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KHN First Edition: October 23, 2017


First Edition

Monday, October 23, 2017
Check Kaiser Health News online for the latest headlines

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

California Healthline: One Nurse Per 4,000 Pupils = Not The Healthiest Arrangement
During a 15-minute recess, the elementary school students trooped from the playground toward nurse Catherin Crofton’s office — one with a bloody nose, a second with a scraped knee and a third with a headache. Kids quickly filled a row of chairs. Staffers brought paper towels for the bleeders and tried to comfort the crying. “We’re here for first aid, emergency, counseling,” said Crofton of the Mount Diablo Unified School District. “There is always something to do.” (Ibarra, 10/23)

The New York Times: McConnell Signals Willingness To Hold Vote On Health Deal If Trump Approves
Senator Mitch McConnell of Kentucky, the majority leader, said on Sunday that he would be willing to bring a bipartisan proposal to stabilize health insurance markets up for debate if President Trump signaled his support. “If there’s a need for some kind of interim step here to stabilize the market, we need a bill the president will actually sign,” Mr. McConnell said on CNN’s “State of the Union.” “And I’m not certain yet what the president is looking for here, but I’ll be happy to bring a bill to the floor if I know President Trump would sign it.” (Fandos, 10/22)

The Hill: Schumer Calls On McConnell To Send Bipartisan Health Care Bill To Floor This Week 
Senate Minority Leader Charles Schumer (D-N.Y.) called on Senate Majority Leader Mitch McConnell (R-Ky.) Sunday to bring a bipartisan short-term ObamaCare stabilization deal to the Senate floor this week, despite uncertain support from President Trump. "This is a good compromise. It took months to work out. It has a majority. It has 60 senators supporting it, we have all 48 Democrats, 12 Republicans. I would urge Senator McConnell to put it on the floor immediately, this week," Schumer told NBC's Chuck Todd on "Meet the Press" on Sunday. (Manchester, 10/22)

Politico: Schumer: Bipartisan Health Care Bill 'Has A Majority'
Senate Minority Leader Chuck Schumer said Sunday that the Alexander-Murray bipartisan health care bill has support from a majority of senators, and he urged Senate Majority Leader Mitch McConnell to bring it to the floor "immediately." “This is a good compromise. It took months to work out. It has a majority. It has 60 senators supporting it. We have all 48 Democrats, 12 Republicans," Schumer (D-N.Y.) said on "Meet the Press" on NBC. "I would urge Senator McConnell to put it on the floor immediately, this week. It will pass and it will pass by a large number of votes.” (Morin, 10/22)

The Associated Press: Top Dems Nix White House Demands To Alter Health Care Deal
Top Senate Democrats rejected White House demands Friday to add provisions weakening the Obama health care law to a bipartisan deal on steadying unsettled insurance markets. The compromise already faced an uphill path and this was the latest blow. Senate Minority Leader Chuck Schumer, D-N.Y., said the Trump administration was involved in the negotiations that produced the accord and "should support it instead of floating other ideas that would further the sabotage both parties are trying to reverse." (10/20)

The New York Times: I.R.S. Says It Will Reject Tax Returns That Lack Health Insurance Disclosure
Despite President Trump’s pronouncements, not only is Obamacare not dead, there are signs that his administration is keeping it alive. In the latest signal that the Affordable Care Act is still law, the Internal Revenue Service said this week that it is taking steps to enforce the most controversial provision: the tax penalty people face if they refuse to obtain health insurance. (Abelson, 10/20)

The Hill: GOP Redoubles Efforts To End ObamaCare Mandate
The GOP is redoubling its efforts to eliminate ObamaCare’s individual mandate, a step that would be yet another blow to the health-care law. They are doing so even as key Senate Republicans seek a bipartisan deal that could strengthen the law by extending critical payments to insurers that help low-income people afford their copays and deductibles. (Weixel, 10/22)

The New York Times: Cheaper Health Plans Promoted By Trump Have A History Of Fraud 
In signing a recent executive order, President Trump promised that millions of Americans could soon obtain “great, great health care” through inexpensive plans that offer consumers options they had been denied under the Affordable Care Act. But these health plans, created for small businesses, have a darker side: They have a long history of fraud and abuse that have left employers and employees with hundreds of millions of dollars in unpaid medical bills. (Pear, 10/21)

The Washington Post: ACA Enrollment Schedule May Lock Millions Into Unwanted Health Plans
Millions of Americans with insurance through the Affordable Care Act could find themselves locked into health plans they do not want for the coming year because of the Trump administration’s schedule for the enrollment season that starts in less than two weeks. The complication arises when people who already have health plans under the law are automatically re-enrolled in the same plan. In the past, a few million consumers each year have been auto-enrolled and then were sent government notices encouraging them to check whether they could find better or more affordable coverage. (Goldstein, 10/20)

The Wall Street Journal: Health Advocates Gear Up For Open Enrollment
Consumer groups and some state officials, facing new pressure to show the Affordable Care Act remains in place after President Donald Trump declared it dead, have begun launching urgent outreach programs to sign people up for health coverage during the coming open-enrollment period. The ACA’s fifth open-enrollment season, which this year runs Nov. 1 through Dec. 15, may be lackluster compared with previous years because the administration has cut the time period in half and cut about $116 million in funding for outreach and advertising. As a result, advocacy groups are mounting on-the-ground efforts aimed at telling consumers they can still get coverage and subsidies despite recent efforts to undo the law. (Armour and Hackman, 10/22)

Los Angeles Times: Obamacare Enrollment Starts Nov. 1. Here's What You Need To Know
Choosing the right health insurance plan can be a cumbersome process, and this year’s political back-and-forth over Obamacare has made it seem even more confusing. For months, executive orders and congressional debates have swirled around the law, officially called the Affordable Care Act. President Donald Trump has declared the law “dead” — but it’s still in effect, and open enrollment for plans on the Obamacare exchange begins Nov. 1. (Schencker, 10/20)

The New York Times: Undocumented 17-Year-Old Must Delay Abortion, Court Rules
The decision by the United States Court of Appeals for the District of Columbia Circuit could put her health at risk, doctors say, especially now that she is about 15 weeks pregnant. “While first-trimester abortion is over 10 times safer than childbirth, the risks gradually increase in the second trimester to those of childbirth,” Dr. Nancy L. Stanwood, the chief of family planning at the Yale School of Medicine, said in an email. Forcing her to wait, she added, “harms her physical health, period.” (Caron, 10/21)

The Associated Press: Immigrant Teen Seeking Abortion Asks Court To Reconsider
Attorneys for a pregnant teen being held in a Texas immigration facility are asking a federal appeals court to reconsider its decision not to order the government to let her obtain an abortion. Lawyers for the 17-year-old on Sunday asked the U.S. Court of Appeals for the District of Columbia to hold another hearing before all the judges on the court. (10/23)

Politico: Teen In Immigration Detention Takes Abortion Fight To Full Appeals Court
"Every additional day she must remain pregnant against her will places a severe strain on J.D., both physically and emotionally. Every additional week the government delays her abortion increases the risks associated with the procedure," the teen's attorneys wrote in the petition for en banc review filed with the D.C. Circuit just after 10 P.M. Eastern Time Sunday. "In a matter of weeks, J.D. will no longer be able to get an abortion at all, and the government will have forced J.D. to have a child against her will." (Gerstein and Rayasam, 10/22)

Politico: States May Roll Back Children’s Health Coverage Without Money From Congress
Federal funds for the Children’s Health Insurance Program (CHIP) expired Sept. 30, leaving states to come up with short-term fixes to keep their programs going. CHIP, now in its 20th year, primarily covers children from low-income families who earn too much to qualify for Medicaid. The program has long had bipartisan support, but lawmakers — consumed by the fight over Obamacare — blew past a key funding deadline and have been slow to extend new money. (Pradhan and Frostenson, 10/23)

The New York Times: The E.P.A.’s Top 10 Toxic Threats, And Industry’s Pushback
The Environmental Protection Agency has published a list of 10 toxic threats it will evaluate first under a law passed last year intended to crack down on hazardous chemicals. (Lipton, 10/21)

The Washington Post: Senators Demand Information On Drug Law Affecting DEA  
More than 30 U.S. senators demanded information Friday on the 2016 law that stripped the Drug Enforcement Administration of its most potent weapon against companies suspected of spilling hundreds of millions of addictive painkillers onto the black market. Thirty-one Democrats and two independents noted that the same law required the DEA and the Department of Health and Human Services to compile a report for Congress on the law’s impact by April 16. Six months later, no report has been submitted. (Bernstein and Higham, 10/20)

Stat: At Opioids Commission Meeting, Insurance Industry Gets A Scolding
Patrick Kennedy, it seemed, had been waiting for a public opportunity to speak directly to the nation’s health insurers. “The historic treatment of addiction and mental illness has been a separate and unequal process,” the former Rhode Island congressman and a member of the president’s opioid commission told a group of insurance executives on Friday. “All of you, as insurers and payers, have treated mental health and addiction as if it’s something other than the rest of medicine.” (Facher, 10/20)

Politico: From Opioids To HIV — A Public Health Threat In Trump Country
The next HIV epidemic in America is likely brewing in rural areas suffering under the nationwide opioid crisis, with many of the highest risk communities in deep red states that voted for President Donald Trump. Federal and state health officials say they are unprepared for such an outbreak, and don’t have the programs or the funding to deal with a surge in HIV cases. And given how little screening for HIV there is in some rural counties, they worry it may have already begun. (Ehley, 10/21)

The Washington Post: Georgia Lawmaker, Wife Of Ex-HHS Secretary, Says Her Remarks About Quarantining HIV Patients Were Misunderstood 
A state lawmaker who has drawn criticism after asking about the legality of quarantining people with HIV has said her comments were misunderstood and intended to be “provocative” and “rhetorical” in a broader conversation about curtailing the virus. Georgia State Rep. Betty Price (R) made the statement Tuesday, at a study committee meeting on barriers to adequate health care. Committee members had been discussing, she later said, why Georgia ranks second in the nation when it came to new HIV cases. (Hui and Wang, 10/22)

The Hill: Price’s Wife On HIV Quarantine Remark: I Was Just Being ‘Provocative’
“What are we legally able to do, and I don’t want to say the quarantine word, but I guess I just said it,” Price says. “Is there an ability, since I would guess that public dollars are expended heavily in prophylaxis and treatment of this condition. So we have a public interest in curtailing the spread. What would you advise, or are there any methods legally that we could do that would curtail the spread?” (Conradis, 10/22)

Politico: Price's Wife Defends AIDS Quarantine Remark As 'Provocative'
On Saturday, Price stressed she has worked in public health for years and had made the comments during a discussion of why there were so many people in Georgia who were not getting treatment and posed a risk of spreading the virus to others. Georgia has one of the highest rates of new HIV infections in the country. (10/22)

The Washington Post: Discounts, Guarantees And The Search For ‘Good’ Genes: The Booming Fertility Business
When Julie Schlomer got the news that she was finally pregnant at the age of 43, her thoughts turned to the other mothers. There were three of them in all, complete strangers, but they shared an extraordinary bond made possible by 21st-century medicine and marketing. They were all carrying half-siblings. Under a cost-saving program offered by Rockville-based Shady Grove Fertility, the women split 21 eggs harvested from a single donor — blue-eyed, dark-haired, with a master’s degree in teaching. Each had the eggs fertilized with her partner’s sperm and transferred to her womb. (Cha, 10/21)

Stat: Genetic Testing Of Embryos Is Creating An Ethical Morass
The issue also pokes at a broader puzzle ethicists and experts are trying to reckon with as genetic testing moves out of the lab and further into the hands of consumers. People have access to more information about their own genes — or, in this case, about the genes of their potential offspring — than ever before. But having that information doesn’t necessarily mean it can be used to inform real-life decisions. A test can tell prospective parents that their embryo has an abnormal number of chromosomes in its cells, for example, but it cannot tell them what kind of developmental delays their child might have, or whether transferring that embryo into a womb will lead to a pregnancy at all. Families and physicians are gazing into five-day-old cells like crystal balls, seeking enlightenment about what might happen over a lifetime. Plus, the tests can be wrong. (Joseph, 10/23)

The Washington Post: Cigarette Taxes Are The Best Way To Cut Smoking, Scaring Big Tobacco
For more than a decade, Kristin Page-Nei begged Montana lawmakers to raise cigarette prices. As a health advocate for the American Cancer Society, she watched year after year as other states increased their cigarette taxes and lowered their smoking rates. “What they’re doing is saving lives,” she kept saying. Finally, this spring, she helped persuade state senators to raise cigarette taxes for the first time in 12 years. Then came the tobacco lobbyists. (Wan, 10/21)

The New York Times: During Labor, Lie Down
Many doctors recommend that women in labor sit upright or walk to speed things along. But a randomized trial suggests the best bet may be to lie on your side. British researchers randomly assigned 3,093 first-time mothers with a low-dose epidural in the second stage of labor to either an upright position (walking, kneeling, standing or sitting up straight) or to a lying-down position (up to 30 degrees inclination). (Bakalar, 10/20)

Reuters: Epidurals May Not Slow Down Birthing Process.
Giving pregnant women epidural spinal anesthesia to ease their pain during the late stages of labor and delivery may not prolong the birthing process, a new experiment suggests. “Many obstetric providers believe that the numbness and weakness in a woman’s legs from epidural medications may affect a woman’s ability to push out a baby,” said senior study author Philip Hess, an anesthesiology researcher at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston. (10/22)

NPR: Brain Training Can Improve Memory, But Won't Make You A Genius
When it comes to brain training, some workouts seem to work better than others. A comparison of the two most common training methods scientists use to improve memory and attention found that one was twice as effective as the other. The more effective method also changed brain activity in a part of the brain involved in high-level thinking. (Hamilton, 10/23)

The Washington Post: Total Ankle Replacement Becomes More Common As Treatment Improves
Once disparaged as borderline quackery, the total ankle replacement is gaining acceptance as a treatment for crippling arthritis and serious injuries. For years, doctors discouraged patients from getting the procedure — called ankle arthroplasty — because of persistent controversy over the earliest techniques, which involved cementing metal ankle reconstruction devices to bone. Sometimes the parts loosened prematurely or caused infections, leaving patients in worse shape than before. (Pianin, 10/22)

NPR: Water Helps Reduce Risk Of Recurring Urinary Tract Infection
Urinary tract infections cause painful urination and are unfortunately widespread. Scientists estimate that somewhere between 40 percent to more than 50 percent of women will get a UTI in their lifetime, and one in four will get a repeat infection. Left untreated, they can lead to kidney problems. (Jochem, 10/20)

Los Angeles Times: Democrats Running For California Governor Debate Over Bringing Single-Payer Healthcare To The State
The top four Democrats running for California governor stood onstage for the first major candidate forum Sunday, splintering over single-payer healthcare but little else. The divide on healthcare mirrored the conflict within the Democratic Party both nationally and in California, with progressives — including those who backed Vermont Sen. Bernie Sanders for president — aggressively pushing for universal healthcare while moderates and establishment party members want to plot a more deliberative, cautious course. (Willon, 10/22)

The Associated Press: More Officers Receive Training To Help Veterans In Crisis
More police officers in Delaware are being trained to help military veterans going through a mental health crisis. The News Journal of Wilmington reported Sunday that a new unit has been formed within the New Castle County Police Department. The Veterans Response Team includes officers who served in the military. It will complement the department’s already existing Crisis Intervention Team. (10/23)

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2017 Kaiser Health News. All rights reserved.

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