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KHN First Edition: September 16, 2016

Drug prices, Obamacare's future, Trump on abortion, Medicaid, his doctor's note and Zika funding are among this morning's stories.

First Edition

Friday, September 16, 2016
Check Kaiser Health News online for the latest headlines

Today's early morning highlights from the major news organizations.

Kaiser Health News: Candidates Decry High Drug Prices, But They Have Few Options For Voters
In this year’s presidential campaign, health care has taken a back seat. But one issue appears to be breaking through: the rising cost of prescription drugs.The blockbuster drugs to treat hepatitis C as well as dramatic price increases on older drugs, most recently the EpiPen allergy treatment, have combined to put the issue back on the front burner. ... Here are five reasons why this issue is back — and why it is so difficult to solve. (Rovner, 9/16)

Kaiser Health News/NPR: California Aims To Limit Surprise Medical Bills
The unexpected charges come when patients are treated by an out-of-network provider at an in-network facility. After several failed attempts in recent years, the California legislature passed AB-72, which aims to protect patients’ pocketbooks when they’re hit by these surprise bills. Gov. Jerry Brown has until the end of September to sign or veto the legislation. He is expected to sign it into law. (O'Neill, 9/16)

Kaiser Health News: Studies Link Cancer Patient’s Survival Time To Insurance Status
Privately insured people with two types of cancer were diagnosed earlier and lived longer than those who were uninsured or were covered by Medicaid, according to two new studies. In one study, researchers examined data from more than 13,600 adult patients who had glioblastoma multiforme, the most common type of malignant brain tumor, between 2007 and 2012. The other study analyzed data from more than 10,200 adults who were diagnosed with testicular cancer between 2007 and 2011. (Andrews, 9/16)

California Healthline: Newly Covered By Medi-Cal, Undocumented Children Also Seek Dental Care
Young Erika is one of almost 138,000 undocumented children in California who have gained Medi-Cal coverage under the so-called “Health for All Kids” law, which provides health care for all California children regardless of their immigration status. Dental coverage under the state’s Denti-Cal program is included in the expanded benefits, and there is widespread hope that it will improve pediatric oral care in California. But delivering on that promise could be a stiff challenge for a program in which more than half of children who were covered before the law took effect had not seen a dentist in the previous year. (Ibarra, 9/15)

Politico: Obama Steps In To Save Obamacare
Deep into the final year of his presidency, Barack Obama is working behind the scenes to secure Obamacare’s legacy, struggling to bolster a program whose ultimate success or failure will likely be determined by his successor. With no lifeline coming from the divided Congress, Obama and his administration are redoubling their pleas for insurers to shore up the federal health care law and pushing uninsured Americans — especially younger ones — to sign up for coverage. The administration is nervously preparing for its final Obamacare open-enrollment season just a week before Election Day, amid a cascade of headlines about rising premiums, fleeing insurers and narrowing insurance options. (Demko, 9/16)

The Associated Press: Behind Health Law's 'Growing Pains,' More Serious Problems?
President Barack Obama told insurers this week his health care overhaul has had some growing pains. But with premiums rising and marquee insurers bailing, could the real diagnosis be "failure to thrive?" The medical term refers to when patients, often youngsters but also adults, fail to achieve or maintain proper weight. This is the fourth election cycle in which the Affordable Care Act has been in play, struggling for political traction and a healthy level of acceptance from a divided public. (Alonso-Zaldivar, 9/15)

The New York Times: By One Measure, Health Care Law Is A Record Success
Included among the many uplifting economic numbers released by the Census Bureau on Tuesday was a remarkable one about health insurance in the United States: Only 9.1 percent of Americans do not have coverage, the lowest level ever recorded by the agency. ... So does that mean the Affordable Care Act is solving the puzzle of getting people covered, a major goal of the law? It certainly looks that way. About 18 million more people have coverage now than did in 2013. But the new numbers also highlight where the law is not working well — and how difficult it will be to drop the uninsured rate much lower. (Abelson and Sanger-Katz, 9/15)

The Associated Press: Oregon Settles Lawsuit For Botched Health Care Rollout
Oregon settled with a California software giant in a lawsuit that accused Oracle America Inc. of collecting tens of millions of dollars to create a state health care exchange website that didn't work. The state initially asked for more than $6 billion in punitive damages when it filed the lawsuit in 2014 against the Redwood Shores, California company, but Oregon ultimately accepted a package that included $35 million in cash payments and software licensing agreements and technical support with an estimated upfront worth of $60 million. (Flaccus, 9/15)

The New York Times: EpiPen Maker Mylan Quietly Steers Effort To Protect Its Price
Against a growing outcry over the surging price of EpiPens, a chorus of prominent voices has emerged with a smart-sounding solution: Add the EpiPen, the lifesaving allergy treatment, to a federal list of preventive medical services, a move that would eliminate the out-of-pocket costs of the product for millions of families — and mute the protests. ... A point not mentioned by these advocates is that a big potential beneficiary of the campaign is Mylan, the pharmaceutical giant behind EpiPens. The company would be able to continue charging high prices for the product without patients complaining about the cost. (Lipton and Abrams, 9/16)

The New York Times: What Happens If EpiPens Get The ‘Preventive’ Label?
Mylan, the maker of EpiPens, an injection device for severe allergy attacks, is trying to persuade the United States Preventive Services Task Force to add the product to the group’s list of preventive medical services. That could make EpiPens available to patients with no insurance co-pay. It could also benefit the company by allowing it to raise prices on the product while limiting complaints from the public. The higher prices would be pushed to the government, insurers or employers. (Abrams, 9/16)

Politico: Trump Taps Top Abortion Foe To Chair Anti-Abortion Coalition
The head of a major anti-abortion rights group is coming on board as chairwoman of Donald Trump’s pro-life coalition. Marjorie Dannenfelser, the president of the Susan B. Anthony List, is assuming that position on Trump’s behalf, her organization plans to announce Friday. Co-chairs are slated to be rolled out later this month. (Glueck, 9/16)

Bloomberg: Trump Says He’d Use Medicaid To Expand Insurance Coverage
Republican presidential nominee Donald Trump said that as president he would use Medicaid to cover poor people who can’t afford private health insurance, and make birth control available without a prescription. The comments appeared to differ both with what some Republicans have proposed in the past, and -- in the case of Medicaid -- aspects of Trump’s own policy proposals on his website. Republicans generally opposed the expansion of Medicaid to higher income levels under Obamacare, for example. (Cortez and Tracer, 9/15)

The Associated Press: Trump Supports Birth Control Without A Prescription
Donald Trump says he believes women should be able to obtain birth control without a prescription. Speaking on an episode of "The Dr. Oz Show" airing Thursday, the Republican nominee suggested that, for many women, obtaining a prescription can be challenging. "I would say it should not be prescription," he told the audience, adding that many women "just aren't in a position to go get a prescription." (Colvin and Sharp, 9/15)

The Washington Post: Trump Doctor’s Letter: He Takes Cholesterol Drug, Is Overweight But Is In ‘Excellent’ Health
Donald Trump released a letter from his personal doctor on Thursday that summarizes his latest physical exam, saying he takes a cholesterol-lowering drug and is overweight but overall is in “excellent physical health.” Trump discussed the results of the exam on "The Dr. Oz Show" on Thursday afternoon, saying that presidential candidates have an "obligation" to voters to be healthy and that he feels like he is still in his 30s. (Costa and Johnson, 9/15)

Los Angeles Times: Trump's Doctor Says He's In 'Excellent Physical Health' But Shares Few New Details
Donald Trump released a one-page doctor’s letter Thursday saying he is “in excellent physical health” while pressing his case that he has more strength and stamina than Hillary Clinton. The letter from Harold N. Bornstein, a Manhattan doctor who has treated Trump since 1980, said the Republican presidential nominee takes low-dose aspirin and a statin drug to lower his cholesterol. (Finnegan, 9/15)

The Associated Press: New Note From Doctor Says Trump's Health Is Excellent
Until now, [Donald] Trump had released far less health information than Democratic rival Hillary Clinton, and Thursday's TV show and letter were an attempt to address that disparity. Clinton has faced her own increased scrutiny this week after a bout of pneumonia. On Wednesday, she released updated details from her doctor declaring her fit to serve as president. Trump's latest letter was more detailed than a four-paragraph summary that his physician, Dr. Harold Bornstein, had issued last December. Still, it doesn't offer a complete picture of the candidate's health. (Neergaard, 9/15)

The Associated Press: Aides: Congress Makes Progress On Zika, Spending
A long impasse that has delayed money to combat Zika for months neared an end Thursday as congressional aides said Republicans would relent and let Planned Parenthood affiliated clinics share in new funding to fight the virus. The potential deal would ease the way for Congress to quit work until after the Nov. 8 election. (Taylor, 9/15)

USA Today: Fight For Zika Money Hampered By Partisan Squabbles
Turns out Zika is as much a political quagmire as it is a health crisis. Finger-pointing and partisan backbiting abound on Capitol Hill, despite pleas from both sides of the aisle to take the politics out of efforts to combat the disease that has infected 805 Floridians and tarnished the state’s reputation as a tourist mecca. (King, 9/15)

The Washington Post: ‘No Room For Doubt': New Science Proves Zika Causes Microcephaly
Scientists have produced the strongest evidence yet that Zika virus infection in pregnant women causes microcephaly in their babies. In a report released Thursday, researchers from Brazil and Britain studied babies born this year in the heart of the epidemic in northeastern Brazil. They compared 32 babies born with microcephaly to 62 babies born around the same time in the same hospitals who did not have the severe birth defect. (Sun, 9/15)

Los Angeles Times: Researchers Strengthen Link Between Zika And Microcephaly
A first-of-its-kind study is strengthening the case that Zika is the culprit behind Brazil’s mysterious surge in babies born with microcephaly. Preliminary results from a study commissioned by the Brazilian Ministry of Health found that 13 out of 32 newborns with microcephaly tested positive for the Zika virus. Meanwhile, none of the 62 newborns in a comparison group who had normal-sized heads showed any sign of infection. (Kaplan, 9/15)

Reuters: Poll Shows 66 Percent Of California Voters Favor Drug Price Initiative
An initiative on California's November ballot aimed at reining in prescription drug prices is favored by 66 percent of state voters, according to a new poll released on Thursday. The California Drug Price Relief Act, also known as Proposition 61, seeks to restrict state-run health programs from paying more for medications than prices paid by the U.S. Department of Veterans Affairs, which is billed about 25 percent less for drugs than other government agencies. (Beasley, 9/15)

The Washington Post: The DEA Wants To Ban Another Plant. Researchers Say The Plan Is ‘Insane.’
The Drug Enforcement Administration has received a torrent of backlash from patients with chronic pain and former opiate users after announcing plans to ban kratom, a plant gaining popularity across the United States for its opiate-like effects. Kratom, which originates in Southeast Asia, has become more widespread in the United States in the past decade, fueled by online testimonials from users and a lack of federal regulation. Advocates say the plant — typically crushed and mixed or brewed with water — poses few health risks while helping users relieve severe pain and overcome addictions to powerful prescription painkillers. (Ingraham, 9/15)

The Washington Post: New Study Finds That Medical Marijuana May Be Helping To Curb The Opioid Epidemic
Researchers analyzed federal crash data in 18 states over the period from 1999 to 2013. States that passed a medical marijuana law during this period saw a reduction in opioid involvement in fatal car accidents, relative to states without such a law. The reduction was greatest among drivers aged 21 to 40, the age group most likely to use medical marijuana where it's available. (Ingraham, 9/15)

The Wall Street Journal: Marijuana Makes For Slackers? Now There’s Evidence
In street marijuana, the THC-to-CBD ratio now tends to be 10 to 1, and it is increasing, a trend occurring even at some marijuana clinics, Dr. Winstanley said. And few people know what effect that has on their brains. A new study by Dr. Winstanley’s group in the Journal of Psychiatry and Neuroscience examines how these two chemicals shape our willingness to face a challenge. Does marijuana make us lazy? (Pinker, 9/15)

The Washington Post: Number Of U.S. Railroad Workers Testing Positive For Drug Use Skyrockets
Early this year, a railroad worker who had just been briefed on his duties for the day was discovered in a restroom, dead from an overdose of illegal prescription drugs. In the months that followed, tests conducted after three railroad accidents resulted in six employees testing positive for drugs. Testing in 2016 has shown that nearly 8 percent of workers involved in rail accidents were positive for drug use, including marijuana, cocaine, ecstasy, benzodiazepine, OxyContin and morphine, according to internal federal documents obtained by The Washington Post. (Halsey, 9/15)

The Washington Post: Turmoil At Federal Agency Threatens Oversight Of Biomedical Research
A small government office that monitors misconduct in biomedical research is in turmoil, jeopardizing oversight of billions of dollars in grants to universities and other institutions around the country. Six of the eight investigators in the federal Office of Research Integrity have signed a letter hinting that they may leave, a move that could hobble federal efforts to detect data ma­nipu­la­tion and other misconduct by laboratory researchers. The office’s new head has filed personnel actions against the two division directors she inherited and installed a new deputy to supervise the entire staff. (Bernstein, 9/15)

The Wall Street Journal: FDA Cracks Down On Online Sales By E-Cigarette Industry
A month after assuming regulatory oversight over e-cigarettes, the U.S. Food and Drug Administration has cracked down on online sales by the industry, issuing 24 letters to websites for illegal sales to minors. The letters, which the FDA released Thursday, are the first sent since the FDA banned e-cigarette sales to anyone under 18 years old on Aug. 8. The agency also issued warning letters to 28 retailers of cigars and e-cigs and three letters to websites selling cigars. (Mickle, 9/15)

The Washington Post: Brain Cancer Replaces Leukemia As The Leading Cause Of Cancer Deaths In Kids
It's official: Brain cancer has replaced leukemia as the leading cause of cancer deaths among children and adolescents. In 1999, almost a third of cancer deaths among patients aged 1 to 19 were attributable to leukemia while about a quarter were caused by brain cancer. By 2014, those percentages were reversed, according to a report published Friday by the National Center for Health Statistics, which is part of the Centers for Disease Control and Prevention. (McGinley, 9/16)

The New York Times: Early Menopause Linked With Heart Risk
Menopause before the age of 45 is associated with an increased risk for cardiovascular disease and death, a review of studies has found. The average age at onset of menopause is 51, but some women start much earlier. Premature menopause is defined as onset before age 40, while early-onset menopause occurs before the age of 45. (Bakalar, 9/15)

NPR: Chemicals In Drinking Water Prompt Inspections Of U.S. Military Bases
Health workers are piecing together a complicated puzzle in El Paso County, Colo. In January, three cities — Security, Fountain and Widefield — noticed synthetic chemicals in the drinking water known as PFCs. Historically, these compounds had been used to make products like carpet and firefighting foam. The Environmental Protection Agency has linked exposure to low birth weights, and even forms of cancer. And the Pentagon says it's examining hundreds of military base sites for possible contamination. (Hood, 9/15)

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