Politico: Pelosi Steams Ahead With Drug Pricing Plan Amid Liberal Angst
Speaker Nancy Pelosi is making a hard sell to her caucus this week on a signature drug pricing bill. But it’s not yet clear whether she can win over skeptical progressives. The California Democrat has won initial praise from key moderate factions in her drive to push the legislation through by Thanksgiving. But the ambitious plan, and its closed-door drafting process, has left progressives worried that the bill will fall well short of their expectations and that they remain cut out of the talks. (Ferris, Cancryn and Karlin-Smith, 9/18)

Stat: Democrats Still Have Questions About Nancy Pelosi’s Drug Pricing Plan
For months, Nancy Pelosi has kept even her fellow Democrats in the dark on her plan to lower drug prices. The big reveal, for the lawmakers, came this week: Pelosi barnstormed the Capitol as if campaigning for office, pitching moderate, progressive, and middle-ground Democratic groups on her plan. But for many members of Congress, Pelosi’s presentation left more to be desired — even as she’s expected to publicly release it as soon as today. (Facher, 9/19)

NPR: Pelosi To Roll Out Bill To Negotiate Prescription Drug Prices
The speaker's proposal would allow the federal government, through the Health and Human Services secretary, to negotiate prices for the top 250 most expensive drugs on the market that don't have at least two competitors. The amounts would be pegged to the costs of the same drugs in other countries — which are generally much cheaper — under an "international price index." It would also levy steep fines on drug companies that refuse to engage in negotiations, and put limits on how much drug costs can go up. (Davis, 9/19)

CQ: House Set To Reveal Drug Price Negotiation Plan
On Wednesday, Energy and Commerce members were briefed by Chairman Frank Pallone Jr., D-N.J., and Ways and Means members were briefed by Chairman Richard E. Neal, D-Mass. Pelosi and her staff spoke to moderate members in the Blue Dog Caucus on Tuesday evening and the New Democrat Coalition on Wednesday. She is expected to brief the liberal Congressional Progressive Caucus Thursday. There are several issues that members from the party’s different blocs would like to change. Rep. Kurt Schrader, D-Ore., a member of both moderate groups, is concerned about a provision in the earlier summary that would set HHS’ maximum price at an average paid by other wealthy countries. He told CQ Roll Call that Pelosi adviser Wendell Primus promised unspecified modifications from the initial summary, which would set the price at 120 percent of the average in six countries. (Siddons, 9/18)

CQ: Health Extenders Included In Short-Term Funding Bill
A stopgap spending bill unveiled by House Democrats Wednesday evening would temporarily extend funding for community health centers and other health care programs set to expire Sept. 30, while delaying payment cuts to safety-net hospitals. The legislation (HR 4378) would extend funding for community health centers to run through Nov. 21. Congress authorized two years of funding for the Children’s Health Insurance Program in January of 2018, but that will expire Sept. 30. (Raman, 9/18)

CQ: House Stopgap Bill Would Fund Farm Payments, Health Programs
The House Rules Committee has scheduled a meeting for 9:30 a.m. Thursday to consider parameters for floor debate, with a vote scheduled for later in the day. The stopgap measure is necessary because none of the dozen regular spending bills have become law yet. Congressional leaders and the White House didn't agree on topline fiscal 2020 funding caps until late July (PL 116-37), right before heading home for the August recess. Without President Donald Trump's signature by midnight Sept. 30, the government would partially shut down. (Mejdrich, 9/18)

Politico Pro: House Sets Thursday Vote On Stopgap Spending Bill Packed With Extensions, Exceptions
The House plans to vote on a nearly two-month stopgap spending bill Thursday that would drag out current funding beyond the Oct. 1 start of the new fiscal year.House Democrats unveiled the 43-page measure, H.R. 4378, on Wednesday night, proposing to kick the next spending deadline to Nov. 21. The Senate is expected to clear the bill next week for President Donald Trump's signature, before all discretionary funding for the federal government runs out at midnight on Sept. 30. (Scholtes, 9/18)

Meanwhile —

CQ: Senate Releases Labor-HHS-Education Spending Bill
Senate Republicans on Wednesday released their $178.3 billion Labor-HHS-Education spending bill for fiscal 2020, ahead of a procedural vote on a broader funding package but with no bipartisan agreement on the largest domestic spending measure. Markups of the Labor-HHS-Education bill that were supposed to occur last week were postponed over a fight about amendments Democrats planned to offer. Democrats wanted to vote on an amendment to overturn a Trump administration policy that restricts federal funding from going to health care providers that offer or refer people for abortions. (Siddons and Bacon, 9/18)

The Wall Street Journal: Attorney General Probes Support For Gun Background Checks On Capitol Hill
Attorney General William Barr is gauging support among lawmakers for a plan to expand gun background checks, signaling that the administration hasn’t dismissed a significant tightening of gun rules, though President Trump hasn’t indicated what he will endorse. Mr. Barr spent several days on Capitol Hill this week with White House legislative affairs director Eric Ueland floating a plan requiring background checks for all commercial gun sales, including at events such as gun shows where buyers currently can largely avoid them. (Gurman, Andrews and Lucey, 9/18)

CNN: Proposal To Expand Background Checks Floated On Hill But Trump Has Yet To Sign Off On It Or Any Other Gun Plan
The pitch -- outlined in a document that was obtained by CNN -- would expand background checks to all advertised commercial sales, though it's not clear whether it would pass muster with lawmakers. The White House on Wednesday made clear that President Donald Trump had not signed off on any plan, and GOP leaders have indicated they are awaiting word from Trump before taking action. (Shortell, Fox, Foran and Barrett, 9/18)

The Daily Caller: Here’s The Document The White House, Barr Are Using To Push Gun Control On Republicans
The Daily Caller obtained a copy of an idea sheet circulating among Republican members, which indicates that the legislation in question would expand background checks to include all commercially advertised unlicensed sales. (Athey, 9/18)

NBC News: Justice Department Circulating Proposal To Expand Background Checks
A Justice Department official confirmed the agency had drafted the background check proposal. “The President has not signed off on anything yet but has been clear he wants meaningful solutions that actually protect the American people and could potentially prevent these tragedies from ever happening again,” White House spokesman Hogan Gidley, who emphasized the document wasn’t from the White House, said in a statement. (Pettypiece, Thorp and Caldwell, 9/18)

Politico: Leaked Background Check Plan Sows Chaos On Hill
“You don’t need to worry about what’s floating around,” Sen. Chuck Grassley (R-Iowa) said. “We aren’t going to do anything that the president isn’t going to sign anyway. ”When asked about the proposal, Sen. Todd Young (R-Ind.) first asked whether Trump publicly endorsed it as his own. “Once the president does, I’ll look forward to reviewing it,” Young said. (Levine and Everett, 9/18)

Axios: Trump Testing GOP Appetite For Background Checks
Why it matters: The president was expected to say this week what, if any, gun control legislation he is prepared to support. Advocates were doubtful he would support expanded background checks because polling suggested it could hurt his standing with core supporters. (Treene, 9/18)

In other news on gun violence —

The New York Times: With Harrowing Ads, Gun Safety Groups Push A Scarier Reality
Going back to school means worrying about what to wear, deciding what classes to take and, increasingly, knowing what to do if someone appears on campus with a gun. This reality in American classrooms is reflected in a harrowing ad being released on Wednesday from Sandy Hook Promise, a gun safety advocacy group created after the shooting at Sandy Hook Elementary School in Newtown, Conn., in 2012. (Hsu, 9/18)

CNN: The Racial Politics Of Gun Control
When Americans talk about guns, what's arguably most interesting isn't what we say about the devices themselves. It's what we betray about whose voices -- and lives -- matter when it comes to our country's virulent gun culture. Indeed, the heartbreaking permanence of the school shooting reality is undeniable when watching Sandy Hook Promise's wrenching new back-to-school PSA, which forces viewers to come to grips with present-day America for school children. (Tensley, 9/18)

Dallas Morning News: Texas Mass Shooting Survivor Lobbies Congress For Less Gun Control
Since surviving a 1991 mass shooting at a Luby's in Killeen, Suzanna Gratia Hupp has lobbied for looser gun control laws that she says could have allowed her to save the 23 victims, including both of her parents. "I reached for the gun in my purse on the floor next to me," Hupp told a congressional committee Wednesday during a hearing on the economic costs of gun violence. She recounted the moments after the killer, George Hennard, crashed his pickup into the restaurant where she was eating with her parents and opened fire. "But then I realized that a few months earlier I had made the stupidest decision of my life. My gun was 100 yards away, dutifully left in my car to obey the law because at that time in the state of Texas, carrying a handgun was illegal." (Cobler, 9/18)

The Washington Post Fact Checker: Sanders’s Apples-And-Oranges Comparison On Medicare-For-All Costs
“Joe said that Medicare-for-all would cost over $30 trillion. That’s right, Joe. Status quo over 10 years will be $50 trillion.” — Sen. Bernie Sanders (I-Vt.), remarks during the third Democratic presidential debate, Sept. 12, 2019. Sanders made this comment after former vice president Joe Biden criticized the senator’s Medicare-for-all plan for potentially adding “$30 trillion, $3.4 trillion a year” to the federal budget. In his response, Sanders favorably compared that $30 trillion to what he called the “status quo” for health-care spending — $50 trillion. He added: “Every study done shows that Medicare-for-all is the most cost-effective approach to providing health care to every man, woman and child in this country.” (Kessler, 9/19)

The Hill: Dem Leader Says Party Can Include Abortion Opponents
The Democrats' tent is big enough to include anti-abortion lawmakers, the No. 2 House Democrat said Wednesday. Majority Leader Steny Hoyer (D-Md.) emphasized that Democrats are overwhelmingly in favor of women's right to terminate a pregnancy. But there's no litmus test, he said, that would exclude those lawmakers who feel otherwise. (Lillis, 9/18)

Politico Pro: How Pete Buttigieg Would Expand Health Coverage
Democratic presidential hopeful Pete Buttigieg today released his long-awaited health plan, pledging that his “Medicare for All Who Want It” proposal would lead to universal health coverage while cutting costs. The plan formalizes proposals the South Bend, Ind., mayor has touted in the campaign, like building on Obamacare and creating a new “public option” to compete with private insurers. (Diamond, 9/19)

The Associated Press: Trump Threatens EPA Action Against San Francisco
President Donald Trump threatened to unleash the Environmental Protection Agency on San Francisco Wednesday after a California visit during which he blamed the homelessness crisis on "liberal" policies. Trump accused the city of allowing a tremendous amount of waste, including needles, to go through storm drains into the ocean. (9/18)

USA Today: 'We Can't Have Our Cities Going To Hell': Donald Trump Threatens Environmental Action Against San Francisco
It was not immediately clear which environmental laws Trump was referring to, or on what authority the Environmental Protection Agency would act. Trump, who was traveling in California on Tuesday and Wednesday for campaign fundraisers, said pollution was flowing into the ocean because of waste in storm sewers and he cited used needles. (Fritze and Subramanian, 9/18)

The New York Times: San Francisco To Get Environmental Violation For Homelessness, Trump Says
San Francisco’s mayor, London Breed, called Mr. Trump’s comments “ridiculous.” “To be clear, San Francisco has a combined sewer system, one of the best and most effective in the country, that ensures that all debris that flow into storm drains are filtered out at the city’s wastewater treatment plants,” Ms. Breed said in a statement Wednesday night. “No debris flow out into the bay or the ocean.” (Shear, Fuller and Baker, 9/18)

The Wall Street Journal: ‘Cities Going To Hell’: Trump’s EPA To Put San Francisco On Notice For Homelessness
Mr. Trump traveled to the Bay Area on Tuesday for the first time since his election, attending a roundtable and a fundraiser near Palo Alto. He has repeatedly attacked San Francisco—a largely liberal city whose congresswoman, House Speaker Nancy Pelosi (D., Calif.) routinely clashes with the president—over its homelessness problem. (Ballhaus, 9/19)

Los Angeles Times: Trump Targeting California Housing Rules To Fix Homelessness
President Trump’s big idea for fixing California’s homelessness crisis should look familiar to many prominent Democrats: Eliminate layers of regulation to make it easier and cheaper to build more housing. On the eve of a two-day swing through the state this week, Trump’s Council of Economic Advisers released a report blaming “decades of misguided and faulty policies” for putting too many restrictions on development and causing home prices to rise to unaffordable levels. It’s a continuation of a strategy that the president began in June, when he signed an executive order to establish a White House council to “confront the regulatory barriers to affordable housing development.” (Dillon and Oreskes, 9/18)

Stat: Groups Push Back Against ‘Troubling’ FDA Crackdown On Genetic Tests
In recent weeks, the genetic testing world has been rattled by the Food and Drug Administration’s efforts to quietly pressure a number of companies to stop reporting results to patients about how their genes may interact with specific drugs. Now, increasingly, the industry is pushing back. On Wednesday, a trade group that represents clinical laboratories sent a sharply worded letter to the agency calling its enforcement actions “troubling” and “inappropriate.” The letter, from the American Clinical Laboratory Association, warned that the agency’s actions could stifle the growth of a burgeoning industry and make it harder for patients to get the right types and doses of their medications. (Robbins, 9/18)

In other news on the FDA —

Stat: FDA To Modernize Its IT — And Make More Efficient Use Of Data
Dr. Amy Abernethy, the principal deputy commissioner at the Food and Drug Administration, is unveiling a three-point plan to radically redirect the agency’s efforts at using computer technology. At a Wednesday meeting held by Friends of Cancer Research, a patient advocacy group, Abernethy, who is also the FDA’s acting chief information officer, plans to outline how regulators can move more of their work to “the cloud” — virtual servers – and automate work that is now done by hand. This, she said, could change the way that the agency interacts with the companies it regulates. (Herper, 9/18)

Politico: Democrats Favor Righteous Rage, GOP The Safer Bet In Purdue Opioids Settlement
Last year, 49 states and thousands of cities, counties and territories joined in massive litigation designed to punish the drug industry for its role in the opioid crisis. But now that one of the companies, Oxycontin-maker Purdue, has put as much as $12 billion on the table as part of a bankruptcy settlement, Democrats and Republicans are fighting over the proper strategy. (Karlin, 9/18)

The Washington Post: Purdue Pharma’s Bankruptcy Plan Includes Special Protection For The Sackler Family Fortune
In 2008, as Purdue Pharma was searching for a new chief executive, Richard Sackler received a memo from an adviser. “In the event that a favorable [recapitalization] deal cannot be structured during 2008, the most certain way for the owners to diversify their risk is to distribute more free cash flow to themselves,” F. Peter Boer, a member of Purdue’s board of directors told Sackler, a prominent member of the wealthy family that owns the company. (Merle and Bernstein, 9/18)

Los Angeles Times: Who's To Blame For The Nation's Opioid Crisis? Massive Trial May Answer That Question
For the families of the roughly 400,000 Americans who have died of opioid drug overdoses since 1999, a legal drama scheduled to unfold in an Ohio courtroom next month may feel like a true shot at justice. After downplaying the risks of dangerous and highly addictive prescription narcotics, and of profiting from their spiraling misuse, the purveyors of prescription painkillers could be forced to reckon with the consequences of their actions. (Healy, 9/18)

Miami Herald: Florida Families Hurt By Purdue Opioids Oppose Settlement
Purdue Pharma is facing thousands of lawsuits from states and municipalities over its role in marketing and aggressively pushing the sale of its opioids. Florida’s tentative agreement was announced Sept. 11 by Florida Attorney General Ashley Moody. Dodds told the Miami Herald that she feels betrayed by state leaders who are heading toward a settlement without talking to her and others like her. (Conarck, 9/18)

In other news on the opioid crisis —

The Star Tribune: New Minnesota Opioid Council Goes To Work 
Minnesota took a major step in a landmark push to combat opioid addiction Wednesday, assembling an independent panel of experts, advocates and lawmakers to allocate tens of millions of dollars in new funding to combat the crisis. The Opioid Epidemic Response Advisory Council, formally appointed Wednesday, will meet for the first time next week. The 19 voting members will spend the coming months making long-awaited recommendations about spending money earmarked for overdose prevention, addiction recovery, law enforcement and other services related to the epidemic. (Van Oot, 9/18)

Kaiser Health News: Doctors And Nurses With Addictions Often Denied A Crucial Recovery Option
Dr. Wesley Boyd, an associate professor of psychiatry at Harvard, has spent years working with state programs that help doctors, nurses and other health care workers who have become addicted to opioids get back on their feet professionally. He supports these non-disciplinary programs, in which doctors and nurses enroll for a number of years and are closely monitored by addiction specialists and state authorities as they seek to maintain or restore their medical licenses. (Yasinski, 9/19)

Pioneer Press: Opioid Task Force Finalized; Group To Determine How To Spend $20M To Respond To Crisis
The 19 members of an Opioid Advisory Council were finalized Wednesday ahead of the groups first meeting next week to begin to address the state’s opioid addiction crisis. The council will decide the best ways to spend an estimated $20 million a year raised from new licensing fees on drug makers and distributors. The fee and council were created by lawmakers during the legislative session that ended in May. Eleven of the 19 voting members of the council were appointed by Human Services Commissioner Jodi Harpstead. The other eight members are appointed by state statute. (Magan, 9/18)

The Associated Press: Teen Vaping Of Nicotine Jumped Again This Year, Survey Finds
A greater share of U.S. teens are vaping nicotine e-cigarettes. About 25% of high school seniors surveyed this year said they vaped nicotine in the previous month, up from about 21% the year before. The University of Michigan study was published online Wednesday by the New England Journal of Medicine. Researchers surveyed more than 42,000 students across the country in grades 8, 10 and 12. (Stobbe, 9/18)

The New York Times: Teenage Vaping Rises Sharply Again This Year
“It’s not good news at all,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse, which decided to release the new vaping numbers from an annual survey conducted by University of Michigan researchers three months earlier than scheduled. “There has to be a policy that would make it much harder for teenagers to be introduced to vaping.”Vaping prevalence more than doubled in the grades surveyed, eighth, 10th and 12th, from 2017 through this year. One in 4 students in the 12th grade reported that they had vaped within the previous 30 days this year, 1 in 5 in the 10th grade; and 1 in 11 in the 8th grade. (Kaplan, 9/18)

The Washington Post: 1 In 9 High School Seniors Vape Nicotine Near-Daily, New Survey Says Amid E-Cigarette Scare
The data could help to strengthen a growing crackdown on e-cigarettes on the heels of bans on sales of flavored vaping products in New York and Michigan. Last week, the Trump administration said it, too, plans to outlaw sales of the flavored liquids that have come under criticism as enticing to teens. (Knowles, 9/18)

The Hill: Teen Vaping Rates Doubled In 2019, With 25 Percent Of High School Seniors Using E-Cigarettes 
Public health experts had expected teen vaping rates to increase in 2019 after seeing last year's shockingly high numbers. Twenty-one percent of 12th graders said the same in 2018. But this year's numbers show policymakers can't wait any longer to act, Volkow said. (Hellmann, 9/18)

CNN: The Rate Of Teen Vaping Has Doubled Within Two Years, New Research Finds
"Current efforts by the vaping industry, government agencies, and schools have thus far proved insufficient to stop the rapid spread of nicotine vaping among adolescents," researchers wrote. "Of particular concern are the accompanying increases in the proportions of youth who are physically addicted to nicotine, an addiction that is very difficult to overcome once established." (Christensen and Stucker, 9/19)

The Hill: Congressional Democrats Threaten To Subpoena Juul In Teen Vaping Investigation
House Democrats are threatening to subpoena Juul for not complying with its investigation into the youth vaping epidemic. Juul, the top e-cigarette company in the U.S., has not produced documents that the House asked for more than three months ago, said Rep. Raja Krishnamoorthi (D-Ill.), chairman of the House Oversight and Reform Subcommittee on Economic and Consumer Policy. (Hellmann, 9/18)

The New York Times: TV Networks Take Down Juul And Other E-Cigarette Ads
As health concerns mount over the rise in teenage vaping, CNN, CBS and Viacom are ending advertisements by e-cigarette companies. The parent company of CNN, WarnerMedia, said on Wednesday that it was removing the ads from its entire portfolio of networks, including TNT and TBS, in response to recent health warnings from authorities including the American Lung Association and the Centers for Disease Control and Prevention. (Yaffe-Bellany, 9/18)

USA Today: Viacom, CBS, WarnerMedia To Pull E-Cigarette Ads From TV
A CBS spokesperson confirmed with USA TODAY it will not take any e-cigarette advertising on the network moving forward. In a statement to CNBC, WarnerMedia said it's dropping e-cigarette ads from TNT and TBS. A WarnerMedia spokesperson wasn't immediately available. Last week, fellow WarnerMedia network CNN told The Daily Beast it was also dropping e-cigarette ads. (Molina, 9/18)

The Associated Press: Michigan Bans Flavored E-Cigarettes A Day After New York
Michigan banned the sale of flavored e-cigarettes on Wednesday, the latest state to act following hundreds of serious breathing issues in people using vaping devices that prompted a federal investigation. The Michigan Department of Health and Human Services said the ban was effective immediately and gave retailers, including online sellers, two weeks to comply. The ban includes menthol and mint flavored products and expires after 180 days if not extended. (9/18)

The Hill: Michigan Bans Sales Of Flavored E-Cigarettes
“I’m proud that Michigan has been a national leader in protecting our kids from the harmful effects of vaping,” Whitmer said. “For too long, companies have gotten our kids hooked on nicotine by marketing candy-flavored vaping products as safe. That ends today. This bold action will protect our kids and our overall public health.” (Hellmann, 9/18)

The Wall Street Journal: New York’s Smokers’ Quitline Offers Little Help To E-Cigarette Users
Thousands of callers a year to the New York State Smokers’ Quitline receive help to stop smoking through education programs, counseling and nicotine-replacement therapy, including free packages of nicotine gum, patches and lozenges to reduce cravings. A smaller, but growing number of people are calling the quitline to stop using e-cigarettes and vaping devices. Those enrollees, by contrast, only receive coaching and information on tobacco use and nicotine addiction, not free nicotine-replacement therapy. (West, 9/18)

Colorado Sun: Colorado’s Attorney General Will Investigate Whether Juul Marketed To Kids, Misled On Smoking Cessation
Colorado’s attorney general says he will investigate whether Juul marketed e-cigarettes to children and positioned its products as smoking cessation devices without any basis for the claim. Democrat Phil Weiser announced in August, as first reported by Colorado Public Radio, that he was launching a probe of Juul. He said the investigation falls under his office’s consumer protection work. (Paul, 9/18)

Boston Globe: After Illnesses Nationwide, Baker, Walsh Eyeing Stricter Vaping Regulations
State and city leaders said Wednesday that they are weighing stricter regulations on the sale of electronic cigarettes and flavored tobacco products, the latest in a series of efforts that elected officials have pushed amid an explosion of vaping-related illnesses nationwide. Governor Charlie Baker said he is evaluating what emergency options the state has to address the sale of vaping products, and Mayor Martin J. Walsh proposed regulations in Boston to help curb youth vaping by limiting where mint and menthol nicotine products can be purchased. (Stout, 9/18)

Hartford Courant: ‘He Was Told To Stop Vaping, But He Cannot’: Connecticut Man Sues Juul Over E-Cigarette Advertising
Robert McCulloch, who started using a Juul electronic cigarette when he was 14, has filed a federal lawsuit against the company, claiming that deceptive advertising and “false promises” led him to start using the nicotine product without an understanding of the health risks it posed. His lawsuit targets Juul Labs on a few fronts, alleging the e-cigarette device manufacturer violated Connecticut trade law, designed a defective product and committed fraud in its advertising. McCulloch began vaping with a Juul as a freshman in high school under the impression that the e-cigarettes contained little-to-no nicotine. He blames that impression on misleading advertising. (Rand, 9/19)

Clarion Ledger: Mississippi Reports First Vaping-Related Lung Illness
The Mississippi State Department of Health announced it has identified the first case of vaping-related lung illness in the state. According to a press release issued Wednesday, the state "is the latest state to join in a national investigation into severe pulmonary disease linked to the use of e-cigarette products (vaping)." (Fowler, 9/19)

ABC News: Most Vaping Deaths Linked To THC Devices, But Experts Still Looking For Root Cause
While some cases of lung illness occurred among smokers who used only nicotine e-cigarettes, the majority of cases were among smokers who used THC vape products, according to the U.S. Centers for Disease Control and Prevention. Other e-cigarette smokers with lung disease used both nicotine and THC devices. "This outbreak does not appear to be associated with traditional legally-sold e-cigarettes, but with illicit and sometimes counterfeit THC vaping cartridges," said Dr. Michael Siegel, a professor at Boston University School of Public Health. (Schumaker, 9/19)

PBS NewsHour: How Teens Across The Country Are Reacting To News Of Vaping Dangers
After reporting that a 40-year-old man died over the weekend due to vaping, the state of California is launching an ad campaign to warn against the dangers of the practice. Federal health officials are also urging people not to vape, but the practice has soared among teenagers in recent years. Our Student Reporting Labs asked teens around the country for their response to the news and warnings. (/18)

California Healthline: Camouflaged Vaping Devices Are Hoodwinking Parents And Schools
In yet another twist for worried parents: Meet the vaping hoodie. This high school fashion mainstay — defined by a hood with drawstrings — is now available as a vaping device, ready to deliver a puff of nicotine (or marijuana) anywhere, anytime. Including in the classroom. It marks an addition to the fleet of discreet — some would say camouflaged — vaping devices that have teachers and parents struggling to monitor the usage of a product that has surged in popularity among high school-aged kids in the past two years, despite laws in most states that allow sales only to people 18 and up. (Barry-Jester, 9/18)

The Associated Press: Will Combo Pill Catch On In US To Prevent Heart Attacks?
A cheap, daily pill that combines four drugs has been tested for the first time in the United States to see if it works as well among low-income Americans as it has in other countries to treat conditions leading to heart attacks and strokes. Experts said the study may draw U.S. interest to a strategy that has been seen as useful only in places with limited access to medical care. (9/18)

Los Angeles Times: A Daily Combo Pill Can Boost The Cardiovascular Health Of Poor And Minority Americans, Study Suggests
The pill contains low doses of three blood pressure drugs and a cholesterol drug. About 300 people, ages 45 to 75, from a community health center in Mobile, Ala., took part in the study. Half were assigned to take the combo pill. The others continued their usual care. (Johnson, 9/18)

Stateline: Yoga, Zumba, Narcan: Check Out Your Local Library 
When most people visualize the day-to-day happenings at a public library, diabetes prevention courses, lectures on wound care and Zumba classes aren’t necessarily the first things that spring to mind. But for small town and rural librarians across Eastern Kentucky, health-centered activities are becoming every bit as common as checking out a book. ...But funding can be a concern. Librarians are constantly looking for ways to stretch their dollars to provide public health information, from asking experts to volunteer to getting creative with materials, said Lisa Lewis, president of the Association for Rural and Small Libraries, via email. (Baird, 9/19)

Bloomberg: Carcinogen Scare Sets Off Global Race To Contain Tainted Zantac 
Drugmakers and global public-health regulators are taking steps to remove supplies of a popular heartburn medication that may have become tainted with a cancer-causing agent from the market. Novartis AG’s Sandoz unit said Wednesday that it was halting worldwide distribution of generic versions of the stomach drug Zantac, just days after regulators in the U.S. and Europe began investigating the discovery of a likely human carcinogen called NDMA, or N-Nitrosodimethylamine, in the medications. (Edney, 9/18)

Modern Healthcare: Most Providers Don't Screen For Social Determinants Of Health
Most U.S. physician practices and hospitals are screening patients for at least one social need, but only a small percentage are screening for all five social needs recommended by the federal government, a new study found. Nearly a quarter of hospitals and 15.6% of physician practices screened patients for all five social determinants of health prioritized by the CMS — food insecurity, housing instability, utility needs, transportation needs and interpersonal violence, according to the study published in JAMA Wednesday. (Meyer, 9/18)

The New York Times: What Should Young Children Drink? Mostly Milk And Water, Scientists Say
A panel of scientists issued new nutritional guidelines for children on Wednesday, describing in detail what they should be allowed to drink in the first years of life. The recommendations, among the most comprehensive and restrictive to date, may startle some parents. Babies should receive only breast milk or formula, the panel said. Water may be added to the diet at 6 months; infants receiving formula may be switched to cow’s milk at 12 months. For the first five years, children should drink mostly milk and water, according to the guidelines. (Rabin, 9/18)

The Associated Press: Uptick Seen In Rare Mosquito-Borne Virus In Some US States
The number of U.S. deaths and illnesses from a rare mosquito-borne virus are higher than usual this year, health officials report. Eastern equine encephalitis has been diagnosed in 21 people in six states, and five people have died. The infection is only being seen in certain counties within a small number of states. The U.S. each year has seen seven illnesses and three deaths, on average. (9/18)

NPR: Gliomas Network With Normal Brain Cells To Grow Faster
Researchers are beginning to understand why certain brain cancers are so hard to stop. Three studies published Wednesday in the journal Nature found that these deadly tumors integrate themselves into the brain's electrical network and then hijack signals from healthy nerve cells to fuel their own growth. (Hamilton, 9/18)

The Associated Press: Louisiana Governor Election Won't Uproot Medicaid Expansion
Louisiana's Democratic governor, John Bel Edwards, moved quickly to expand Medicaid when he took office in 2016, making his state the only one in the Deep South to embrace that signature piece of President Barack Obama's health care law. And in a conservative state that solidly supports President Donald Trump, the $3 billion-plus Medicaid expansion program that is Edwards' hallmark achievement isn't going anywhere, even if the Democratic governor is ousted by a Republican in this fall's election. (DeSlatte, 9/18)

Raleigh News & Observer: Republicans Seek Medicaid Expansion Bill After NC Budget Vote
The topic at the heart of the summerlong state budget standoff — Medicaid expansion — is getting renewed attention after state House Republicans surprised Democrats with a budget vote while most of them were absent. NC Health Care for Working Families, House Bill 655, was added to the House floor calendar on July 9, at the same time as the budget override veto. The issues were tied together: Gov. Roy Cooper vetoed the budget primarily because it did not expand Medicaid as the Obama-era Affordable Care Act allows and as 36 states and the District of Columbia have decided to do. House Republicans offered a bill that they said would be considered along with the override, as a way to address Medicaid expansion without passing the full expansion that Cooper and Democrats want. (Vaughan, 9/18)

North Carolina Health News: Medicaid Expansion Bill Passes Commiittee 
After years of waiting, advocates for extending health insurance to hundreds of thousands of low-income North Carolinians finally saw a bill cross the starting line at the state legislature. House Bill 655 would allow for people who earn too much to qualify for Medicaid and too little to receive subsidies on the health insurance online marketplace to get access to insurance through the Medicaid program. The Health Care for Working Families Act would charge people who fall into the “coverage gap,” earning between 50 and 133 percent of the federal poverty level (from about $6,200 to $16,611 per year for an individual) to pay small premiums and copays in order to receive coverage. (Hoban, 9/19)

San Francisco Chronicle: California, 14 Other States Call Out Administration On Misleading Contraceptive Messages
The Trump administration is falsely suggesting to the public that employers with moral objections to contraception can deny birth control coverage to female employees, despite court orders requiring the coverage to continue, leaders from California and 14 other states said Wednesday. The government has “several misleading websites that fail to inform the public that there are injunctions in place” against its rules allowing employers to withhold contraceptive coverage, Attorney General Xavier Becerra and his counterparts in other states said in a letter to Trump administration officials. (Egelko, 9/18)

Columbus Dispatch: Abortion Pill 'Reversals' Debated In Ohio As Toledo Clinic Halts Surgeries To End Pregnancies
Despite critics’ claims of junk science, the Republican-led Ohio Senate held its first hearing Wednesday on a bill that would require doctors who provide medication for an abortion to tell their patients that the procedure could be reversed. The proposal, under consideration by the Health, Human Services and Medicaid Committee, is controversial because many medical experts say the claim is false and not supported by science. (Rowland, 9/18)

The Associated Press: Judge Denies Missouri Request To Allow 20-Week Abortion Ban
A federal judge has denied a request by Missouri to allow a ban on abortions after 20 weeks of pregnancy to go into effect while the state waits for further court action. The Kansas Star reports that U.S. District Court Judge Howard Sachs had previously paused parts of Missouri’s new abortion law. It was set to go into effect Aug. 28 and criminalizes abortions after eight weeks of pregnancy. It also triggered bans at 14, 18 and 20 weeks if the initial eight-week ban was found unconstitutional. (9/18)

Modern Healthcare: Court Win May Not Solve Hospitals' Site-Neutral Pay Problem
While hospitals groups have welcomed a federal judge's ruling against the CMS' expansion of site-neutral payments for basic doctor's visits, some analysts see it as a short-term solution that can't survive as a long-term strategy. U.S. District Judge Rosemary Collyer's ruling Tuesday sealed the divide between the Trump administration and hospitals in the push to lower costs. But policymakers and regulators will continue to push for deep payment reforms despite the recent loss. (Luthi, 9/18)

Modern Healthcare: Ballad Health At Odds With Community Over Controversial Changes
Since the merger to form Ballad became official in February 2018, the health system, which has $2 billion in annual revenue, has swiftly rolled out changes to consolidate high-level services into Ballad’s Johnson City hospital a half-hour south. That’s meant stripping the Kingsport hospital of its neonatal intensive care unit and downgrading its trauma center. Ballad’s CEO, Alan Levine, said competition between the two legacy systems led to an irrational, inappropriate duplication of services in the region that were expensive to run. He also said patient care will be safer once it's centralized in Johnson City. (Bannow, 9/18)

Modern Healthcare: Ochsner Health System, Rush Health Systems Solidify Partnership
Ochsner Health System and Rush Health Systems on Tuesday solidified a long-term partnership that will unify their electronic health records as they look to streamline operations and build on their telehealth capabilities. Through the partnership, New Orleans-based Ochsner will install and implement Epic, which will sync up with Meridian, Miss.-based Rush's system and ideally improve care coordination, patient registration, scheduling, clinical integration and billing, executives said. The not-for-profit health systems also plan to build on their telehealth partnership and expand their digital health offerings. (Kacik, 9/18)

Bloomberg: Sandy, Other 2012 Events Cost Health Care $10 Billion, NRDC Says 
The environmental advocacy group estimates that Superstorm Sandy, which wreaked havoc in the Northeast, and nine other events it says were linked to climate change in 2012 cost the U.S. health-care system about $10 billion. Other incidents included in the study done with the the University of California San Francisco include a resurgence in mosquito-borne West Nile virus in Texas and a record-breaking heat wave in Wisconsin. (Flanagan, 9/18)

The Associated Press: 25 Californians Charged With $150M In Health Care Fraud
Twenty-five Southern California doctors and others are accused of billing Medicare and other health plans for $150 million in fraudulent charges. Federal cases were announced Wednesday in Los Angeles and Santa Ana. (9/18)

Colorado Sun: Colorado’s Reinsurance Program Could Fall $50 Million Short Next Year, According To Health Insurer Estimates
Colorado’s much-lauded reinsurance program — credited with dramatically reducing health insurance prices next year for people who purchase coverage on their own — could cost as much as $50 million more than the state estimated if early projections from insurers prove correct. That’s potentially a big actuarial miss for one of the signature legislative accomplishments passed this year by Capitol Democrats and Gov. Jared Polis. The insurers’ tally is about 20% more than the state’s estimate for the program’s cost. (Ingold, 9/18)

Detroit Free Press: GM, UAW Bicker Over Health Care Cut-Off
General Motors and the UAW continue to try to strike a deal at the bargaining table while also bickering in public over GM's move to shift the cost of striking workers' health care to the union. About 46,000 UAW workers across the United States went on strike at midnight Sunday after the UAW let its contract expire the night before. UAW leaders and members say they were blindsided Tuesday to learn that GM had canceled health care benefits the night before. (LaReau, 9/18)

Kansas City Star: Missouri Families Sue Schools And State Over Vaccine Rules
Four families are suing Missouri schools and the state health department over vaccine requirements, calling the process of filing for an exemption a violation of religious freedom. A federal judge has already ruled that one of the unvaccinated students may continue going to school in Kansas City while the case continues. (Ritter, 9/19)

Sacramento Bee: Sutter Davis Leader Details $69.5 Million Expansion Plans
The chief executive officer of Sutter Davis Hospital shared details Tuesday on the planned $69.5 million expansion of the facility’s emergency department, birthing center and medical-surgical unit. The construction, she said, should be finished by 2024. (Anderson, 9/18)

San Francisco Chronicle: Gov. Newsom Signs AB5, Making Gig-Work Reform Bill Law
Gov. Gavin Newsom has signed AB5, California’s landmark gig-worker bill that could turn thousands of independent contractors into company employees with protections and benefits.“ The hollowing out of our middle class has been 40 years in the making, and the need to create lasting economic security for our workforce demands action,” Newsom said Wednesday, in a signing statement released by his office. (Gardiner, 9/18)

Modern Healthcare: Dignity Health Loses Transgender Discrimination Appeals Case
In a setback for Catholic hospitals, a California appellate court ruled that Dignity Health discriminated against a transgender man seeking a hysterectomy when one of its hospitals turned him away for the procedure. The 1st District Court of Appeal ruled unanimously Tuesday that the state nondiscrimination law, the Unruh Act, barred discrimination against the patient, Evan Minton. The court sent the case back to the San Francisco Superior Court, which had dismissed the lawsuit on the basis that Minton had quickly received the procedure at another facility. (Meyer, 9/18)

Miami Herald: Homestead Center Cost $33 Million So Far To House No Kids
The government has spent more than $33 million in 46 days to keep the Homestead detention center up and running even though no children are housed there, according to federal officials. On Wednesday, Jonathan Hayes, the acting director of the Office of Refugee Resettlement — the agency in charge of housing unaccompanied migrant children — testified at a House Appropriations subcommittee hearing, along with other Department of Homeland Security leaders, about mental health services for migrant children. (Madan, 9/18)

Houston Chronicle: Survey: Houston Far From A Picture Of Health 
One in five Harris County residents rates their health as poor or fair, according to a new University of Texas survey, double the U.S. average and no better than nearly a decade ago. The survey, which provides a snapshot of county health disparities across 38 communities, found the worst health assessments were in Aldine, Settegast, Edgebrook, Gulfton and South Acres, all economically depressed areas. The percentage of respondents rating their health as poor or fair ranged from 28 in South Acres to 45 in Aldine. (Ackerman, 9/18)

Miami Herald: State Of Florida Says Nurse Stole Drugs From 3 Facilities
A St. Petersburg licensed practical nurse had her license restricted after, the Florida Department of Health said, she was fired from three healthcare facilities this year for stealing Percocet, Ultram and other pain medications. The emergency restriction order says Sarah O’Halloran “admitted to [addiction Dr. Lawrence] Wilson, that she diverted controlled substances from [Golfview Healthcare Center] and Boca Ciega [Center]. (Neal, 9/18)

Health News Florida: Disabilities Organization Faces Concern And Questions
An organization focused on helping Floridians with disabilities find jobs has not complied with some key demands by Education Commissioner Richard Corcoran, who threatened to shut it down because of concerns about potential misuse of money. The commissioner last month cited “egregious concerns” with the operation of The Able Trust, a non-profit organization for the Department of Education’s Division of Vocational Rehabilitation, and demanded it cut all ties with a charitable foundation it created without authorization from the Legislature. (Ceballos, 9/18)

San Jose Mercury News: East Bay Mayor Claims ‘Lives Will Be Lost’ If Alta Bates Closes
Nason and El Cerrito Mayor Rochelle Pardue-Okimoto said that the hospital closure would affect residents, the uninsured, homeless, UC Berkeley students and the elderly. Both mayors are members of a task force, convened by Berkeley Mayor Jesse Arreguin, that is working to convince Sutter Health to keep Alta Bates open. (Kawamoto, 9/18)

The Advocate: Babies In NCIU At North Oaks Can Now Receive Donated Breast Milk 
Premature and low birth weight babies born at North Oaks Medical Center can now receive the health benefits of donor breast milk during their Neonatal Intensive Care Unit stay in cases where their own mothers’ milk is not available. Babies born before 33 weeks or with a birth weight less than or equal to 3.3 pounds are eligible to receive a donor human milk prescription with parental consent during their time in the NICU, according to a news release. (9/18)

Urban Institute: Children, Seniors, And Families Would Lose SNAP Benefits Under A Trump Administration Proposal
In July, the Trump administration proposed significant changes (PDF) to some eligibility criteria for the Supplemental Nutrition Assistance Program (SNAP). The proposal would limit states’ ability to increase SNAP’s income limits and remove or relax SNAP asset limits set at the federal level, a policy known as broad-based categorical eligibility (BBCE). Thirty-nine states and the District of Columbia, as well as Guam and the Virgin Islands, now use BBCE, and many have done so for several years. BBCE helps SNAP reach households that may have slightly higher income and assets and very significant expenses, like high housing costs (in excess of 50 percent of income) and medical out‐of‐pocket expenses. (Waxman and Joo, 9/16)

JAMA Internal Medicine: Association Between Forced Sexual Initiation And Health Outcomes Among US Women
Forced sexual initiation in women appears to be common and associated with multiple adverse reproductive and general health outcomes. These findings highlight the possible need for public health measures and sociocultural changes to prevent sexual violence, particularly forced sexual initiation. (Hawk et al, 9/16)

The Henry J. Kaiser Family Foundation: Nearly 8 In 10 Immigrants Who Entered The U.S. Without Legal Permanent Resident Status Have At Least One Characteristic That Could Count Against Them Under The New “Public Charge” Rule
Seventy-nine percent of noncitizen residents who originally entered the United States without legal permanent resident status have at least one characteristic that could count against them under the Trump Administration’s new “public charge” rule, according to an updated KFF analysis. Such characteristics – including having an income below 125 percent of the federal poverty level or lacking a high school diploma or private health insurance — could make it harder for immigrants to obtain admission into the U.S. or get a green card under the administration’s final rule to change “public charge” inadmissibility policies scheduled to take effect on October 15. (9/18)

The New York Times: Early Inflammation May Portend Early Death
Adolescents who show signs of body-wide inflammation may be at risk of early death decades later, researchers report. A study published in JAMA Pediatrics used blood samples from 106,000 healthy Swedish men, 16 to 20 years old, examined for compulsory military service. Their checkups included a test known as a “sed rate,” which is a general indicator of inflammation. (Bakalar, 9/18)

The Atlantic: What Trump Once Understood About Homelessness
Donald Trump has long understood that he can leverage homelessness to motivate people. In the early 1980s, the developer was desperate to get tenants out of a building he owned in Manhattan so that he could tear it down and build a new one. The tenants were not obliging, so Trump tried a series of moves to force them to vacate—including offering to house homeless New Yorkers in the building, hoping revulsion would scare the tenants out. (David A. Graham, 9/19)

CNN: Homelessness Is Reaching An Emergency Level In Los Angeles
Los Angeles is enduring a crisis of homelessness. We are in the eye of an economic storm -- fighting the forces of high rents, stagnant wages, and a deficit of a half million units of affordable housing -- that is pushing thousands from housed to homeless. And its cost, the moral expense to us as a community and region, deserves a statewide declaration of a State of Emergency. This year's count revealed that at any given point in time, there are more than 58,900 Angeleños experiencing homelessness; many are families sleeping in places not meant for human habitation. It is a frightening illustration of the challenges we face that many from afar may not easily comprehend -- for every 133 people our service providers house every day, 150 more people become newly homeless. (Mark Ridley-Thomas, 9/18)

Los Angeles Times: Why A One-Size Solution To L.A.'s Homelessness Crisis Is Destined To Fail
Homelessness is the Rorschach test of humanitarian crises: We all see what we want to see. Some identify the core problem as the lack of affordable housing or inadequate rent control laws. Others fault the lack of quality treatment for people struggling with mental illness, addiction, rampant economic inequality or the plague of mass incarceration. As someone who spends his days providing services to our homeless neighbors, I can tell you every one of those things plays a role. There are as many reasons for homelessness as there are people sleeping on sidewalks. And that means we need a wide range of approaches to solving the problem, aimed at addressing the needs of individuals. We simply can’t force all homeless people into a relatively narrow set of solutions. (Kevin Murray, 9/19)

San Francisco Chronicle: President Trump Is Both Right And Wrong About California Homelessness
President Trump has discovered the shameful situation that is homelessness in California. Last week, his administration announced it was considering unilateral action to dismantle tent encampments and remove homeless people from the streets of California cities.On Monday, his Council of Economic Advisers released a 40-page report that painted a grim picture of homelessness in California, noting correctly that our state has just 12% of the nation’s population but about half of the nation’s unsheltered homeless people. (9/18)

The Washington Post: Can Justice Be Found In The Rubble Of Purdue Pharma?
What is the main purpose of the multiple lawsuits seeking to hold the pharmaceutical industry liable for the epidemic of opioid addiction and death that has swept the country over the past two decades? By filing for bankruptcy and offering to distribute billions of dollars among jurisdictions that agree to settle their claims against it, Purdue Pharma has implied that the plaintiffs are really interested in one thing, money. And undoubtedly they are: Purdue’s cash could do a lot of good for victims of opioid addiction, especially if it does indeed get spent on addiction treatment and on preventing new addiction, as opposed to being diverted for general purposes as much of the nationwide tobacco lawsuit settlement was. Nevertheless, the plaintiffs also seek justice. (9/17)

The Hill: Media And Candidates Should Be Ashamed That They Don't Talk About Obesity
The Democratic presidential debate on Sept. 12 raised numerous issues related to health care, gun control, and immigration reform. Why didn’t one of the media representatives ask “How do you plan to address the obesity epidemic?” Obesity should be the plum topic. It affects 40 percent of eligible voters (the same percentage of the population as all registered Democrats) plus 20 percent of our children. There are ethnic/racial disparities. African, Asian, Latino and Native Americans are disproportionately affected. There are income disparities. (Michael Rosenbaum, 9/18)

The Hill: Experts Say No Sugary Drinks For Kids, But Parents Can't Do It Alone
This week, four of the largest organizations dealing with pediatric health came together to endorse new guidelines about what young children should drink. On the surface, these recommendations are not surprising: They suggest that kids under five should be drinking primarily water and dairy milk and avoiding sugary drinks and juices. But heeding even this intuitive advice is a major public health challenge — one that will take more than just informed consumer choices. These guidelines point to an urgent need for stronger regulations, system changes and more cooperation from industry to protect our children’s current and future health.  (Mary Story, 9/18)

Stat: Dreamers Like Me Fill Critical Gaps In Mental Health Care 
In 1993, when I was 3 years old, my family left Pakistan for the United States. My parents were searching for a brighter, safer future and better educational opportunities for their children. All of that came true for me, but now it is being threatened by President Trump’s decision to rescind the Deferred Action for Childhood Arrivals (DACA) program, which gives young undocumented immigrants — often called Dreamers — the right to live and work in the United States without fear of deportation.I’m now working in my dream job as a psychiatrist in a hospital and Veterans Health Administration clinic just outside Chicago. (Aaima Sayed, 9/18)

Stat: Innovation Litmus Test: Does It Ease Health Care 'Tensions'?
It is easy to understand why: the promise of innovation is astounding. Innovation done well can improve health care outcomes, decrease costs, serve more people, create market share, and help institutions gain cutting-edge reputations. And as health care spending approaches 20% of the U.S. economy, it’s apparent why the concept holds so much appeal for decision-makers and innovators.Yet innovation theater and liberally labeling projects as “innovations” pose threats of equal proportion. We believe there is value in innovation and want to protect it, but to do so it’s important to discern what it really means in health care. (Joseph S. Salama, Alex Lee and Ashkan Afshin, 9/19)

The Washington Post: The GM Strike And America’s Health-Care Burden 
Almost 50,000 General Motors workers represented by the United Auto Workers union went on strike just after midnight on Monday. At issue: Workers want the Big Three automakers to address pay disparities that trace back to the Great Recession (people hired before 2007 earn more than those who came on after). The companies can certainly afford that, given that GM’s profits alone topped $8.1 billion in 2018. And, since this is the United States in 2019, do I need to tell you that health care is also an issue in the strike? (Helaine Olen, 9/18)

The New York Times: A New Wave Of Caregivers: Men
When you hear the word “caregiver,” what image comes to mind? Most likely it is a woman in her 40s — someone tucking her children in with a phone call to her aging mother before bed. And in fact, this isn’t inaccurate. But did you know that of the 40 million family caregivers in America, nearly half of them are men? (Courtney E. Martin, 9/18)