/6)

The Associated Press: Suit Seeks Payout For Immigrant Families Separated At Border
President Donald Trump's administration should be held accountable for emotional trauma inflicted on children who were separated from their parents at the U.S. border, lawyers say in a lawsuit that could result in compensation for more than 2,000 immigrant families. The federal class-action lawsuit filed late Wednesday seeks unspecified monetary damages and the creation of a fund to pay for mental health treatment for children who were taken away from their parents after the Republican administration adopted a policy requiring anyone who crossed the border illegally to be prosecuted. (Richer, 9/6)

Stat: FDA Official: Trump Restrictions On Hiring Foreign Scientists Hurts Recruitment
The Trump administration’s restrictions on hiring foreign scientists are making it more difficult for the agency to attract top scientific talent, a top Food and Drug Administration official said Thursday. “[The policy] definitely has created an additional challenge, I think, for us,” said Melanie Keller, the FDA’s acting associate commissioner for scientific and clinical recruitment. She added that “the U.S. just doesn’t graduate the number that we need to fill our vacancies.” (Swetlitz, 9/6)

The New York Times: The E.P.A.’s Review Of Mercury Rules Could Remake Its Methods For Valuing Human Life And Health
When writing environmental rules, one of the most important calculations involves weighing the financial costs against any gains in human life and health. The formulas are complex, but the bottom line is that reducing the emphasis on health makes it tougher to justify a rule. Last week the Trump administration took a crucial step toward de-emphasizing the life and health benefits in this calculus when the Environmental Protection Agency said it would rethink a major regulation that restricts mercury emissions by coal-burning power plants. (Davenport and Friedman, 9/7)

The Associated Press: Congress Wants EPA To More Quickly Regulate Unsafe Chemicals
Republican and Democratic lawmakers pressed the Environmental Protection Agency on Thursday to act faster to bring more of the country's most hazardous industrial chemicals and substances under tighter regulation, saying agency action on the health risks was "bogged down." The hearing by a House environment subcommittee focused on one of the biggest rapidly emerging health threats to public water systems, a family of widely used industrial coatings now linked to some cancers and to development problems in children, among other health risks. (9/6)

The New York Times: DeVos Punts To Congress On Federally Funded Guns For Schools
Education Secretary Betsy DeVos has left it to Congress to decide whether states can use federal funds to purchase firearms for their schools, prompting congressional Democrats to begin a last-ditch effort to restrict those funds. Conservatives said Ms. DeVos’s stance was consistent with her championing of local school control. But Democrats and advocates denounced her decision as a tacit endorsement of federally funded firearms in schools, and federal policy experts saw the move as an abdication of the department’s core function to help districts navigate the federal bureaucracy. (Green, 9/6)

The Washington Post: Scientists And Doctors Zap Theory That Microwave Weapon Injured Cuba Diplomats
A series of attacks with a microwave weapon is the latest theory for what could have sickened or distressed roughly two dozen people associated with the U.S. Embassy in Cuba over the past two years. This hypothesis, advanced in recent days in several news reports, dominated a House Foreign Affairs subcommittee hearing on Cuba policy Thursday afternoon. But a panel of State Department officials said there is still no explanation for the reported injuries. (Kaplan and Achenbach, 9/6)

The Hill: Trump Health Chief Meets With GOP Lawmakers On Lowering Drug Prices 
Secretary of Health and Human Services Alex Azar on Thursday met with Republican lawmakers on the House Ways and Means Committee to discuss ways to lower drug prices. President Trump has railed against drug prices and his administration has rolled out a series of actions seeking to lower prices, though many say the moves have been relatively modest. (Sullivan, 9/6)

The Wall Street Journal: Walgreens To Offer Allergy Treatment Auvi-Q As EpiPen Shortage Persists
Walgreens Boots Alliance Inc. is set to be the first retail pharmacy to offer EpiPen alternative Auvi-Q as the country faces a shortage of the potentially life-saving devices. Auvi-Q, an epinephrine auto-injector from privately held Kaléo, had been primarily available through its direct delivery. (Barba, 9/6)

Bloomberg: Generic-Drug Venture Backed By Hospitals Taps CEO From Amgen 
A drugmaking venture backed by major U.S. hospitals has picked a chief executive officer, hastening the arrival of another threat to generic pharmaceutical manufacturers. Martin VanTrieste, 58 and a former top executive at biotechnology giant Amgen Inc., will run the organization, a not-for-profit called Civica Rx. Dan Liljenquist, 44 and an Intermountain Healthcare executive, will be chairman. Health systems with a total of about 500 hospitals -- including Intermountain, HCA Healthcare Inc., Mayo Clinic and Catholic Health Initiatives -- will help govern the venture, alongside several philanthropies. (Tracer, 9/6)

Reuters: Passengers Fall Ill On Two Flights From Europe To Philadelphia
Passengers and crew on two flights arriving in Philadelphia from Europe on Thursday were screened by medical teams after 12 people aboard became ill with flu-like symptoms, a day after a similar outbreak on a flight from Dubai to New York. All 250 people on separate American Airlines flights from Munich and Paris were "held for a medical review" as a precaution, and the U.S. Centers for Disease Control and Prevention (CDC) was notified, Philadelphia International Airport spokeswoman Diane Gerace said. (Whitcomb, 9/6)

The New York Times: Passengers On Emirates Flight From Dubai Had Flu And Common Cold
The sick passengers on the Emirates airline flight that landed at Kennedy International Airport in New York on Wednesday were most likely suffering from the flu and common cold, a spokesman for the Centers for Disease Control and Prevention said Thursday. (Pager, 9/6)

Stat: How A 'Hidden Safety Net' Was Rolled Out In Response To Quarantined JFK Plane
In the confusing first hour or two after an Emirates Airline jet was quarantined at New York’s JFK Airport on Wednesday, there was little certainty over how many people were sick or what was ailing them. But one thing was clear: A system years in the making to spot and halt importation of dangerous illnesses to the United States was set into motion. The system, involving federal, state, and local agencies across the U.S. at major ports of entry, is the country’s “hidden safety net,” Dr. Martin Cetron, director of the Centers for Disease Control and Prevention’s division of global migration and quarantine, told STAT. (Branswell, 9/7)

The Hill: Senate To Vote Next Week On Opioid Package
The Senate will vote next week on a package of bills aimed at curbing the nation's opioid epidemic, Majority Leader Mitch McConnell (R-Ky.) announced Thursday. McConnell's spokesman said that Democrats had dropped their holds on the legislation. Some Democrats had previously objected to a provision, calling it an earmark for a PhRMA-funded advocacy group. (Hellmann, 9/6)

Politico: Senate Set To Vote On Opioid Response Package Next Week
The agreement comes after weeks of slowed negotiations between lawmakers over hot-button provisions like requiring Medicaid to cover treatment at more inpatient facilities and loosening privacy restrictions for substance-abuse patients' medical records. Neither provision made it into the final deal, but they are part of an opioid response package passed by the House earlier this year. (Ehley and Tahir, 9/6)

The Associated Press: Maryland Charges Opioid Maker With Major Misconduct
Maryland authorities announced charges Thursday against an Arizona-based drugmaker that they say engaged in a nationwide scheme "characterized by extraordinary misconduct" to boost profits amid the coast-to-coast opioid epidemic. The office of Attorney General Brian Frosh filed charges against Insys Therapeutics alleging multiple violations of the state's consumer protection law. The pharmaceutical company makes a highly addictive opioid spray used to manage uncontrollable pain for adult cancer patients, but Frosh says Insys joined with local health care providers in a "calculated scheme" to target non-cancer patients, including those seeking relief from knee or back pain. (9/6)

Stateline: Take Two Carrots And Call Me In The Morning
Half a century after Americans began fighting hunger with monthly food stamps, the nation’s physicians and policymakers are focusing more than ever on what’s on each person’s plate. In the 21st century, food is seen as medicine — and a tool to cut health care costs. The “food is medicine” concept is simple: If chronically ill people eat a nutritious diet, they’ll need fewer medications, emergency room visits and hospital readmissions. (Mercer, 9/7)

The Associated Press: New Sugar Label Rules About Maple Syrup, Honey Coming Soon
The U.S. Food and Drug Administration says new guidance about added sugars that will provide an alternate labeling option for pure maple syrup and honey will be released next year. The agency announced months ago that it was considering requiring pure maple syrup and honey to be labeled as containing “added sugars.” Members of the industries that produce those products protested the labels, saying they would be misleading and unfair. (9/6)

Stat: After Cancer Spreads, A Single Drug Should Target All Tumors, Study Suggests 
Scientists reported on Thursday that, in any one patient, untreated metastases are driven by the same genetic mutations, whether they’re in the lung or liver or anywhere else. That conclusion, based on the most extensive analysis to date of metastatic tumors, bodes well for targeted therapies, because it means a single drug should work against all of a patient’s metastases — and it is the metastases, not the primary tumor, that are responsible for 90 percent of cancer deaths. (Begley, 9/6)

The New York Times: Kids, Get Your Flu Shot
The American Academy of Pediatrics is recommending that everyone older than 6 months get a flu shot for the 2018-19 season as soon as it is available, preferably before the end of October. The policy statement, published in the October issue of Pediatrics, states that the inactivated influenza vaccine, which is given as a shot, is best. Children with egg allergy, even severe allergy, can take the shot safely. (Bakalar, 9/6)

Stat: A Stimulant Is Banned In Sports But Found In Supplements. A Doctor Asks Why 
[Dr. Pieter] Cohen’s latest target is the stimulant higenamine, an ingredient listed on the labels of weight loss and sports supplements. Working with a public health team from the Netherlands and an international testing lab, the Harvard Medical School associate professor studied 24 products containing higenamine. The amount on the label was never the same as the amount found in the bottle, the team found in a study published Thursday, and the serving sizes also varied, from trace amounts to 110 milligrams per day. (Cooney, 9/6)

NPR: The Power Of Expectations
Do you think that the private thoughts in your head could influence how other people — or creatures — act? The answer is "Of course not," right? Because to say yes would be to admit you believe in mind control or telekinesis or some other phenomenon usually reserved for superhero comic books. But early in his career, a research psychologist named Bob Rosenthal wasn't so sure. So to test his hypothesis, he designed a devious experiment. (Simstrom, 9/7)

The Washington Post: Scooter Use Is Rising In Major Cities. So Are Trips To The Emergency Room.
They have been pouring into emergency rooms around the nation all summer, their bodies bearing a blend of injuries that doctors normally associate with victims of car wrecks — broken noses, wrists and shoulders, facial lacerations and fractures, as well as the kind of blunt head trauma that can leave brains permanently damaged. When doctors began asking patients to explain their injuries, many were surprised to learn that the surge of broken body parts stemmed from the latest urban transportation trend: shared electric scooters. (Holley, 9/6)

The Washington Post: Black Hairy Tongue: This Missouri Woman's Tongue Turned Black And Hairy, Study Says
Do not panic, but there is a medical condition in which a person's tongue can take on a dark, woolly appearance — and it is appropriately called “black hairy tongue." Doctors in Missouri diagnosed a 55-year-old woman with the condition last year after she reported feeling nauseated and having a foul taste in her mouth — and a black, hairy-looking tongue, according to a study published Thursday in the New England Journal of Medicine. (Bever, 9/6)

The Wall Street Journal: A Year After Hurricane Irma, Most Florida Nursing Homes Still Working On Emergency Power Plans
Most nursing homes in Florida are still working to meet new backup-power rules, which were triggered by a dozen patient deaths after Hurricane Irma knocked out air conditioning at their residence a year ago. About 75% of Florida’s 684 nursing homes received a seven-month extension beyond a June 1 deadline to put in place a permanent emergency-power plan, according to state data. All of the nursing homes are still considered compliant because extensions require them to keep temperatures at or below 81 degrees for at least 96 hours after a power loss through temporary measures. (Kamp, 9/7)

The Associated Press: Audit Finds Many Michigan Child Protection Agency Failures
A child welfare investigator in Michigan found evidence a male caretaker had sexually abused a child, and the child's mother continued to allow the man — her live-in boyfriend — access to her children during the investigation. State auditors say the investigator didn't refer the case to a prosecutor or file a court petition, assessed far too low of a risk of future harm to the child and closed the investigation with no monitoring of the family afterward. (9/6)

The Associated Press: Texas Player Treated At Hospital After Heat Illness
Texas sophomore offensive lineman Patrick Hudson was treated in intensive care and remains hospitalized because of a heat-related illness at practice this week, the school said Thursday night. Hudson, who is 6-foot-4, 335 pounds, was being treated for "exertional heat cramps" Wednesday when medical staff noticed his body temperature rising and he was placed in a cold tub, Texas head athletic trainer Anthony Pass said in a statement. (9/6)

Los Angeles Times: State Says Disney Failed To Properly Clean Cooling Towers Linked To Legionnaires' Outbreak; Disney Disputes Claims
In what became one of the nation’s biggest Legionnaires’ disease outbreaks, 22 people fell sick with the dangerous lung infection last fall in Orange County, including one who died. Local health officials said the outbreak seemed connected to Disneyland, as 19 of the 22 people who were infected had visited the park. But they never pinpointed a cause of the infections. The California Occupational Safety and Health Administration in March cited the park and fined it more than $33,000 for failing to properly clean cooling equipment linked to the outbreak and for other related violations. Cal-OSHA didn't announce the fine. The Times requested and recently obtained the citation. (Karlamangla, 9/6)

The Associated Press: Doctor Disciplined For Looking Up Vegas Shooter Drug Records
A doctor was disciplined by Nevada state pharmacy regulators after they found he improperly accessed prescription records of the dead gunman in last October's mass shooting in Las Vegas, his lawyer said Thursday. Dr. Ivan Goldsmith could have lost of his ability to prescribe medications, but attorney E. Brent Bryson said he was instead ordered to pay a $10,000 fine; $16,000 in attorney fees and costs, and serve one year of probation. (9/6)