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KHN First Edition: October 27, 2017


First Edition

Friday, October 27, 2017
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: What The Health? Open Enrollment Is Nigh
Despite the best efforts of President Donald Trump and the GOP-led Congress, the Affordable Care Act is still the law of the land. And after a turbulent year, open enrollment for individuals who buy their own health insurance begins Nov. 1 and ends Dec. 15. (10/26)

California Healthline: Acute Confusion As Exchange Enrollment Nears
If the comments on Covered California’s Facebook page are any indication, you’re all suffering from acute health insurance confusion. ... I don’t blame you. Choosing a health plan will be doubly hard this year given President Donald Trump’s recent move to cut off federal payments for a key consumer subsidy, his administration’s decision to shorten exchange open-enrollment periods in most states to 45 days, Congress’ failed attempts to repeal Obamacare and the departure of some insurers from certain markets. (Bazar, 10/27)

Kaiser Health News: Beyond The Shattered Lives And Bodies, Money Worries Weigh On Las Vegas Victims
Kurt Fowler and his wife, Trina, were celebrating their 18th wedding anniversary at a country music festival when the shooting started. Fowler, 41, knew he’d been hit in the ankle and couldn’t run. He hid under the stage until the gunfire ended. “I knew my foot was completely useless,” said Fowler, a firefighter from Lake Havasu City, Ariz., and a father of three. He underwent surgery, spent nearly two weeks in the hospital and still may need another operation. He also will need rehabilitation and follow-up visits with a specialist. (Gorman, 10/27)

Kaiser Health News: Millennials Embrace Nursing Profession — Just In Time To Replace Baby Boomers
The days are long past when the only career doors that readily opened to young women were those marked teacher, secretary or nurse. Yet young adults who are part of the millennial generation are nearly twice as likely as baby boomers were to choose the nursing profession, according to a recent study. These young people, born between 1982 and 2000, are also 60 percent more likely to become registered nurses than the Gen X’ers who were born between 1965 and 1981. (Andrews, 10/27)

California Healthline: California Cracks Down On Weed Killer As Lawsuits Abound
Jack McCall was a fixture at the local farmers market, where he sold avocados and other fruits he grew on his 20-acre ranch in Cambria, on California’s Central Coast. The U.S. postal worker and Little League coach was “very environmentally friendly,” said Teri McCall, his wife of 41 years. He avoided chemicals, using only his tractor-mower to root out the thistle and other weeds that continually sprouted on the flat areas of the ranch. (O'Neill, 10/26)

The New York Times: Trump Declares Opioid Crisis A ‘Health Emergency’ But Requests No Funds
President Trump on Thursday directed the Department of Health and Human Services to declare the opioid crisis a public health emergency, taking long-anticipated action to address a rapidly escalating epidemic of drug use. But even as he vowed to alleviate the scourge of drug addiction and abuse that has swept the country — a priority that resonated strongly with the working-class voters who supported his presidential campaign — Mr. Trump fell short of fulfilling his promise in August to declare “a national emergency” on opioids, which would have prompted the rapid allocation of federal funding to address the issue. (Davis, 10/26)

The Washington Post: Trump Declares Opioid Crisis A Public Health Emergency; Critics Say Plan Falls Short
With Trump’s declaration, the federal government will waive some regulations, give states more flexibility in how they use federal funds and expand the use of telemedicine treatment, according to senior administration officials. But the president stopped short of declaring a more sweeping national state of emergency that would have given states access to funding from the federal Disaster Relief Fund, as they would after a tornado or hurricane. Officials who briefed reporters said that such an emergency declaration would not be a good fit for a longtime crisis and would not offer authorities that the government doesn’t already have. (Wagner, Bernstein and Johnson, 10/26)

Politico: Trump's Call To Bolster Virtual Opioid Treatment Lacks Muscle, Critics Say
The first item in Trump’s public health emergency declaration was to use telemedicine — video and phone-enabled communications with doctors, pharmacists and nurses — to remotely prescribe drugs for substance abuse and mental illness. Under a 2008 law, doctors have been barred from prescribing anti-addiction medications to patients they haven’t seen in person first. The law created a barrier for addicts in rural, doctor-starved places that have been hit hardest by the crisis — and that voted for Trump in droves last November. (Pittman, 10/26)

Stat: Naloxone Is Missing Puzzle Piece In Trump Opioid Plan, Advocates Say
[Trump's] announcement included nothing about access to naloxone, the overdose-reversal drug that first responders across the country have credited with saving innumerable lives. “I think this was a missed opportunity,” said Regina LaBelle, the chief of staff for the Office of National Drug Control Policy under former president Barack Obama. “They could have purchased naloxone and distributed it to hard-hit areas, to local governments as well as to community groups.” (Facher and Joseph, 10/26)

The Associated Press: Trump Calls For Liberation From 'Scourge' Of Drug Addiction
Trump's declaration, which will be effective for 90 days and can be renewed, will allow the government to redirect resources in various ways and to expand access to medical services in rural areas. But it won't bring new dollars to fight a scourge that kills nearly 100 people a day. "As Americans we cannot allow this to continue," Trump said in a speech Thursday at the White House, where he bemoaned an epidemic he said had spared no segment of society, affecting rural areas and cities, rich and poor and both the elderly and newborns. (10/27)

The Washington Post: ‘I Learned Because Of Fred’: Trump Cites Brother’s Struggle In Talking About Addiction
President Trump stood in the White House’s grandly decorated East Room on Thursday afternoon and read from a teleprompter as he explained how his administration will launch “a massive advertising campaign” to tell children to never try drugs. Then the teleprompter halted as the president went off script.“I learned myself. I had a brother, Fred. Great guy, best-looking guy, best personality — much better than mine,” Trump said, as those gathered in the room, many of whom have lost loved ones to the opioid crisis, laughed at the overly confident president’s rare jab at himself. “But he had a problem. He had a problem with alcohol. And he would tell me: ‘Don’t drink. Don’t drink.’ ” (Johnson, 10/26)

The Washington Post: How The Government Can Fight The Opioid Epidemic Under A Public Health Emergency
At this point in the nation's opioid epidemic, fighting back is mainly about quickly making money available: Money for treatment. Money for the overdose antidote naloxone. Money to hire more people to help overwhelmed cities and states battle a crisis that killed an estimated 64,000 Americans last year. President Trump did not identify any big new sources of funding when he declared the situation a  public health emergency Thursday afternoon. But his official pronouncement will help the government speed any available resources to communities, where the epidemic is playing out on the streets every day, and will eliminate some obstacles that stand in the way of providing assistance. (Bernstein, 10/26)

The Wall Street Journal: Trump’s Opioid-Crisis Declaration Draws Praise, Criticism
Officials and activists on the front lines of the opioid crisis split Thursday over President Donald Trump’s designation of a “public health emergency,” with some praising it as a necessary move and others saying more money is needed. Ryan Hampton, a national recovery activist in Pasadena, Calif., who is personally recovering a struggle with opioids, called the president’s announcement “a welcome step in the right direction” but also said the president’s words require funding support. “The big, open-ended question, though, is will there be follow through, will there be action?” Mr. Hampton said. (Kamp and Mahtani, 10/26)

The Hill: Advocates Pan Trump Effort On Opioid Crisis 
Advocates for greater opioid treatment panned the president’s long-awaited declaration of a public health emergency, saying they need dollars to fight the epidemic killing tens of thousands of Americans every year. President Trump’s declaration, promised in August, doesn't include millions in new federal funding. Nor did it ask Congress to appropriate any new money, and Democrats are calling for tens of billions in more funds. (Roubein and Weixel, 10/26)

NPR: 'They Need Help': Trump Faces Backlash For Slow Response To Opioid Crisis
The president's announcement gives states more leeway to spend federal money in response to the rise in drug overdose deaths. It also broadens the reach of medical services in rural areas. "I think declaring an emergency is important, but it is not going to make much difference if we don't actually put resources towards this public health crisis," says Sen. Claire McCaskill, D-Mo. (Raphelson, 10/26)

The Hill: NH Dems Say Money Must Be Provided For Opioid Declaration 
New Hampshire Sens. Maggie Hassan (D) and Jeanne Shaheen (D) are calling on President Trump to pledge financial resources to combat the widespread opioid crisis, as he moves to declare the epidemic a public health emergency. "I'm pleased he's designated this as a public health emergency, but I really want to see the resources that need to come in order for our communities and families in New Hampshire to be able to fight this horrible disease," Shaheen said on MSNBC's "Andrea Mitchell Reports," in a joint interview with Hassan on Thursday. (Beavers, 10/26)

NPR: Trump Administration Declares Opioid Crisis A Public Health Emergency
Dr. Andrew Kolodny, co-director of the Opioid Policy Research Collaboration at Brandeis University's Heller School, calls the announcement "very disappointing." Without funding for new addiction treatment, he says, declaring a public health emergency isn't enough. "This is not a plan," he says. "The administration still has no plan" for dealing with opioids, he says. (Allen and Kelly, 10/26)

The Hill: Christie: Trump's Opioid Declaration 'Exactly What We Asked For'
New Jersey Gov. Chris Christie (R) on Thursday praised President Trump’s decision to declare the opioid epidemic a public health emergency, calling it “exactly what we asked for.” “The president, what he did today gives this Cabinet and the executive branch of this government every bit of authority they need to do whatever it is they want to do in concert with Congress to be able to do what needs to be done,” Christie told CNN following a ceremony at the White House. (Samuels, 10/26)

The New York Times: The Opioid Crisis: An Epidemic Years In The Making
The current opioid epidemic is the deadliest drug crisis in American history. Overdoses, fueled by opioids, are the leading cause of death for Americans under 50 years old — killing roughly 64,000 people last year, more than guns or car accidents, and doing so at a pace faster than the H.I.V. epidemic did at its peak. (Salam, 10/26)

Reuters: U.S. Attorney General Says People Should Just 'Say No' To Opioids 
U.S. Attorney General Jeff Sessions equated the opioid epidemic to a personal failing by many Americans who cannot "say no" to drugs on Thursday, and he said that marijuana could be serving as a gateway to the problem. "People should say no to drug use. They have got to protect themselves first," he said during a question-and-answer session at the Heritage Foundation think tank in Washington. (Lynch, 10/26)

The Washington Post: Former Executive Charged With Conspiring To Illegally Distribute Fentanyl
The founder of an Arizona-based pharmaceutical company has been charged with spearheading a “nationwide conspiracy” to illegally distribute fentanyl, a powerful prescription painkiller. John N. Kapoor, 74, was charged with numerous felonies, including RICO (Racketeer Influenced and Corrupt Organization) conspiracy and wire fraud. Prosecutors allege Kapoor, the founder of Insys Pharmaceuticals, colluded with doctors and pharmacies to prescribe fentanyl that was not medically necessary and defraud insurance companies for payment. (Zezima, 10/26)

The Associated Press: Drug Company Founder Indicted In US-Wide Opioid Conspiracy
The case naming Kapoor follows indictments against the company’s former CEO and other executives and managers on allegations that they provided kickbacks to doctors to prescribe a potent opioid called Subsys. In the new indictment, Kapoor, 74, of Phoenix, and the other defendants are accused of offering bribes to doctors to write large numbers of prescriptions for the fentanyl-based pain medication that is meant only for cancer patients with severe pain. Most of the people who received prescriptions did not have cancer. (Snow and Davenport, 10/26)

NPR: Narcan Opioid Overdose Spray Is Now Stocked By All Walgreens Pharmacies
It has the power to save lives by targeting opioid overdoses — something that kills more than 140 Americans every day. And now Narcan, the nasal spray that can pull a drug user back from an overdose, is being carried by all of Walgreens' more than 8,000 pharmacies. "By stocking Narcan in all our pharmacies, we are making it easier for families and caregivers to help their loved ones by having it on hand in case it is needed," said Walgreens vice president Rick Gates. (Chappell, 10/26)

The Wall Street Journal: More ACA Plans To Come With No Premiums In 2018
Insurers selling Affordable Care Act plans have a compelling new pitch: free health insurance. When sales of plans on the law’s exchanges begin Nov. 1, a growing number of consumers around the country will be able to get coverage for 2018 without paying any monthly premium, according to health insurers and an analysis of newly available federal data. (Wilde Mathews and Weaver, 10/27)

NPR: Some States Face Hard Choices After Federal Health Navigator Funds Are Slashed
Despite all of the efforts in Congress to repeal and replace the Affordable Care Act this year, it remains the law of the land. People can start signing up for health insurance for 2018 starting Nov. 1. But the landscape for the law has changed a lot. Take navigators, for instance. Those are specially trained people who help consumers sign up for coverage. In August, the Centers for Medicare & Medicaid Services cut funding for navigators by 41 percent. (Olgin, 10/26)

The Hill: Trump's ObamaCare Move May Bolster Law 
President Trump’s decision to cancel key ObamaCare payments could be backfiring. Trump has claimed the health law is “imploding,” and earlier this month he took an action seemingly aimed at that goal: cutting off key payments to insurers known as cost-sharing reductions. (Sullivan, 10/27)

Reuters: Americans Want To See A Bipartisan Fix For Obamacare: Reuters/Ipsos Poll
As Republican and Democratic lawmakers clash over the future of Obamacare, Americans largely are eager for a bipartisan solution to its shortcomings, according to a Reuters/Ipsos opinion poll released on Thursday. The Oct. 14-23 poll found that 62 percent of Americans want former President Barack Obama's healthcare law to be maintained, up from 54 percent in a January poll. About half – including 51 percent of Democrats and 56 percent of Republicans – want "a bipartisan group" rather than just members of their own parties to improve the healthcare system. (Mincer and Kahn, 10/26)

The Washington Post: What It’s Like To Look For Health Insurance Now That Trump Has Tried To Undermine Obamacare
Cindy Purvance of Park City, Utah, was incensed when she received a letter in the mail alerting her that her family’s health insurance premium would skyrocket to $1,300 a month next year — a $500 increase. Purvance vented on social media, called her insurance company and eventually consulted with an expert who helps people sign up for health plans. She learned something counterintuitive: She would probably see a smaller increase if she bought the same kind of plan she currently has — but off the Affordable Care Act exchange. (Johnson, 10/26)

The New York Times: CVS Is Said To Be In Talks To Buy Aetna In Landmark Acquisition
CVS Health, the giant drugstore chain that also runs walk-in clinics and a pharmacy benefit business, is in talks to buy Aetna, one of the nation’s largest health insurance companies, according to people briefed on the talks. Negotiations between the two companies could still fall apart, these people say. But if consummated, the deal could be worth more than $60 billion based on Aetna’s current market value, which would make it one of the largest corporate acquisitions this year and one of the largest in the history of the health industry. (Sorkin, de la Merced and Thomas, 10/26)

The Wall Street Journal: CVS Makes Blockbuster Aetna Bid
CVS Health Corp. is in talks to buy Aetna Inc. for more than $66 billion as the drugstore giant scrambles to fortify itself against looming competition from Inc. amid a continuing reordering of the health-care industry. CVS has made a proposal to buy the health insurer for more than $200 per share, people familiar with the matter said. The talks may not lead to a deal, but in a sign of their seriousness, the companies’ respective chief executives— Larry Merlo at CVS and Mark Bertolini at Aetna—have met multiple times over a period of roughly six months, one of the people said. (Mattioli, Terlep and Wilde Mathews, 10/26)

The Wall Street Journal: The Real Reason CVS Wants To Buy Aetna? Amazon Inc. has struck again. Only this time the internet giant is shaking up an industry it hasn’t yet entered. Amazon’s potential entry into the pharmacy-services industry helped spur CVS Health Corp.’s $66 billion bid for insurance giant Aetna Inc., AET 11.54% according to a person familiar with the matter. An acquisition of a major insurer was among roughly a dozen strategies CVS’s management team recently presented to directors, the person said. (Terlep and Stevens, 10/27)

The Hill: Amazon Gets Pharmacy Licenses In At Least 12 States: Report 
Tech giant Amazon is expanding into the pharmacy business, according to a Thursday report from the St. Louis Post-Dispatch. The popular shopping website has allegedly received approval for wholesale pharmacy licenses in at least 12 states: Nevada, Arizona, North Dakota, Louisiana, Alabama, New Jersey, Michigan, Connecticut, Idaho, New Hampshire, Oregon and Tennessee. (Bowden, 10/26)

Reuters: Zenefits And Co-Founder Parker Conrad To Pay SEC Fine Of Nearly $1 Million
Silicon Valley business software startup Zenefits and its co-founder Parker Conrad have been fined nearly $1 million by the U.S. Securities and Exchange Commission as part of a settlement over charges that they misled investors. Zenefits will pay a $450,000 penalty and Conrad, who resigned as the company's chief executive in early 2016, will pay more than $533,000 to settle charges that the company lied about its compliance with state insurance regulations. (Somerville, 10/26)

The Wall Street Journal: Health-Benefits Broker Zenefits, Co-Founder Conrad Settle With SEC
Health-benefits broker Zenefits and its co-founder Parker Conrad have settled charges brought by the U.S. Securities and Exchange Commission that they misled investors, the regulator said Thursday. Zenefits will pay a $450,000 penalty and Mr. Conrad will pay $534,000 to settle the charges without admitting or denying the findings that they violated securities laws. The SEC charged that the company and Mr. Conrad made false statements to investors about whether its employees were properly licensed to sell insurance. The company offers businesses free human-resources software in hopes of selling them health-insurance plans. (Winkler, 10/26)

The New York Times: ‘Fat But Fit’? The Controversy Continues
Can you be fit and healthy, even if you’re overweight? And will working out, despite the extra pounds, reduce your risk of a heart attack? The idea that you can be “fat but fit” has long been controversial. While health experts endorse physical activity as beneficial, many doctors view the concept of being “fat but fit” with suspicion. (Rabin, 10/26)

The New York Times: Why Doing Good Is Good For The Do-Gooder
The past few months, with a series of disasters seemingly one on top of another, have felt apocalyptic to many, but the bright side to these dark times has been the outpouring of donations and acts of generosity that followed. From Hurricane Harvey flooding Houston to Hurricanes Irma and Maria ripping through the Caribbean to wildfires burning Northern California, cities and charities have been flooded with donations and volunteers. The outpouring of support is critical for helping affected communities to recover. But acts of generosity benefit the do-gooder, too. (Karlis, 10/26)

NPR: Researchers Find Frequency Of Sex Rises With Marijuana Use
Tobacco companies put a lot of effort into giving cigarettes sex appeal, but the more sensual smoke might actually belong to marijuana.Some users have said pot is a natural aphrodisiac, despite scientific literature turning up mixed results on the subject. At the very least, a study published Friday in the Journal of Sexual Medicine suggests that people who smoke more weed are having more sex than those who smoke less or abstain. But whether it's cause or effect, isn't clear. (Chen, 10/27)

Reuters: Federal Judge Strikes Down Two Abortion Restrictions In Alabama
A U.S. judge on Thursday struck down two abortion restrictions in Alabama that limited how close clinics can be to public schools and banned a procedure used to terminate pregnancies in the second trimester. The decision is a blow to abortion opponents in Alabama, who have joined conservatives in other states in enacting new laws that critics said were chipping away at the U.S. Supreme Court's 1973 Roe v. Wade decision legalizing abortion. (Kenning, 10/26)

The Washington Post: Judge Blasts District Agency For Treatment Of Defendants With Mental Illness
A D.C. Superior Court judge Thursday threatened to hold the District agency charged with overseeing mental-health services in contempt for failing to provide a defendant with a court-ordered psychological evaluation. Judge Milton C. Lee called the hearing after a woman who was arrested and accused of simple assault with a knife was sent away after she showed up at the courthouse for the scheduled Oct. 17 evaluation. (Alexander and Silverman, 10/26)

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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