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KHN First Edition: November 14, 2016


First Edition

Monday, November 14, 2016
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Abortion By Mail Delivers Promise For Better Access But Political Questions Remain
Phil Galewitz reports: "When the abortion pills arrived in her mailbox this summer, she felt anxious but also in control, knowing she could end her pregnancy entirely in the privacy of her own home. “I was happy that I was going to be able to do it myself and I did not have a nurse there or doctors there staring at me and judging me,” she said, asking to be identified only by her middle name, Marie, because she did not want people outside her immediate family to know about her abortion." (Galewitz, 11/14)

Kaiser Health News: Community Paramedics Work To Link Patients With Mental Health Care
Shefali Luthra reports: "For Kelly Kjelstrom, plugging the gaps in mental health care can mean something as simple as a late-night taco and a friendly chat. Kjelstrom, 45, is a community paramedic in Modesto, California. Part of his job is to help psychiatric patients in need of care avoid winding up in the emergency room, where they can get “boarded” for days, until they are released or a bed frees up at an inpatient facility." (Luthra, 11/14)

Kaiser Health News: Study: Many Caregivers Spend $7K Annually Out Of Pocket
Rachel Bluth reports: "Denise Sleeper has sold her home, spent most of her retirement savings and quit her job to care for her husband since his Alzheimer’s disease struck two years ago. “It’s been like a tsunami in my life,” said Sleeper, of Gilford, N.H. She’s drained $168,000 from the couple’s retirement account since her husband, Scott, was diagnosed with the degenerative illness. At first, she cared for him at home, but he’s in a nursing home now. Sleeper gets by on his disability checks and the $32,000 left in their 401k." (Bluth, 11/14)

California Healthline: What Will The Rollback Of Obamacare Look Like In California?
California went all in on Obamacare and now faces the prospect of President-elect Donald Trump and Congress dismantling key parts of that historic expansion in coverage. Under the Affordable Care Act, the state’s insurance exchange has enrolled more than 1.4 million people and California’s Medi-Cal program added about 3.5 million lower-income residents to the rolls. (11/14)

The Wall Street Journal: Donald Trump, In Exclusive Interview, Tells WSJ He Is Willing To Keep Parts Of Obama Health Law
President-elect Donald Trump said he would consider leaving in place certain parts of the Affordable Care Act, an indication of possible compromise after a campaign in which he pledged repeatedly to repeal the 2010 health-care law. In his first interview since his election earlier this week, Mr. Trump said one priority was moving “quickly” on President Barack Obama’s signature health initiative, which Mr. Trump said has become so unworkable and expensive that “you can’t use it.” Yet, Mr. Trump also showed a willingness to preserve at least two provisions of the law after Mr. Obama asked him to reconsider repealing it during their meeting at the White House on Thursday. (Langley and Baker, 11/11)

The New York Times: Donald Trump Says He May Keep Parts Of Obama Health Care Act
Just days after a national campaign in which he vowed repeatedly to repeal President Obama’s signature health care law, Donald J. Trump is sending signals that his approach to health care is a work in progress. Mr. Trump even indicated that he would like to keep two of the most popular benefits of the Affordable Care Act, one that forces insurers to cover people with pre-existing health conditions and another that allows parents to cover children under their plan into their mid-20s. He told The Wall Street Journal that he was reconsidering his stance after meeting with Mr. Obama on Thursday. (Abelson, 11/11)

The Associated Press: What Trump Might Really Do With Health Care
President-elect Donald Trump has said he may keep some parts of his predecessor's signature health care overhaul. No final decisions have been made. Based on interviews with congressional Republicans, here's a general idea of what goes, what may stay, and what's in doubt. (11/12)

Politico: Trump Could Preserve Parts Of Obamacare
The shift brings Trump in line with past Republican attempts at repealing and replacing the law, which focused on rolling back large elements like the individual mandate while holding onto several of its most popular provisions. However many policy experts have warned that requiring plans to cover sick people without a mandate or other way of bringing healthy people into the insurance pool will send premiums sky-high. (Cancryn, 11/11)

The Washington Post: Trump Health-Care Agenda Evolves Toward Core Republican Thinking
During the brief period since his election, President-elect Donald Trump has begun to revise his health-care agenda in ways that conform more closely to the heart of Republican thinking in recent decades. On the presidential transition website, at, antiabortion statements and policy positions have appeared that were not part of the campaign’s health-care platform. Other proposals have been deleted. (Goldstein, 11/11)

Politico: GOP Feuds Over How To Kill Obamacare
For some Republicans, obliteration of Obamacare can’t come soon enough. Others want a gradual phaseout, fearing both the political and practical consequences of throwing 20 million Americans off their health plans virtually overnight. And President-elect Donald Trump, who vowed to repeal and replace “the disastrous” Obamacare, sent mixed signals Friday about how he will proceed. (Haberkorn, 11/11)

Reuters: Some Republicans See Attacking Obamacare Through Regulation
Congressional Republicans are looking for the quickest ways to tear down Obamacare following Donald Trump's election as U.S. president, including rapidly confirming a new health secretary who could recast regulations while waiting for lawmakers to pass sweeping repeal legislation. Trump's victory on Tuesday means Republicans will control the White House, Senate and House of Representatives. But congressional Democrats are expected to put up a huge fight against Republican efforts to repeal the 2010 law considered President Barack Obama's signature domestic policy achievement. (Cornwell, 11/12)

Los Angeles Times: If Obamacare Is Repealed, California Has The Most To Lose — Putting The Insured On Edge
California led the way with Obamacare, signing up more people for health insurance than any other state. Now with a possibility that President-elect Donald Trump will repeal the law, as he has promised, the stakes are higher here than anywhere else. “We’ve basically cut the number of uninsured in a little bit more than half, which is enormous progress,” said Dr. Gerald Kominski, head of the UCLA Center for Health Policy Research. But California’s huge gains also mean that if the Affordable Care Act is undone, “we have the most to lose.” (Karlamangla, 11/13)

Los Angeles Times: If The Obamacare Law Is Repealed, Could California Keep It Anyway?
Millions of Californians have gained health insurance under the Affordable Care Act. Now the future of that federal law – and medical coverage for those people  -- is in doubt. President-elect Donald Trump said repeatedly during his campaign that one of his first acts would be to “repeal and replace” the law known as Obamacare. The Times spoke to experts about whether it would be possible for the state to keep operating its Obamacare exchange called Covered California, where consumers shop for subsidized health insurance, if the law was repealed. (sen, 11/11)

USA Today/Milwaukee Journal Sentinel: Obamacare Is Doomed. Now What?
After surviving two challenges that reached the U.S. Supreme Court and more than six years of unrelenting controversy, the Affordable Care Act in its current form is doomed. Now the questions are how the Trump administration and Republican-controlled Congress will go about dismantling the law, how soon that may happen, and what would replace it. That’s where all this could get messy. (Boulton, 11/13)

The Wall Street Journal: Paul Ryan’s Comments Appear To Put Medicare In Play For 2017
Are Republicans, now in full control of the government, gearing up for a fight over Medicare as well the Affordable Care Act? Remarks by Republican House Speaker Paul Ryan that the two are entwined raised the prospect that the popular seniors’ health program may be on the table. “Obamacare rewrote Medicare, rewrote Medicaid, so if you’re going to repeal and replace Obamacare, you have to address those issues as well,” Mr. Ryan said in a Fox News Channel interview Thursday night. (Radnofsky, 11/11)

The Washington Post: Is Paul Ryan Already Eyeing Medicare Cuts?
House Speaker Paul D. Ryan said Thursday that Medicare has “serious problems” that would need to be addressed when Congress moves to repeal and replace President Obama’s health-care reform law — a signal that he is willing to immediately enter the treacherous politics of entitlement reform and perhaps break with President-elect Donald Trump. (DeBonis, 11/11)

The New York Times: U.S. Consumers Will Want Trump, Congress To Take On Drug Prices
Americans' growing alarm over rising prescription drug costs will pressure a new U.S. administration and Congress to take action on pharmaceutical pricing, industry executives and healthcare experts say. Drugmaker stocks, battered in recent months, soared this week after Republican presidential candidate Donald Trump's victory. (Beasley and Clarke, 11/11)

The New York Times: Donald Trump Appears To Soften Stance On Immigration, But Not On Abortion
President-elect Donald J. Trump appeared to soften some of his hardest-line campaign positions on immigration on Sunday, but he also restated his pledge to roll back abortion rights and used Twitter to lash out at his critics, leaving open the possibility that he would continue using social media in the Oval Office and radically change the way presidents speak to Americans. (Davis, 11/13)

Reuters: Trump Win Fuels Donations, IUD Demand At Planned Parenthood
Planned Parenthood is reporting a spike in donations and demand for long-acting contraceptives since Donald Trump's election as U.S. president while abortion foes hope to gain momentum in their quest to cut public funding to the women's health organization. Officials with Planned Parenthood said its patrons are worried about the impact of a Trump presidency on access to abortions and birth control in the United States. (Mincer and Ingram, 11/12)

The New York Times: Where Even Nightmares Are Classified: Psychiatric Care At Guantanamo
Every day when Lt. Cmdr. Shay Rosecrans crossed into the military detention center at Guantánamo Bay, Cuba, she tucked her medical school class ring into her bra, covered the name on her uniform with tape and hid her necklace under her T-shirt, especially if she was wearing a cross. She tried to block out thoughts of her 4-year-old daughter. Dr. Rosecrans, a Navy psychiatrist, had been warned not to speak about her family or display anything personal, clues that might allow a terrorism suspect to identify her. (Fink, 11/12)

The New York Times: Secret Documents Show A Tortured Prisoner's Descent
Ramzi bin al-Shibh, an admitted and unapologetic co-conspirator in the Sept. 11, 2001, attacks, was captured in Pakistan in 2002. For years, the C.I.A. shuttled him through its network of prisons, interrogating him with some of its most brutal methods. The full list of techniques used against him remains classified, but a Senate Intelligence Committee report and former government officials have said that he was chained naked to the ceiling, deprived of sleep for more than 72 hours at a time, and subjected to long stretches of darkness, cold temperatures and persistent loud music. (Apuzzo and Fink, 11/12)

The New York Times: Celebrex Is Found To Be No Riskier For Hearts Than Other Pain Drugs
The drugs seemed miraculous when they were introduced in 1999, and they soon became blockbusters, with billion-dollar sales. Vioxx, made by Merck, and Celebrex, made by Pfizer, could quell pain and inflammation just as well as drugs like ibuprofen and naproxen, but they did not cause ulcers and gastrointestinal bleeding. But then, the shocker. A Merck clinical trial asking if Vioxx could also prevent colon cancer revealed that the drug increased the risk of heart attacks, and the company pulled it off the market in 2004. (Kolata, 11/13)

The Washington Post: Surprising New Findings About Pain Relievers Taken By ‘Everyone On The Planet’
In 2004, when drugmaker Merck voluntarily pulled the pain-reliever Vioxx off the market amid evidence that it increased the risk of heart attacks, concern naturally turned to its nearly identical rival, Celebrex.The medication works the same way, by inhibiting production of an enzyme that causes pain and inflammation — as do naproxen, ibuprofen and others in the class of widely used analgesics known as non-steroidal anti-inflammatory drugs (NSAIDS). Now the first large-scale study of the three drugs finds that Celebrex poses no greater risk of heart attack, stroke, other cardiovascular problems or death than naproxen or ibuprofen. (Bernstein, 11/13)

NPR: Naproxen And Ibuprofen Problems Seen At High Doses In Study
Nissen and other heart specialists cautioned that Celebrex can increase the chance of cardiovascular complications. But it doesn't appear to boost those odds nearly as much as Vioxx, or even as much as other painkillers thought to be safer. Both Vioxx and Celebrex are so-called Cox-2 inhibitors, which act by blocking an enzyme involved in inflammation. (Stein, 11/13)

The Associated Press: Prisons Fight Opioids With $1,000 Injection: Does It Work?
U.S. prisons are experimenting with a high-priced monthly injection that could help addicted inmates stay off opioids after they are released, but skeptics question its effectiveness and say the manufacturer has aggressively marketed an unproven drug to corrections officials. A single shot of Vivitrol, given in the buttocks, lasts for four weeks and eliminates the need for the daily doses common with alternatives such as methadone. But each shot costs as much as $1,000, and because the drug has a limited track record, experts do not agree on how well it works. (Johnson, 11/14)

The Wall Street Journal: DEA Listing Synthetic Opioid U-47700 As Threat To Public Health
The Drug Enforcement Administration placed a synthetic opioid called U-47700 on the most restrictive list of controlled substances, calling the drug a threat to public health and blaming it in part for scores of deaths around the U.S. The ban, which is scheduled to take effect Monday, is the latest action by the DEA to try to crack down on the growing peril of synthetic narcotics. (Campo-Flores, 11/11)

The Washington Post: Parents Are Insisting On Doctors Who Insist On Vaccinations
Pediatricians around the country, faced with persistent opposition to childhood vaccinations, are increasingly grappling with the difficult decision of whether to dismiss those families from their practices to protect their other patients. Doctors say they are more willing to take this last-resort step because the anti-vaccine movement in recent years has contributed to a resurgence of preventable childhood diseases such as measles, mumps and whooping cough. Their practices also have been emboldened by families who say they will only choose physicians who require other families to vaccinate. (Sun, 11/12)

NPR: Good Health Habits Can Reduce Genetic Risk For Heart Attack
You can't choose your parents, so you can't help it if you're born with genes that increase your risk of heart disease. But a study finds that you can reduce that risk greatly with a healthful lifestyle. Scientists have been wondering whether that's the case. To find out, one international consortium looked at data from four large studies that had isolated genetic risk factors for heart disease. (Harris, 11/13)

The Washington Post: New Statin Guidelines: Everyone 40 And Older Should Be Considered For The Drug Therapy
The U.S. Preventive Services Task Force on Sunday issued new guidance for the use of cholesterol-busting statin drugs. The report greatly expands the universe of people who should be screened to see if they need the medication to everyone over a

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