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KHN First Edition: November 9, 2017


First Edition

Thursday, November 09, 2017
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Maine Voters Greenlight Medicaid Expansion, But Governor Says Whoa
Just hours after Maine voters became the first in the nation to use the ballot box to expand Medicaid under the Affordable Care Act, Republican Gov. Paul LePage said he wouldn’t implement it unless the Legislature funds the state’s share of an expansion. “Give me the money and I will enforce the referendum,” LePage said. Unless the Legislature fully funds the expansion — without raising taxes or using the state’s rainy day fund — he said he wouldn’t implement it. (Wight, 11/9)

Kaiser Health News: Election Night Surprise: Health Care Galvanizes Voters
Health care appears to have played an unexpectedly robust role in Tuesday’s off-year elections, as Democrats swept statewide races in Virginia and New Jersey and voters told pollsters it was a top concern. The health headline of the night came in Maine, where voters by a large margin rebuked Republican Gov. Paul LePage and approved a referendum expanding Medicaid under the Affordable Care Act. Maine is one of 19 states that has not expanded the program to people with incomes up to 138 percent of the federal poverty line, or about $16,600 for an individual. An estimated 70,000 to 90,000 Mainers could gain insurance under the expansion. (Rovner, 11/8)

Kaiser Health News: Breathing Fire: Health Is A Casualty Of Climate-Fueled Blazes
As the deadliest fires in California history swept through leafy neighborhoods here, Kathleen Sarmento fled her home in the dark, drove to an evacuation center and began setting up a medical triage unit. Patients with burns and other severe injuries were dispatched to hospitals. She set about treating many people whose symptoms resulted from exposure to polluted air and heavy smoke. “People were coming in with headaches. I had one. My eyes were burning,” said Sarmento, the director of nursing at Santa Rosa Community Health, which provides health care for those who cannot afford it. But respiratory problems — coughs and shortness of breath — were among the biggest risks. “We made sure everyone had a mask.” (Upton and Feder Ostrov, 11/9)

Kaiser Health News: Grass-Roots Network Of Doctors Delivers Supplies To Puerto Rico
After Hurricane Harvey flooded her city of Houston in August, Dr. Jennifer McQuade planned to donate socks to those affected. Instead, surprised by the lack of medical care at a nearby shelter, McQuade, an oncologist, became the unofficial leader of a group of physicians and mothers providing emergency aid at the George R. Brown Convention Center in Houston. She triaged patients, solicited donations and recruited more doctors to join. (Martyn, 11/9)

Kaiser Health News: KHN Discussion On Advance Care Planning: What You Need To Know Now
Planning for end-of-life medical care can be daunting and uncomfortable, which is why so many people put it off — or don’t do it at all. On Wednesday, Nov. 8, Kaiser Health News senior correspondent JoNel Aleccia moderated a discussion of the pressing issues surrounding end-of-life advance care planning. (11/8)

The Associated Press: Governor Says Voters Wrong to Approve Medicaid Expansion 
Maine's governor said Wednesday that residents of his state made an expensive mistake when they voted to expand access to Medicaid under the federal health care law, and he's hesitant to implement it. Gov. Paul LePage, an opponent of "Obamacare" like his ally and fellow Republican, President Donald Trump, has vetoed five different attempts by the state Legislature to expand the program. But Maine voters decided the issue at the polls Tuesday, approving a Medicaid expansion under former President Barack Obama's signature Affordable Care Act. (11/8)

The Washington Post: Maine Voters Just Resoundingly Approved A Medicaid Expansion. Their Governor Is Trying To Stop It From Going Into Effect. 
LePage issued a statement Wednesday saying he will open Medicaid to new people only if the state legislature fully funds it without raising taxes, without pulling from the state's rainy day fund or without taking money from the elderly or disabled. That's despite the fact Maine residents voted on the initiative knowing it would likely raise taxes. "Credit agencies are predicting that this fiscally irresponsible Medicaid expansion will be ruinous to Maine’s budget," LePage said. (Phillips, 11/8)

The New York Times: Election Results Invigorate Medicaid Expansion Hopes
The election results in Maine and Virginia have energized supporters of expanding Medicaid under the Affordable Care Act in several holdout states. After months of battling Republican efforts to repeal the law, they now see political consensus shifting in their direction. Groups in Idaho and Utah are already working through the process of getting Medicaid expansion initiatives on next year’s ballots, hoping to follow Maine’s path after failing through the legislative route. (Goodnough and Sanger-Katz, 11/8)

The Associated Press: Nebraska Lawmaker Seeks Medicaid Expansion After Maine Vote
Nebraska voters could get the chance to decide whether to expand Medicaid coverage as part of the federal health care law after Maine voters defied conservative opponents and overwhelmingly approved a similar measure. State Sen. Adam Morfeld said Wednesday he will propose a resolution next year to have lawmakers place the issue on the November 2018 general election ballot. Morfeld announced his intentions after Maine on Tuesday became the first state to expand coverage through a statewide referendum. (11/8)

The Associated Press: In Election Glow, Dems See Health Care As A Winning Issue
Democrats are starting to see a political edge in health care — particularly the idea of widening Medicaid access for more low-income people — after big election victories Tuesday night. In Virginia, Democrat Ralph Northam promised a vigorous push as governor to expand Medicaid. Voters who said health care was important went decisively for Northam. (11/9)

The Wall Street Journal: Democratic Wins Dent Efforts To Roll Back Health Law’s Individual Mandate
Democratic wins in Tuesday’s elections make it less likely that Republicans, as part of their tax package, will seek to repeal the Affordable Care Act’s requirement that most people have health coverage, according to congressional aides. Voters in Maine this week decisively backed a referendum to expand Medicaid under the ACA, and exit polls showed health care was a central issue for Virginians who elected Democrat Ralph Northam as their state’s governor. (Armour and son, 11/8)

Politico: Battered By Trump, Obamacare Triumphs At The Polls
As Democrats now look to the 2018 midterms that will decide control of the House, Senate and key governorships across the country, they can begin to more confidently embrace the law that’s covering 20 million Americans and that emerged politically stronger after surviving months of concentrated Republican repeal attacks. (Pradhan, 11/8)

The New York Times: Ending Medical Tax Break Could Be A ‘Gut Punch’ To The Middle Class
Suzanne Hollack tried to care for her husband at home after he was diagnosed with frontotemporal dementia at age 69. But it got to the point where she couldn’t take a shower for fear he would stray out of the house. So 18 months ago, she moved him to a memory care community near their home in Scottsdale, Az., which like most long-term care, is not covered by Medicare. That, plus his other medical expenses, cost the couple $90,000 last year. (Zernike and Goodnough, 11/8)

The New York Times: Congress Weighs Repeal Of Tax Credit For Rare Disease Drugs
A decades-old tax credit designed to spur cures for rare diseases has been so successful that it’s now become a target in the House Republican tax plan. The proposal under consideration would end the tax breaks for development of what are called orphan drugs. Ending the credit used by big and small drug companies could save the government an estimated $54 billion over the next decade, an effort to help offset some of the anticipated losses in revenue if other Republican tax cut provisions become law. (Thomas and Kaplan, 11/8)

Reuters: Repeal Of Individual Mandate Would Increase Uninsured, Premiums: CBO
The Congressional Budget Office said on Wednesday that repealing the Obamacare individual mandate would increase the number of uninsured by 13 million by 2027 and reduce the federal budget deficit less than initially forecast. The CBO, the nonpartisan budget-scoring agency, said that eliminating the Obamacare mandate that all Americans purchase health insurance or else pay a fine would lower the deficit by $338 billion over the next decade, not $416 billion as it estimated in December. (Brice and Abutaleb, 11/8)

The Hill: Repealing ObamaCare Mandate Means Millions Fewer Insured: CBO
Getting rid of the individual mandate means fewer people with health insurance. That means fewer subsidies the government will pay to help people afford their ObamaCare health plans, and thus, savings. Premiums in the individual insurance market would increase by about 10 percent in most years of the decade, CBO concluded, because repealing the mandate means less healthy people will buy insurance. That would leave sicker, older people to share the costs in the market, resulting in higher premiums. (Roubein and Hellmann, 11/8)

Politico: CBO: Obamacare Mandate Repeal Would Cut Deficit By $338 Billion
The new analysis finds that repealing the mandate would not have as big of an impact as the estimates CBO made nearly a year ago. A December 2016 CBO analysis found that undoing the mandate would reduce the budget deficit by $416 billion over nearly a decade and result in 15 million more uninsured Americans in 2026 than under current law. (Haberkorn, 11/8)

NPR: CBO: Repealing Health Coverage Mandate Would Save $338 Billion
House Republicans are toying with the idea of repealing the so-called individual mandate — a key part of the Affordable Care Act — as part of their plan to overhaul the tax code. Including the provision could be a win-win for Republicans. The move would allow them to offset more of the tax cuts they want in their tax plan and give them the chance to claim they repealed one of the most hated parts of the Affordable Care Act, also known as Obamacare. (Kodjak, 11/8)

Reuters: Ex-Pharma Exec Azar Is Top Choice to Run U.S. Health Agency: Sources
Alex Azar, a former pharmaceutical company executive, is U.S. President Donald Trump's top pick to run the Department of Health and Human Services, two sources with knowledge of the confidential process said on condition of anonymity on Wednesday. Azar served at Eli Lilly for a decade, including five years as president of its U.S. Lilly USA, LLC unit. (Abutaleb, 11/8)

Reuters: Trump Says He And China's Xi To Try To End Opioid Crisis
U.S. President Donald Trump said on Thursday that he and Chinese President Xi Jinping would be focusing "very strongly" on the U.S opioid crisis, which he has declared a public health emergency. Trump said shortly before arriving in Beijing he would discuss as a "top priority" stopping the "flood of cheap and deadly" fentanyl "manufactured in China" when he meets Xi. (Holland and Wen, 11/9)

The New York Times: Alternatives To Opioids For Pain Relief
A combination of Tylenol and Advil worked just as well as opioids for relief of pain in the emergency room, a randomized trial has found. Researchers studied 416 men and women who arrived in the E.R. with moderate to severe pain in their arms or legs from sprains, strains, fractures or other injuries. (Bakalar, 11/8)

The Washington Post: Genetically Modified Skin Grown From Stem Cells Saved A 7-Year-Old Boy’S Life
Scientists reported Wednesday that they genetically modified stem cells to grow skin that they successfully grafted over nearly all of a child's body — a remarkable achievement that could revolutionize treatment of burn victims and people with skin diseases. The research, published in the journal Nature, involved a 7-year-old boy who suffers from a genetic disease known as junctional epidermolysis bullosa (JEB) that makes skin so fragile that minor friction such as rubbing causes the skin to blister or come apart. (Cha, 11/8)

The Wall Street Journal: New Skin for 7-Year-Old Boy Marks Advance In Gene Therapy
The new skin remains functional after 21 months, and doesn’t blister or require ointment or medication, according to the team of scientists and doctors from Austria, Germany and Italy who described the case in a paper in the journal Nature. The child in the study has Junctional Epidermolysis Bullosa (JEB), part of a family of rare, often lethal, skin-blistering diseases. Epidermolysis Bullosa affects only around 1 in every 20,000 births in the U.S.; JEB is a severe form of the disease, often leading to death in early childhood. (Dockser Marcus, 11/8)

Los Angeles Times: 9-Year-Old Boy With Rare Disease Now Has Engineered Skin Covering 80% Of His Body
Over a five-month period in the fall and winter of 2015, they harvested some of the boy's few remaining healthy skin cells. Using a virus to invade the cells, they introduced a corrected version of the mutated gene that had caused the catastrophic failure of his epidermis, the body's largest organ. They cultured the corrected cells and, on sheets backed with plastic and a naturally-occurring adhesive, used them to build many square meters of healthy new epidermis. Then, ever so delicately, they clothed his small body in a new set of skin. (Healy, 11/8)

NPR: Genetically Altered Skin Saves A Boy Dying Of A Rare Disease
After eight months in the intensive care unit, the boy was well enough to go home. And, two years later, he is in school, even playing soccer. "The kid is doing quite well," Rothoeft said. "The skin is of good quality, it doesn't need any ointments or stuff like that. It's perfectly smooth and it is quite stable. And if he gets any bruises, they just heal like bruises in every other kid." (Harris, 11/8)

The New York Times: Are Mass Murderers Insane? Usually Not, Researchers Say 
If what people do is any reflection of who they are, then Devin P. Kelley, who slaughtered 26 churchgoers on Sunday in Texas, surely was a madman. Before the atrocity, he had attempted to sneak weapons onto an Air Force base after making death threats to his superiors, according to a local police report. In 2012, he had escaped from a mental hospital in New Mexico to which he had been sent after assaulting his wife and fracturing his stepson’s skull. (Carey, 11/8)

Stat: New Brain Technologies Pose Threats To Privacy And Autonomy That Are All Too Real, Experts Warn 
W ith Elon Musk aiming to build brain implants so people can communicate telepathically, fMRIs already (approximately) reading minds, under-the-radar companies working on computer chips to control brain activity that generates intentions, and technologies promising to boost brain performance like Bradley Cooper’s in “Limitless,” it might seem like neuroscience has become neurofiction. But the advances, and the threats they pose, are all too real, experts warned on Wednesday. In an essay in Nature, 27 neuroscientists, physicians, ethicists, and artificial intelligence experts argue that these and other powerful “neurotechnologies,” originally conceived to help people who are paralyzed or have other neurological disorders, could “exacerbate social inequalities and offer corporations, hackers, governments or anyone else new ways to exploit and manipulate people.” (Begley, 11/8)

Stat: Risky Stimulants Turn Up — Again — In Weight Loss And Workout Supplements
Dr. Pieter Cohen, the Harvard internist and noted supplement detective, took the case. He and his collaborators purchased and analyzed six supplements marked as containing one of the mystery ingredients. They expected that, however they were listed, all the ingredients would turn out to be a stimulant known as octodrine, which the Food and Drug Administration approved decades ago, in inhaled form, as a treatment for bronchitis, laryngitis, and other conditions. (Robbins,11/8)

The New York Times: Pesticides Tied To Problems In Assisted Pregnancies
Eating fruits and vegetables high in pesticides may lower the chance of successful birth with assisted reproductive technology, according to a new report. Researchers studied 325 women undergoing fertility treatment in Boston. They collected data on medical and lifestyle factors and had the women fill out food frequency questionnaires. (Bakalar, 11/8)

The Washington Post: Chuck Norris Claims His Wife Was Poisoned During MRI Scans, Sues For $10 Million
Actor and martial artist Chuck Norris is suing several health-care companies, claiming his wife was poisoned by a chemical used during magnetic resonance imaging scans. In a lawsuit filed last week in San Francisco Superior Court, Chuck and Gena Norris argued that gadolinium, a metal used as a contrast agent in MRI scans, caused Gena to sustain gadolinium deposition disease, experiencing “multiple, debilitating bouts of pain and burning throughout her body” and suffering long-term damage. (Bever, 11/8)

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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