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KHN First Edition: May 1, 2017


First Edition

Monday, May 01, 2017
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Exodus By Puerto Rican Medical Students Deepens Island’s Doctor Drain
Carmen Heredia Rodriguez reports: "Myladis Reyes, 26, fell in love with medicine by accident. She was a sophomore at the University of Puerto Rico studying chemistry seven years ago when she visited her aunt, a clinic internist, in New Jersey and witnessed the difference she made with patients. “She was always smiling. She always made little jokes,” Reyes said. “I just saw that and I thought, what better way to help?” The experience showed Reyes a new way to harness her interest in science and directly improve people’s lives." (Heredia Rodriguez, 5/1)

Kaiser Health News: Trump’s Vow To Squeeze ‘Sanctuary Cities’ Could Play Havoc With Health Programs
Shefali Luthra reports: "The Trump administration’s tough stance on immigration has some local health department officials worried it could spur cuts in federal funding and complicate a wide variety of programs, from efforts to battle the opioid epidemic to domestic violence initiatives. The Department of Justice (DOJ) sent letters April 21 to nine jurisdictions — including the state of California and cities such as Chicago, New Orleans, Philadelphia and New York — threatening to deny them agency funding because of their status as “sanctuary cities.” That federal assistance broadly supports criminal justice initiatives, but it often reaches well beyond police departments and courtrooms to include violence prevention programs and other efforts to address social factors that affect health." (Luthra, 5/1)

California Healthline: Federal Money For State-Level Zika Tracking, Prevention May End This Summer, Worrying Health Officials
Ana B. Ibarra reports: "Money that has helped states with Zika tracking and education may come to an end by this summer, putting at risk efforts to better understand the mostly mosquito-borne virus and the devastating birth defects associated with it. The Centers for Disease Control and Prevention told state health officials in a meeting last month that Zika funding is running out and that additional support should not be expected, according to a news report." (Ibarra, 5/1)

California Healthline: Running Short On Time, Covered California And Insurers Seek Obamacare Answers From GOP
Chad Terhune reports: "With a major deadline looming, California’s health exchange and a key insurer pressed Republican leaders in Washington to clear up confusion over their commitment to key provisions of the Affordable Care Act. Health insurers participating in the Covered California exchange for individuals and families must submit initial rates for 2018 on Monday. Lee, the exchange’s executive director, warned in a conference call Thursday that rates could jump by more than 40 percent if the Trump administration and Republican-led Congress walk away from crucial elements of the health law." (Terhune, 4/28)

The Associated Press: Lawmakers Settle On Hard-Fought $1 Trillion Spending Bill
Congressional Republicans and Democrats have reached agreement on a huge $1 trillion-plus spending bill that would fund most government operations through September but denies President Donald Trump money for a border wall and rejects his proposed cuts to popular domestic programs. Aides to lawmakers involved in the talks disclosed the agreement Sunday night after weeks of negotiations. The bill was made public in the pre-dawn hours Monday. ... The measure funds the remainder of the 2017 budget year, through Sept. 30, rejecting cuts to popular domestic programs targeted by Trump such as medical research and infrastructure grants. (5/1)

The Washington Post: Congress Reaches Deal To Keep Government Open Through September
Democrats fought to include $295 million to help Puerto Rico continue making payments to Medicaid, $100 million to combat opioid addiction, and increases in energy and science funding that Trump had proposed cutting. If passed, the legislation will ensure that Planned Parenthood continues to receive federal funding through September. (Snell, 4/30)

The New York Times: Pushing For Vote On Health Care Bill, Trump Seems Unclear On Its Details
After two false starts on President Trump’s promise to repeal the Affordable Care Act, Trump administration officials are pressing the House to vote on a revised version of the Republican repeal bill this week, perhaps as soon as Wednesday, administration officials said. And on Sunday, Mr. Trump insisted that the Republican health legislation would not allow discrimination against people with pre-existing medical conditions, an assertion contradicted by numerous health policy experts as well as the American Medical Association. (Pear, 5/1)

The Wall Street Journal: Trump Pushing For Vote On Health Bill, But Stumbling Blocks Remain
Both President Donald Trump and Vice President Mike Pence in television interviews Sunday suggested confidence that they could win enough votes to pass a bill to undo the Affordable Care Act. But skepticism among centrist members of the party remains a stumbling block, and it’s unclear that congressional leaders have made enough progress to call a roll, as they grapple with Republicans who have expressed concern that recent changes to satisfy more conservative lawmakers may push coverage costs higher. (Radnofsky and son, 4/30)

USA Today: Trump Dominates The 101st Day With Tweets, Tough Talk About Health Care
Trump maintained there is yet another version of the American Health Care Act, House Republicans' plan to replace the Affordable Care Act, and blamed obstruction by Democrats for Congress' failure to pass the legislation before his 100th day in Congress, although Republicans control both chambers of Congress. Trump also maintained that "preexisting conditions are in the bill. I mandated it."  Coverage with people with existing medical conditions has to be included, he continued, because "Obamacare is dead." (O'Donnell, 4/30)

The Wall Street Journal: Trump Issues Health ‘Guarantee,’ Sidesteps Affordability Concerns
Interviewer John Dickerson repeatedly asked Mr. Trump if the Republican plan—being negotiated among GOP lawmakers in the House—would guarantee coverage to people in every state, regardless of their medical history. Mr. Trump said that it would, but he didn’t directly address the possibility that some states could opt to charge more to people with such pre-existing conditions, the current sticking point in negotiations between GOP centrists and conservatives. (Radnofsky, 4/30)

The Wall Street Journal: New Plan, Same Hurdle In GOP’s Quest To Gut Obamacare
After weeks of debating and arm-twisting, Republicans intent on toppling the Affordable Care Act remain vexed by the same obstacle they faced when they tried to overturn the law last month: Taking away people’s guaranteed health insurance is hard to do. A renewed effort to bring a House Republican plan to the floor faltered by week’s end, a blow to President Donald Trump’s hopes of landing a health-care deal in his first 100 days. Republicans are vowing to push ahead with the bill, saying it has stalled but not died. (Armour and son, 4/28)

Politico: GOP Faces Make-Or-Break Moment On Obamacare Repeal
House Republican leaders and White House officials are increasingly confident about passing their long-stalled Obamacare replacement bill: More lawmakers than ever are committed to voting “yes," they say, and GOP insiders insist they’re within striking distance of a majority. But the window of opportunity for Speaker Paul Ryan and his leadership team is closing fast. The House is scheduled to leave town for a one-week recess on Thursday, and some senior Republicans worry that failing to get it done by then would fritter away critical momentum. Skittish Republicans would return home to face a barrage of pressure from Democrats and progressive outside groups. (Bade, Bresnahan and Cheney, 4/30)

The Associated Press: Personal Tragedy Shaped Congressman's Effort On Health Care
New Jersey Rep. Tom MacArthur has experienced personal tragedy and understands the need for health insurance. "I lost my mother at 4 years old. My father had no insurance and I watched him until I was in college pay off medical bills," says the two-term Republican lawmaker. Years later, MacArthur suffered the anguish over the death of his 11-year-old daughter, Gracie. "We had over $1 million of medical bills. I had insurance, but I still had a lot of uncovered expenses, and it's brutal," he says. (Freking, 4/28)

The Associated Press: Fears Of Losing Pre-Existing Conditions Protection Under GOP
From cancer to addiction, doctors and patient groups are warning that the latest Republican health care bill would gut hard-won protections for people with pre-existing medical conditions. Some GOP moderates who may seal the legislation's fate are echoing those concerns. In a strongly worded statement this week, the American Medical Association said the Republican protections "may be illusory." The American Cancer Society Cancer Action Network said the plan could take the nation back to a "patchwork system" that pushes costs on people with life-threatening conditions. (4/28)

The Washington Post: Lawmakers’ Questionable Stock Trades Prompt New Bill
Rep. Louise M. Slaughter introduced a bill Friday to close “ethics loopholes” in a five-year-old law that has failed to stop members of Congress from taking advantage of exclusive stock deals that are not available to the general public. Slaughter (D-N.Y.), a co-author of the 2012 Stock Act, said she decided that amendments to the law are needed because of controversial, discounted stock purchases that were made by Reps. Chris Collins (R-N.Y.) and Tom Price (R-Ga.), now the secretary of health and human services,  in 2015 and 2016. (Kindy, 4/28)

The New York Times: Florida Deal Would Reverse Key Part Of Obama’s Medicaid Expansion
The Trump administration appears to have scrapped one of the key tools the Obama administration used to encourage states to expand Medicaid under the Affordable Care Act. The shift involves funding that the federal government provides to help hospitals defray the cost of caring for low-income people who are uninsured. Under a deal with Florida, the federal government has tentatively agreed to provide additional money for the state’s “low-income pool,” in a reversal of the previous administration’s policy. The Obama administration balked at providing more money to help hospitals cope with the costs of “uncompensated care” for people who could be covered by Medicaid. (Pear, 4/30)

The Washington Post: Trump Appoints Antiabortion Champion To HHS Post
President Trump announced Friday that he will appoint Charmaine Yoest, one of the nation’s most prominent antiabortion ­activists, to a high-level post in the Department of Health and Human Services. Yoest, a former Reagan administration official who until last year was president of Americans United for Life, will serve as assistant secretary of public affairs. In that position, she will help develop a communications strategy for the sprawling agency that includes Medicaid, Medicare, the Affordable Care Act and family planning programs. (Somashekhar, 4/28)

The Associated Press: Appeals Court Upholds Decision To Block Anthem Bid For Cigna
A federal appeals court on Friday left in place a decision blocking Blue Cross-Blue Shield insurer Anthem’s bid to buy rival Cigna, saying that a bigger company is not better for consumers. The 2-1 decision upholds a federal judge’s ruling in February that said the proposed $48 billion acquisition would further reduce competition in the already concentrated health insurance market. Anthem argued the combination would save $2.4 billion in medical costs and lead to lower consumer premiums. But the Justice Department said Anthem had no real plan to reach those savings. (Hananel and Murphy, 4/28)

The Wall Street Journal: Opioid Epidemic Takes Its Toll On Camden
Police in Camden, N.J., are fielding more calls for overdoses than for homicides this year. Fatal opioid overdoses this year in the city of about 76,000 had surged to 35 as of Friday afternoon compared with 10 at the same point in 2016, and will likely eclipse last year’s 12-month total of 40 deaths within weeks, according to Police Chief J. Scott Thomson. “The pace is really alarming,” he said. (King and Kanno-Youngs, 4/29)

The Wall Street Journal: Unsparing Look At The Opioid Crisis In ‘Warning: This Drug May Kill You'
When director Perri Peltz’s son was diagnosed with a severe case of strep throat last year, his emergency-room doctor sent him back to college with 30 Percocet pills. Ms. Peltz couldn’t believe it. She had just begun filming “Warning: This Drug May Kill You,” a documentary about opioid addiction in the U.S. “If I hadn’t started working on this I might not have thought twice about the prescription,” Ms. Peltz says. “He was going back to a dormitory, and I realized that this moment in the ER was in a way ground zero for how opioid addiction can begin.” (Wolfe, 4/30)

The Washington Post: Waiting And Watching With ‘Stage 0’ Breast Cancer Put To Nationwide Test
Barbara Nickles and Ligia Toro de Stefani are both women in their early 60s who were diagnosed with abnormal cells in a breast, or Stage 0 breast cancer, as it’s sometimes labeled. Nickles decided to have a double mastectomy. Toro de Stefani opted for “active surveillance” and a twice-yearly battery of tests. “I wish I had breasts, but I am also happy they are gone so that I don’t have to worry so much about breast cancer,” says Nickles, whose grandmother had the disease. “Quality of life is the most important thing to me,” says Toro de Stefani, an avid traveler and scuba diver. (McGinley, 4/29)

The Washington Post: You Just Learned You Have Breast Cancer. What’s Next?
Steven Katz, an internist at the University Michigan, researches how medical decisions are made. Over the last dozen years, he has surveyed 10,000 patients and their doctors to better understand how they discuss a diagnosis and decide to proceed. “Women have taught me a lot,” says Katz. Sorting out various options can be “very confusing and very tough.” He has distilled what he has learned and offers the following suggestions for women suddenly confronted with breast cancer. More than a quarter-million women in the United States are diagnosed with the disease every year. (McGinley, 4/29)

NPR: Stroke Procedure Results In Miraculous Recovery For Some Patients
On July 17, 2014 Kurt Hinrichs, of Gladstone, Mo., went to bed early. As often happens, he woke in the middle of the night. When he tried to get out of bed, he crashed to the floor, which woke his wife, Alice. "At first it was like, 'What's going on?' " Alice says. "Are you dreaming? Are you sleepwalking?" Kurt wasn't responding to anything Alice asked him, so she called 911. "I [was] thinking, 'this is a nightmare,' " Kurt says. (Zhorov, 5/1)

Los Angeles Times: The Amputation Rate For Diabetics In Poor Areas Is High. This Boyle Heights Clinic Is Trying To Change That
Maria Valdez didn’t have a lot of options. A wound on her foot that had become infected wasn’t healing because of her diabetes. She started using a wheelchair to get around. A year and a half ago, it seemed likely she was going to lose part of her leg. On a recent weekday, Valdez lay on a bed in a clinic in Boyle Heights. Her doctor, Stanley Mathis, pulled off her sock and lifted her foot toward the ceiling. The heel, which once was so decayed he could see the white of the bone, was now covered in smooth skin. (Karlamangla, 5/1)

The Washington Post: What Makes Someone Donate A Kidney To A Stranger?
Would you donate a kidney to someone you've never met? The idea is layered with soul-searching judgments — questions of risk and benefit, sacrifice and selfishness, not to mention the physical pain of the surgery itself. But a small number of people have done this, and researchers at Georgetown University are studying them, providing a window on altruism in a world seemingly dominated by a me-first philosophy. (Bernstein, 4/28)

NPR: Yo-Yo Dieting Could Be Harmful To The Heart
So-called 'yo-yo dieting' — where people lose weight and gain it back again – doubles the risk of a heart attack, stroke or death in people who've already got significant heart disease. That's the conclusion of an international study published recently in the New England Journal of Medicine. (Neighmond, 5/1)

NPR: U.S. Supply Of Yellow Fever Vaccine Will Run Out By Midsummer
Come July, the yellow fever vaccine could be tough to find. So, if you're traveling this summer to a place with the disease, you probably want to schedule a trip to a clinic sooner rather than later, the Centers for Diseases for Control and Prevention tells NPR. "Take heed of our warning: Plan ahead," says CDC spokesperson Tom Skinner. "It may be difficult to get this vaccine. And if you can't get it, then you should postpone your trip." (Doucleff, 4/28)

Los Angeles Times: Tea Made From Deer Antlers May Cause Botulism; Health Officials Issue Alert
Tea made from deer antlers may have sickened two Orange County residents with botulism, a serious illness caused by a bacteria that can cause paralysis, breathing difficulty and is potentially deadly. One adult has a confirmed case of botulism, and the other has a suspected case, the Orange County Health Care Agency said Friday. An investigation by the Los Angeles County Department of Public Health suggests the botulism illnesses may be connected with drinking deer antler tea obtained in March. (Lin, 4/29)

The Associated Press: California Seeks Control Of Unruly Medical Pot Industry
California is trying to get control of its unruly medical marijuana industry. State regulators released draft regulations Friday intended to impose order on the loosely organized marketplace created over two decades ago. The proposal would establish the first comprehensive rules for growing, testing, t

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