Politico: Obamacare’s Secret Base: America’s Middle Class
Millions of middle-class Americans who get health coverage through work have been getting Obamacare benefits for years — whether they know it or not. And millions of older Americans who rack up big drug costs under Medicare get more financial help through Obamacare — whether they know it or not. Now a Texas federal judge who just invalidated the entire health care law has put them at risk — whether they know it or not. (Kenen and Ollstein, 12/19)

Milwaukee Journal Sentinel: If Ruling On ACA Is Upheld, Entire Insurance Market Would Be Affected
Cathy Mahaffey, the chief executive of Common Ground Healthcare Cooperative, has a simple question if the Affordable Care Act no longer exists: “What is Wisconsin’s Plan B?” Others were asking the same question after a federal judge in Texas on Friday ruled in favor of 20 states, including Wisconsin, that asked the court to declare the law unconstitutional. (Boulton, 12/18)

Boston Globe: Here’s Why Experts Say The Judge In The ACA Case Went Too Far
Yet a federal judge in Texas has ruled that the Republican elimination of the tax penalty for the uninsured also invalidated the legal mandate that every adult American have health insurance. Based on just those two issues, Judge Reed O’Connor ruled the entire law is unconstitutional. But Boston-area law professors who specialize in health care law and the intersection between health care and the US Constitution contend O’Connor’s vaporizing of the Affordable Care Act as a whole is the judicial equivalent of a doctor performing surgery on the wrong body part — it’s just not right. (Ellement, 12/18)

Cleveland Plain Dealer: Texas Judge’s Obamacare Ruling Is ‘Bananas,’ Says Case Western Law Professor Whose Research Fueled Previous Attempt To Gut Law
A Case Western Reserve University law professor whose research formed the foundation for a major challenge to the Affordable Care Act recently found himself on the other side – essentially defending the current state of the controversial law. Jonathan Adler, who has taught at Case since 2001, said a Texas federal judge’s recent ruling that struck down the entire healthcare law, commonly known as Obamacare, has analysis that the professor considers “bananas.” (Heisig, 12/18)

Bloomberg: Obamacare Battle Now Before A Baltimore Judge Picked By Obama 
Five days after a Texas judge declared the Affordable Care Act unconstitutional, Obamacare supporters are back in court in a bid to save it. A lawsuit filed in September as a hedge against just the sort of ruling U.S. District Judge Reed O’Connor in Fort Worth issued Dec. 14 is the new front in the nearly nine-year war over President Barack Obama’s signature achievement and could force the issue back before the U.S. Supreme Court. (Harris, 12/19)

Modern Healthcare: Texas ACA Ruling Complicates Politics Of Medicaid Expansion
A Texas federal judge's ruling Friday invalidating the Affordable Care Act could create political headaches for Medicaid expansion supporters in states that are moving to implement or maintain expansion. If it's upheld on appeal, which is highly uncertain, U.S. District Judge Reed O'Connor's decision declaring the entire ACA unconstitutional would eliminate federal authorization and funding for the expansion of Medicaid to low-income adults. That would force states to shoulder the full price of covering people who would not qualify for coverage under pre-ACA criteria, rather than having the federal government pick up 90% of the cost. (Meyer, 12/18)

In other news —

The Baltimore Sun: Maryland AG Frosh Seeks To Preserve Affordable Care Act And Opposes Acting U.S. Attorney General's Involvement
The Maryland attorney general's office is seeking to preserve its suit sustaining the Affordable Care Act while challenging the legality of Matthew Whitaker's appointment as acting U.S. attorney general. U.S. District Judge Ellen Hollander scheduled a hearing in the case for Wednesday morning in Baltimore. The suit seeks a declaration that the Affordable Care Act — once known as Obamacare — is constitutional, and it aims to uphold provisions protecting people with pre-existing medical conditions when they seek insurance. (Barker, 12/19)

Denver Post: Colorado Health Insurance Market Showing Stability, According To State Report
Uncertainty may be flooding the health care market after a Texas judge’s ruling on the Affordable Care Act, but in Colorado there is some good news: There’s another sign pointing to the individual market stabilizing. Insurers didn’t lose as much money on the individual market last year as they did in 2016 and 2015, according to a new report by the Colorado Division of Insurance. As for consumers, officials offered good news: They’re likely to see lower increases in their health insurance premiums than in previous years. (Seaman, 12/18)

The Wall Street Journal: Pfizer, Glaxo To Combine Consumer-Health Businesses
Pfizer Inc. and GlaxoSmithKline PLC plan to combine their consumer-health units, and eventually spin off the joint venture—creating a global giant selling drugstore staples like Advil and Sensodyne toothpaste. The deal announced Wednesday is an unexpected ending to a yearlong process by Pfizer to shed its consumer business, as it and other pharmaceutical companies focus more on higher-margin prescription-drugs. Glaxo has been pursuing the same focus, though has until now stayed committed to its consumer business, which its chief executive led before her promotion to the top job. (Martuscelli and Roland, 12/19)

The New York Times: GlaxoSmithKline And Pfizer To Merge Consumer Health Units
The companies said they expected the deal to close in the second half of next year, and that plans call for the new business to be spun off within five years via a listing on the British stock markets. The divisions being merged had combined global sales of $12.7 billion in 2017. (Condliffe, 12/19)

Bloomberg: Glaxo Plans Breakup After Pfizer Deal Combines Panadol, Advil 
The non-cash transaction creates the world’s biggest supplier of over-the-counter medicines with brands of painkillers such as Advil and Panadol and marks a shift from Glaxo Chief Executive Officer Emma Walmsley’s previously stated strategy of keeping the steadily performing consumer and vaccine businesses under the same roof as the more volatile pharma operations. (Paton, 12/19)

Reuters: Drugmaker GSK To Split After Striking Pfizer Consumer Health Deal
For Pfizer, the deal resolves the issue of what to do with its consumer health division, which includes Advil painkillers and Centrum vitamins, after an abortive attempt to sell it outright earlier this year. GSK, whose consumer products include Sensodyne toothpaste and Panadol painkillers, had withdrawn from that earlier Pfizer auction process but Walmsley said the opportunity to strike an all-equity deal cleared the way for the new agreement. (12/19)

In other health industry news —

Bloomberg: J&J, Imerys Said To Pay More Than $1.5 Million In Talc Case Deal 
Johnson & Johnson may be sending a peace signal after two years of warring over allegations that its iconic baby powder causes cancer. In what appears to be a first-of-its-kind settlement while facing thousands of lawsuits, the world’s largest health-care products maker and its talc supplier agreed to pay more than $1.5 million to a woman who claimed J&J’s baby powder gave her asbestos cancer, according to people familiar with the accord. (Feeley and Fisk, 12/18)

The New York Times: Allergan Halts Sales In Europe Of Textured Breast Implants Linked To Rare Cancer
Breast implants made by Allergan that have been linked to an uncommon form of cancer are being taken off the market in Europe, French authorities announced on Tuesday. The implants, which have a textured or slightly roughened surface, rather than a smooth covering, cannot be manufactured or sold in Europe for the time being, and the ones kept on hand at health centers are being recalled. (Grady, 12/18)

Reuters: Judge Mulls Using Monitor To Oversee CVS During Court Process
A federal judge said on Tuesday that he was considering using a court-appointed monitor to make sure CVS Health Corp refrains from fully integrating with insurer Aetna while he examines the companies' settlement with the government. Judge Richard Leon of the U.S. District Court for the District of Columbia held the hearing as part of his review of the antitrust settlement reached with the Justice Department to win approval for the companies' $69 billion merger. (12/18)

The New York Times: Judge Seeks Monitoring Of CVS And Aetna During Antitrust Review
Judge Richard J. Leon, of the United States District Court in the District of Columbia, stopped short of an attempt to block the $69 billion merger, but he reiterated his concerns over the Justice Department’s approval of the combination. He went on to scold the government’s lawyers for being “hostile to the role of the federal courts” in looking after the public’s interest, telling them they “would do well to re-evaluate the tone with which you address this court.” (Baumgaertner, 12/18)

The Wall Street Journal: CVS Urges Judge Not To Halt Integration Of Aetna
CVS has argued that halting all integration would cause irreparable harm to the company and its customers. Instead, it offered four measures it said would help facilitate Judge Leon’s review. Among them, CVS pledged that Aetna would maintain its historical control over pricing of products and services for its insurance customers, and that CVS and Aetna wouldn’t exchange competitively sensitive information for the time being. (Kendall, 12/18)

Modern Healthcare: CVS-Aetna To Keep Some Business Operations Separate While Judge Weighs Merger
CVS Health attorney Enu Mainigi said the company could follow its self-imposed measures for six months pending Leon's review, but that adhering to them any longer than that could prove problematic. Leon told her that he couldn't give "a promise or an estimate" on when he is likely to wrap up the review. "Each case is unique," he said. (Luthi, 12/18)

The New York Times: Trump Administration Report On School Safety Plays Down Role Of Guns
Unveiling a report commissioned by President Trump in the aftermath of a mass shooting last winter at a Florida high school, administration officials on Tuesday played down the role of guns in school violence while focusing instead on rescinding Obama-era disciplinary policies, improving mental health services and training school personnel in the use of firearms. The report — by the Federal Commission on School Safety, which consists of four cabinet officials and is led by Education Secretary Betsy DeVos — drew on months of research marked by political conflict and mixed messaging from the administration on how to handle violent events like the Feb. 14 shooting at Marjory Stoneman Douglas High School in Parkland, Fla. Seventeen students and staff members were killed and 17 others were injured in the shooting. (Rogers and Green, 12/18)

The Associated Press: Trump's Safety Panel Seeks To Revoke School Discipline Rules
The panel was asked to study a range of options to bolster security at America's schools, from the regulation of guns to the regulation of violent video games. Yet rather than suggest a series of sweeping changes, the commission issued 100 smaller suggestions that largely avoid strong stances on topics like gun control and whether schools should arm teachers. "Our conclusions in this report do not impose one-size-fits-all solutions for everyone, everywhere," said Education Secretary Betsy DeVos, who led the commission. "The primary responsibility for the physical security of schools and the safety of their students naturally rests with states and local communities." (Binkley, 12/18)

The New York Times: Trump Administration Imposes Ban On Bump Stocks
The Trump administration on Tuesday issued a new rule banning bump stocks, the attachments that enable semiautomatic rifles to fire in sustained, rapid bursts and that a gunman used to massacre 58 people and wound hundreds of others at a Las Vegas concert in October 2017. The new regulation, which had been expected, would ban the sale or possession of the devices under a new interpretation of existing law. Americans who own bump stocks would have 90 days to destroy their devices or to turn them in to the Bureau of Alcohol, Tobacco, Firearms and Explosives. The Justice Department said A.T.F. would post destruction instructions on its website. (Savage, 12/18)

Atlanta Journal-Constitution: Federal School Safety Plan Similar To State Proposal
President Donald Trump’s school safety commission on Tuesday released its report, saying the question of arming school teachers and other employees should be left to states and schools to decide. It also called for a rollback of an Obama-era policy that was meant to curb racial disparities in school discipline but that critics say left schools afraid to take action against potentially dangerous students. (Smith Broady, 12/18)

Meanwhile —

The New York Times: Nearly 40,000 People Died From Guns In U.S. Last Year, Highest In 50 Years
More people died from firearm injuries in the United States last year than in any other year since at least 1968, according to new data from the Centers for Disease Control and Prevention. There were 39,773 gun deaths in 2017, up by more than 1,000 from the year before. Nearly two-thirds were suicides. It was the largest yearly total on record in the C.D.C.’s electronic database, which goes back 50 years, and reflects the sheer number of lives lost. (Mervosh, 12/18)

The New York Times: Thousands Of Migrant Children Could Be Released After Policy Change
The Trump administration announced on Tuesday that it planned to ease onerous security requirements for sponsors of migrant children, meaning that thousands who have been parked in shelters for months could soon be released and reunited with family members. In a major policy reversal, the Department of Health and Human Services, which oversees the care of migrant children through its Office of Refugee Resettlement, said that it would no longer require that all members of a household where a child is to live be fingerprinted. Instead, fingerprints will be required only of the adult who is sponsoring the minor, typically a parent or another relative. (Jordan, 12/18)

Reuters: U.S. Reverses Policy In Move To Speed Release Of Migrant Children
The Department of Health and Human Services (HHS), which cares for children who cross the border alone, said on Tuesday the policy of fingerprinting all adults living with the sponsors enacted in June had increased the time children were in government custody without turning up more red flags. The number of immigrant children in government-run shelters has ballooned to a record 14,700 as of Dec. 17, according to HHS. U.S. laws limit the time migrant juveniles can be detained, so those caught crossing the border without a parent or legal guardian are often released to adult sponsors in the United States. The children are then expected to show up to immigration court to fight their deportation cases. (12/18)

The Hill: Thousands Of Migrant Children Could Be Released Under Newly Relaxed Trump Policy
Starting immediately, only the sponsors will continue to be fingerprinted and run through FBI and state databases and through Department of Homeland Security arrest records. The administration has come under fire for the policy, which immigration advocates say has resulted in thousands of children remaining in HHS custody for longer than necessary. The requirement was first put into place in June. (Weixel, 12/18)

The Washington Post: Democrats Retrace Migrant Girl’s Journey Before Her Death, Denounce Conditions At Border Patrol Stations
Democratic lawmakers who came to the Border Patrol station here Tuesday vowing to investigate the death of a 7-year-old migrant girl emerged from their tour with a litany of accusations but few solutions for helping the agency manage the surge of families that has left agents overwhelmed. The congressional delegation, led by members of the House Hispanic Caucus, described a facility jam-packed with families, lacking sufficient medical care and poorly equipped to care for children. “The only reason this facility is still open as it is now is because these cameras can’t get in,” Rep. Al Green (D-Tex.) told reporters who had to wait outside the station, nearly 90 miles north of the border along Interstate 10. (Miroff, 12/18)

The Associated Press: Officials Baffled By Large Migrant Groups At Remote Crossing
Large numbers of Guatemalan families and unaccompanied children are surrendering to U.S. immigration agents in an extremely remote and dangerous stretch of New Mexico desert, a new smuggling route that has baffled authorities. It is where 7-year-old Jakelin Caal and her father were found Dec. 6 with 161 others near a border crossing in Antelope Wells. ... The U.S. has shifted additional medical personnel and more vehicles to Lordsburg and Antelope Wells to help manage. (Spagat and Long, 12/18)

In other news —

WBUR: Proposed 'Public Charge' Rule Could Make It Difficult For Legal Immigrants To Get Visas
The Trump administration has proposed a new "public charge" rule requiring officials to look at legal immigrants' use of public benefits when evaluating their visa applications. Health care professionals fear fewer immigrants will get preventative care and other public services like food assistance, leading to health problems in cities with large immigrant populations. (Trovall, 12/18)

Modern Healthcare: Rubio Launches DSH Overhaul Debate In Senate 
Florida's GOP Sen. Marco Rubio on Tuesday jump-started legislative talks for a potential congressional overhaul of how the federal government pays out billions of dollars in disproportionate-share hospital funding.Under current law, Florida receives one of the lowest allotments in the country and Rubio seeks to remedy this in his new bill. Rubio has proposed tweaking the so-called DSH funding formula so a state's allotment is based on its overall population of adults below poverty level. Hospitals that treat a high number of very poor patients would get more money, and states would be able to reserve some unspent DSH funds to use in the future. (Luthi, 12/18)

Reuters: U.S. Surgeon General Wants Tougher Action To Tackle Teen Vaping Epidemic
U.S. Surgeon General Jerome Adams on Tuesday issued a rare advisory calling for aggressive steps against e-cigarette use among teens, which he said has become an "epidemic". The detailed advisory listed various strategies that states, communities, health professionals and parents can apply to restrict the use of e-cigarettes. (12/18)

The Hill: Surgeon General Calls For More Restrictions To Battle Youth Vaping
"We need to protect our kids from all tobacco products, including all shapes and sizes of e-cigarettes,” Adams said in the advisory. “Everyone can play an important role in protecting our nation’s young people from the risks of e-cigarettes.” The National Institute on Drug Abuse on Monday released data showing that the number of high school seniors who say they used an e-cigarette within the last 30 days spiked by 75 percent since last year, according to the advisory. (Birnbaum, 12/18)

NPR: Vaping 'Epidemic' Among Youths Declared By U.S. Surgeon General
The surgeon general's advisory called on parents and teachers to educate themselves about the variety of e-cigarettes and to talk with children about their dangers. Health professionals should ask about e-cigarettes when screening patients for tobacco use, the advisory said. And local authorities should use strategies, such as bans on indoor vaping and retail restrictions, to discourage vaping by young people. (Stein, 12/18)

The New York Times: Addicted To Vaped Nicotine, Teenagers Have No Clear Path To Quitting
A Harvard addiction medicine specialist is getting calls from distraught parents around the country. A Stanford psychologist is getting calls from rattled school officials around the world. A federal agency has ordered a public hearing on the issue. Alarmed by the addictive nature of nicotine in e-cigarettes and its impact on the developing brain, public health experts are struggling to address a surging new problem: how to help teenagers quit vaping. (Hoffman, 12/18)

The New York Times: How To Help Teenagers Quit Vaping
Nicotine is the addictive chemical that chains both cigarette smokers and vapers, compelling them to repeated use. Its grip is tough to break. Teenagers, whose brains are still developing, are particularly susceptible. Parents and educators are discovering that, unfortunately, there are no established protocols to help teenagers quit vaping. But there are measures parents can take. (Hoffman, 12/18)

The New York Times: Suicide Among Veterans Is Rising. But Millions For Outreach Went Unspent By V.A.
Suicide prevention efforts by the Department of Veterans Affairs fell off sharply in the last two years, even though reducing the high suicide rate among veterans is the agency’s top clinical priority, according to a new report. With the department’s top management in turmoil, the suicide prevention effort lacked leadership, planning meetings were repeatedly canceled, millions of dollars budgeted for outreach went unspent, and the television and radio ads that had been broadcast thousands of times across the country in previous years went all but silent. (Philipps, 12/18)

The Washington Post: Trump’s VA Vowed To Stop Veteran Suicide. Its Leaders Failed To Spend Millions Set Aside To Reach Those At Risk. 
As the number of veterans taking their own lives climbed, VA’s media outreach plunged in fiscal years 2017 and 2018 — with fewer social media posts, public service announcements and paid advertisements compared with the agency’s efforts during the Obama administration, auditors said. About 20 veterans die by suicide every day, VA data shows. That’s nearly twice the suicide rate among Americans who did not serve in the military. VA set aside $6.2 million this year alone to advertise its crisis hotline — the centerpiece of its suicide-prevention efforts — online, on billboards, buses and trains, and via local and national radio commercials. But as of September, the agency had spent $57,000 — less than 1 percent of that budget, auditors wrote. (Rein, 12/18)

The Hill: VA Left Millions Unspent For Veterans Suicide Prevention: GAO 
The department's use of social media for veterans suicide prevention outreach also dropped in fiscal years 2017 and 2018, the report found. After developing 339 pieces of social media content for veterans suicide prevention in President Obama's final year in office in 2016, the department posted 159 pieces of content in fiscal year 2017 and had made 47 posts in fiscal year 2018 as of July 2018. Officials at the Veterans Health Administration, the health-care branch of the department, told the GAO that the drop off in suicide prevention media outreach was because of leadership turnover dating back to 2017. (Burke, 12/18)

ProPublica: The VA’s Private Care Program Gave Companies Billions and Vets Longer Waits
For years, conservatives have assailed the U.S. Department of Veterans Affairs as a dysfunctional bureaucracy. They said private enterprise would mean better, easier-to-access health care for veterans. President Donald Trump embraced that position, enthusiastically moving to expand the private sector’s role. Here’s what has actually happened in the four years since the government began sending more veterans to private care: longer waits for appointments and, a new analysis of VA claims data by ProPublica and PolitiFact shows, higher costs for taxpayers. (Arnsdorf, 12/18)

Tampa Bay Times: The VA’s Private Care Program Gave Companies Billions And Vets Longer Waits
They said private enterprise would mean better, easier-to-access health care for veterans. President Donald Trump embraced that position, enthusiastically moving to expand the private sector’s role. Here’s what has actually happened in the four years since the government began sending more veterans to private care: longer waits for appointments and, a new analysis of VA claims data by ProPublica and PolitiFact shows, higher costs for taxpayers. (Arnsdorf and Greenberg, 12/18)

Politico: Anti-Abortion Groups Demand Ouster Of NIH Chief Over Fetal Tissue
Two influential anti-abortion groups called Tuesday for the ouster of NIH Director Francis Collins over his support for fetal tissue research for medical science. Live Action, March for Life and other conservative groups have been frustrated that the Trump administration has not banned research using fetal tissue donated by women who have had abortions. (Ollstein, 12/18)

The Hill: Anti-Abortion Groups Call On NIH Chief To Resign In Fight Over Fetal Tissue 
“Collins’ actions are inconsistent with the pro-life policies of this administration and with the consensus of Americans who oppose entangling taxpayer dollars with abortion. It is time for his departure,” March for Life President Jeanne Mancini said in a statement. "Director Collins must be replaced with someone who recognizes that children who are killed by abortion should be mourned, not experimented on,” Live Action President Lisa Rose said in her group's statement. (Hellmann, 12/18)

The Washington Post: NIH Official Commits To Continued Funding For Some Fetal Tissue Research
The National Institutes of Health pledged Tuesday at a private meeting of scientists who use fetal tissue that the government’s premier funder of biomedical research would continue to support such work despite a conservative broadside against it. The commitment by a senior official of NIH’s National Institute for Allergy and Infectious Diseases to continue funding for researchers who work for nongovernment labs came at the end of a seven-hour meeting with about 40 researchers from around the country, according to two participants. (Goldstein, 12/18)

The Wall Street Journal: U.S. Weighs Potential Conflicts In Hospital-Accreditation Groups With Consulting Arms
The Trump administration is weighing whether to continue approving hospital and health-accreditation groups that also have consulting arms, following potential conflicts of interest raised in an article in The Wall Street Journal. Among the groups affected could be the Joint Commission, the nation’s largest hospital and health organization accrediting organization. Critics say the commission’s role — accrediting most of the nation’s hospitals while also providing consultants for facilities hoping to be accredited — creates a conflict. The consultants are available through a commission subsidiary. (Armour, 12/18)

The Washington Post: Congressional Report: Drug Companies, DEA, Failed To Stop Flow Of Millions Of Opioid Pills
The distributors of powerful prescription opioids and the Drug Enforcement Administration failed to stop the flow of millions of pills into rural West Virginia despite rampant warning signs that the pills were being diverted for abuse, inertia that contributed to the nation’s opioid epidemic, a congressional report has found. A report from the majority staff of the House Energy and Commerce Committee found that distributors, which fulfill orders for prescription drugs to pharmacies, failed to conduct proper oversight of their customers by not questioning suspicious activity and not properly monitoring the quantity of painkillers that were being shipped to individual pharmacies. (Zezima, 12/19)

The Washington Post: FDA Panel Backs Prescribing Opioid Antidote Alongside Painkillers
Advisers to the Food and Drug Administration recommended Tuesday that labels on prescription opioids urge doctors to simultaneously prescribe the overdose antidote naloxone for at least some of their patients. Several members of two advisory committees, which met jointly, described their 12-to-11 vote as a message to the government that the fast-acting antidote must be made more widely available, at lower cost and with fewer barriers to obtaining it. (Bernstein, 12/18)

Kaiser Health News: Hep C And Drug Abuse Often Go Hand In Hand, But Screening For Infection Lags
When people seek help at a drug treatment center for an opioid addiction, concerns about having contracted hepatitis C are generally low on their list. They’ve often reached a crisis point in their lives, said Marie Sutton, the CEO of Imagine Hope, a consulting group that provides staff training and technical assistance to facilitate testing for the liver-damaging virus at more than 30 drug treatment centers in Georgia. (Andrews, 12/19)

San Francisco Chronicle: SF Sues Drug Companies Over Marketing Of Addictive Painkillers
San Francisco City Attorney Dennis Herrera filed a federal lawsuit Tuesday accusing Purdue Pharma and other pharmaceutical companies of fueling the nation’s epidemic of opioid addiction by deliberately misleading doctors and the public about the dangers of powerful painkillers. In a complaint running more than 160 pages, Herrera’s office alleges that Purdue, which makes OxyContin, and the drugmakers Janssen Pharmaceuticals, Endo Pharmaceuticals, Cephalon, Insys Therapeutics, Mallinckrodt Pharmaceuticals and Actavis, aggressively marketed addictive opioid painkillers to treat chronic pain knowing they had a high potential for abuse. (Fracassa, 12/18)

Boston Globe: Fed Up With Stepping Over Needles To Walk To School, Students Stage A Protest
The students of the Orchard Gardens K-8 Pilot School in Roxbury wanted to send a message that they had had enough: enough of the dirty syringes that surround their school and playgrounds, and enough of official indifference to their safety. So they gathered at the corner of Melnea Cass Boulevard and Albany Street — along with their parents, many of their teachers, and some community activists — and held a protest. (Walker, 12/19)

Seattle Times: Inslee Proposes $30M In Budget To Address Opioid Crisis In Washington 
Gov. Jay Inslee proposed the state spend $30 million to help combat the opioid epidemic by creating new programs and complementing actions already underway across the state. The money, included in his proposed  $54.4 billion budget, would be directed toward treatment and prevention of opioid-use disorder. Under the umbrella of treatment, programs ranging from peer support to residential programs for women would get funds. (Blethen, 12/18)

The Associated Press: California Doctor Accused Of Prescribing Drugs In 5 Deaths
A Southern California doctor was arrested Tuesday on charges of doling out drugs to patients he didn’t examine and is alleged to have prescribed drugs to five people who died of overdoses as well as an impaired driver who struck and killed a bicyclist, federal prosecutors said. Dr. Dzung Ahn Pham, 57, faces charges of illegally distributing powerful opioids and prosecutors said he prescribed drugs to addicts or people selling them on the street. He prescribed some drugs after receiving text messages requesting specific quantities and doses, prosecutors said. (Melley, 12/18)

The Washington Post: Boyhood At 11 And 12: Navigating A Social Ecosystem That Prizes Alpha Males Over Quirky Kids
At the height of summer, a trio of tween boys walk away from the muggy heat and into the chilled air of their favorite place, the hockey rink. This is where their friendship was formed. It’s where they unleash their aggressions, test their abilities and confront disappointment, and where they saw one of their own through tragedy. It’s where they learned that the claw game is totally rigged but still beg their parents for quarters to see if they can beat it. (McCarthy and Joyce, 12/18)

Politico: Training The EHR To Speak When A Child Can’t
At the UPMC Children’s Hospital in Pittsburgh, scores of babies and older children with head trauma are admitted each year and abuse is the leading cause of death in the ICU. These injured patients are often too young to explain their bruises and fractures, whether accidental or inflicted. If caretakers are responsible, they may not admit it to clinicians, who usually must flag young patients for screening based on their own intuition. (Ravindranath, 12/18)

The New York Times: How Exercise May Make Us Healthier
People who exercise have different proteins moving through their bloodstreams than people who do not, according to an interesting new study of the inner landscapes of sedentary and active people. The proteins in question affect many different aspects of our bodies, from immune response and blood-sugar levels to wound healing, so the new findings may bring us closer to understanding just how exercise enhances our health at a deep, molecular level. (Reynolds, 12/19)

NPR: A Partnership Between Hospital And Campus Helps Students Through A Breakdown
Sometimes a psychiatric crisis can be triggered by something small. For Alexia Phillips, 21, it was a heated argument with a close family member in February 2017. She remembers the fight blew up before she left the house to go to classes at Queens College in Flushing, New York. By midday, Phillips, then a sophomore, says she began to cry loudly and uncontrollably. (Weinstock, 12/18)

San Jose Mercury News: Shampoo, Soap May Play A Role In Early Puberty
Many parents already worry about the chemicals in the personal care products that their kids use but now a new study takes that fear to the next level: the exposure starts even before a child is born. Girls exposed to chemicals commonly found in shampoo, toothpaste and soap may hit puberty earlier, even if their only exposure is through the products their moms used while were pregnant, according to a new longitudinal study led by researchers at UC Berkeley. (D'Souza, 12/18)

Stat: Sales Of Antibiotics Used In Food-Producing Livestock Dropped Last Year 
After years of concern over the use of medically important antibiotics given to food-producing livestock, sales of these medicines fell 33 percent in the U.S. in 2017, according to a new report by the Food and Drug Administration. Notably, the results are the first to include sales and distribution data that was gathered after these medicines were no longer allowed to be used for promoting growth in food-producing livestock and could only be obtained through a veterinarian. Bulking up the animals makes them better suited for increased production, but can also encourage unnecessary antibiotic use. (Silverman, 12/18)

CNN: Nearly Two-Thirds Of US Women Use Contraception, CDC Reports
The most common methods for preventing pregnancy, according to a new government report are female sterilization, oral contraception, long-acting reversible contraception such as IUDs and implants and male condoms. To help understand fertility patterns across demographics, researchers combed through the latest data from the National Survey of Family Growth to study contraceptive use among women. (Ravitz, 12/19)

The New York Times: Breast-Feeding Tied To Smaller Waist Size In Mother
Breast-feeding for longer than six months may lead to a smaller waist size for the mother, researchers report, and the effect persists for as long as a decade. Their analysis, in The Journal of Women’s Health, used data on 678 women enrolled in two studies who were followed for an average of 11 years after giving birth. (Bakalar, 12/18)

CNN: Loneliness Peaks At Three Key Ages, Study Finds
Rising rates of loneliness may not be news, but the three periods when it peaks may come as a surprise: More people reported feeling moderate to severe loneliness during their late 20s, their mid-50s and their late 80s than in other life periods, according to research published Tuesday in the journal International Psychogeriatrics. The general sense of isolation was also more prevalent than the researchers expected. A full three-quarters of all study participants reported moderate to high levels of loneliness, said Dr. Dilip Jeste, senior author of the study and a professor of psychiatry and neurosciences at the University of California, San Diego. (Scutti, 12/19)

The New York Times: The Hospital’s Gift Of Downtime
Christmas week is a strange time in the hospital. There’s an added melancholy for patients who spend the holidays hospitalized — a sense that their illness, whatever it might be, is so bad they must lie in bed while the world hangs ornaments and roasts chestnuts on open fires. It’s a time when the doctors and nurses on call start to feel the weight of jobs that too often keep them close to computers and far from their families. (Khullar, 12/19)

The Washington Post: D.C. Council Approves Bill Relaxing Restrictions On Southeast Hospital Deal
A deal to build a new hospital east of the Anacostia River appeared to survive — at least temporarily — on Tuesday, as the D.C. Council approved a last-minute measure that proponents say will allow negotiations for the project to move forward. The legislation, most of it drafted by council member Vincent C. Gray (D-Ward 7), stipulated that Howard University’s medical school must have an academic affiliation with either the new hospital or some other medical facility. (Jamison, 12/18)

The Associated Press: State Medical Board Confirms Complaint Records On OSU Doctor
The State Medical Board has acknowledged for the first time that it has confidential records about the investigation of a complaint involving former Ohio State University team doctor Richard Strauss who is accused of widespread sexual misconduct against students decades ago. The documents can't be viewed by the law firm investigating allegations that Strauss abused scores of male student-athletes in the 1980s and 1990s, but still might help guide its inquiry. (12/18)

The Star Tribune: Minnesota AG Swanson Seeks Law On For-Profit Health Plan Deals 
Attorney General Lori Swanson is reminding lawmakers that a moratorium blocking nonprofit health plans from becoming for-profit companies is set to expire next year, and therefore requires follow-on legislation. Swanson is highlighting the issue in a letter to Gov.-elect Tim Walz and legislative leaders that was obtained by the Star Tribune. The attorney general, who is leaving office next year, pushed for the current moratorium on for-profit conversions following 2017 legislation that struck down a 40-year ban on for-profit HMOs in Minnesota. (Snowbeck, 12/18)

KQED: In Effort To Keep Alta Bates Open, Officials Point To New Report About Potential Impacts Of Closure
Politicians and unions in the East Bay are stepping up the pressure on Sutter Health to keep Alta Bates Medical Center operational as a full-service hospital. On Tuesday, a task force unveiled a long-awaited report by UC Berkeley heath planning researchers on the impact of the hospital closure on health in the East Bay. (Dillon, 12/18)

Dallas Morning News: Medical City Fort Worth's New $65 Million Tower Expands ER, Intensive Care Unit 
Medical City Fort Worth will begin accepting patients Wednesday in a new three-story, $65 million tower that expands its emergency services. The 90,000-square-foot tower includes a 30-room emergency department, a 28-bed intensive care unit and a rooftop helipad for easier access to the ER. Jyric Sims, CEO of Medical City Fort Worth, described the project as "a labor of love" that brings advanced technology to its emergency room. (O'Donnell, 12/18)

Georgia Health News: Effort To Change Georgia’s CON Laws Gains More Momentum
Following a similar move by a House panel, a Georgia Senate study committee has proposed some major changes in the state’s health care regulatory structure known as certificate of need (CON).The panel, chaired by state Sen. Ben Watson (R-Savannah), a physician, has formulated draft legislation that could ease restrictions involving Cancer Treatment Centers of America, which has a hospital in Newnan, and clear a path for a planned sports medicine center in Alpharetta. (Miller, 12/18)

Atlanta Journal-Constitution: Flu Season In Georgia: How Schools, Churches Are Coping
With Christmas less than a week away, the leader of the state’s 1.2 million Catholics is asking parishioners to consider skipping services if they think they have the flu and says the church may take further steps, so grave are fears about another dangerous flu season. Atlanta Archbishop Wilton D. Gregory said in a memo to priests and deacons that the situation will be monitored. (Poole and Stirgus, 12/17)

KCUR: After Her Son Nearly Rejects Transplanted Liver, Missouri Woman Campaigns Against Mail-Order Drugs 
The big three mail-order companies – Express Scripts, CVS Caremark and OptumRX – insist that’s not a problem. They say they’ve got shipping drugs down to a science. Inside an enormous OptumRX warehouse in a Kansas City suburb, an endless line of orange prescription bottles flies along conveyor belts while pharmacists scan barcodes and technicians refill bins of pills. Lead pharmacist Alysia Heller explains that this shipping behemoth, which sends out up to 100,000 prescriptions a day, includes a system to account for weather. (Smith, 12/19)

The Oregonian: PeaceHealth To Buy Zoom Care After Years Of Legal, Financial Troubles
A West Coast hospital chain has agreed to acquire Portland-based Zoom Care, in a move that will likely bring stability to the chain of neighborhood clinics. Executives would not discuss the financial terms of the merger announced Tuesday. The companies’ leadership would remain separate, they said. But it is unclear whether the charismatic CEO Dave Sanders will remain with Zoom after the deal is completed. PeaceHealth, founded in Vancouver, operates clinics and laboratories in Oregon, Washington and Alaska. The health system generated revenue of $2.2 billion in 2016 and employs about 16,000. Besides its major hospital in Springfield, the company operates Sacred Heart University in Eugene and PeaceHealth Southwest Medical Center in Vancouver. (Harbarger, 12/18)

Denver Post: Kaiser Permanente Faces National Labor Relations Board Complaint
Unions representing Kaiser Permanente employees in Colorado and seven other states say the National Labor Relations Board has agreed to consider a complaint that the company is illegally refusing to negotiate new contracts. The Coalition of Kaiser Permanente Unions is also challenging what it says is an attempt by the company to prevent union members from engaging in political action, Sean Wherley, a spokesman for SEIU-United Healthcare Workers, said Tuesday. (Kohler, 12/18)

The Philadelphia Inquirer: Big Marijuana Tightens Grip, Receives Most New Pa. Dispensary Permits
On Tuesday, the state Department of Health doubled the number of marijuana dispensaries that will be allowed to set up shop in Pennsylvania, awarding 23 new permits to cannabis companies. Each permit will allow a company to operate three retail storefronts. The latest batch of licensing brings the total number of permits to 50. (Wood, 12/18)

Stat: A Drug That Was Once Inexpensive Gets A New Price Tag: $375,000
An old, formerly inexpensive drug called Firdapse was just slapped with a steep new price tag: $375,000. The Food and Drug Administration approved Firdapse late last month to treat a rare, neuromuscular disorder called Lambert-Eaton myasthenic syndrome. Although it’s the first approved therapy for this disease in the U.S., there’s a catch: For years, hundreds of patients have been receiving an unapproved version of this drug for free. (Keshavan, 12/13)

The New York Times: Trump Officials Say Drug Prices Are Inflated. So Are Some Of Their Claims On A Solution.
In his zeal to fulfill a campaign promise, President Trump has correctly identified high drug prices as a major problem for many Americans. But in defending his proposed solutions, he has sometimes stretched the facts. Mr. Trump has proposed that Medicare pay for certain prescription drugs based on the prices paid in other developed countries. He called this “a revolutionary change” and said it would save money for the government and for Medicare beneficiaries without hurting their ability to get the medicines they need. (Pear, 12/16)

Stat: Feds Want To Dismiss Lawsuits Alleging Nurse Programs Are Kickbacks 
In a boon to the pharmaceutical industry, the federal government moved to dismiss nearly a dozen lawsuits alleging drug makers devised schemes in which nurses were used illegally to promote their medicines and boost prescriptions, an arrangement that purportedly violated federal kickback laws. In explaining its rationale, the U.S. Department of Justice argued the company that made the allegations was a “professional” whistleblower that used “false pretenses” to gather information for the “cloned” lawsuits. The feds complained that several investors created a company to file the lawsuits and pretended to conduct research studies in order to obtain information for their allegations, according to court documents in a case involving Bayer Pharmaceuticals. (Silverman, 12/17)

Reuters: Indivior Plans Cheaper Opioid Addiction Drug If Rivals Launch Copycats
Indivior Plc said on Tuesday it could launch a cheaper version of its blockbuster opioid addiction treatment, Suboxone, if rivals release generic versions of the drug. The British drugmaker is also looking to reduce its dependence on Suboxone, which accounts for about 80 percent of its revenue, by focusing on another opioid addiction drug Sublocade and schizophrenia treatment Perseris. (Aripaka and Nair, 12/18)

Bloomberg: Big Pharma Grants License To Kill Drug Programs As Costs Surge
Big Pharma is looking for good kills, and its own labs are the hunting ground. Industry executives long trained to sniff out blockbuster drugs are now having to hone another skill: a feel for medicines that are unsafe, unoriginal or just unlikely to succeed. As costs escalate, knowing when to terminate those medicines has become just as important as when to move forward. (Lauerman and Paton, 12/13)

Stat: Pharma Sales Growth Is Being Crimped As Price Hikes Diminish
In the pharmaceutical world, price hikes have been the gifts that keep on giving because the hefty cumulative effects of rising price tags greatly help year-over-year revenue growth. But a new analysis suggests the trend will slow considerably as drug makers face political pressure over pricing practices. To wit, the compounded effect of rising prices contributed, on average, 5 percent in revenue growth annually over the last five years. Although total revenue growth slowed over the past year to around 1 percent, without price increases, the sales growth would have declined by a notable 6 percent, according to Leerink analyst Geoffrey Porges, who analyzed data for 17 large drug makers. (Silverman, 12/14)

Reuters: Bristol-Myers Gets $1.6 Billion Offer For French Consumer Health Unit
Bristol-Myers Squibb Co received an offer from Japanese healthcare firm Taisho Pharmaceutical Holdings Co Ltd to buy the company's French over-the-counter drugs business UPSA for $1.6 billion, the companies said on Wednesday. Bristol-Myers said it estimates the potential deal would be approximately $0.04 dilutive to 2019 earnings. (12/19)

FiercePharma: Shire Gears Up To Battle Allergan's Linzess With New Constipation Drug Motegrity
Takeda is set to gulp up Shire, whether disgruntled investors like the deal or not. But for those in the latter camp, the biotech’s latest approval may make it easier to swallow. The company has picked up an FDA blessing for Motegrity, which will take on rivals from Allergan and Synergy in the chronic idiopathic constipation market. Unlike its competitors, Motegrity works by stimulating muscle movement in the colon, Shire said. (Helfand, 12/17)

Bloomberg: Activist Is Said To Push Drugmaker Clovis To Pursue A Sale
Armistice Capital LLC, which has an activist stake in Clovis Oncology Inc., has encouraged the cancer drugmaker to pursue a sale, according to a person familiar with the matter. The hedge fund has been in contact with Clovis’s management about the matter, the person said. Last month, Armistice disclosed in a securities filing that it had amassed a 9.8 percent stake, making it Clovis’ second-biggest holder. At the time, it said it could push for a sale, management changes or other options. (Tan and Koons, 12/17)

Stat: Novartis Braces For A Battle Over The Cost Effectiveness Of A Gene Therapy 
In advance of a key report, Novartis is trying to prepare payers and policymakers for a forthcoming gene therapy that the company argues would be cost effective at $4 million to $5 million for each patient. The drug maker held a media briefing on Monday to discuss a draft report due later this week from the Institute for Clinical and Economic Review on Zolgensma, which was developed to treat spinal muscular atrophy, a rare and inherited neurodegenerative disease that in its most fatal form causes children to die by the time they turn 2 years old. Trials showed a single dose corrected a defective gene. (Silverman, 12/17)

Bloomberg: Novartis May Team With Reinsurers To Cut Drug Costs, FT Reports
Swiss drugmaker Novartis AG is considering working with reinsurers to provide alternative financing options for life-saving drugs, potentially saving substantial health-care costs, Financial Times reported on Sunday. Among the options proposed includes a “reinsurance model in which a third party underwrites the catastrophic case of a child having one of these conditions," Novartis Chief Executive Officer Vas Narasimhan told the FT in an interview. (Poh, 12/16)

FiercePharma: Lilly's Taltz Beats Out AbbVie's Megadrug Humira In Psoriatic Arthritis Showdown
What’s a surefire way to get noticed in any field? Beat out a behemoth. And that’s what Eli Lilly’s Taltz has just done in psoriatic arthritis (PsA). Monday, the Indianapolis drugmaker said its anti-inflammatory player had topped AbbVie’s Humira, the world’s best-selling drug, in a study of PsA patients who hadn’t yet been treated with a biologic. At week 24, patients treated with Taltz showed more symptom improvement than those who’d taken the megablockbuster. (Helfand, 12/18)

FOX31 Denver: Insulin, Other Drug Prices To Be Major Topic At Colorado State Capitol 
When Democrats take office in January, the progressive agenda will be lengthy. Unlike previous years, Democrats will control the State House, State Senate, and governor's office. Prescription drug prices are one of the things they will discuss. "It is really outrageous. We are getting ripped off," Governor-Elect Jared Polis told FOX31 in a September interview. (St. George, 12/17)

Boston Globe: A Dangerous Plan For Rationing Essential Prescription Drugs
This past summer, Rhode Island-based CVS Caremark, the biggest pharmacy benefit manager (the intermediary between drug manufacturers and insurers), announced that it would allow its insurer clients to exclude from their plans any drugs priced greater than $100,000 per QALY. The CVS decision allows insurers to forbid access to prescription drugs that cost more than $100,000 per extra year lived in perfect health or per extra few years lived in mediocre health. (Terry Wilcox, 12/17)

Washington Examiner: Elizabeth Warren's Silly Drugmaking Scheme
Should the U.S. government create its own chain of grocery stores — “Uncle Sam’s Club”? Should it begin a new government-run restaurant? A new government chain of gas stations — “7-Eleven Trillion,” perhaps? Should Uncle Sam build his own line of patriotic American cars (“Government Motors”)? How about government oil-drilling and coal-mining companies, or government makers of solar panels? (12/19)

The Wall Street Journal: More Lawsuits = Higher Drug Prices
What spreads holiday cheer like a defeat for the trial lawyers? So seasons greetings from the Food and Drug Administration, which last week withdrew a destructive rule that would have enriched the tort bar at the expense of patients who rely on prescription medicines. The rule proposed by the Obama Administration in 2013 allowed generic drug makers to tailor their own safety labels, which historically must be identical to the branded product. The rule’s biggest supporter was the plaintiffs bar, which figured this would open up more opportunities for lawsuits for failing to warn consumers about all and sundry risks. The practical effect would be to make drug labels even more incomprehensible than they are now, varying among products that are chemically identical. Side effects may include confusion. (12/18)

Stat: Cure 'Futures' Offer A Way To Pay For Million-Dollar Medicines
You could buy a futures contract as a call option for the right to purchase a therapy that has not yet been invented but is close. Individuals would pay something, say $250 a year for illustration purposes, for the right to buy a disease-specific cure at a fixed affordable amount, one that their health plan would likely cover. Contract owners who end up not needing this cure could sell their contracts to people who need or want access to it. For multiple diseases, one would need to buy multiple contracts. That annual option purchase, paid by tens of millions of people to the institutions working on cures for specific diseases, would help fund research into new drugs and make the resulting cures more affordable. Think of it as a giant Kickstarter campaign. (Maria Ferrante-Schepis, 12/14)

New England Journal of Medicine: Disclosing Prescription-Drug Prices In Advertisements — Legal And Public Health Issues
Under a new proposed rule, television advertisements for prescription drugs and biologic products would be required to disclose the product’s list price. Although there is broad support for improving price transparency, the rule raises public health and legal concerns. (Stacie B. Dusetzina and Michelle M. Mello, 12/13)

Stat: How Traditional Pharmacies Can Survive The Amazon Threat
Are traditional pharmacies doomed to the same fate as Borders, Blockbuster, and Sears? The threat is real.Companies like Capsule and PillPack are redesigning the pharmacy for the digital age. In addition to making it effortless to get prescription medications, these disruptors are bent on cutting out the physical store. This summer, Amazon bought PillPack, bringing heft, customer-service expertise, and gargantuan corporate ambition to the fight. (Vik Panda, 12/13)

The Hill: Medicare Drug Proposal Will Prevent New Medicines From Coming To Market
A new threat has emerged to our country’s position as the global leader in pharma innovation and it comes from within our borders. The administration's new proposal to tie Medicare reimbursement to the price control rates paid by European single-payer states will undoubtedly harm competition and reduce the number of new medicines coming to market. As a former secretary of the Department of Health and Human Services (HHS), I want to suggest another way to get to the same result rather than foreign price controls as a reference price for Medicare drugs. (Former Department of Health and Human Services Secretary Tommy G. Thompson, 12/18)

The Virginia Gazette: Seeking Clarity On Drug Pricing
Health and Human Services Secretary Alex Azar wants to make prescription drug pricing more transparent. We agree, but his well-intentioned plan will only confuse and mislead consumers. What's the good of listing drug prices in advertising if almost no one pays that "list price?" When patients say, "My drugs are too expensive," they're not talking about the list price — they're talking about their co-pays at the pharmacy. (Peter J. Pitts and Merrill Matthews, 12/11)

The Hill: States Have New Roadmap For Health Care Reform 
A new federal report gives states a roadmap for improving access to health care and making it more affordable, and lawmakers across the nation should act on it soon. The report, a collaboration of several agencies, is a much-anticipated response to President Donald Trump’s 2017 executive order to promote choice and competition in the health care marketplace. That order and the report are based on a recognition that state and federal regulations have created significant barriers to innovation in health care, declines in the quality of care, and cost increases that taxpayers cannot sustain. (Lindsay Killen, 12/18)

Forbes: The 5 Biggest Healthcare Stories Of 2018 And The Bad News Ahead
Dems take House. Kavanaugh confirmed. Trump undermines Obamacare. Baby genetically altered. Drug pricing under attack. Gawande becomes CEO.Bold, juicy and salacious, these headlines kept the spotlight on healthcare throughout 2018. And despite the hype these stories generated, here's a rather boring prediction for 2019: Not much is going to happen to U.S. medicine next year. In fact, 2019 will be a year of ongoing inaction and erosion within the U.S. healthcare system. This puttering will ultimately set the stage for industry-wide change down the road. (Robert Pearl, 12/17)

The Hill: Health Care Will Suffer If Judge's ACA Rule Stands 
Though the Affordable Care Act has so far withstood Trump administration sabotage and two Supreme Court challenges, the health care system goes through unnecessary shocks every time the law is threatened — and everyday people (especially older Americans) must live in constant fear of losing coverage. If the federal judge’s decision is allowed to stand, tens of millions of Americans would lose health coverage — and the roughly 1 in 2 non-elderly Americans with pre-existing conditions might not be able to find an affordable plan. (Max Richtman, 12/18)

The Detroit News: Home Care Necessary In Health Care
According to caregiver.org, by 2050, the number of Americans in need of long-term care services is expected to double from the 13 million using services in 2000, to 27 million people. Medicare Advantage will be a critical introduction and, depending on coverage levels and reimbursements, it is expected to not only increase the quality of life and care for a growing population that is aging in place, but may also provide critical data in the years ahead for non-medical home care that effectively decreases hospital readmission rates and emergency department visits for seniors. (Steve Greenbaum, 12/18)

Miami Herald: Medicare Advantage Should Provide What Patients Truly Need, Not Just What’s Covered 
Three in four Americans over 65 live with multiple chronic conditions, such as diabetes, heart disease and asthma, and the cost of providing their care is rapidly increasing. Beginning in January, Medicare Advantage, or MA, Medicare’s managed-care plans, will offer some relief by providing health-related supplemental benefits to beneficiaries with chronic conditions. Some plans will offer new benefits such as smoking cessation programs, in-home personal assistance, caregiver support and adult daycare. But that’s not enough. (Katherine Jett Hayes, 12/17)

The Washington Post: A Proposed New ‘Public Charge’ Rule Puts Children’s Health Insurance At Risk
The obstacles to gaining citizenship in this country grow higher by the day. Some of these new hurdles are dramatic: The administration has placed severe restrictions on asylum seekers, and the military has been deployed to string concertina wire at the U.S.-Mexico border. Other changes are dry and bureaucratic, but no less potentially devastating. One especially consequential policy shift is the Trump administration’s proposal to modify the “public charge” rule — which it can do without consulting Congress. (Alicia Wilson and Catalina Sol, 12/18)

Boston Globe: Climate Change Threatens Public Health And Doctors’ Ability To Provide Care 
The reality of climate change — and the need to combat it — could not be clearer. As health care professionals, we know that climate change harms those we seek to heal and we recognize that it compromises our ability to provide care. (George Q. Daley, Ashish Jha and Aaron Berstein, 12/18)

Stat: What Kidney Cancer Is Teaching Me About Serendipity, Persistence 
When I think about all of the circumstances that had to go just right for me to be born and just wrong for me to be diagnosed with kidney cancer, I realize there is so much serendipity in this world that it cannot be understood or predicted. The same universal chaos that caused an artillery shell not to explode 75 years ago — allowing me to exist at all — also led to my diagnosis. It’s the same mysterious force that connected me to a stranger a thousand miles away with a foundation that sent me to meet one of the scientists working to find a cure for kidney cancer just down the street, who had his own serendipitous route to studying it. (Adam Philip Stern, 12/18)

Kansas City Star: Why Would Hawley And Blunt Fix Health Care Law They Broke?
You know that cliché about the kid who killed his parents and then begged the court to have mercy on his poor orphaned self? Meet Missouri’s top Republican lawmakers, Sen. Roy Blunt and Senator-elect Josh Hawley. After their many broad-daylight attempts to poison, strangle and shoot the Affordable Care Act as it drove away, they are all sad-faced innocence now that a Texas judge has ruled that Obamacare shouldn’t survive.Suddenly, Blunt says we needn’t worry because that’s not really going to happen. Wait, but aren’t you the Roy Blunt who spent years calling for just this outcome? (12/18)

Akron Beacon Journal: Again, Two Abortion Bills At The Extreme And Deserving Vetoes
The Republican legislative majorities approved last week two bills that severely restrict abortion rights. Now lawmakers await the decisions of John Kasich. The governor already has pledged to veto one of the measures, the “heartbeat” bill, which bars abortion once a physician detects a fetal heartbeat, as early as six weeks, or before many women know they are pregnant. He did so two years ago, reasoning, correctly, that the legislation is unconstitutional and would result in an expensive court battle. Nothing has changed since.What about the other bill, a ban on the dilation and evacuation procedure? It is the most commonly used method to end a pregnancy in the second trimester, from 13 weeks to 24 weeks. This editorial page argued a week ago the bill is just as extreme. With the governor now weighing his course, it is worth reiterating why the measure also deserves a veto. (12/17)