Stat: Biden Wants To Cure Cancer. Now Trump Does, Too. But Cancer, Like Health Care, Is Complicated
As a crowd of 20,000 looked on, laughing, Donald Trump Jr. on Tuesday mocked his father’s emerging rival Joe Biden for the ambitious pledge he made recently to “cure cancer” if elected president. “I’m going to cure cancer,” Trump Jr. said contemptuously, throwing his arms above his head. “Wow! Why the hell didn’t you do that over the last 50 years, Joe?” Once President Trump took the stage at his campaign kickoff rally in Orlando, he made his own pledge: He, too, would cure cancer once and for all. (Facher and Joseph, 6/19)

The Associated Press: Biden Anti-Cancer Groups Could Pose Influence Concerns
Joe Biden was on friendly turf when he appeared in January 2018 at a San Francisco health care conference to call for urgency in the search for a cancer cure. He had come before an invitation-only crowd of 2,000 health care industry leaders and investors to tout the work of his Biden Cancer Initiative, the nonprofit that has been his defining venture since leaving the Obama White House more than two years ago. (Braun, 6/19)

In other news on the elections —

The Washington Post Fact Checker: Joe Biden’s Claim That ‘Almost Half’ Of Americans Live In Poverty
What does it mean to be poor? Biden took an expansive view at a presidential candidate forum hosted by anti-poverty advocates. The Census Bureau calculates the poverty rate in different ways. Using the official poverty measure, 12.3 percent of U.S. residents were below the federal poverty line in 2017. Using the supplemental poverty measure, the rate was 13.9 percent. Biden says it’s much more: almost half the country. We surveyed several leading researchers on poverty, and almost all agreed Biden was including people who are not poor. (Rizzo, 6/20)

Politico: How Kamala Harris Would Prevent The Spread Of HIV
Sen. Kamala Harris (D-Calif.) released a plan Thursday that would seek to slow the spread of HIV by making a preventive drug more accessible. What’s the reason for the plan? Pre-Exposure Prophylaxis (PrEP) has been found to reduce the risk of contracting HIV by up to 92 percent for those who take it on a daily basis. But the drug cost more than $20,000 a year in 2018, according to Harris' office. (Levine, 6/20)

The Hill: Key Senators Release Bipartisan Package To Lower Health Care Costs 
A pair of key senators on Wednesday unveiled a revised version of their bipartisan package aimed at lowering health care costs, ahead of a committee markup expected next week. Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) released the package, which takes steps to protect patients from receiving massive “surprise” medical bills when they get care from an out-of-network doctor. It also cracks down on anti-competitive clauses in hospital contracts with insurers that can drive up costs, and encourages the introduction of cheaper generic drugs.  (Sullivan, 6/19)

Politico: HELP Committee Leaders Back Benchmark For 'Surprise' Billing
The benchmark is pegged to the median in-network rate for an area, the same approach advanced by House Energy and Commerce Committee leaders in a bipartisan discussion draft last month. HELP Chairman Lamar Alexander (R-Tenn.) wants to mark up the legislation next week. The committee's remedy for surprise bills is different than a proposal Alexander said on Tuesday he "instinctively" liked — requiring all physicians at the same facility to be considered in-network.Alexander in a statement acknowledged the change, noting that CBO indicated the benchmark approach is "the most effective at lowering health care costs." (Roubein, 6/19)

Kaiser Health News: Sen. Alexander Details His Plan To Fix Surprise Medical Bills
Alexander and Murray formally introduced their wide-ranging bill Wednesday, but they had offered a broad outline before without taking a stand on how to mediate between health care providers and patients on the surprise bills. When a patient is seen by a doctor who isn’t in their network, the Alexander-Murray bill says insurance would pay them the “median in-network rate,” meaning the rate would be similar to what the plan charges other doctors in the area for the same procedure. If there aren’t enough other doctors covered by the plan to compute a median in-network, the plan would use a database of local charges that is “free of conflicts of interest.” (Bluth, 6/19)

Modern Healthcare: Senate Health Bill Includes Pay Cap For Surprise Bill Disputes
The committee's choice of the "benchmark payment" policy is a blow to hospital groups, which have staunchly opposed any kind of reimbursement cap. This rate cap would also hit air ambulance companies. While air ambulances have made headlines for particularly high balance bills, they weren't originally included in the May discussion draft. (Luthi, 6/19)

CQ: Senate Health Measure Aligns With House's On Surprise Bills
Sen. Bill Cassidy, R-La., who prefers to allow arbitration as the negotiating mechanism if providers and plans disagree over the median in-network rate, warned that the bill should include safeguards to ensure that providers aren't disadvantaged by benchmarking. He told CQ Roll Call that he's working with Alexander "to find something that protects the interest of all, most importantly the patients' access." "If there's not safeguards for providers, you won't be able to recruit providers to certain hospitals and those hospitals will close. There is a kind of dynamic that will absolutely occur," he said. (McIntire, 6/19)

Meanwhile, a new study shows how urgent the problem is —

Kaiser Health News: 1 In 6 Insured Hospital Patients Get A Surprise Bill For Out-Of-Network Care
About 1 in 6 Americans were surprised by a medical bill after treatment in a hospital in 2017 despite having insurance, according to a study published Thursday. On average, 16% of inpatient stays and 18% of emergency visits left a patient with at least one out-of-network charge. Most of those came from doctors offering treatment at the hospital, even when the patients chose an in-network hospital, according to researchers from the Kaiser Family Foundation. Its study was based on large employer insurance claims. (Bluth, 6/20)

The Associated Press: 1 In 6 ER Visits Or Hospital Stays Triggers 'Surprise' Bill
Roughly one in every six times someone is taken to an emergency room or checks in to the hospital, the treatment is followed by a "surprise" medical bill, according to a study released Thursday. And depending on where you live, the odds can be much higher. The report from the nonpartisan Kaiser Family Foundation finds that millions of people with what's considered solid coverage from large employers are nonetheless exposed to "out-of-network" charges that can amount to thousands of dollars. (Alonso-Zaldivar, 6/20)

The Hill: Grassley Announces Opposition To Key Trump Proposal To Lower Drug Prices 
Senate Finance Committee Chairman Chuck Grassley (R-Iowa) on Wednesday announced his opposition to one of President Trump’s signature proposals aimed at lowering drug prices. Grassley told reporters that he opposes a plan that Trump announced in October to lower the prices Medicare pays for certain drugs by tying them to lower prices paid in other countries, an idea known as the International Pricing Index. (Sullivan, 6/19)

CQ: Grassley Opposes Trump Plan On Foreign Drug Prices In Medicare
The Iowa Republican, whose panel oversees Medicare, had held back from commenting directly on the idea since the administration first outlined it in October. The administration still hasn't formally proposed the plan, and Grassley had been waiting for more details but said he’s studied it enough to render an opinion. “I don’t think that this administration’s approach on international pricing is going to be to the benefit of the adoption of research for modern drugs,” he told reporters Wednesday. (Siddons, 6/19)

Modern Healthcare: Senate Committee Leaders Tangle Over Drug Pricing Reform
The panel's Ranking Democrat Ron Wyden of Oregon said he and Grassley are meeting daily and sometimes several times a day about the proposals, which are now expected to come after the July Fourth recess, but he also declined to discuss specifics. (Luthi, 6/19)

In other news, another Senate committee is moving forward with a drug pricing hearing —

Stat: Senate Committee To Vote On Health Package With Plan To Lower Drug Prices
A key Senate committee is pushing forward with a surprisingly ambitious plan to lower drug prices as well as other health care costs. The bipartisan pair atop the Senate Health, Education, Labor, and Pensions committee formally introduced a major health care package Tuesday and simultaneously scheduled a vote on the measure for next week. It will be the first time a major Senate committee has taken up drug pricing legislation this year. (Flaherty, 6/19)

The Hill: Trump Administration Defends Controversial Changes To Family Planning Program On Capitol Hill 
The Trump administration faced fierce backlash from Democrats Wednesday when it defended its controversial decision to ban abortion providers from participating in a federally funded family planning program. Deputy Assistant Secretary for Population Affairs Diane Foley, a Trump appointee, testified before Congress for the first time Wednesday about the administration’s changes to Title X, a decades-old grant program for family planning clinics that offer contraception and preventive health services to low-income women. (Hellmann, 6/19)

CQ: HHS Official Defends Family Planning Program Changes
The House Energy and Commerce Subcommittee on Oversight and Investigations hearing on the family planning program, known as Title X, was spurred in part by contention over the Trump administration's changes that would limit which providers may receive federal grants. A recent administration rule would disqualify grantees that provide or refer for abortions or co-locate with an abortion provider, even though federal funds cannot be used for abortions in most cases under current law. The rule was blocked nationwide, at least temporarily, in the courts. Democrats, who oppose the currently enjoined rule, worry it would decrease access for women and cause clinics to close. Republicans counter the rule is necessary to ensure program integrity and fully separate abortion from other aspects of family planning. (Raman, 6/19)

In other news from Capitol Hill —

The Hill: VA Chief Pressed On Efforts To Prevent Veteran Suicides 
Veterans Affairs Secretary Robert Wilkie told lawmakers his agency is stepping up efforts to prevent veteran suicides during testimony before a Senate panel Wednesday. Wilkie testified before a Senate Veterans Affairs Committee hearing, where he was pressed on efforts the Trump administration is taking to address what many have called a growing epidemic of suicide among former military servicemembers. (Slaughter, 6/19)

The Hill: Chris Murphy May Oppose Bipartisan Health Bill Unless It Addresses ObamaCare 'Sabotage' 
Sen. Chris Murphy (D-Conn.) said Wednesday he may vote against a bipartisan measure to lower health care costs next week unless it addresses a GOP “sabotage” of ObamaCare. Murphy told reporters he is worried that there is “no language in the measure to counteract the massive sabotage campaign that's happening by the administration.” The measure is currently before members of the Senate Health Committee. (Sullivan, 6/19)

The Associated Press: White House Offers Budget Freeze If Dems Don’t Agree To Deal
Trump administration bargainers offered a one-year budget freeze and said Democratic spending demands remained too high as talks with congressional leaders aimed at averting deep cuts in defense and domestic programs seemed no closer to resolution Wednesday. After White House Chief of Staff Mick Mulvaney took shots at House Speaker Nancy Pelosi, Democrats said White House involvement in the negotiations was hindering progress and rejected the proposed freeze. The exchange suggested the two sides were not near a handshake to avert automatic cuts and instead boost both defense and domestic programs, perhaps for two years. (Taylor and Fram, 6/19)

Politico: House Backs $1T Spending Bill Amid Fears Of A Fall Shutdown
House Democrats cheered the exhausting legislative feat, having worked on the floor past 4 a.m. in recent days to finish the massive funding package. Democratic leaders know, however, that their measure will be headed to the shredder if a bipartisan budget deal isn’t struck soon. Congressional leaders from both parties and Trump administration officials were set to meet later Wednesday in the hopes of negotiating the parameters of a compromise that would ward off the fiscal chaos later this year. (Emma and Scholtes, 6/19)

Modern Healthcare: More Arkansans Uninsured, Unemployed Post-Medicaid Work Requirement
After Arkansas established a Medicaid work requirement last year, significantly fewer low-income adults subject to the mandate reported having health insurance than the year before, and fewer had a job or were engaged in other qualifying community engagement activities, a new study found. That contrasted with the experience of low-income adults in Arkansas who were not subject to the work requirement, as well as with comparable people in Kentucky, Louisiana and Texas, three states that did not impose a Medicaid work requirement. Those comparison groups all reported little or no change in their insurance rate from 2017 to 2018. (Meyer, 6/19)

Politico: Trump-Approved Medicaid Work Rules Didn't Increase Employment, Study Finds
Researchers from the Harvard School of Public Health found the uninsured rate also increased for Arkansans between 30 and 49 years old — the age range of the first Medicaid beneficiaries subject to the new work requirements. The findings could undercut one of the Trump administration's central arguments for approving the requirements — that mandating work as a condition of Medicaid coverage would spur employment and improve health. (Pradhan, 6/19)

Kaiser Health News: Study: Arkansas Medicaid Work Requirement Hits Those Already Employed
While the thousands of Arkansas residents losing Medicaid coverage has been documented since last year, the Harvard study is the first to provide evidence that the change left them uninsured and did not promote employment. The results, based on a telephone survey of about 3,000 low-income adults in Arkansas, concluded that the law befuddled enrollees and that its mandatory reporting requirements led many to unnecessarily lose coverage. “Lack of awareness and confusion about the reporting requirements were common, which may explain why thousands of individuals lost coverage,” the researchers wrote. (Galewitz, 6/19)

In other news on Medicaid —

Politico: Pulse Check: What It's Like To Run Medicaid, With Tim Hill
Tim Hill carved out a nearly three-decade career in the federal government, ultimately rising to a role where he oversaw Medicaid for much of last year. Now at IMPAQ International, Hill sat down with Dan Diamond to discuss the day-to-day operations of programs like Medicaid, balancing civil service with political changes and some CMS initiatives that have been overshadowed. After the break, Rachana Pradhan and Adam Cancryn join Dan to discuss POLITICO's report on rising tensions between HHS and the White House. (6/20)

Stat: Court Documents Reveal Amazon Strategy For Disrupting U.S. Drug Business
Amazon is seeking to contract directly with health plans and employers to sell prescription drugs through its PillPack subsidiary, a move that would cut out existing pharmacy benefit managers and potentially reshape the sale and distribution of medicines in the U.S., according to newly surfaced court documents. The revelations are contained in a lawsuit CVS filed in April seeking to prevent one of its former executives from taking a job at PillPack, an online pharmacy based in New Hampshire. In its complaint, CVS notes that Amazon-PillPack has “already begun aggressively approaching CVS Caremark’s clients,” including Blue Cross Blue Shield, “to provide its members with prescription home delivery.” (Ross, 6/19)

Boston Globe: Boston Drug-Pricing Watchdog Group Has Pharma Companies’ Attention
ICER researchers spend about eight months studying how well a medicine works and whether it might reduce other health care costs, then publicize their findings in the hopes of getting drug makers to set a fair price. In the past two years or so, the nonprofit persuaded a partnership of two drug firms to charge far less for an injectable eczema treatment than analysts had expected; pressured the same partnership and a third firm to cut the costs of two competing cholesterol-lowering drugs; and saw the Department of Veterans Affairs adopt the institute’s pricing guide for medicines prescribed to military veterans. (Saltzman, 6/19)

The Wall Street Journal: Merck Seeks More Deals As It Expands Its Cancer Treatments Portfolio
Merck & Co. is searching for small and midsize deals, including more transactions aimed at expanding its portfolio of cancer treatments beyond the company’s top-selling product Keytruda, according to people familiar with the matter. Merck has been buying cancer drugmakers with promising therapies and technologies. This month, Merck bought Tilos Therapeutics Inc. for $773 million. In May, it agreed to acquire Peloton Therapeutics Inc. for $1.1 billion. (Hopkins, 6/19)

Reuters: GSK Kicks Off Sale Of $1.2 Billion Consumer Health Drugs-Sources
GlaxoSmithKline has kicked off the sale of some consumer health brands as it seeks to raise about £1 billion before pressing ahead with a spinoff of its consumer healthcare business, sources told Reuters. The drugmaker has bundled the non-core drugs into three different portfolios and has hired boutique investment bank Greenhill to market the products to separate bidders, said three sources familiar with the matter, speaking on condition of anonymity. (6/19)

Modern Healthcare: Premier Pharmacy Labs Recalls Drugs After FDA Inspection
Premier Pharmacy Labs, a sterile compounding pharmacy, has issued a nationwide recall of nearly two dozen unexpired drugs following a recent inspection by the U.S. Food and Drug Administration. The voluntary recall applies to medications that are intended to be sterile. Premier Pharmacy Labs is recalling the drugs due to a lack of sterility assurance, based on concerns voiced at the FDA inspection. (Cohen, 6/19)

The Washington Post: Meet The New York Couple Donating Millions To The Anti-Vax Movement
A wealthy Manhattan couple has emerged as significant financiers of the anti-vaccine movement, contributing more than $3 million in recent years to groups that stoke fears about immunizations online and at live events — including two forums this year at the epicenter of measles outbreaks in New York’s ultra-Orthodox Jewish community. Hedge fund manager and philanthropist Bernard Selz and his wife, Lisa, have long donated to organizations focused on the arts, culture, education and the environment. But seven years ago, their private foundation embraced a very different cause: groups that question the safety and effectiveness of vaccines. (Sun and Brittain, 6/19)

Politico: Study: Around The World, Troubling Levels Of Vaccine Mistrust
Declining confidence in government institutions is feeding a growing mistrust of vaccination around the world, according to a report out today based on the largest global survey of attitudes in science and health. The Wellcome Trust report, which relies on 2018 interviews with at least 1,000 people in each of 142 countries, shows that income inequality, lower education levels and lack of confidence in government contribute to mistrust of science. At the same time, high percentages of people in almost every country trust doctors and nurses. (Allen, 6/19)

In other news on vaccinations —

The Associated Press: Public To Weigh In On Revised California Vaccine Bill
Residents are getting their first chance to weigh in on a revised California measure giving state public health officials oversight of doctors who grant over five vaccination medical exemptions annually vaccinations and schools with vaccination rates less than 95%. Thursday's Assembly committee hearing is expected to draw hundreds of people against vaccines to the Capitol. (Thompson, 6/20)

Los Angeles Times: 2020 Hopeful Marianne Williamson Apologizes For Calling Vaccine Mandates ‘Draconian’ And ‘Orwellian’
Presidential candidate Marianne Williamson, an author and self-help guru who will appear on the Democratic debate stage next week, apologized Wednesday night after she attacked mandatory vaccinations as “draconian” and “Orwellian” at a Manchester, N.H., event. “To me, it’s no different than the abortion debate,” Williamson said at the event, according to a tweet from an NBC News reporter. “The U.S. government doesn’t tell any citizen, in my book, what they have to do with their body or their child.” (Pearce, 6/19)

The New York Times: Black Leaders Denounce Juul’s $7.5 Million Gift To Medical School
Earlier this month, Meharry Medical College, a 143-year-old historically black institution in Tennessee, proudly announced that it had received the second-largest grant in its history — $7.5 million to start a center to study public health issues that affect African-Americans. But the gift has prompted a vehement backlash from African-American health experts and activists because of the source of the funds: Juul Labs, the fast-growing e-cigarette company, now partially owned by the tobacco giant Altria. (Kaplan, 6/19)

The New York Times: E-Cigarette Exploded In A Teenager’s Mouth, Damaging His Jaw
Kailani Burton bought a vaping kit for her teenage son Austin, hoping he would use it to quit smoking. In March of last year, she and her husband were sitting in the living room when they heard a loud pop. Austin raced in, holding his bloodied jaw. An e-cigarette had exploded in his mouth. “He was bleeding really bad,” Ms. Burton said in an interview. “It looked like a hole in his chin.” (Kaplan, 6/19)

The New York Times: The Court Cases That Changed L.G.B.T.Q. Rights
Beginning before Stonewall and continuing in the 50 years since, lesbian, gay, bisexual and transgender people have regularly turned to the courts for protection against mistreatment or to overturn laws that targeted them. From H.I.V.-based discrimination to the fight for marriage equality to President Trump’s attempt to ban transgender people from the military, courts across the country have played a key role in the story of L.G.B.T.Q. rights in America. (Geidner, 6/19)

The Associated Press: Homophobia Study Shows Perception, Reality 'Disconnect'
Researchers say a survey of players in the Australian Ice Hockey League shows homophobic language is often used but that an even higher percentage of competitors would make a gay player feel welcome. It's an apparent contradiction the researchers call a "disconnect between perception and reality" because anti-gay comments can often be a cultural norm. (Passa, 6/19)

The New York Times: America’s Skies Have Gotten Clearer, But Millions Still Breathe Unhealthy Air
When asked about climate change, President Trump often shifts the focus to America’s “clean air.” “We have the cleanest air in the world in the United States and it’s gotten better since I’m president,” he said again this month while meeting with Prime Minister Leo Varadkar of Ireland. America’s air is much cleaner than it used to be, but it’s still not “the cleanest.” And recent data suggests that air pollution is ticking back up. (Popovich, 6/19)

Stat: Experimental Drug For Women Revives An Intense Debate On Sexual Desire
Cancer therapies should shrink tumors. Diabetes treatments ought to lower blood sugar. But what should society expect from drugs for sexual desire? In the coming days, the Food and Drug Administration will decide whether to approve an injection meant to increase women’s drive for sex. Its demonstrated effects are modest, but some doctors say the drug would meet a real need for thousands of women. Others, however, argue it is simply pharmaceutical overreach, another effort that reduces the complexity of human sexuality to a set of measurable dots on a chart. (Garde, 6/20)

The New York Times: Rotavirus Vaccine May Help Protect Against Type 1 Diabetes
Rotavirus disease is a highly contagious virus that can cause severe illness and death in infants and young children, but there is a vaccine that is highly effective in preventing it. A large new study confirms previous research suggesting that the vaccine may have an added benefit: lowering the risk for Type 1 diabetes. About 1.3 million Americans have Type 1 diabetes, an autoimmune disease that usually arises in childhood, and there are an estimated 40,000 new cases each year. (Bakalar, 6/19)

The Wall Street Journal: New Study Links Toxic Sept. 11 Dust To Prostate Cancer
Physicians and researchers have long known that men exposed to toxic dust after the collapse of the World Trade Center on Sept. 11, 2001, may have an increased risk of developing prostate cancer. The challenge has been to provide a link between exposure and the cancer. In a new study out Thursday, researchers from Mount Sinai found that World Trade Center responders with prostate cancer showed signs that inflammation was activated in the prostate after exposure to the toxic dust. (West, 6/20)

PBS NewsHour: Why The Race To Stop The Next Flu Outbreak Starts At State Fairs And The Beach
Public health officials agree the constantly mutating influenza virus has the potential to cause a major outbreak and a deadly global crisis. For the second part of the NewsHour’s series on preparing for such a pandemic, we examine how research and testing depends on animals. (Brangham, 6/19)

The New York Times: Boarding Now: Parents Of Children With Food Allergies
A recent government ruling may transform air travel for passengers with life-threatening food allergies by extending to them the protections afforded other individuals with disabilities. In September 2016, gate agents for American Airlines refused Nicole Mackenzie’s request to preboard a flight from Portland, Ore., to Charlotte, N.C., to clean the area around the seat assigned to her seven-year-old daughter, who has life-threatening nut and seed allergies. (Rabin, 6/19)

The Washington Post: Australian Researchers Find 'Horns' Growing On Young People's Skulls From Phone Overuse
Mobile technology has transformed the way we live — how we read, work, communicate, shop and date. But we already know this. What we have not yet grasped is the way the tiny machines in front of us are remolding our skeletons, possibly altering not just the behaviors we exhibit but the bodies we inhabit. (Stanley-Becker, 6/20)

Kaiser Health News: Stem Cell Company Persuades Employers To Steer Workers Toward Controversial Therapy
A Midwestern grocery chain, Hy-Vee, is taking an unusual — and highly controversial — approach to reducing health care costs. Before employees in certain cities can undergo knee replacement, they first must visit a stem cell provider. Hy-Vee has contracted with one of the United States’ leading stem cell companies — Regenexx, based in Des Moines, Iowa — that claims injections of concentrated bone marrow or platelets can help patients avoid expensive joint surgery. (Szabo, 6/20)

WBUR: When Surgeons Are Abrasive To Co-Workers, Patients' Health May Suffer
The study, which looked at interactions between surgeons and their teams, found that patients of surgeons who behaved unprofessionally around their colleagues tended to have more complications after surgery. Surgeons who model unprofessional behavior can undermine the performance of their teams, the authors write, potentially threatening patients' safety. (Neilson, 6/19)

The New York Times: The Need For Clinical Trial Navigators
Since a Phase I trial has prolonged my life for almost seven years, I find it perplexing that fewer than 5 percent of adult American cancer patients enroll in clinical studies. Why do so few people — with various stages and types of cancer — participate in research that can improve care? One obstacle may be the baffling scaffolding scientists erect around their studies. For example, cancer is a disease of aging, but many clinical trials on cancer drugs exclude older people from participating. (Gubar, 6/20)

The Wall Street Journal: Two Abortion Clinics, 20 Minutes And A Legal Universe Apart
Two abortion clinics are just 20 minutes apart. But separated by the Mississippi River, they operate in political worlds that are very far from each other. The Hope Clinic for Women in Granite City, Ill., has hired more staff and doubled its number of doctors, and it is considering adding hours as an influx of patients from neighboring states with growing restrictions seek abortion procedures there, said Alison Dreith, the clinic’s deputy director. (Calfas, 6/20)

Boston Globe: Governor Raimondo Signs Rhode Island Abortion Rights Bill
In a matter of hours on Wednesday, the Rhode Island General Assembly passed legislation and the governor signed into law the abortion rights protections that advocates have sought for decades. The action began with the state Senate voting 21-17 for the bill, which aims to protect abortion rights in Rhode Island in case the U.S. Supreme Court overturns Roe v. Wade. (Fitzpatrick, 6/19)

The Associated Press: Anti-Abortion Ballot Drives To Start Within Days In Michigan
Groups backing two anti-abortion ballot drives in Michigan said Wednesday that they will begin collecting signatures within days after clearing procedural steps at the state elections board following a debate over what abortion-rights advocates complained are misleading and inaccurate summaries atop the petitions. The measures are citizen-initiated bills, meaning that if enough voters sign, the Republican-led Legislature could enact them into law without the signatures of Democratic Gov. Gretchen Whitmer, who has vowed to veto similar proposals that were introduced as regular legislation. (6/19)

Bloomberg: Opioid Lawsuits: Billions At Stake, But Not As Much As Tobacco 
An Oklahoma case, the first of more than 1,600 lawsuits filed by U.S. state and local governments against opioid makers to go to trial, could serve as a key benchmark for governments hoping to recoup costs associated with the public health crisis. However, verdicts and legal settlements resulting from the litigation are likely to be smaller than the 1998 global settlement with tobacco companies and won’t significantly affect government budgets, according to Fitch Ratings. (Braun, 6/19)

The Associated Press: Oklahoma Medical Examiner Testifies In State Opioid Lawsuit
Oklahoma’s chief medical examiner shared tragic details about the opioid-related deaths of about three dozen residents during testimony in the state’s lawsuit alleging drug manufacturer Johnson & Johnson and some of its subsidiaries contributed to the epidemic. Dr. Eric Pfeifer testified Tuesday that the tragic narratives represent only a small portion of the autopsies his office has performed in recent years as overdose deaths skyrocketed. Attorney General Mike Hunter, who filed the case in 2017, has said curbing and ending the opioid epidemic in Oklahoma could cost billions of dollars. (6/19)

The Wall Street Journal: Cities, States Denied Committee Seats In Opioid Maker’s Bankruptcy
Federal bankruptcy watchdogs turned a cold shoulder to states and cities battling the opioid epidemic, denying them seats on the official committee representing creditors of drugmaker Insys Therapeutics Inc. Lawyers for states and towns across the U.S. were sent packing Wednesday at a meeting in Wilmington, where a bankruptcy overseer from the Justice Department was picking which creditors would have the loudest voice in the first chapter 11 filing stemming from the opioid crisis. (Brickley, 6/19)

The Associated Press: UN Health Agency To Remove Controversial Opioid Guidelines
The World Health Organization notified U.S. lawmakers Wednesday that it will discontinue two publications on prescribing opioid painkillers in response to allegations that the pharmaceutical industry influenced the reports. The pledge to remove the guidelines comes a month after U.S. Reps. Katherine Clark and Hal Rogers accused the WHO of being influenced by Purdue Pharma, the American manufacturer of the potent painkiller OxyContin. (6/19)

The Associated Press: $4.5M In Settlements Over Deaths Tied To Doc In Murder Case
An Ohio hospital system has reached nearly $4.5 million in settlements so far over the deaths of patients who allegedly received excessive painkiller doses ordered by a doctor now charged with murder. Over two dozen wrongful-death lawsuits have been filed against the Columbus-area Mount Carmel Health System and now-fired intensive care doctor William Husel.

Cincinnati Enquirer: How An Ohio Jail Is Fighting Opioid Addiction With Suboxone
It's a vicious cycle for the addicted and their families, one that has safety, financial and other consequences for the rest of society. But since May, health care providers at the Hamilton County jail have been using medicine to help break the connection. Fifty-two inmates now are receiving bupenorphine, an FDA-approved medication that is to temper cravings. They represent about 3 percent of the jail's daily population. (DeMio, 6/19)

Pioneer Press: Departure Of MN DHS Employee May Impair State Opioid Response Efforts, Colleagues Fear 
The longtime medical director of Minnesota’s Medicaid program is out at the Department of Human Services, and his colleagues say his departure could impair the state’s opioid response efforts. Dr. Jeff Schiff said he was told earlier this month that the position he held for 13 years had been eliminated. Schiff, described by his colleagues as the brains behind the state Opioid Prescribing Work Group, said the move was sudden and done without clear explanation. (Faircloth, 6/19)

The Wall Street Journal: FTC Approves UnitedHealth’s $4.3 Billion Purchase Of DaVita Physicians Group
Federal regulators approved UnitedHealth Group Inc.’s $4.3 billion purchase of DaVita Inc.’s physician group with the condition that the UnitedHealth UNH 1.83% sell one of its newly purchased health-care provider organizations in Nevada. The Federal Trade Commission said Wednesday UnitedHealth has agreed to divest a primary-care practice in the Las Vegas region known as HealthCare Partners Nevada to Utah-based Intermountain Healthcare. (Thomas, 6/19)

The Star Tribune: FTC Puts Limit On $4.3 Billion Clinic Deal For UnitedHealth Group 
Minnetonka-based UnitedHealth first announced a deal in late 2017 to acquire Colorado-based DaVita Medical Group, an acquisition that promised to significantly expand UnitedHealth’s network of clinics, urgent-care centers and surgery centers. The Federal Trade Commission spent more than a year and a half reviewing the proposal, before announcing a proposed settlement Wednesday that lets the deal move forward in five states. The purchase by UnitedHealth Group of about 225 clinics fits with a broader trend of the nation’s largest health insurers morphing into health care conglomerates that directly provide patient care through pharmacies, clinics and other outlets. (Snowbeck, 6/19)

Modern Healthcare: UnitedHealth Closes DaVita Medical Group Purchase, With Conditions
The original FTC complaint against the proposed deal said it would result in a near monopoly controlling more than 80% of the market for services delivered by MCPOs to Medicare Advantage insurers. (Bannow, 6/19)

In other news from the health industry —

Modern Healthcare: Health Systems Eye Commercial Payers For More Downside Risk
Finance executives at hospitals and health systems see the most opportunity to work with commercial insurers to increase downside risk in payment contracts, according to a new survey. The survey, published Wednesday by consultancy Navigant, found 64% of finance leaders said they plan to assume additional risk in contracts with commercial payers in the next one to three years. Medicare and Medicare Advantage were behind with 57% of executives saying they plan to take on more risk in traditional Medicare contracts while only 51% of executives answered that they plan to assume more risk in the Medicare Advantage sector. (Castellucci, 6/19)

Modern Healthcare: Soon-Shiong Steps Down From ONC Advisory Committee
Dr. Patrick Soon-Shiong, the billionaire physician-entrepreneur at the helm of health technology company NantWorks, on Wednesday said he is resigning from the federal Health Information Technology Advisory Committee. Soon-Shiong said his time has been occupied by developing a cancer vaccine through his biotechnology company Nant, which is under the NantWorks umbrella, and overseeing the Los Angeles Times, which he purchased in 2018. (Cohen, 6/19)

Los Angeles Times: Activists Target Mayor Eric Garcetti With A Recall Campaign, Citing Homelessness Crisis
Los Angeles Mayor Eric Garcetti is being targeted for removal from office over his handling of the homelessness crisis. On Wednesday, Alexandra Datig, a political commentator who is leading the effort, told reporters at a news conference outside City Hall that the mayor was served with a notice of intent for recall — the first step of a long-shot attempt. (Smith, 6/19)

The CT Mirror: Lamont Signs Bill Upping Tobacco Purchase Age To 21
Starting in October, Connecticut residents must be 21 to purchase tobacco or vaping products. Gov. Ned Lamont signed a bill Tuesday raising the legal age to buy cigarettes, cigars, vaping pens and other tobacco paraphernalia from 18 to 21. (Carlesso, 6/19)

Des Moines Register: Iowa Gov. Kim Reynolds Says 'a Lot Of Factors' Led To Agency Director Exit
Gov. Kim Reynolds said Wednesday that many factors led her to ask the director of Iowa's largest state agency to step down, although she declined repeatedly to say whether her request was tied to disciplinary action. "It was a lot of factors that went into that decision. Just a lot of factors," Reynolds told reporters at the Capitol. A reporter had asked her if Jerry Foxhoven's exit from the Iowa Department of Human Services was related to human resources issues, including disciplinary action. (Rodriguez and Akin, 6/19)

Nashville Tennessean: PainMD Clinics Abandoned Patient's Medical Records In Storage Units
PainMD, a Nashville-area pain management company that recently shuttered clinics and stranded patients without medicine, disclosed in a court filing this week they've lost access to countless patient medical records that are stuck in storage units spread across Tennessee, Virginia and South Carolina. PainMD said it can no longer reach the records because, as the company has been crumbled into bankruptcy while accused of widespread fraud, all the employees with access the storage units have left. (Kelman, 6/19)

Columbus Dispatch: Black Ohio Legislators Want Board Created To Study Childbirth-Related Deaths
Black mothers are more likely to die in childbirth or within a year of giving birth, but state Rep. Erica Crawley contends that putting those women into broad race categories can confuse the conversation about disparities in health care. The Columbus Democrat wants a pregnancy-associated mortality review board that — if the proposal is kept in the final version of the state budget — would be established under state law to “disaggregate” more granular race data in order to help officials study the medical and social factors that contribute to mothers dying in pregnancy. (Rouan, 6/19)

The New York Times: Final Push To Legalize Pot Fails In New York
New York’s plan to legalize marijuana this year collapsed on Wednesday, dashing hopes for a potential billion-dollar industry that supporters said would create jobs in minority communities and end decades of racially disproportionate policing. Democratic lawmakers had been in a headlong race to finalize an agreement before the end of the legislative session this week. But persistent disagreement about how to regulate the industry, as well as hesitation from moderate lawmakers, proved insurmountable. (Wang, 6/19)

Chicago Tribune: Rush Hospital Permanently Closing Kids’ Inpatient Mental Health Unit 
Rush University Medical Center will no longer offer inpatient mental health care for children, making it the latest Chicago hospital to cut back on overnight stays for kids. The West Side hospital had 15 beds for child and adolescent behavioral health. It temporarily closed that unit in March, along with two adult inpatient mental health units, after the state found deficiencies in how the hospital protected its psychiatric patients from harming themselves through hanging or strangulation. The units were supposed to reopen following renovations to correct the issues and the state’s approval, but Rush has decided the pediatric unit will not reopen. (Schencker, 6/19)

Arizona Republic: Police Shooting: U.S. Army Vet's Final Hours Before He Is Fatally Shot
Balladares enrolled in the Army when he was only 19, in the years following 9/11. He served as special forces and was trained as a sniper. He spent the next decade going back and forth between two separate worlds of the Army and home. Coming back home was almost as hard as leaving. (Burkitt, 6/19)

Columbus Dispatch: Ohio's Population Ages Fast As Services Try To Keep Up
By 2030, the U.S. Census Bureau predicts, people over the age of 65 will outnumber children under the age of 18 for the first time in the nation’s history. It’s already happening in Ohio.According to census population estimates released Thursday, 13 of Ohio’s 88 counties already had more people of retirement age in 2018 than they had children. (Caruso, 6/20)

Pioneer Press: Minnesota Nurses, Allina Hospitals Reach Agreement On New Contract 
Allina Health has reached a deal with its nurses’ union that provides raises each of its 3 years. The tentative agreement was announced Wednesday morning by the Minnesota Nurses Association. The contract would provide annual raises of 3 percent, 3 percent and 2.25 percent. It must still be ratified by the union membership. A contract vote has been scheduled for June 27 by the union. The Minnesota Nurses Association had stressed safety issues early and said the new deal addresses workplace violence. (Chaudhry, 6/19)

MPR: Nurses Land Pay Raises, New Injury Protections
In a departure from contentious contract negotiations in the past, the Minnesota Nurses Association has reached tentative contract agreements with five Twin Cities hospital systems, including four more announced Tuesday and Wednesday. In 2016, Allina Health nurses spent 47 days on strike in a failed attempt to keep their union-only health insurance coverage. (Enger, 6/19)

Atlanta Journal-Constitution: Emory Healthcare Innovation Center Adds Major Partners
Four major medical companies plan to announce Thursday that they have joined an innovation program at Emory Healthcare aimed at lowering health costs and improving patient care. The companies will develop and refine new systems, from health information technology to mobile diagnostic tools, at Emory facilities across the metro area. (Trubey, 6/20)

Sacramento Bee: Syphilis PSA Poster By Sacramento County Joked About Online
Sacramento County Public Health tweeted the image almost a month ago, in May. It’s a clever enough concept for a public service announcement, but it didn’t appear to get any attention at the time – not a single retweet. But a few weeks later, many local social media users can’t help but laugh about the poor model in the stock photo, who’s now inextricably linked to the STD. (McGough, 6/19)

Seattle Times: Judge Orders Madigan To Pay $12.3 Million In Operating-Room Fire That Disfigured Child 
Madigan Army Medical Center has been hit with a $12.3 million verdict after the Army admitted it was negligent and responsible for a 2015 operating room fire that severely disfigured a 13-month-old child undergoing a routine, minor surgical procedure. The child’s face was engulfed in a fireball when a surgeon activated an electrocautery device — a sort of electric scalpel — while an anesthesiologist administered concentrated oxygen through a face mask, leaving the boy with severe burns on one side of his face and his nose, according to court documents. (Carter, 6/19)

Kansas City Star: Nurse Charged With Raping Patient At Independence Hospital
A nurse has been charged with raping a patient last weekend at Centerpoint Medical Center, the Jackson County Prosecutor’s Office announced in a news release. The nurse, identified in charging documents as Chukwuemeka U. Emmanuel, a 35-year-old Overland Park resident, is charged in Jackson County Circuit Court with first-degree rape. (Schwers, 6/19)

Health Affairs: Spousal Caregivers Are Caregiving Alone In The Last Years Of Life
Caregiving in the last years of life is associated with increased depression and negative health outcomes for surviving spouses, many of whom are themselves in poor health. Yet it is unclear how often spouses are caregiving alone, how they differ from supported spouses, and whether lack of support affects postbereavement outcomes. We hypothesized that spouses who were solo caregivers—that is, the only caregivers (paid or unpaid) who provided assistance with a spouse’s self-care or household activities—would experience more depression after bereavement than supported spouses would. Using information from the Health and Retirement Study, we found that 55 percent of the spouses of community-dwelling married people with disability were solo caregivers. (Ornstein et al, 6/3)

JAMA Psychiatry: Medicaid Acceptance By Psychiatrists Before And After Medicaid Expansion
Medicaid is the principal payer of behavioral health services in the United States and has been expected to play an increasing role in financing behavioral health services after states’ implementation of Medicaid expansions.1,2 Little is known about recent trends in psychiatrists’ acceptance of Medicaid, including before and after 2014, when most Medicaid expansions under the Affordable Care Act went into effect. Without adequate participation in Medicaid among psychiatrists, Medicaid enrollees with behavioral health needs may be unable to find a local psychiatrist who accepts new patients with Medicaid or have to wait a long time for an intake appointment. (Wen et al, 6/5)

Pediatrics: School Restroom And Locker Room Restrictions And Sexual Assault Risk Among Transgender Youth
Transgender and gender nonbinary adolescents experience high rates of peer victimization, but the prevalence of sexual assault in this population has not been established. Some schools restrict transgender and nonbinary students from using restrooms and locker rooms that match their gender identity, with unknown effects on sexual assault risk. We tested whether these restrictions were associated with the 12-month prevalence of sexual assault victimization. (Murchison et al, 6/3)

The Henry J. Kaiser Family Foundation: An Examination Of Surprise Medical Bills And Proposals To Protect Consumers From Them
This analysis examines how often patients get hit with surprise medical bills, what circumstances tend to give rise to them and what proposals are being considered to protect consumers from this problem. The study of claims data from large employer health plans finds that in roughly 1 of every 6 emergency room visits and inpatient hospital stays in 2017, patients came home with at least one out-of-network medical bill. More specifically, 18 percent of all emergency visits and 16 percent of in-network hospital stays had at least one out-of-network charge, leaving patients at risk for surprise medical bills. (Pollitz, 6/20)

JAMA Cardiology: Vitamin D Supplementation And Cardiovascular Disease Risks In More Than 83 000 Individuals In 21 Randomized Clinical Trials: A Meta-Analysis
Observational studies have reported an association between low serum vitamin D levels and elevated risk of cardiovascular disease (CVD) events, but such studies cannot prove causation because of possible unmeasured confounding. (Barbarawi, 6/19)

Stat: After Training In Primary Care, We Aren't Becoming Primary Care Docs 
Nearly three years ago, we began training as primary care doctors in two residency programs at a Harvard-affiliated teaching hospital. We understood the value of longitudinal patient-doctor relationships and wagered that primary care would be the bedrock of this nation’s health care system. That was even after hearing the warnings: predictions of a national shortage of more than 44,000 primary care physicians (PCPs) by 2035, rampant physician burnout, and a workforce saddled with two hours of required documentation for every hour of patient care. Nevertheless, we felt inspired to join the front lines of health care. Yet when we finish our residencies on June 28, neither of us will be practicing traditional primary care. We are not alone in turning away from this field: Approximately 80% of internal medicine residents, including nearly two-thirds of those who specifically chose primary care tracks, do not plan to pursue careers in primary care. (Richard Joseph and Sohan Japa, 6/20)

Las Vegas Review Journal: Meeting Future Demand For Health Care Workers
Rep. Steven Horsford, a Democrat serving Nevada’s 4th Congressional District, has introduced the Health Providers Training Act 0f 2019. The measure is intended to address a national “shortage” of health care workers. “Our country faces a growing aging population,” a press release notes, “a rise in chronic diseases and increased behavioral health conditions — all of which contribute to a substantial need for a dynamic health care workforce that can meet the demands of today and tomorrow.” The congressman has a valid point. Baby boomers are fast approaching or in the midst of their retirement years. The market for in-home medical services is projected to grow from $108 billion in 2018 to $173 billion by 2026, according to Business Insider, outpacing every other medical sector. (6/19)

The Washington Post: How To Take On Bernie Sanders On Medicare-For-All
Sen. Bernie Sanders (I-Vt.), who champions Medicare-for-all, will face nine fellow candidates for the Democratic presidential nomination next Thursday on the second night of the debates — most of whom don’t agree with his prescription. Former Colorado governor John Hickenlooper, former vice president Joe Biden and Sen. Michael F. Bennet (D-Colo.) are among those who will share the stage and who have pushed back against a system that would outlaw private insurance. I doubt Biden will want to “punch down” at Sanders, but Hickenlooper and Bennet could create buzz and enhance their vice presidential prospects by debunking Sanders’s idea. (Jennifer Rubin, 6/19)

USA Today: Joe Biden Can't Cure Cancer And There Were Scandals In The Obama Years
In a Trumpian-turn, the former vice president claimed that electing him would cure cancer. No, seriously."I promise you if I'm elected president, you're going to see the single most important thing that changes America. We're gonna cure cancer," he told a crowd in Ottumwa, Iowa. Right. The war on cancer goes back to Richard Nixon, and in the years since the National Cancer Act of 1971, we’ve made a ton of progress. But even five decades later, there’s not going to be a cure any time soon for one simple reason: Cancer isn’t one disease. It is a complex constellation of distinct ailments caused by a diverse mix of environmental and genetic factors. (David Mastio, 6/19)

The New York Times: Homes To Heal Trafficked Children
Lisbeth takes out her cellphone and flashes a picture of her foster daughter. Two years ago, the teenager was living on the streets near Miami. Her mother, who was addicted to drugs, would disappear for long stretches at a time, and her father was in jail. The 14-year-old girl would steal noodles and cold cuts from local bodegas to feed herself and her two half-siblings, aged 4 and 5. She wasn’t in school. Eventually, she was found by staff at the Florida Department of Children and Families, who determined that she was being sold for sex. Her legs were pocked with cigarette burns. “She doesn’t talk about the past,” Lisbeth said. (Rikha Sharma Rani, 6/19)

The Washington Post: Elizabeth Warren Has Lots Of Ideas. Bad Ideas.
The ascent of Elizabeth Warren in the Democratic race should warm the heart of any policy wonk. Her mantra is “I’ve got a plan for that,” and she has more than three times as many plans as any of the other 22 candidates. But while the Massachusetts senator is to be commended for her relentlessly serious campaign, it doesn’t necessarily mean her ideas are good or that they will help her defeat a lowbrow president. On both counts, there is ample room for skepticism. Warren’s big idea is the opposite of President Bill Clinton’s. In 1996, Clinton said “the era of big government is over.” Warren thinks it is just beginning. She wants to build 3 million new housing units and reduce rents by 10 percent. (Max Boot, 6/19)

The Hill: Harnessing The Power Of Community To Tackle The Issue Of Veteran Suicide
Veteran suicide is real and personal. When I was a young lieutenant in the Army, my soldiers and I believed that our communications section chief Sergeant First Class Terry Dennis was the strongest man in our unit. In our minds, he was invincible. But we never realized that he suffered from the invisible wounds of war. While still on active duty, Dennis killed himself.From 2008 to 2016, there were more than 6,000 veteran suicides each year, according to research conducted by the Department of Veterans Affairs. In 2016, the suicide rate was 1.5 times greater for veterans than for nonveterans. (Miguel Howe, 6/19)

The New York Times: Time Is Running Out To Stop An Ebola Epidemic
Ebola is ravaging the northeastern Democratic Republic of Congo, a country riven by violent conflict and neglected for decades by the international community. The World Health Organization has less than half of the $98 million it needs to confront the crisis. And the United States government has undermined its own experts with a slow-footed response and cumbersome aid restrictions. (6/19)

Los Angeles Times: A Plan To Clean Up L.A. And Help The Homeless? Get It Done Already
Finally, Los Angeles city officials are recognizing the urgent need to clean up the trash near homeless encampments. Both the trash that homeless people have nowhere to put and the garbage illegally dumped by businesses are a blight and health hazard for everyone in the city. Too bad our elected representatives had to be shamed into performing one of local government’s most basic duties. Under a $6-million plan laid out by city officials, sanitation workers would place trash receptacles in high-density homeless encampments and provide regular trash collection. In addition, a pilot program would be set up to employ homeless people to clean up trash in encampments, which is a great idea. There are homeless people sweeping dirt and trash away from their encampments right now. (6/20)

Atlanta Journal-Constitution: Former Health Leaders: It’s Time To Make Atlanta Smoke-Free
As doctors and former public servants who have worked as the Secretary of Health and Human Services and as U.S. Surgeons General, we are deeply invested in protecting the public health of American communities. That’s why we are voicing our support for the recently introduced City Council ordinance that would make all Atlanta workplaces smoke-free. (Louis Wade Sullivan, Vivek Murthy and David Satcher, 6/19)

Arizona Republic: School Safety Goes Far Beyond Hiring More Officers And Counselors
What does "school safety" really mean? Our schools face a number of security issues, such as guns, drugs, bullying, gangs and sexual assault. We must find solutions to all of these if we want to create a climate in which all students feel safe. (Joseph Erardi, Kristi Sandvik, Paul Penzone, Mark Joraanstad and Dick Foreman, 6/19)