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Kaiser Health News Original Stories

3. Political Cartoon: 'Chipping Away?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Chipping Away?'" by John Cole, The Scranton Times.

Here's today's health policy haiku:

DO OUR NEIGHBORS TO THE NORTH HAVE THE ANSWER?

Ready for reform?
Just look north, America.
Medicare for all.

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Summaries Of The News:

Capitol Hill Watch

4. Tax Bill To Take Slight Detour Back To House Following Senate Passage Then Head To Trump's Desk

The House needs to vote on the Senate's version once more because of legislative rules that bumped three provisions out of the legislation. But it's expected to sail through the lower chamber once more. Media outlets take a look at how the package, which includes the repeal of the Affordable Care Act's individual mandate, will affect the health industry.

The Washington Post: GOP Tax Bill’s Passage Slightly Delayed Over Last-Minute Senate Snag
House Republicans thought they had finished their tax work on Tuesday afternoon when they passed a version of the bill 227 to 203. But the effort hit a snag Tuesday afternoon when the Senate parliamentarian ruled that three of its provisions violated that chamber’s Byrd Rule — guidelines on what types of legislation can pass with a simple 50-vote majority. (Stein and Paletta, 12/20)

Bloomberg: Cornyn Says Tax Bill Mandate Repeal Makes Obamacare ‘Unworkable'
The No. 2 Senate Republican said Tuesday that the GOP’s tax bill will make Obamacare “unworkable,” which he hopes will force Democrats into negotiations to replace the law. Asked about the failure of the GOP’s efforts to overhaul the Affordable Care Act, Senator John Cornyn of Texas noted the tax measure will repeal the penalty for not buying health insurance, a central element of the Affordable Care Act. (Dennis, 12/19)

The Wall Street Journal: How The Tax Plan Affects Business: Everything You Need To Know
Health insurers, an overwhelmingly domestic industry, will reap enormous benefits from the tax bill’s sharp cut to the corporate rate. Analysts project that the companies initially could see sharp increases in earnings—perhaps in the 15% to 20% range, said Ana Gupte of Leerink Partners LLC. “It’s huge,” she said. She suggested that insurers are likely to find a variety of outlets for the additional cash, including share repurchases, dividends, investing to grow their businesses and merger activity, which would come on top of a fast pace of managed-care deals already under way. (Wilde Mathews, 12/19)

Modern Healthcare: House Republicans Pass Tax Cut Bill 
The Tax Cuts and Jobs Act could dramatically alter the healthcare landscape by repealing the Affordable Care Act's individual mandate starting in 2019. It also could result in tighter access to capital and greater margin pressure for not-for-profit health systems. Experts caution that the legislation will have big downstream effects on funding for Medicare, Medicaid, Affordable Care Act subsidies and other federal and state healthcare programs. That's because the projected $1.5 trillion increase in the federal budget deficit resulting from the tax cuts would put pressure on Congress to slash healthcare spending. (Meyer, 12/19)

Meanwhile, the tax package is just the latest attempt by the Republicans to chip away at the health law —

Politico: The Stealth Repeal Of Obamacare
Obamacare survived the first year of President Donald Trump, but it’s badly damaged. The sweeping Republican tax bill on the verge of final passage would repeal the individual mandate in 2019, potentially taking millions of people out of the health insurance market. On top of that, the Trump administration has killed some subsidies, halved the insurance enrollment period, gutted the Obamacare marketing campaign, and rolled out a regulatory red carpet for skimpy new health plans that will change the insurance landscape in ways that are harmful to former President Barack Obama’s signature health care law. (Kenen, 12/19)

5. Colo. Governor Makes Emergency Request For Lawmakers To Dip Into State Coffers To Fund CHIP

Congress has been dawdling on renewing money for CHIP, causing states to scramble as their funding wells start to run dry.

Denver Post: Hickenlooper Makes Emergency Plea For Lawmakers To Extend Children’s Health Insurance Program 
Colorado may use state money to extend the life of a health insurance program for children, as Congress continues to delay reauthorizing the federal funds that normally pay for it. Gov. John Hickenlooper on Tuesday sent an emergency request to lawmakers to dip into state coffers and extend the life of the program for one month — until the end of February. The program, which in Colorado is known as the Children’s Health Plan Plus, is currently set to end on Jan. 31 unless Congress reauthorizes the money for it. (Ingold, 12/19)

The Hill: Connecticut To End Children's Health Program Unless It Gets Money From Congress
Connecticut plans to shutter its health-care program for low- and middle-income children Jan. 31 unless Congress provides new federal funding. Congress let the Children’s Health Insurance Program (CHIP) lapse on Sept. 30, to the frustration of state officials and advocates. The program provides insurance to nearly 9 million children nationwide. (Roubein, 12/19)

Houston Chronicle: San Antonio Girl Pleads For CHIP Funding At U.S. Senate 
In an 11th-hour drive to rescue a nationwide children's health program, 11-year-old Harmonie Flores-Brown of San Antonio gazed up at a microphone in an ornate Senate hearing room and described what might happen if Congress fails her. "Me and other kids depend on CHIP, and if it is taken away, I won't be able to see," she said, describing her serious vision disorders. "We need the insurance, I need the insurance. So please don't take it away." (Lambrecht, 12/19)

Wyoming Public Radio: Insurance For 3,000 Kids In Wyoming In Congress's Hands
Nearly 3,000 kids in Wyoming have access to a highly subsidized health insurance through a program called Kid Care CHIP operated by the Wyoming Department of Health. Those kids could lose that coverage as soon as April, if Congress does not re-authorize funding for the Children’s Health Insurance Plan. (Watson, 12/19)

The CT Mirror: Congress’s Inaction Threatening Community Health Center Funding
Federal money for community health centers in Connecticut and across the nation remains in limbo, causing center officials to create contingency plans that include layoffs and cuts to services. Despite broad bipartisan support, Congress missed its Sept. 30 deadline to reauthorize money for the Community Health Center Fund, which represents the largest chunk of federal funds going to the centers. (Rigg, 12/20)

Health Law

6. Fresh Off Major Legislative Victory, McConnell And Ryan Barreling Toward Battle Over Health Subsidies

Senate Majority Leader Mitch McConnell (R-Ky.) promised Sen. Susan Collins (R-Maine) he'd pass legislation that stabilizes the health law's marketplaces. House lawmakers, however, are furious over the guarantee. Meanwhile, a new fight over abortion becomes latest wrench in year-end spending deal.

Politico: Ryan And McConnell Head For Clash Over Obamacare
Speaker Paul Ryan and Senate Majority Leader Mitch McConnell are about to lock horns over Obamacare — part of a House-Senate clash that needs to be resolved by Friday to avert a government shutdown. McConnell promised moderate GOP Sen. Susan Collins of Maine that he would prop up President Barack Obama’s signature health law in a must-pass, year-end spending bill — so long as she backs tax reform. But Ryan’s more conservative conference is flatly rejecting that idea and urging the Wisconsin Republican to stand firm against his Senate counterpart. (Bade and Haberkorn, 12/19)

Politico Pro: Senate To Pack Stopgap Bill With CHIP, Disaster Aid, Obamacare Subsidy Fix
Senate GOP leaders are planning to load up this week’s must-pass spending bill with contentious provisions ranging from Obamacare subsidies to surveillance powers, the No. 2 Republican said Tuesday. Senate Majority Whip John Cornyn (R-Texas) told reporters Tuesday afternoon that the stopgap spending bill would serve as a catchall for a spate of “must-do” policy items — offering the clearest signal yet of the chamber’s plan to avoid a shutdown on Friday. (Ferris, 12/19)

Politico: Collins Decries Coverage Of Her Tax Bill Support As 'Unbelievably Sexist'
Sen. Susan Collins on Tuesday blasted coverage of her support for the GOP tax bill as “extremely discouraging” and “unbelievably sexist." The Maine Republican, a key swing vote on the tax package, accused reporters of ignoring her influence over the final legislation and unfairly criticizing her efforts to pass a pair of Obamacare stabilization bills. (Cancryn, 12/19)

The Hill: Abortion Fight Threatens Collins Deal, Risks Shutdown 
A new fight over abortion has thrown a late obstacle into negotiations on the year-end stopgap spending deal days before a possible government shutdown. House Republicans say two ObamaCare measures that Senate GOP leaders are expected to attach to the stopgap as part of a deal with Sen. Susan Collins (R-Maine) must include Hyde Amendment language prohibiting the use of federal funds for abortion. (Hellmann and Sullivan, 12/19)

The Hill: Anti-Abortion Groups Press For Change To ObamaCare Bills
More than 50 anti-abortion groups are calling on Congress to amend an ObamaCare stabilization bill to ensure that federal funding doesn't go to plans that cover abortions. Led by the Susan B. Anthony List, the groups are pressuring lawmakers to vote against the bill, sponsored by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), that would reimburse insurance companies for giving discounted deductibles and copays to low-income customers. (Hellmann, 12/19)

Administration News

7. Federal Moratorium Lifted On Funding To Make Germs More Lethal

But critics say researchers risk creating a monster germ that could escape the lab and seed a pandemic.

The New York Times: A Federal Ban On Making Lethal Viruses Is Lifted
Federal officials on Tuesday ended a moratorium imposed three years ago on funding research that alters germs to make them more lethal. Such work can now proceed, said Dr. Francis S. Collins, the head of the National Institutes of Health, but only if a scientific panel decides that the benefits justify the risks. (McNeil, 12/19)

The Washington Post: U.S. Lifts Research Moratorium On Enhancing Germs’ Danger
The new policy for pathogens capable of creating a pandemic will allow researchers who want to study them to apply for funding through the new process outlined by the Department of Health and Human Services. The end of the moratorium applies to research on the SARS, MERS, influenza and other dangerous viruses. The October 2014 pause was put in place after researchers in Wisconsin and the Netherlands sparked a debate by announcing in 2011 that they had made the deadly H5N1 bird flu virus more contagious in ferrets, which are used as a model for how disease might spread among humans. This kind of research is known as “gain of function” because it introduces new abilities into existing germs. (Bernstein, 12/19)

NPR: NIH Lifts Ban On Research That Could Make Deadly Viruses Even Worse
On Tuesday, the Department of Health and Human Services released a new framework for making decisions about funding research that has the potential to create a new pandemic strain. "We have a responsibility to ensure that research with infectious agents is conducted responsibly, and that we consider the potential biosafety and biosecurity risks associated with such research," said Francis Collins, director of the National Institutes of Health, in a statement. The move by officials may mark the end of a long saga that has sharply divided the scientific community in recent years. (Greenfieldboyce, 12/19)

8. Fight Over Pregnant Immigrant Fizzles After Birth Certificate Shows She's Not A Minor

The government had been gearing up for another fight of a pregnant immigrant who wanted to seek an abortion. But because she's 19 and not 17, she is no longer in the custody of the Health and Human Services Department office that oversees housing of immigrant children.

The Associated Press: Prospects Ebb For High Court Fight Over Immigrant’s Abortion
A potential Supreme Court confrontation over the ability of a pregnant immigrant teenager in U.S. custody to have an abortion appears to be receding. The Trump administration says in court papers filed Tuesday that it has obtained the teen’s birth certificate and it shows she is 19 years old, not 17. That means she will no longer be in the custody of the Health and Human Services Department office that oversees shelters housing immigrant children. (12/19)

Politico: Supreme Court Abortion Showdown Is Defused
The age difference is significant because Immigration and Customs Enforcement, which is responsible for adults in immigration detention, tends to have fewer restrictions on pregnant women seeking to obtain abortions while in custody. Later Tuesday, the Justice Department said the immigrant was turned over to ICE and released on her own recognizance. That leaves her free to seek an abortion if she wishes to do so. (Gerstein and Rayasam, 12/19)

Marketplace

9. Burst Of Deals Reveals A Fast-Changing Health Industry Landscape

On Tuesday, health insurer Humana became the latest company to tout a new acquisition that will move the industry away from hospitals and toward clinics, doctors’ offices and surgery centers.

The Wall Street Journal: Deals Boom In Push To Move Health Care Out Of Hospitals
A recent burst of deal-making among health-care companies is set to accelerate the shift in how and where Americans get medical care—away from hospitals and toward clinics, doctors’ offices, surgery centers and even drugstores. Potential mergers disclosed since early December involve companies with more than $550 billion in cumulative revenue, a sign of how much of the industry is caught up in efforts to reshape the landscape. (Wilde Mathews and Evans, 12/20)

Reuters: Humana, Private Equity Firms Buy Kindred Healthcare For $810 Million
Humana, the fourth largest U.S. health insurer, will pay $800 million in cash for Kindred shares and to cover other costs. That will give it a 40 percent stake in Kindred at Home, which will employ the 40,000 Kindred caregivers who serve about 130,000 patients daily. It will not have a stake in the second Kindred unit. (Humer, 12/19)

Modern Healthcare: Humana, Two Private Equity Firms Will Buy Kindred Healthcare For $4.1 Billion 
In the latest in a string of deals pairing insurers with healthcare providers, health insurer Humana and two private equity companies will divide and buy long-term care and home healthcare provider Kindred Healthcare for $4.1 billion, the companies announced Tuesday. Humana, TPG Capital and Welsh, Carson, Anderson & Stowe will split Kindred into two companies, with TPG and Welsh taking over its long-term care hospitals and inpatient rehab facilities. The two private equity companies and Humana together will operate Kindred's home health, hospice and community care businesses as a stand-alone company. Humana will own 40% of that company, and the private equity firms will own the rest. (Livingston, 12/19)

Meanwhile, in other industry news —

Modern Healthcare: Tenet Mulls Sale Of Revenue-Cycle Management Subsidiary Conifer
In an announcement Tuesday morning, Tenet said it is expanding its cost-cutting strategy from $150 million to $250 million in expected savings realized by the end of 2018. It also enlisted Goldman Sachs to explore selling Conifer and is aligning executive compensation with patient quality and experience benchmarks. Conifer provides software to hospitals and doctors to help them register patients, authorize their insurance and bill them and payers for care. It serves Tenet's 77 hospitals and more than 700 other hospitals, including some that are managed by Catholic Health Initiatives, which owns a minority stake in Conifer. (Kacik and Barr, 12/19)

Dallas Morning News: Tenet Looks To Sell Conifer, Its Frisco-Based Debt Collection Company 
With $15 billion in long-term debt logged as of June 30, the company said Tuesday that it is continuing to take “aggressive actions” to improve its financial performance, accelerate growth and eliminate unnecessary costs. "We remain open to all options that can enhance shareholder value," said the interim chairman and chief executive, Ronald Rittenmeyer, who took over the organization in September. (Rice, 12/19)

The Philadelphia Inquirer: Cooper Health Sues After Failed Hospital Acquisitions
Cooper University Health Care has gone to court to recover $15 million held in escrow after its abandoned attempt to acquire Lourdes Health System and St. Francis Medical Center. In late August, Cooper announced it had signed a letter of intent to acquire Lourdes and St. Francis from Trinity Health, a large Catholic health system based in Livonia, Mich. Once completed, Camden-based Cooper would have grown into the largest health system in South Jersey with nearly $2 billion in revenue yearly. (Moran, 12/19)

Pharmaceuticals

10. First-Of-Its-Kind Gene Therapy Approved To Treat Blindness, But Sticker Price Predicted To Be Astronomical

The price of the treatment could be more than $1 million. But the Food and Drug Administration's approval of the treatment signals a new era in gene therapy because it is the first to target a disease caused by mutations in a specific gene.

The Wall Street Journal: FDA Blesses Blindness Treatment That Could Cost $1 Million
The Food and Drug Administration approved for sale the first therapy in the U.S. that delivers a functional gene to replace a faulty, disease-causing one—a treatment that could carry a price in excess of $1 million, its maker has said. The injected gene therapy from Spark Therapeutics Inc. is designed to improve sight in people with a rare form of vision loss caused by an inherited genetic mutation. The condition, retinal dystrophy, often manifests itself in young children and affects up to 3,000 Americans, Spark said. (Loftus, 12/19)

The Washington Post: FDA Approves First Gene Therapy For An Inherited Disease
In a historic move, the Food and Drug Administration on Tuesday approved a pioneering gene therapy for a rare form of childhood blindness, the first such treatment cleared in the United States for an inherited disease. The approval signals a new era for gene therapy, a field that struggled for decades to overcome devastating setbacks but now is pushing forward in an effort to develop treatments for hemophilia, sickle-cell anemia and an array of other genetic diseases. Yet the products, should they reach patients, are likely to carry stratospheric prices — a prospect already worrying consumer advocates and economists. (McGinley, 12/19)

Los Angeles Times: FDA Approves Gene Therapy To Fix Mutations That Can Lead To Blindness
Tuesday's announcement marks the third time in five months that the drug safety agency has allowed a gene therapy — a form of treatment with a long and fitful safety history — on the U.S. market. The first approval went to Kymriah, which treats a form of leukemia, in August. In October, the drug agency cleared a second gene-based treatment called Yescarta to treat a form of lymphoma. "Gene therapy will become a mainstay in treating, and maybe curing, many of our most devastating and intractable illnesses," Dr. Scott Gottlieb, the FDA's commissioner, said Tuesday. "We're at a turning point when it comes to this novel form of therapy." (Healy, 12/19)

Stat: FDA Approves First Gene Therapy Targeting Rare Form Of Inherited Blindness
Like other gene therapies, Luxturna inserts a functional piece of DNA into cells in order to replace or override a defective, disease-causing gene. For Spark, the injection site is the eyes of people, mostly children and young adults, who have a type of inherited retinal disease caused by a mutation in a gene called RPE65. People born with mutated RPE65 genes suffer from severe vision problems, including night blindness. As the disease progresses, people lose all functional vision and can eventually become totally blind. (Feuerstein, 12/19)

NPR: Luxturna Approved By FDA To Treat Inherited Form Of Blindness
In tests on patients, the treatment often produced dramatic results, restoring the ability of patients to see things they could never see before, such as the stars, the moon, fireworks and their parents' faces. The treatment also enabled patients to do many things that had been impossible, such as read, play sports, ride bicycles and go outside at night by themselves. "Today's approval marks another first in the field of gene therapy," said FDA Commission Scott Gottlieb in a statement announcing the decision. "This milestone reinforces the potential of this breakthrough approach in treating a wide range of challenging diseases." (Stein, 12/19)

For more news on high drug costs, check out our weekly feature, Prescription Drug Watch, which includes coverage and perspectives of the issue.

11. Storm Brewing On Capitol Hill Over Drug Discount Program

Pharma and hospitals are going head-to-head over cuts to the 340B drug program, which requires pharmaceutical companies to give steep discounts to hospitals and clinics that serve high volumes of low-income patients.

Modern Healthcare: House Lawmakers To Discuss 340B Legislation This Week As Tensions Build
Big Pharma and hospitals are coming head-to-head over the 340B drug reimbursement program with substantial changes at stake. Capitol Hill lawmakers who want to enact a moratorium on CMS' imminent Medicare payment cuts to 340B hospitals face mounting pressure to include reporting and transparency measures; the pressure comes from inside their ranks and from the drug industry. According to a document obtained by Modern Healthcare, the measures being floated on Capitol Hill drastically alter reporting requirements for 340B hospitals. (Luthi, 12/19)

Modern Healthcare: 340B Guidance From CMS Further Inflames Worries Over Reimbursement Cuts
Guidance meant to provide more clarity on forthcoming changes to the 340B program has only added anxiety and uncertainty for hospital executives. Although legislators are considering trying to stop the changes, as the rules stand now payment for drugs in the program are soon going to drop sharply. Beginning Jan. 1, the CMS will pay for drugs acquired through the 340B program at the average sales price minus 22.5% of that price, which is a significant change from the current rate of the average sales price plus 6%. The change would reduce payments through the program by $1.6 billion, the agency estimated. (Dickson, 12/19)

Medicaid

12. Arkansas Cuts 80,000 From Medicaid In 2017 After Eligibility Review

Another 7,198 enrollees are set to lose coverage Jan. 1 after state officials received information indicating they are eligible for Medicare. In other developments, congressional Democrats blast the House disaster relief package for not meeting Puerto Rico's Medicaid needs, Oregon appears likely to lose a Medicaid managed care company and Connecticut lawmakers postpone a special session aimed at fixing a glitch in their program.

The Associated Press: Arkansas Removes 80K From Medicaid After Eligibility Review
Officials at the Arkansas Department of Human Services say more than 80,000 people were removed from the state's Medicaid rolls in 2017 after new technology and data were used to show they were ineligible for the benefits. Nearly one-third of those cases involved people who did not report changes of address as required by the state. More than 25,000 people were removed from the program because they were receiving public benefits from more than one state. (12/19)

Arkansas Online: State Medicaid Rolls Cut By 2,900
Enrollment in Arkansas' Medicaid expansion program, known as Arkansas Works, fell by about 2,900 people in November to just under 307,000, the state Department of Human Services reported Tuesday. In a meeting with reporters, Human Services Department officials also outlined eligibility verification efforts they said have resulted in the removal of about 73,000 people from the program since the beginning of 2017. (Davis, 12/20)

The Hill: Dem Rips Disaster Package For Failing To Address Medicaid In Puerto Rico, Virgin Islands
A top Democratic lawmaker on Tuesday ripped the House’s disaster funding package for failing to include any provisions helping Medicaid programs for Puerto Rico and the U.S. Virgin Islands. “It’s disgraceful that the House Republican’s emergency supplemental funding package does absolutely nothing for the more than 1.6 million Americans in Puerto Rico and the U.S. Virgin Islands that are counting on Medicaid in the wake of overwhelming devastation,” said Rep. Frank Pallone Jr. (N.J.), the top Democrat on the House Energy and Commerce Committee. (Weixel, 12/19)

The Oregonian: Oregon Officials Prepare For Shutdown Of The State's Second Largest Medicaid Carrier
Oregon health officials are preparing to transfer the roughly 113,000 Portland-area Medicaid recipients to a new health care provider in January after their current carrier, FamilyCare, announced it would likely close. On Monday, FamilyCare president and CEO Jeff Heatherington put the company's chance of survival at "probably about 5 percent at the best." He said the state's proposed reimbursement rates for 2018 are too low and estimated that medical costs would exceed revenues by $95 million, forcing the company into bankruptcy. (Borrud, 12/19)

The CT Mirror: Session For Medicare Fix Delayed Until Early January
State legislative leaders Tuesday again delayed their plans to reverse cuts to the Medicare Savings Program in December, but pledged to restore all funds in early January. Democratic and Republican leaders of the House and Senate, who had petitioned the General Assembly into special session between Dec. 24 and 29, said they now hope to gather the full legislature on Jan. 4 or 5. ... Leaders said they have reached a tentative agreement to redistribute about $54 million from other line items in the budget to shore up the Medicare Savings Program. Otherwise an estimated 113,000 low-income seniors and disabled would lose some or all of the assistance they currently get starting in late February. (Phaneuf, 12/19)

Public Health And Education

13. EPA Bans On Toxic Chemicals In Consumer Products Indefinitely Postponed

The chemicals, which have caused death from inhalation and been linked to cancer and other negative health effects, can be found in paint strippers and cleaning agents. In other public health news: glioblastoma, racism-induced stress, diabetes, vaccines, toxic shock syndrome, and more.

The New York Times: E.P.A. Delays Bans On Uses Of Hazardous Chemicals
The Environmental Protection Agency will indefinitely postpone bans on certain uses of three toxic chemicals found in consumer products, according to an update of the Trump administration’s regulatory plans. Critics said the reversal demonstrated the agency’s increasing reluctance to use enforcement powers granted to it last year by Congress under the Toxic Substances Control Act. (Kaplan, 12/19)

Stat: Creating Electric Fields In The Brain Buys Glioblastoma Patients Extra Months
An unusual cancer treatment that creates electric fields in the brain via a bathing-cap-like device can buy a few more months of life for patients with glioblastoma, the aggressive brain cancer that is essentially always fatal, physicians reported on Tuesday in JAMA, the Journal of the American Medical Association. ... The Optune device, which costs about $21,000 a month, caused some skin irritation but otherwise has no serious side effects. It works by interfering with cell division; in the brain, cancer cells are almost the only ones that divide. (Begley, 12/19)

NPR: Stress From Racism May Be Causing African-American Babies To Die More Often
In February 2009, Samantha Pierce became pregnant with twins. It was a time when things were going really well in her life. She and her husband had recently gotten married. They had good jobs. "I was a kick-ass community organizer," says Pierce, who is African-American and lives in Cleveland. She worked for a nonprofit that fought against predatory lending. The organization was growing, and Pierce had been promoted to management. (Chatterjee and Davis, 12/20)

PBS NewsHour: Why Having More Friends Reduces Your Risk Of Type 2 Diabetes
To add to this growing list, researchers at the Maastricht University Medical Center in the Netherlands found that people with larger social groups receive fewer type 2 diabetes diagnoses compared to socially isolated people. This research, published Monday in the journal BMC Public Health, suggests that promoting social interaction could prevent or treat type 2 diabetes. (Shivni, 12/19)

Stat: Experts Call For Use Of Sanofi’s Dengue Vaccine To Be Halted In Most Cases
The use of the world’s first dengue vaccine should be temporarily suspended except in limited circumstances because of concerns that it could put some people at heightened risk of severe disease, according to prominent public health experts. That step, they say, is necessary after studies showed that the vaccine, manufactured by Sanofi Pasteur, can have an unfortunate effect: worsening — rather than preventing — future cases of dengue in some people who had not previously been infected with it. (Branswell, 12/19)

The Washington Post: A Model's Warning About Tampons And Toxic Shock Syndrome
Lauren Wasser woke up in a hospital bed 80 pounds heavier than she was supposed to be — filled with fluids to try to flush the toxins from her body. She struggled to move, and her feet felt like they were being lit with a lighter again and again. But the model did not know how dire her situation was — until she overheard a nurse discussing the surgery that would upend her life: Wasser, just 24 years old at the time, would need a below-the-knee amputation on her right leg. (Bever, 12/19)

Kaiser Health News: Doing More Harm Than Good? Epidemic Of Screening Burdens Nation’s Older Patients
Elena Altemus is 89 and has dementia. She often forgets her children’s names, and sometimes can’t recall whether she lives in Maryland or Italy. Yet Elena, who entered a nursing home in November, was screened for breast cancer as recently as this summer. “If the screening is not too invasive, why not?” asked her daughter, Dorothy Altemus. “I want her to have the best quality of life possible.” (Szabo, 12/20)

Los Angeles Times: Rich People Experience Happiness In A More Self-Centered Way Than Poor People, Study Suggests
Rich people are different from the rest of us — and that includes the way they experience happiness. Instead of feeling positive emotions that involve connections with other people, their happiness is more likely to be expressed as feelings that focus on themselves, new research shows. However, this difference doesn't necessarily mean that high-income people have more total happiness than people who earn less. The findings were published this week in the journal Emotion, and they seemed to fit a larger pattern, according to the psychologists who conducted the study. (Kaplan, 12/19)

The Washington Post: She Finally Had A Baby Naturally — With A 24-Year-Old Frozen Embryo.
When Tina Gibson got married seven years ago, the 26-year-old knew it was unlikely that she would have children naturally. Her husband, 33-year-old Benjamin Gibson, had cystic fibrosis, a condition that can make men infertile, the couple told CNN. The East Tennessee pair decided they would eventually adopt a child instead — and that they would foster several children in the meantime, until they were ready. (Eltagouri, 12/19)

14. Cities, Counties Saying 'Enough Is Enough' As They Challenge Opioid Makers In Court

"It's not that we want to profit from litigation, we want to stop it through litigation," said Michigan's Macomb County Executive Mark Hackel. Detroit and Macomb are the latest to take the court route as a way to battle the opioid epidemic, and Nashville may be close to follow.

Detroit Free Press: Detroit And Macomb Sue Drugmakers Over Opioid Epidemic
Detroit and Macomb County are the latest local governmental entities to sue drugmakers for the costs of the opioid epidemic, accusing pharmaceutical companies of recklessly selling addictive pills. On Tuesday, Detroit Mayor Mike Duggan and Macomb County Executive Mark Hackel announced the lawsuit, which includes the cities of Lansing and Escanaba, and Delta and Chippewa counties in the Upper Peninsula. (Wisely, 12/19)

Nashville Tennessean: Nashville Cleared To Explore Lawsuit Against Opioid Manufacturers
After facing an unexpected setback, Mayor Megan Barry's administration is now cleared to use an outside law firm to explore a potential lawsuit against opioid manufacturers and distributors following Metro Council action Tuesday. The council voted 31-1 to defeat a motion to reconsider contracting Nashville-based Lieff Cabraser Heimann & Bernstein, LLP, reaffirming an initial vote from two weeks ago.  (Garrison, 12/19)

In other news on the crisis —

The Baltimore Sun: Baltimore Health Commissioner Says Businesses Can Help With Opioid Epidemic
Baltimore City Health Commissioner Dr. Leana S. Wen told business leaders Tuesday that they can play a role in fighting the opioid epidemic and offered examples of how they can help. Speaking at a breakfast briefing sponsored by the Greater Baltimore Committee, Wen said one thing businesses can do to help reduce the staggering number of overdoses facing the country is to have their employees trained to administer naloxone, the drug used to reverse opioid overdoses. (McDaniels, 12/19)

Arizona Republic: Arizona Livestock Officers To Carry Opioid Overdose Treatment
The Arizona Department of Agriculture has made its first step in contributing to Gov. Doug Ducey's effort to deter opioid-related deaths in the state. Mark Killian, the agency's director, said livestock officers are receiving training that will allow them to carry Narcan nose spray, an anti-opioid treatment for overdoses. (Santistevan, 12/19)

State Watch

15. State Highlights: Following Reports Of Neglect In Minn. Nursing Homes, Health Commissioner Resigns; Va. Panel Seeks Solutions For Transporting Psychiatric Patients

Media outlets report on news from Minnesota, Virginia, Kansas, Florida, California, Iowa and Wisconsin.

Pioneer Press: Minnesota Health Commissioner Quits After Problems Investigating Elder Abuse Exposed – Twin Cities
Minnesota Health Commissioner Dr. Ed Ehlinger resigned suddenly Tuesday after a series of reports that the state agency he leads was not doing enough to protect seniors from neglect and abuse. Ehlinger’s resignation was effective at the end of the day Tuesday. He will be replaced on an interim basis by Dan Pollock, the deputy health commissioner. Ehlinger’s resignation comes after media reports, including a five-part series in the Minneapolis-based Star Tribune, found residents of senior care facilities statewide were neglected, abused and robbed, but the perpetrators were often never punished and in most instances complaints were never properly investigated. The state Department of Health is responsible for licensing and oversight of senior care centers. (Magan, 12/19)

Richmond Times-Dispatch: Legislative Panel Pushes For New Way Of Transporting Mentally Ill
The Joint Subcommittee to Study Mental Health Services in the 21st Century agreed on Tuesday to seek statewide funding for the alternative transportation project, rather than a more limited approach recommended by an advisory work group to test the concept in the Charlottesville region and six communities in Southwest Virginia at a cost of $1.7 million. (Martz, 12/19)

The Star Tribune: Mayo Hospital Workers In Albert Lea Call One-Day Strike To Protest Stalled Talks
Mayo employees picketed their hospital here Tuesday to draw attention to stalled labor talks — a move that Mayo officials dismissed as political grandstanding timed for the holidays. The one-day strike at Mayo Clinic Health System in Albert Lea included about 80 maintenance and general workers who accused the hospital of cutting positions, threatening to take benefits, and refusing to negotiate. (McKinney, 12/19)

The Associated Press: Kansas State Mental Hospital Regains Certification For Unit
The state mental hospital in eastern Kansas has regained federal certification for one of its treatment units after two years of working to address safety and patient care issues, a dose of good news as officials consider the entire hospital's future. The Kansas Department for Aging and Disability Services confirmed Tuesday that Osawatomie State Hospital, about 50 miles (80 kilometers) southwest of Kansas City, had passed a federal inspection after Thanksgiving, the second within four months. (12/19)

KCUR: Osawatomie State Hospital Regains Federal Certification — And Funding 
Osawatomie State Hospital is again eligible for millions of dollars in federal Medicare payments after the Centers for Medicare and Medicaid Services recertified its acute care center. The state psychiatric hospital lost its certification in December 2015 after the reported rape of an employee exposed security concerns and staffing shortages. A subsequent inspection in May 2017 revealed problems with sanitation, infection control and fire safety. (Fox, 12/19)

Miami Herald: Mumps Cases In Florida On Rise In 2017
At least 56 cases of mumps have been reported in Florida in 2017, a significant rise over prior years but well below outbreaks in other states, which have reported hundreds of infections this year. In Florida, mumps cases have occurred across all ages, with the most infections reported in Broward, Collier, Duval, Hillsborough and Palm Beach counties, according to a Florida Department of Health advisory to physicians dated Dec. 11. (Chang, 12/19)

Pioneer Press: Report: Despite Relatively High Rate, Too Few Minnesotans Get Flu Shots 
Barely more than half of Minnesotans got a flu shot during the fall and winter of 2016-17, said a report released on Tuesday. But the state’s 51.7 percent flu vaccination rate was the seventh-highest in the country, according to “Ready or Not? Protecting the Public’s Health from Diseases, Disasters and Bioterrorism,” a report from the nonprofit Trust for America’s Health. The U.S. Centers for Disease Control and Prevention has a goal of 70 percent vaccination, noted John Auerbach, president and CEO of the trust, during a telephone news conference. (Lundy, 12/20)

Health News Florida: Report: Police Responding To Pulse Nightclub Performed Well
A new report from the Department of Justice and the Police Foundation takes a critical look at the police response to the Pulse nightclub shooting. The nearly 200 page review concluded that the Orlando Police Department responded to the shooting in a “manner consistent with national best practices and under extremely volatile and difficult circumstances.” (Aboraya and Byrne, 12/19)

Miami Herald: University Of Miami Names CEO For Health System
Five months after the University of Miami hired Dr. Edward Abraham as dean of the Miller School of Medicine, UM officials this week named him the full-time chief executive of the UM Health System — the network of hospitals, clinics and doctors that make up the largest and among the most visible UM franchises. (Chang, 12/19)

California Healthline: Frail Patients Losing Access To Dental House Calls
Devon Rising shakes his head and tries to cover his face with his hands. It’s time to get his few remaining teeth cleaned, and he fusses for a bit. Gita Aminloo, his dental hygienist, tries to calm him by singing “Itsy Bitsy Spider,” the classic children’s song. Rising, 42, is mentally disabled and blind. He has cerebral palsy and suffers from seizures. It’s hard for him to get to a dentist’s office, so Aminloo brought her dental picks, brushes and other tools to him at the residential care facility he shares with several other people who have developmental disabilities. (Ibarra, 12/19)

Iowa Public Radio: New Rules For Firearms At Iowa Child Care Centers On Hold
Kim Reynolds’ administration is backing off proposed rules for guns in Iowa day cares, something the Department of Human Services up to now has not addressed. DHS was scheduled to present the proposed rules before state lawmakers last week, but the item was pulled from the Administrative Rules Review Committee agenda. (Russell, 12/19)

Milwaukee Journal Sentinel: Chemical Barrel Recycling Factory Spews Foul Odors And May Be Making People Ill
In February, a Milwaukee Journal Sentinel investigation exposed workplace hazards and environmental violations at the plant and others here and around the country, prompting investigations by five state and federal agencies that so far have resulted in more than 70 violations and $114,000 in fines. With reports of the bad odors continuing, the Journal Sentinel tested the air and examined other testing documents that both show the St. Francis plant is emitting pollutants that constitute — at a minimum — a nuisance odor and which may be leading to residents' health ailments. (Diedrich, 12/19)

San Francisco Chronicle: Berkeley OKs Continued Use Of Pepper Spray In Crowds
The Berkeley City Council voted Tuesday to keep in place a recently passed ordinance that allows police officers to use pepper spray on violent protesters, rejecting a recommendation from a civilian commission to roll back the law for health concerns. The 5-3 vote will allow police to continue to use the spray in crowd situations when targeting individuals who have become violent, but Police Chief Andrew Greenwood said that officers have not had to do so since the ordinance passed. (Ma, 12/19)

Prescription Drug Watch

16. Pharma Is Pocketing More Profits Even As Outrage About Costs Boils Over, Report Finds

News outlets report on stories related to pharmaceutical pricing.

Stat: Lawmakers Who Scold Pharma For Price Gouging Get Some New Ammunition
As anger rose over prescription drug prices, two Washington lawmakers criticized drug makers for taking advantage of Americans, but wanted numbers to back up their claims. Now a new government report, which they requested, provide those numbers — and also potential ammunition in the fight over drug prices. From 2006 to 2015, global sales for the pharmaceutical industry, including biotech companies, jumped 45 percent to $775 billion. Two-thirds of all drug makers experienced rising profit margins, which averaged 17 percent in 2015. And from 2008 through 2014, worldwide R&D spending — most of which went to drug development, rather than research — increased 8.5 percent, to $89 billion. (Silverman, 12/19)

The Washington Post: This Old Drug Was Free. Now It’s $109,500 A Year.
For decades, Don Anderson of Seattle has been taking the same drug to help control the temporary bouts of immobility and muscle weakness caused by a rare and frightening genetic illness called periodic paralysis. “It's like putting a 50-pound pack on your back and standing up at the dinner table,” Anderson, 73, said. “It's like wearing lead shoes around all the time. ”The drug Anderson has been taking all these years was originally approved in 1958 and used primarily to treat the eye disease glaucoma under the brand name Daranide, its price so unremarkable that he can't quite remember how much it cost at the pharmacy counter. (Johnson, 12/18)

Bloomberg: Amazon Hasn’t Figured Out Drugstores Yet. But It Will Have To
For months now, pharmacy and health benefits companies have fretted that they’re the next targets of Jeff Bezos’s disruption steamroller. In September Amazon.com Inc. acquired Whole Foods Market, a grocery chain that could theoretically add drug counters to stores; a month later came word that the e-commerce giant had secured pharmacy licenses in more than a dozen states. Analysts issued dire warnings; shares see-sawed. ...No clear strategy has emerged, according to three people familiar with the company’s plans, because Amazon hasn’t yet figured out how to shake up a notoriously complex business. So for the time being Amazon is focused on the $200 billion market for medical supplies. The company already sells bulk packs of latex gloves, bed pads and syringes; now it’s getting into medical devices and instruments. (Soper and Chen, 12/18)

Stat: Those Calculators For The True Value Of A Drug? They Could Backfire
In this era of concern about soaring health care spending, economists have raced to devise calculators to capture the true value of a drug — and sometimes concluded that pricey therapies may not be worth their cost. But how accurate are these calculators? A new white paper, released on Thursday by an organization that’s partly funded by drug and diagnostics makers contends that such value measures are usually deeply flawed and could inadvertently set back the push to personalize care. But a group that developed one such calculator critiqued by the new report told STAT that the white paper mischaracterizes its work. (Robbins, 12/14)

Bloomberg: A Bipartisan Approach On Drug Prices Is Emerging
While soaring prescription costs have drawn fire from across the political spectrum, action has been scant. There are signs however that a consensus is forming on Capitol Hill on how to curtail tactics that shield blockbuster medicines from competition. Among industry practices lawmakers are taking a critical look at are paying competitors to keep new generics on the sidelines and making minor tweaks to drugs to extend their patent life. Safety programs that keep rivals from accessing a medicine, effectively blocking generic versions by making drugs harder to copy, are also drawing scrutiny. (Edney, 12/14)

Kaiser Health News: Drug Industry Spent Millions To Squelch Talk About High Drug Prices
Facing bipartisan hostility over high drug prices in an election year, the pharma industry’s biggest trade group boosted revenue by nearly a fourth last year and spread the millions collected among hundreds of lobbyists, politicians and patient groups, new filings show. It was the biggest surge for the Pharmaceutical Research and Manufacturers of America, known as PhRMA, since the group took battle stations to advance its interests in 2009 during the run-up to the Affordable Care Act. (Hancock, 12/19)

PBS NewsHour: Fighting The Public Health Threat Of Counterfeit Drugs
Fake pharmaceuticals are a multi-billion dollar problem around the world. Made and packaged to look like the real deal, these phonies may contain a fraction of the active ingredients or none at all. these fake drugs can have serious consequences in countries with tenuous health care, as well as in the developed world. (Lazaro, 12/14)

Stat: A Former Biotech CEO Used The Company As A 'Personal Piggy Bank'
A small drug maker settled charges by the U.S. Securities and Exchange Commission of accounting and disclosure violations, including a failure to report millions of dollars in perks that were actually compensation to its former chief executive officer and chief financial officer. As a result, Provectus Biopharmaceuticals (PVCT) shareholders did not have a complete or accurate financial picture of the company. The agency alleged that former Provectus chief executive Craig Dees treated the company like his “personal piggy bank,” using roughly $3.2 million he received from 2011 to early 2016 to pay for business travel that he never took. (Silverman, 12/13)

Modern Healthcare: Some Healthcare Industry Middlemen Will Get Squeezed Out If They Don't Adapt And Prove Their Value.
Certain healthcare industry middlemen including pharmacy benefit managers, drug wholesalers and insurers will get squeezed out if they don't adapt and reaffirm their value, according to a new report from PricewaterhouseCoopers. Intermediaries like PBMs that work for payers to negotiate with pharmaceutical companies on the price of their products have been targeted for their role in huge price hikes that have plagued the industry. These middlemen should increase price transparency, deliver better pharmaceutical and clinical data to boost patient care, and diversify their business lines to secure their place in the industry, PwC's Health Research Institute said in its annual report issued Tuesday. (Kacik, 12/12)

Stat: Biosimilars May Get To Market Still Faster, Thanks To Another Court Ruling
In a decision with implications for health care costs, a federal appeals court ruled drug makers cannot use state laws to punish their biosimilar rivals from withholding information about their medicines. The ruling came in response to opposing views of a procedure found in the Biologics Price Competition and Innovation Act, which is supposed to determine when biosimilar drugs can be launched. A biosimilar drug is a nearly identical variant of a biologic and is expected to provide the same result in patients. (Silverman, 12/14)

Axios: Medicare To Scrutinize Prescription Drug Plans
The Centers for Medicare & Medicaid Services may hire a contractor to track whether the companies that sell Medicare prescription drug plans are doing a good enough job, according to a document that outlines potential contractor tasks. Between the lines: Many Medicare drug plans have been reprimanded for some serious violations, and CMS wants to figure out what's going on. Seniors and disabled people who buy the plans often complain about bad service and inappropriate denials of drug coverage. (Herman, 12/14)

Stat: How Alex Azar Could Try To Shake Up Drug Prices Through Medicare Part B
Alex Azar might have big plans to overhaul how Medicare pays for drugs. At a congressional hearing at the end of November, the nominee to be secretary of Health and Human Services wondered aloud about how to modify a government health insurance program that helps tens of millions of Americans over the age of 65 pay for medicines. Such changes might impact the price of the drugs across the board. (Swetlitz, 12/12)

17. Perspectives: The Drug Industry Really Doesn't Want You To Know It's Ripping You Off

Read recent commentaries about drug-cost issues.

Los Angeles Times: Drug Industry Lawsuit Shows It Wants To Keep Patients In Dark On Pricing
The drug industry really, really doesn't want you to know that it's ripping you off with frequent and questionable price increases for prescription meds. The Pharmaceutical Research and Manufacturers of America, the industry's main lobbying group, filed a lawsuit the other day seeking to derail a California law that will require 60 days' notice before drugmakers raise prices beyond a certain threshold. The law, SB 17, is set to take effect Jan. 1. (David Lazarus, 12/15)

Bloomberg: Pfizer Shareholders Are Already Enjoying The Fruits Of Tax Cuts
If you already know most of what's going to be in the GOP's tax bill, that it's going to pass, and that it's going to benefit you enormously, then why wait to start spending the proceeds? Pfizer Inc. announced Monday that its board had authorized a $10 billion share repurchase  -- on top of an already authorized $6.4 billion -- and will be hiking its already generous dividend by 6 percent. The buyback isn't exactly a value play: Pfizer's share price is within 30 cents of its highest point since 2004. (Max Nisen, 12/19)

Forbes: Time For Big Pharma To Step Up Before The Drug Price Debate Rises Again
In today’s social and political climate, public opinion and public action can galvanize and turn on an issue in an instant. We’re seeing it right now as the personal misconduct of public figures eviscerates careers and upends personal lives. We saw something similar on the political front happen not too long ago in healthcare when the Affordable Care Act (Obamacare) was up for repeal earlier in the year and congressional town halls were flooded with agitated constituents flogging their GOP representatives. During the 2016 election cycle, the cost of drugs took center stage repeatedly between Martin Shkreli, Mylan Pharmaceuticals and the EpiPen price hikes, and Hillary Clinton’s Tweet that rattled the markets. (Steve Brozak, 12/18)

The Hill: Allowing Public Payers To Base Coverage On A Drugs Value Is An Effective Way To Cut Prices
In October President Trump reaffirmed his belief that “Prescription drug prices are out of control.” Food and Drug Administration (FDA) commissioner Scott Gottlieb is trying to speed the approval time for generic drugs, but otherwise the Trump administration has taken few steps to address the problem. It refused to comment on a recently released National Academy of Sciences report on policies to reduce drug spending. Now, Arizona and Massachusetts have presented the administration with an unprecedented opportunity to take action. (David Howard, 12/19)

Bloomberg: Don't Count On Gilead Buying Galapagos
Though Gilead Sciences Inc. has only just begun to absorb its $12 billion purchase of Kite Pharma Inc. in October, drums are already beating for another deal. The current buzz is about Galapagos NV, a European biotech that has a licensing deal with Gilead for its autoimmune drug filgotinib. Buyout rumors have cropped up because Galapagos exercised an option on Friday to co-promote filgotinib if the drug gets regulatory approval in parts of Europe, and because a lockup and standstill agreement tied to Gilead's stake in the company expires New Year's Eve. Galapagos shares rose nearly 9 percent on Friday, pushing its market cap to nearly 4 billion euros. (Max Nisen, 12/15)

Editorials And Opinions

18. Viewpoints: Tax Cut... Check. CHIP Funding... Still On The To-Do List; The Impact Of Seven Little Words

A selection of opinions on health care from news outlets around the country.

Detroit Free Press: CHIP Funding: Congress Leaves Poor Children Out In The Cold At The Holidays
In its mad rush to pass tax cuts for the fabulously wealthy, the Republican-controlled Congress has neglected to extend funding for the Children's Health Insurance Program. The families of about 9 million not fabulously wealthy children rely on CHIP to help cover the health care costs. And now 16 states say they'll to run out of cash needed to help fund the program at the end of January. And a Merry Christmas to you too, Congress. (Mike Thompson, 12/19)

Axios: Tax Cuts Could Make It Harder To Change Medicare, Medicaid
After their victory with the tax bill, Republican leaders in the House have said they will go after entitlement and "welfare" spending, with both Medicare and Medicaid potentially on the table. ... Republicans aren't making any connection to the $1.4 trillion the tax cuts will add to the deficit, but Democrats are sure to make the connection for them — that any reductions in Medicare and Medicaid spending would be used to pay for the tax cuts. (Drew Altman, 12/20)

Bloomberg: A Seven-Word Mystery At The CDC
It now appears the rumor that the government was banning the term “evidence-based” from the Centers for Disease Control was itself not entirely evidence-based. The very thought of the U.S. government banning words -- any words -- is shocking. Over the weekend, outrage spread through the media like wildfire through California. Many people judged this alleged threat to the concept of evidence to be far too serious to warrant waiting for evidence. (Faye Flam, 12/19)

The Washington Post: The Government Shouldn’t Ban Words. But Here’s My List.
CDC Director Brenda Fitzgerald went straight to Twitter, writing: “I want to assure you there are no banned words at CDC. We will continue to talk about all our important public health programs.” What really happened? It’s hard to know for sure at this point. The Post sees a heavy-handed silencing, but National Review’s Yuval Levin offers a different explanation. According to Levin’s sources, the Department of Health and Human Services, which oversees the CDC, issued a style guide to departments for the preparation of budget documents. Included were three of the words mentioned above — “vulnerable,” “diversity” and “entitlement” — with the suggestion that they be used as little as possible because they were either used too often or incorrectly. (Kathleen Parker, 12/19)

Sacramento Bee: Single Payer Is Still Best Health Care Fix For California
With growing alarm in Sacramento over attacks on health care in Washington – threats to the Children’s Health Insurance Program and the Medicare cuts sure to come under the GOP tax plan – there’s no shortage of irony in the frantic search by Assembly Speaker Anthony Rendon to find alternatives to a solution readily at hand, the guaranteed health care bill. (Malinda Markowitz, 12/19)

Forbes: Is The Republican Tax Bill Worse Than Obamacare?
Let's be clear that health policy was hardly neutral prior to Obamacare. The missed opportunity of Obamacare lay in the fact that rather than clearing away the major well-known inequities in the prior system, Obamacare instead tilted the playing field in a different but still inequitable direction and then added a few new inequities to the mix! (Chris Conover, 12/19)

Stat: End The Ban On Over-The-Counter Oral Contraceptives
In response to concerns that women may forgo necessary preventive care visits if birth control pills are available over the counter, ACOG states that “cervical cancer screening or sexually transmitted infection (STI) screening is not required for initiating OC [oral contraceptive] use and should not be used as barriers to access.” In fact, there is currently a debate among gynecologists regarding the need and benefits of annual pap exams. (Jeffrey A. Singer, 12/19)

Omaha World-Herald: More Needs To Be Done To Address State's Medicaid Challenges
Nebraska began a new approach this year to managing medical and mental health services for low-income people eligible for Medicaid. The new system, in which three private companies manage and pay for the bulk of Medicaid services, has some commendable virtues. Many clients receive better coordinated, more effective care, a major improvement from past practice. But testimony at the State Capitol this week made clear that the new system, called Heritage Health, continues to place big burdens on rural hospitals and many behavioral health providers. Claims are processed inconsistently, and in some cases payments for services are delayed or unpaid. (12/20)

Stat: Deported Veterans Should Not Be Denied The Health Care They've Earned
Born in Mexico, Armando came to the U.S. as a child. When he came of age, he enlisted in the armed forces and served several tours of duty in Korea and Germany. During his service, he developed addictions to alcohol and opioids. After being honorably discharged from the service, Armando returned to the U.S. A few years later, a drug charge landed him before a judge. Addiction is a common problem in the military, and courts have recently begun to offer veterans treatment instead of jail time. But instead of being offered treatment, Armando was deported to Mexico. (Lello Tesema and Stephen Merjavy, 12/19)

Miami Herald: Postal Loophole Allows Opioids From Abroad To Flood Into Florida
The increasing prevalence and commonplace nature of these deadly synthetic drugs in our neighborhoods is terrifying. But over the past few years, America’s opioid epidemic has ballooned into one of the deadliest public health crises in the nation’s history, in part because of a loophole in the global postal system that allows synthetic drugs to be ordered online and shipped directly to our doorsteps. (Juliette Kayyem, 12/29)

The New York Times: The Ghoulish Pursuit Of Executing A Terminally Ill Inmate
When judges schedule a lethal injection for a terminally ill prisoner whose struggle against lymphatic cancer and extensive medical history has left him without any easily accessible veins, our law descends into a ghoulish inferno. It is a place where our most august jurists ruminate over catheter gauges and needle sizes, and ponder whether to slice deep into the groin or puncture internal jugular veins. History will not view us favorably. (Bernard E. Harcourt, 12/20)