KHN First Edition: May 31, 2018

Kaiser Health News: Another Cause Of Doctor Burnout: Being Forced To Give Immigrants Unequal Care
There are an estimated 6,500 undocumented immigrants in the U.S. with end-stage kidney disease. Many of them can’t afford private insurance and are barred from Medicare or Medicaid. Treatment of these patients varies widely from state to state, and in many places the only way they can get dialysis is in the emergency room. [Dr. Lilia] Cervantes and her colleagues interviewed 50 health care providers in Denver and Houston and identified common concerns among them. The researchers found that providing undocumented patients with suboptimal care because of their immigration status contributes to professional burnout and moral distress. (Harper, 5/31)

The Washington Post: Virginia Lawmakers Expand Medicaid To 400,000, After Years Of GOP Resistance
The Virginia legislature voted Wednesday to make government health insurance available to 400,000 low-income residents, overcoming five years of GOP resistance. The decision marks a leftward shift in the legislature and an enormous win for Gov. Ralph Northam (D), the pediatrician who ran on expanding access to health care. (Vozzella and Schneider, 5/30)

The Associated Press: Gridlock Over: Virginia Lawmakers Approve Medicaid Expansion
White House officials, including budget director Mick Mulvaney, urged Virginia lawmakers this year not to expand Medicaid. ... But Virginia GOP Speaker Kick Cox said the Trump administration’s openness to conservative reforms, including work requirements, “was probably the biggest key” in getting Republican support for Medicaid expansion this year. And a failure by the GOP-led Congress to repeal and replace the health law helped spur several Republican state legislators to flip positions. (Suderman, 5/31)

The New York Times: After Years Of Trying, Virginia Finally Will Expand Medicaid
The House passed the Senate bill within hours; it will now go to Mr. Northam’s desk. The measure includes a requirement that many adult recipients who don’t have a disability either work or volunteer as a condition of receiving Medicaid — a provision that was crucial to getting enough Republicans on board. (Goodnough, 5/31)

Politico: Virginia Poised To Expand Medicaid
[Gov.] Northam was able to make inroads with statehouse Republicans — who had long rebuffed his Democratic predecessor Terry McAuliffe‘s expansion efforts — after the GOP suffered major electoral losses in November that nearly flipped control of one legislative chamber to Democrats. (Pradhan, 5/30)

Los Angeles Times: Despite GOP Effort To Kill Obamacare, Virginia Becomes 33nd State To Expand Medicaid Under The Law
The breakthrough — made possible by a coalition of Democrats and a handful of Republicans in the statehouse — continues the expansion of the government safety net made possible by the 2010 healthcare law, often called Obamacare. Virginia’s move also serves as something of a retort to President Trump and his Republican allies in Congress, who have called for sweeping cuts in federal aid to states for Medicaid. (Levey, 5/30)

Politico: New Jersey Becomes Second State To Adopt Individual Health Insurance Mandate
Gov. Phil Murphy on Wednesday signed into law a bill that will require all New Jersey residents to have health coverage or pay a penalty, making the state the second in the country to adopt an individual health insurance mandate. Democratic lawmakers drafted the bill in response to Congress’ decision to repeal the federal mandate established under the Affordable Care Act. The repeal, the New Jersey lawmakers feared, would drive healthier people out of the state’s Obamacare market and cause premiums to spike. (Jennings, 5/31)

Reuters: Trump Says Drug Companies To Announce 'Massive' Price Cuts Soon
President Donald Trump on Wednesday said he expects major drug companies to slash prices on their products in two weeks, but did not provide details on which companies would do so or how such reductions would be made. Health care lobbyists in Washington said they were caught by surprise and had no idea what Trump was talking about. (Abutaleb and Holland, 5/30)

Politico: Trump’s Drug Price Comments Appear To Catch Industry Off Guard
A White House spokesperson declined to provide details. Press secretary Sarah Huckabee Sanders at her daily briefing said, “We do expect some specific policy pieces to come out on that soon,” but wouldn't elaborate. The Pharmaceutical Research and Manufacturers of America, the trade group for brand-name drug manufacturers, did not immediately respond to requests for comment. Trump this month issued a 44-page plan to lower drug prices that included steps like requiring drugmakers to list prices in their advertisements, as well as government-funded pilot programs exploring new ways to hold the cost of medicines. (Ehley, 5/30)

The Associated Press: Trump Signs Bill For Terminal Patients To Try Unproven Drugs
President Donald Trump signed legislation Wednesday aimed at helping people with deadly diseases try experimental treatments, calling it a “fundamental freedom” that will offer hope and save lives. Joined by families dealing with amyotrophic lateral sclerosis, also called Lou Gehrig’s disease, and other diseases, Trump signed the so-called Right to Try bill and said he never understood why the issue had lagged for years and Congress hadn’t acted sooner. (Thomas, 5/30)

The New York Times: Fact Check Of The Day: Trump Oversells New ‘Right To Try’ Law
President Trump claimed that a new law allowing access to experimental drugs would save “hundreds of thousands” of lives. But there is already a federal program in place, and similar state laws have had a minimal effect. (Qiu, 5/30)

Los Angeles Times: Trump's New Insurance Rules Are Panned By Nearly Every Healthcare Group That Submitted Formal Comments
More than 95% of healthcare groups that have commented on President Trump’s effort to weaken Obama-era health insurance rules criticized or outright opposed the proposals, according to a Times review of thousands of official comment letters filed with federal agencies. The extraordinary one-sided outpouring came from more than 300 patient and consumer advocates, physician and nurse organizations and trade groups representing hospitals, clinics and health insurers across the country, the review found. (Levey, 5/30)

The Associated Press: Trump Remaking Federal Policy On Women's Reproductive Health
Step by methodical step, the Trump administration is remaking government policy on reproductive health — moving to limit access to birth control and abortion and bolstering abstinence-only sex education. Social and religious conservatives praise the administration for promoting “a culture of life.” But women’s-rights activists and some medical experts view the multi-pronged changes as a dangerous ideological shift that could increase unintended pregnancies and abortions. (Alonso-Zaldivar and Crary, 5/30)

The New York Times: Cancer Group Calls For Colorectal Cancer Screening Starting At Age 45
A prominent cancer organization is for the first time recommending Americans initiate colorectal cancer screening at age 45 instead of waiting until age 50, a threshold long endorsed by many other medical groups. The new guidelines, from the American Cancer Society, would extend routine colorectal cancer screening to an additional 22 million American adults between the ages of 45 and 49 and send a clear message that colorectal cancer, which has been rising in young adults, is no longer just a disease of older people. (Rabin, 5/30)

The Washington Post: Colorectal Cancer Screening Should Start At Age 45, Not 50, American Cancer Society Says
The American Cancer Society, responding to a rise in colorectal cancer rates among younger people, is now recommending that adults undergo screening for the disease beginning at age 45 rather than 50. The organization, which announced the change in its guidelines Wednesday, said extensive analysis showed that lowering the starting age for screening would save lives. The recommendations apply to adults who are at average risk of the disease; this includes most people in the United States. (McGinley, 5/30)

NPR: Colorectal Cancer Screening Should Start Earlier, American Cancer Society Says
Colorectal cancer is the second-leading cause of cancer death in the United States, most frequently diagnosed among adults over 65. To catch those typically slow-growing malignancies early, when they can often be cured, most doctors' groups recommend colorectal cancer screening starting at age 50. But the American Cancer Society this week changed its advice and is recommending that screening start five years earlier. (Neighmond, 5/30)

The Associated Press: Cancer Group Says Colon Screening Should Start At 45, Not 50
The guidelines are for men and women ages 45 to 75 of average risk for colon cancer; recommendations are different for people with certain conditions, like Crohn’s disease, or a family history of colon cancer. The group endorses six kinds of screening exams, from inexpensive take-home stool tests performed every year to colonoscopies done every 10. “All of these tests are good tests, and the choice should be offered to patients,” said the cancer society’s Dr. Rich Wender. “The best test is the test that gets done.” (Stobbe, 5/30)

The Washington Post: This Mock Pandemic Killed 150 Million People. Next Time It Might Not Be A Drill.
The fictional outbreak kept getting worse. It had a 10 percent fatality rate, about the same as the SARS virus that traveled around the world in 2002-2003. Because the virus in the drill was new, no one had previous immunity to it, and it spread quickly in large cities. As it killed more than 100 million people globally, health-care systems collapsed, panic spread, the U.S. stock market crashed, and the president, members of Congress and the Supreme Court were incapacitated. “We didn’t want to have a Disney ending,” Inglesby said. “We wanted to have a plausible scenario. We did know it would be jarring.” (Sun, 5/30)

The New York Times: U.S. Struggles To Stop Smuggling Of Mail-Order Opioids
Federal agents are struggling to stop opioid smugglers who are reaping vast profits, according to interviews and documents, as the number of Americans dying from drug overdoses continues to rise. Officials at the Department of Homeland Security say the drugs are shipped in such minute amounts that detecting them among cargo in a tractor-trailer is close to impossible. That the drugs increasingly are bought online and shipped directly to buyers — either through the Postal Service or commercial couriers like FedEx and UPS — makes inspections all the more difficult. (Nixon, 5/30)

The Associated Press: AP FACT CHECK: Trump Overstates Progress On Opioids
President Donald Trump is overstating progress against the opioid epidemic, claiming “the numbers are way down” despite an increase of opioid-related deaths and overdoses in his first year in office. A look at his comments during a political rally in Nashville on Tuesday night. (Woodward, 5/31)

Boston Globe: Tearful Dad Testifies In Favor Of Bill To Notify Families When Drug-Addicted Patients Are Released
On Wednesday, Thomas Berry, 52, of Pembroke fought back tears at the State House while testifying in favor of a bill that would require health providers to notify families of patients released early from their court-mandated treatment under the state’s Section 35 law. ...Had he known his son was on the street, Berry said, he would have brought him to a facility in Falmouth to continue his treatment, which had been the original plan. (Andersen, 5/30)

Reveal: Inside A Rehab Empire
The collision of the opioid epidemic with criminal justice reform has created a boom for the rehab industry. ... But the less fortunate have become easy prey for rehabs with a tantalizing promise: freedom from addiction for free. (Harris and Walter, 5/31)

The Associated Press: Minnesota Sues Arizona-Based Opioid Manufacturer
Minnesota’s attorney general is suing an Arizona-based pharmaceutical company, alleging it illegally marketed a painkiller made from the synthetic opioid fentanyl. The lawsuit was filed Wednesday against Insys Therapeutics. The suit accuses the drugmaker of encouraging physicians to prescribe the painkiller Subsys at higher doses than recommended. (5/30)

California Healthline: In Health Care Arena, The Prize For Calif. Insurance Commissioner Is A Bullhorn
The person who wins the four-way race to become California’s next insurance commissioner will inherit a job with broad authority over policies that cover homes, businesses, cars and even airplanes. But medical insurance? Not so much. The commissioner’s direct control over health insurers is limited, because the California Department of Insurance — headed by the commissioner — regulates only a small slice of the market.Still, the job carries the power of the bully pulpit, amplifying the commissioner’s voice on matters of regional, statewide and national importance. (Bartolone, 5/30)

The Associated Press: Judge Blocked California Law On Life-Ending Drugs. Now What?
A judge has thrown out a 2016 California law allowing terminally ill people to end their lives after finding that the Legislature unconstitutionally approved it during a special session. State Attorney General Xavier Becerra asked an appeals court to block and reverse last week’s decision by Riverside County Superior Court Judge Daniel Ottolia. The court denied the request to immediately block the ruling. But experts say Becerra has other legal options and could ask the state Supreme Court to weigh in to try to restore the law. (Taxin, 5/30)

The Hill: Louisiana's Dem Governor Signs Nation's Most Restrictive Abortion Ban 
Louisiana's Democratic Gov. John Bel Edwards on Wednesday signed a bill that would ban abortions after 15 weeks. The law will only take effect if a similar law in Mississippi is upheld by a federal court in its ongoing legal battle, according to The Associated Press. (Hellmann, 5/30)

The Washington Post: CHIP, CHIMPs And Trump’s Budget-Rescission Request: A Guide To The Debate
As we often remind readers, the most complicated issues are the most susceptible to manipulation by politicians. If the subject is complex, it’s easier to mislead. So here’s a guide to the rescission debate, which revolves around acronyms like CHIP and CHIMPs. (Kessler, 5/31)

USA Today: Ambien-Maker To Roseanne: Racism Is Not A Side Effect Of Our Drug
Sanofi, who makes Ambien, tweeted a response Wednesday morning: "While all pharmaceutical treatments have side effects, racism is not a known side effect of any Sanofi medication." Dr. Rachel Salas, associate professor of Neurology in the Sleep Medicine Division at Johns Hopkins Medicine, said “people could text or tweet while on Ambien and not remember.” She advises people to avoid sleeping near their phone or electronics while taking sleep medication. (May, 5/30)

The Associated Press: Science Says: Ambien's Odd Side Effects Don't Include Racism
Ambien and similar sleep aids are well-known for sometimes causing some weird behavioral side effects, but changing one’s political or cultural views is not one of them. ... But people also have reported making phone calls, eating meals, having sex and doing other things that they don’t remember after taking so-called “sedative-hypnotic” medications. People charged with crimes occasionally even have tried “the Ambien defense.” Doctors call these “complex sleep behaviors.” On its official Ambien labeling, manufacturer Sanofi calls the side effects “abnormal thinking and behavioral changes” — changes that can include decreased inhibition. (5/30)

The New York Times: Roseanne Barr’s ‘Ambien-Tweeting,’ Explained. Sorta.
The scientific research, too, suggests there’s good reason to be skeptical. It’s true that Ambien on occasion produces significant side effects, including hallucinations and memory lapses. But blaming the drug for bilious tweeting is a stretch. (Carey, 5/30)

The Wall Street Journal: Clean Bill Of Health For Insurance Deals
Small health insurers have every incentive to get bigger. That is the takeaway from Tuesday’s  announcement that WellCare Health Plans plans to buy privately held insurer Meridian for $2.5 billion. Like WellCare, Meridian specializes in government-sourced business such as Medicaid and Medicare Advantage. (Grant, 5/30)

The Wall Street Journal: New Stroke Technology To Identify Worst Cases Gets FDA Approval
The Food and Drug Administration Wednesday gave marketing clearance for a device that can potentially revamp stroke care by allowing paramedics in the field to diagnose severe strokes requiring specialized treatment. The Lucid Robotic System is aimed at one of the central dilemmas of modern neurology: How to quickly identify patients with the most severe strokes who could benefit from being taken immediately to hospitals that can perform a complex clot-removal procedure, potentially helping to avoid major disability. (Burton, 5/30)

The Wall Street Journal: Did We Say $1.5 Million? We Meant $10.9 Million. Firms Fix CEO Pay Flubs
When Laboratory Corp. of America disclosed pay for its chief executive in March, the company said he made $1.5 million in 2016. A week later, the diagnostic-lab chain filed a new document listing his pay at $10.9 million. Chief Executive David King didn’t get a retroactive raise. His employer just proofread its work. Such a big discrepancy is unusual, but LabCorp isn’t the only big company to make significant adjustments to past pay disclosures. (Francis, 5/30)

The Wall Street Journal: Allergan To Sell Businesses In Bid To Appease Shareholders
Allergan is exploring the sale of two relatively small businesses, in a bid to jolt sagging shares and ease the minds of worried investors. Allergan Chief Executive Brent Saunders told investors Wednesday that the company has begun a process to sell its women’s-health and infectious-disease businesses. (Rockoff, 5/30)

Reuters: Gap In Regulating Biotech Drug Copies Prompts WHO To Step In
Cut-price copies of expensive biotech drugs promise to slash the cost of treating serious diseases, including cancer, in rich and poor countries alike - but uneven regulation has created a lopsided market. Now the World Health Organization (WHO) is stepping in to assess the quality of such so-called biosimilars, offering a global stamp of approval that could make them more widely available, while also raising the quality bar. (Hirschler, 5/30)

NPR: Can Artificial Intelligence Diagnose Cancer?
Artificial intelligence, which is bringing us everything from self-driving cars to personalized ads on the web, is also invading the world of medicine. In radiology, this technology is increasingly helping doctors in their jobs. A computer program that assists doctors in diagnosing strokes garnered approval from the U.S. Food and Drug Administration earlier this year. Another that helps doctors diagnose broken wrists in x-ray images won FDA approval on May 24th. (Harris, 5/31)

The Associated Press: Texas Governor Unveils School Safety Plan Following Shooting
A handful of the recommendations involved gun safety in Texas, a state that embraces its gun-friendly reputation and has more than 1.2 million people licensed to carry handguns. (Stengle, 5/30)

The New York Times: Texas Governor’s School Safety Plan: More Armed Guards, No Big Gun Controls
And [Gov. Greg Abbott] asked state legislators to “consider the merits” of passing a so-called red flag law that would allow the police, family members or a school employee to petition a judge to temporarily take guns away from someone deemed a threat to themselves or others. Texas would become one of only about 10 states with red flag laws, if legislators were to pass such a law, though proposals for similar legislation are pending in more than a dozen other states. (Oppel, 5/30)

The Washington Post: Poor People Die Younger In The U.S. That Skews American Politics.
Meanwhile, because low socioeconomic status leads people to be sicker and to die earlier, poor Americans have far less chance of shaping political life — or of pursuing the policies that would help improve their health and lengthen their lives, such as improvements in health care, education, child care, neighborhood safety, nutrition, working conditions and so forth. (Rodriguez and Capotescu, 5/31)

The Associated Press: Poll: Seniors Ready To Skype Doctors, Care Quality A Concern
The vast majority of older Americans and their caregivers are ready to give virtual health care a try: Nearly 9 in 10 adults ages 40 and over would be comfortable using at least one type of telemedicine for themselves or an aging loved one, says a new poll from The Associated Press-NORC Center for Public Affairs Research. (Neergaard and Swanson, 5/31)

The Washington Post: White America’s Racial Resentment Is The Real Impetus For Welfare Cuts, Study Says
White Americans are increasingly critical of the country’s social safety net, a new study suggests, thanks in part to a rising tide of racial resentment. The study, conducted by researchers at two California universities and published Wednesday in the journal Social Forces, finds that opposition to welfare programs has grown among white Americans since 2008, even when controlling for political views and socioeconomic status. (Dewey, 5/30)

The Washington Post: She Was Convicted Of Disposing Of Her Stillborn Fetus. Now, Va.’s Attorney General Says His Office Made Wrong Call.
Virginia’s attorney general has issued an official opinion that a state law prohibiting the concealment of dead bodies does not apply to stillborn fetuses, a move that will hearten supporters of abortion rights and dismay opponents. The opinion comes after the Virginia Court of Appeals recently upheld the controversial conviction of a southern Virginia woman who was tried and found guilty under the statute for disposing of a fetus that died in her womb, leading to a miscarriage. She was sentenced to five months in jail. (Jouvenal, 5/30)

The New York Times: They Let Their 15-Year-Old Son Smoke Pot To Stop His Seizures. Georgia Took Him Away.
The pharmaceuticals weren’t working. The 15-year-old boy was having several seizures per day, and his parents were concerned his life was in danger. So Suzeanna and Matthew Brill, of Macon, Ga., decided in February to let their son try smoking marijuana — and his seizures stopped for 71 days, they say. But Georgia is not among the states that have legalized medical marijuana, and the Brills’ decision led to the boy, David, being taken away from his parents, who face possible fines and jail time after being charged with reckless conduct for giving him the drug. (Victor, 5/30)

NPR: Battling Depression And Suicide Among Female Veterans
The suicide rate for female veterans has soared 85 percent in recent years, leading the military, VA and advocacy groups to try new ways to improve women's mental health care during and after service. One key focus: how to tailor the sometimes tricky jump from the military to the civilian world. Women's experiences in the military are different from men's, so their transition needs to be different, too, said retired Army Col. Ellen Haring, director of research for the advocacy group Service Women's Action Network (SWAN). (Price, 5/30)

NPR: Domestic Violence: A Leading Cause Of Women's Brain Injuries
Hundreds of survivors of domestic violence have come through the doors of neurologist Glynnis Zieman's Phoenix clinic in the past three years." The domestic violence patients are the next chapter of brain injury," she says. ... While many patients initially seek out the clinic because of physical symptoms, such as headaches, exhaustion, dizziness or problems sleeping, Zieman says her research shows anxiety, depression and PTSD usually end up being the most severe problems. (Stone, 5/31)

The Washington Post: Trump, Fast Food Lover And Exercise Avoider, Lectures Nation On Importance Of Fitness
It’s Sports and Fitness Day at the White House. That means President Trump — a man who has spoken out on the dangers of exercising and devours McDonald’s, KFC chicken, chocolate cake and double scoops of vanilla ice cream — will be lecturing the nation on the importance of staying fit. (Wan, 5/30)

The Associated Press: Conspirator Gets Prison Term In Massive Health Fraud Scheme
Craig Nordman had pleaded guilty to conspiracy to bribe doctors and money laundering and faced a maximum combined sentence of 25 years, but he received a 21-month sentence in exchange for his cooperation with prosecutors. Since charges were announced in 2013, more than 50 people, including more than three dozen doctors, have pleaded guilty in the scheme involving Biodiagnostic Laboratory Services. The Parsippany, New Jersey-based blood testing lab used a variety of methods to bribe doctors to send patients' blood samples to be tested — and often for tests that weren't necessary. (Porter, 5/30)

The Associated Press: Easy Entry Into Oregon's Legal Pot Market Means Huge Surplus
When Oregon lawmakers created the state’s legal marijuana program, they had one goal in mind above all else: to convince illicit pot growers to leave the black market. That meant low barriers to entry that also targeted long-standing medical marijuana growers, whose product is not taxed. As a result, weed production boomed — with a bitter consequence. (Flaccus, 5/31)