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KHN First Edition: November 28, 2016


First Edition

Monday, November 28, 2016
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: A Frenzy Of Lobbying On 21st Century Cures
Sydney Lupkin reports: "The 21st Century Cures Act now being refined by the lame-duck Congress is one of the most-lobbied health care bills in recent history, with nearly three lobbyists working for its passage or defeat for every member on Capitol Hill. More than 1,455 lobbyists representing 400 companies, universities and other organizations pushed for or against a House version of a Cures bill this congressional cycle, according to federal disclosure forms compiled by the Center for Responsive Politics. (Lupkin, 11/28)

Kaiser Health News: Pence Expanded Health Coverage As Governor, Now Threatens To Take It Away
Phil Galewitz reports: "Chris Cunningham was so thrilled with Indiana Gov. Mike Pence’s Medicaid expansion under the Affordable Care Act, she readily accepted his invitation to an event celebrating its first anniversary in January. Gaining Medicaid ended her eight years without health coverage and paid for her treatment of a thyroid problem, her lung disease and prescription drugs to help both. She stopped working in 2008 to care for her disabled husband." (Galewitz, 11/28)

Kaiser Health News: Alone And Aging: Creating A Safety Net For Isolated Seniors
Sharon Jayson reports: "Phyllis Krantzman knows what she should do, but like many of her peers, the 71-year-old doesn’t know how to approach a casual acquaintance to ask who will take care of her when she needs it most. Krantzman, of Austin, Texas, is among a growing number of seniors who find themselves alone just when aging and end-of-life care becomes real." (Jayson, 11/28)

The Associated Press: What Trump Can Learn From Obama's Rough Ride On Health Care
President Barack Obama took on the problems of a lack of access to health care and high cost, but he and Democrats paid a political price. President-elect Donald Trump has promised to undo much of what Obama put in place, and pledged to make the system better. Although Trump is lacking in specifics, he seems to want to make costs his priority. States, insurers, businesses, and individuals would get more leeway to sort out access. Health care keenly reflects the country's deep political divide. A look at some lessons Trump might learn from Obama's rough ride. (Alonso-Zaldivar, 11/27)

The Washington Post: Trump Spurs Fears, Hopes Among Americans Insured By The Affordable Care Act
A 30-year-old cancer survivor in a small West Virginia town worries how she would pay for treatment if a tumor returned. A Chicago doctor wonders whether her hospital would cut back on care for ill or premature infants. In Northern Virginia, the head of a small nonprofit clinic lies awake at night fearing a surge of uninsured patients she couldn’t afford to take in. Two weeks after the unexpected election of Donald Trump, the incoming administration and the Republicans who control Congress have defined few specifics for how they will carry out their promise to eliminate the Affordable Care Act. Yet the shift in Washington’s political geometry already is stoking anxiety among many of the 11 million people who have gained private insurance under the law, as well as among those who help care for them. (Goldstein, 11/23)

The New York Times: Many In Florida Count On Obama’s Health Law, Even Amid Talk Of Its Demise
Florida helped hand Mr. Trump the presidency when he narrowly won the state, but it has also provided more customers for the federal health insurance marketplace than any other state. This makes Florida a window to the complex and delicate task Mr. Trump and congressional Republicans face in deciding whether to scrap the entire law, which has brought coverage to more than 20 million people, and what to replace it with. ... Jay Wolfson, a professor of public health and medicine at the University of South Florida, said that while many Floridians would be happy to see the law disappear, and the state’s Republican leaders have never shied away from attacking it, failing to come up with a substantive replacement could be politically risky. (Goodnaugh, 11/25)

NPR: Worries About Health Insurance Cross Political Boundaries
This month's election results could have big implications for those who now have insurance because of the Affordable Care Act — either through the exchanges or Medicaid expansion. President-elect Trump and Republicans in Congress have made it clear they want to scrap the law, but it's unclear what may replace it. That gap between repeal and replacement has left many unsure of what will happen with their medical care. We have these reports from around the country from people who could be affected by changes. (11/26)

Wall Street Journal: Planned Medicaid Overhaul Could Put GOP Governors In An Awkward Spot
President-elect Donald Trump has proposed converting the federal-state [Medicaid] program into block grants to the states in an effort to give them more latitude over how the program is run. This would jibe with many leading Republicans in Congress, who for years have wanted a Medicaid overhaul that hands more control over to the states. But such a move is likely to expose divisions among Republicans over how significantly to peel back coverage protections for the more than 12 million people who gained Medicaid in the 31 states, as well as Washington, D.C., that expanded the program. (Armour, 11/24)

The Associated Press: Republican States That Expanded Medicaid Want It Kept
Former Arizona Gov. Jan Brewer fought her own Republican party in the state Legislature for months to push through a Medicaid expansion under the Affordable Care Act. That was three years ago. Now, as an early Donald Trump supporter who has his ear, Brewer hopes one of the pillars of President Barack Obama’s health care law can be saved as Trump pushes to dump much of the overhaul. (Christie, 11/27)

Politico: How Heritage Is Influencing Trump And Health Care's Next Chapter
As a candidate, Donald Trump vaguely promised to fix health care by repealing Obamacare and "getting rid of the lines." But as president-elect, his health policy is getting more robust — and there's a straight line to the Heritage Foundation. "Our view … it's about giving people choices. It's about having the markets work well, the structure and the incentives," Heritage health policy analyst Ed Haislmaier said on POLITICO's "Pulse Check" podcast this week. "It's not about products." (Diamond, 11/23)

Reuters: Trump's Shifting Positions Since U.S. Election Win
After firing up crowds with boisterous and sometimes divisive campaign rhetoric, Donald Trump has appeared to moderate some stances since he won the U.S. presidential election on Nov. 8. ... During the campaign, Trump said he would repeal President Barack Obama's signature Affordable Care Act. He called Obamacare a "disaster" and said he would replace it with a plan that would give states more control over the Medicaid health plan for the poor and allow insurers to sell plans nationally. In an interview with the Wall Street Journal published on Nov. 11, Trump said he was considering keeping parts of the law, including provisions letting parents keep adult children up to age 26 on insurance policies and barring insurers from denying coverage to people with pre-existing conditions. "Either Obamacare will be amended, or repealed and replaced," Trump told the Journal. (Kerry, 11/25)

Wall Street Journal: Companies Retool Lobbying As Donald Trump’s Administration Nears
Corporations are scrambling to retool their lobbying efforts as Republicans, preparing for control of the House, Senate and White House come January, hope to break the partisan logjam that has blocked the passage of legislation for six years. Among policy areas back on the table—in some cases for the first time since Barack Obama was elected president in 2008 along with a Democratic-controlled House and Senate—are immigration, health care, the tax code, infrastructure and Wall Street regulations. ... To get a sense of how big those fights will be, consider this: In 2009, the Obama administration’s first year, corporations spent $556 million lobbying on health-related issues and $473 million lobbying on the financial and real-estate industries, according to the Center for Responsive Politics. That marked jumps of $66 million and $17 million, respectively, in lobbying spending on those issues from the previous year. (Balhaus, 11/27)

The New York Times: A Battle To Change Medicare Is Brewing, Whether Trump Wants It Or Not
Donald J. Trump once declared that campaigning for “substantial” changes to Medicare would be a political death wish. But with Election Day behind them, emboldened House Republicans say they will move forward on a years-old effort to shift Medicare away from its open-ended commitment to pay for medical services and toward a fixed government contribution for each beneficiary. (Pear, 11/24)

NPR: Paul Ryan's Health Care Plan Would Privatize Medicare
President-elect Donald Trump and House Speaker Paul Ryan agree that repealing the Affordable Care Act and replacing it with some other health insurance system is a top priority. But they disagree on whether overhauling Medicare should be part of that plan. Medicare is the government-run health system for people aged 65 and older and the disabled. Trump said little about Medicare during his campaign, other than to promise that he wouldn't cut it. Ryan, on the other hand, has Medicare in his sights. (Kodjak, 11/26)

The Washington Post: Many Medicare Cancer Patients Hit By High Out-Of-Pocket Costs
Cancer patients with only Medicare coverage face steep out-of-pocket costs, spending on average almost a quarter of their household incomes on treatment, according to a study published Wednesday. The study by researchers at Johns Hopkins University found that Medicare beneficiaries without additional health coverage paid an average of $8,115 a year, or 23.7 percent of their incomes, on out-of-pocket costs after a cancer diagnosis. Some paid up to 63 percent of their incomes. Hospitalizations were the major factor for their high expenses, the researchers said. (McGinley, 11/23)

Los Angeles Times: Drug Costs Skyrocket For Many Older Americans, Despite Medicare Coverage
To avoid liver damage, Roberta Solar, a 71-year-old cancer patient, has to take a medicine called ursodiol, perhaps for the rest of her life. Next year her annual out-of-pocket costs for the drug will jump from $93 to $1,878 – a rise of almost 2,000%, according to information that she and her husband recently received from the insurer that covers their medicines under Medicare. The drug is just one of dozens of medications whose skyrocketing prices are increasingly hitting older Americans on fixed incomes. And that has renewed calls that the law be changed to allow Medicare, the government system that covers older Americans, to use its size and power to negotiate better drug prices. (sen, 11/23)

The Wall Street Journal: Lawmakers Try For Year-End Bill On Medical Research, Devices And Opioid Addiction
U.S. Senate and House negotiators are in final stages of talks toward legislation that would boost funding for the National Institutes of Health, provide states with $1 billion for opioid-addiction treatment and improve access to mental-health treatment. The bill, which is likely to become completed in the next few days, will also have potentially significant impact on the regulation of medical devices and drugs. The House is scheduled to vote on some version of the legislation as early as Wednesday. ... People familiar with the talks, however, said that over the weekend there are major provisions to be hammered out, especially regarding Food and Drug Administration regulation of drugs and devices. One of those people said on Saturday that there was still the possibility that this emerging deal would fall apart. (Burton, 11/26)

The Associated Press: House To Vote On Bill Aimed At Speeding Approval Of Drugs
The House plans to vote Wednesday on a $6.3 billion bill aimed at speeding federal approval of drugs and medical devices and boosting biomedical research. The legislation, a priority for congressional leaders in the lame-duck session, seeks to streamline how federal regulators assess the safety of new treatments and let them reach markets more quickly. It provides new money for the National Institutes of Health and Food and Drug Administration, including funding for the White House's cancer moonshot and precision medicine initiatives. (11/26)

Reuters: Senate Panel Postpones Mylan Hearing
The U.S. Senate Judiciary Committee on Monday postponed a hearing planned for next week to discuss Mylan NV's pending $465 million settlement to resolve charges that it underpaid government healthcare programs by misclassifying its EpiPen emergency allergy treatment. Mylan, the Justice Department and the Centers for Medicare and Medicaid Services had all declined to send officials to the Nov. 30 hearing, the committee said in a statement. (Bartz, 11/24)

The Associated Press: Grassley Mulls Subpoenas For Mylan, DOJ Over EpiPen
The chairman of the Senate Judiciary Committee said Wednesday he is considering a subpoena or another method of compelling testimony from the pharmaceutical company Mylan, the Justice Department and the federal Centers for Medicare and Medicaid Services. All three parties have refused to attend a committee hearing next week. Sen. Charles Grassley, R-Iowa, said in a statement that he is postponing the Nov. 30 hearing on a possible settlement between Mylan and the Justice Department over Mylan's life-saving EpiPen. Grassley said that because of the parties' refusal to participate, "we must now consider compelling their participation." (Jalonick, 11/23)

The New York Times: Eli Lilly’s Experimental Alzheimer’s Drug Fails In Large Trial
An experimental Alzheimer’s drug that had previously appeared to show promise in slowing the deterioration of thinking and memory has failed in a large Eli Lilly clinical trial, dealing a significant disappointment to patients hoping for a treatment that would alleviate their symptoms. The failure of the drug, solanezumab, underscores the difficulty of treating people who show even mild dementia, and supports the idea that by that time, the damage in their brains may already be too extensive. And because the drug attacked the amyloid plaques that are the hallmark of Alzheimer’s, the trial results renew questions about a leading theory of the disease, which contends that it is largely caused by amyloid buildup. (Belluck, 11/23)

The Wall Street Journal: Eli Lilly Alzheimer’s Drug Fails Trial
An experimental Eli Lilly & Co. drug failed to significantly help Alzheimer’s disease patients in a closely watched clinical trial, dealing another blow to the pharmaceutical industry’s long quest to find a better treatment for the brain-damaging condition. (Loftus, 11/23)

The Wall Street Journal: Failure Of Another Alzheimer’s Drug Forces A Reassessment
The pursuit of a treatment for Alzheimer’s disease has long focused on clearing clumps of a protein called beta amyloid that build up in the brain of those with the mind-robbing condition. But the failure of Eli Lilly & Co.’s experimental amyloid buster is the latest indication that targeting amyloid is far from straightforward. Other treatments that target these so-called plaques have proven disappointing. (Hernandez, 11/23)

McClatchy: Trump's Impending Presidency Sparks Surge In Calls To Planned Parenthood
The phone has been ringing off the hook at Planned Parenthood of Greater Washington and North Idaho, with women rushing to make appointments to get long-acting birth control. In the two weeks since Donald Trump won the presidency, the number of appointments at the organization's 12 clinics has jumped by 81 percent, according to spokeswoman Tiffany Harms. The most popular requests: intrauterine devices, or IUDs, small plastic devices that are inserted into the uterus and left in place, and hormonal implants. Planned Parenthood officials say it's a similar situation across the country, with many women braced for the worst. They fear that Trump will try to follow through on his promises to outlaw abortion and scrap the Affordable Care Act, which helps many poor women by providing birth control with no co-pays. (Hotakainen, 11/26)

The Associated Press: CDC: US Abortion Rate Falls To Lowest Level In Decades
The number and rate of abortions tallied by federal authorities have fallen to their lowest level in decades, according to new data released Wednesday. The latest report by the Centers for Disease Control and Prevention, incorporating data from 47 states, said the abortion rate for 2013 was 12.5 abortions per 1,000 women aged 15-44 years. That's half the rate recorded in 1980. The last time the CDC recorded a lower rate was 1971, two years before a Supreme Court ruling extending abortion rights nationwide. (Crary, 11/23)

The Associated Press: Man Who Killed Abortion Doctor Gets More Lenient Sentence
The man who seven years ago ambushed and fatally shot one of the few U.S. doctors performing late-term abortions was given a more lenient sentence Wednesday of at least 25 years in prison before becoming eligible for parole. At a surprise resentencing hearing, prosecutors withdrew their request that Scott Roeder serve at least 50 years before parole eligibility. Roeder also was sentenced to an additional two years for aggravated assault for threatening two church ushers as he fled. (Hegeman, 11/24)

The Associated Press: New GOP Majority Could Bring Abortion Restrictions To Iowa
For years, Iowa's divided Legislature shielded the state from a wave of Republican-backed laws that restricted abortion access around the country. But a new GOP majority will take control in January, meaning nearly a dozen abortion-related bills could soon be on the table, and Democrats will be unable to block them by vote for the first time in a decade. (Rodriguez, 11/23)

NPR: Surge In Demand For Long-Acting Birth Control Strains Clinic Budgets
In the two weeks since the election, Planned Parenthood Federation of America has seen a huge increase in volunteers and donations – over 200,000 donations in a single week. But this surge in support hasn't reached many other reproductive health organizations. And many of these centers are already struggling to meet a spike in demand for long-acting contraception after the election of Donald Trump. (Ross, 11/23)

The Washington Post: As The Aedes Aegypti Mosquito Spreads Globally, So Does The Risk Of Epidemics
Of all the mosquito species that populate the planet, few have proved themselves more resilient or more deadly to humans than the Aedes aegypti. The epidemics fueled by this tiny mosquito stretch across hundreds of years and include millions of victims. Yellow fever, dengue fever, chikungunya. And now Zika, which has spread to more than 50 countries and can cause an array of severe birth defects. ... Writing Thursday in the journal Science, Yale University’s Jeffrey R. Powell, a professor of ecology and evolutionary biology, detailed how this species now breeds year-round in locations where it once didn’t exist — including in the District and California. (Dennis, 11/24)

The Washington Post: Major HIV Vaccine Trial In South Africa Stokes Hope
After decades of shadowboxing with the human immunodeficiency virus, researchers were encouraged four years ago when a test of a vaccine on 16,000 people in Thailand turned up a previously unknown vulnerability in the resilient pathogen. The vaccine was only 31 percent effective and wore off over time, so it could not be approved for use in a general population. But the study’s results allowed scientists to exploit the chink in HIV’s armor, reformulate the drug and bring it back for another clinical trial. (Brown and Bernstein, 11/25)

NPR: Patients Increasingly Influence Medical Research
Patients and their advocates are getting an ever-larger voice in how medical research is carried out. They participate in the design of experiments and have a greater say in what outcomes they care about most — and it's not always simply living longer. Sharon Terry has lived through a couple of decades during which patients went from being complete outsiders to participants. She worries now that they risk being co-opted by the medical research juggernaut. (Harris, 11/28)

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