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KHN First Edition: January 11, 2018

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First Edition

Thursday, January 11, 2018                       Visit Kaiser Health News for the latest headlines

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

Kaiser Health News: Trump Administration Clears Way To Require Work For Some Medicaid Enrollees
The Trump administration early Thursday initiated a pivotal change in the Medicaid program, announcing that for the first time the federal government will allow states to set work requirements as a condition for coverage. The announcement came in a 10-page memo with detailed directions about how states can reshape the federal-state health program for low-income people. The document says who should be excluded from the new work requirements — including children and people being treated for opioid abuse — and offers suggestions as to what counts as “work.” (Galewitz, 1/11)

Kaiser Health News: Fallout From ‘Nuclear Button’ Tweets: Sales Of Anti-Radiation Drug Skyrocket
A Twitter battle over the size of each “nuclear button” possessed by President Donald Trump and North Korea’s Kim Jong-un has spiked sales of a drug that protects against radiation poisoning. Troy Jones, who runs the website, said demand for potassium iodide soared last week, after Trump tweeted that he had a “much bigger & more powerful” button than Kim — a statement that raised new fears about an escalating threat of nuclear war. (Aleccia, 1/11)

Kaiser Health News: For Elder Health, Trips To The ER Are Often A Tipping Point
Twice a day, the 86-year-old man went for long walks and visited with neighbors along the way. Then, one afternoon he fell while mowing his lawn. In the emergency room, doctors diagnosed a break in his upper arm and put him in a sling. Back at home, this former World War II Navy pilot found it hard to manage on his own but stubbornly declined help. Soon overwhelmed, he didn’t go out often, his congestive heart failure worsened, and he ended up in a nursing home a year later, where he eventually passed away. (Graham, 1/11)

The Wall Street Journal: Trump Administration Sends Mixed Messages On Welfare Work Rules
The Trump administration issued guidelines Thursday to help states impose the first-ever work requirements on Medicaid beneficiaries, one of the biggest changes in the program’s 50-year history. That approach contrasts with a move the administration made with less fanfare earlier in the week to extend waivers that allow food-stamp recipients in 33 states to avoid work requirements. The different approaches reflect the complex political forces that surround safety-net programs. (Radnofsky and Armour, 1/11)

Reuters: Trump Administration Will Allow States To Test Medicaid Work Requirements
Certain Medicaid populations would be exempt from the rules, including those with disabilities, the elderly, children and pregnant women. Verma also said states would have to make "reasonable modifications" for those battling opioid addiction and other substance use disorders. "This gives us a pathway to start approving waivers," Verma said on a call with reporters on Wednesday. "This is about helping those individuals rise out of poverty." (Abutaleb, 1/11)

CQ: Proposed Medicaid Changes Could Spur Lawsuits
A national health advocacy group says it is seriously considering taking legal action against the Trump administration if it approves state proposals that would make key changes to Medicaid programs including requiring tens of thousands of poor Americans to join jobs programs or lose access to health care. Federal health officials are expected to begin announcing decisions on the state Medicaid proposals soon. The plans include a variety of conservative concepts, such as requiring premiums and co-payments, eliminating retroactive coverage and locking people out of coverage for failure to make payments or other issues. (Williams, 1/11)

Politico: Trump’s Secret Plan To Scrap Obamacare
Early last year as an Obamacare repeal bill was flailing in the House, top Trump administration officials showed select House conservatives a secret road map of how they planned to gut the health law using executive authority. The March 23 document, which had not been public until now, reveals that while the effort to scrap Obamacare often looked chaotic, top officials had actually developed an elaborate plan to undermine the law — regardless of whether Congress repealed it. (Haberkorn, 1/10)

The Hill: Internal Document Reveals Trump's Strategy On ObamaCare Changes 
An internal Trump administration document shared with Republican lawmakers last year shows officials' plans to change ObamaCare through administrative actions, in what Democrats say is evidence of “sabotage” of the health law. The one-page document lists 10 actions the administration planned to take to make conservative-leaning changes to how the law is implemented. It was shared at a meeting with House GOP lawmakers on March 23, in the heat of the effort to win votes for the House’s ObamaCare repeal measure, which was pulled the next day. (Sullivan, 1/10)

The Hill: Bipartisan Senators Discuss Path Forward On ObamaCare Fix 
Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) met Wednesday to discuss the path forward for their bipartisan legislation aimed at stabilizing ObamaCare, aides in both parties said. The legislation’s future has been thrown into question after it was punted at the end of last month. Alexander is now pushing for the legislation to be included in a government funding package when a long-term deal on that measure is reached. (Sullivan, 1/10)

The Hill: Lawmakers Say They're Close To Deal On CHIP Funding 
Lawmakers in both parties say that a long-running disagreement over children’s health funding has almost been resolved and that funding could be passed as soon as next week. The reauthorization of the Children’s Health Insurance Program (CHIP) could be attached to a short-term government funding bill that must pass before Jan. 19, lawmakers say. Whether the reauthorization is ultimately tied to the bill, however, will depend on broader leadership negotiations. (Sullivan, 1/10)

The Wall Street Journal: States In Limbo As Lawmakers Disagree On How To Pay For Children’s Health Program
Some states risk running out of money for a children’s health program in a countdown that is pressuring Congress to approve new money quickly, part of a continuing funding delay that has turned a little-known insurance program into an unwelcome embarrassment for Congress. Democrats and Republicans agree on the need to preserve funding for the Children’s Health Insurance Program, or CHIP, which covers about 9 million low-income children. Its formal funding ended Sept. 30. (Armour, 1/10)

The New York Times: What If CHIP Funds Run Out? Here’s What 6 Families Would Do
The Children’s Health Insurance Program, better known as CHIP, covers nearly nine million children whose parents earn too much for Medicaid, but not enough to afford other coverage. But the program, which ran out of funding in September, is at a crisis point. Congress passed a stopgap spending bill late last month that was expected to keep CHIP running through March, but the Centers for Medicare and Medicaid Services said some states could run out of money as early as next week. We asked readers to tell us how they would be affected if their children lost CHIP coverage. Their stories have been condensed and edited for clarity. (Haque, 1/10)

The New York Times: Trump Officials, After Rejecting Obama Medicare Model, Adopt One Like It
In a notable back flip, the Trump administration has decided that maybe the Obama administration was right in its efforts to change the way doctors and hospitals are paid under Medicare. The Trump administration said late Tuesday that it was starting a Medicare payment model very similar to the ones it canceled and curtailed last year. The Obama administration devised the earlier projects using authority in the Affordable Care Act. In the new program, as described by Trump appointees, Medicare will make a single “bundled payment” for nearly all the services provided in a 90-day period to certain Medicare patients who are admitted to a hospital or have certain outpatient medical procedures. (Pear, 1/10)

Stat: Overhaul Of 340B Program Could Happen This Spring, Key Republican Says
Republicans on the House Energy and Commerce Committee are gearing up to overhaul a controversial Medicare drug discount program as soon as this quarter, a key Republican tells STAT. That’s a win for drug makers who have long pushed to narrow the scope of the so-called 340B drug discount program. At the same time, however, the committee will also examine whether to restore a recent $1.6 billion cut to the program, which came under a Trump administration rule that took effect Jan. 1, according to committee Chairman Greg Walden of Oregon. Hospital groups have called the cut “devastating” and have lobbied Congress to reverse it. (Mershon, 1/11)

The Hill: Lawmakers Look To Step Up Oversight On Discount Drug Program 
House Republicans are demanding more oversight and transparency for a discount drug program they say has grown out of control in recent years. The 340B drug program, created to help rural and charity hospitals and clinics, has become the subject of intense scrutiny in recent years, with more than 12,000 entities now participating in the multibillion-dollar program, far more than when the program was created in 1992. (Hellmann, 1/10)

Stat: Drug Makers Signal Interest In Exiting Vaccine Development During Crises
Every few years an alarming disease launches a furious, out-of-the-blue attack on people, triggering a high-level emergency response. SARS. The H1N1 flu pandemic. West Nile and Zika. The nightmarish West African Ebola epidemic. In nearly each case, major vaccine producers have risen to the challenge, setting aside their day-to-day profit-making activities to try to meet a pressing societal need. With each successive crisis, they have done so despite mounting concerns that the threat will dissipate and with it the demand for the vaccine they are racing to develop. (Branswell, 1/11)

The Washington Post: Trump Administration Freezes Database Of Addiction And Mental Health Programs
Federal health officials have suspended a program that helps thousands of professionals and community groups across the country find effective interventions for preventing and treating mental illness and substance use disorders. The National Registry of Evidence-based Programs and Practices is housed within the Health and Human Services Department’s Substance Abuse and Mental Health Services Administration. (Sun and Eilperin, 1/10)

Stat: 'Evidence-Based' Program That Evaluates Behavioral Health Therapies Halted
The Trump administration has abruptly halted work on a highly regarded program to help physicians, families, state and local government agencies, and others separate effective “evidence-based” treatments for substance abuse and behavioral health problems from worthless interventions. The program, called the National Registry of Evidence-Based Programs and Practices, was launched in 1997 and is run by the Substance Abuse and Mental Health Services Administration. Its website lists 453 programs in behavioral health — aimed at everything from addiction and parenting to HIV prevention, teen depression, and suicide-hotline training — that have been shown, by rigorous outcomes measures, to be effective and not quackery. The most recent were added last September. (Begley, 1/10)

Politico: 'Nothing Is Actually Being Done': Trump's Opioid Emergency Order Disappoints
President Donald Trump in October promised to "liberate" Americans from the "scourge of addiction," officially declaring a 90-day public health emergency that would urgently mobilize the federal government to tackle the opioid epidemic. That declaration runs out on Jan. 23, and beyond drawing more attention to the crisis, virtually nothing of consequence has been done. (Ehley, 1/11)

The Associated Press: Trump Signs Bill To Improve Opioid Screening Technology
President Donald Trump signed legislation Wednesday aimed at giving Customs and Border Protection agents additional screening devices and other tools to stop the flow of illicit drugs. Speaking at a surprise bill signing ceremony flanked by members of Congress from both parties in the Oval Office, Trump described the bill as a "significant step forward" in the fight against powerful opioids such as fentanyl, which he called "our new big scourge." (1/10)

Reuters: Judge Deals Setback To Cherokee Nation Lawsuit Over Opioids
A federal judge in Oklahoma has dealt a blow to a Cherokee Nation lawsuit seeking to stop the flow of addictive opioid painkillers in its territory by issuing a preliminary injunction to prevent the case from being heard in tribal court. In a decision late Tuesday, U.S. District Judge Terence Kern ruled the tribal court lacked jurisdiction because the lawsuit involving six wholesale drug distributors and pharmacy operators does not directly concern tribal self-government. (Krehbiel-Burton, 1/10)

The Associated Press: Ohio Imposes Strict Rule On Workers' Back Surgery, Opioids
Ohio residents with work-related back injuries in most cases must try remedies like rest, physical therapy and chiropractic care before turning to spinal fusion surgery and prescription painkillers under a groundbreaking new guideline that is partly meant to reduce the overprescribing of opioids but isn't sitting well with everyone. (1/10)

The Associated Press: Medical Credit Cards Can Mean Aches And Pains For Patients
Few people look forward to a trip to the doctor or dentist, especially if they're not sure how they will pay for it. Some choose to use a special kind of credit card offered by medical professionals to pay for care at certain locations or networks. Often pitched by office assistants, they can seem like a quick fix for pricey procedures not covered by insurance including dental work, cosmetic surgery or laser vision correction. (1/10)

NPR: ER Visits Linked To Alcohol Are Rapidly Rising
Most Americans drink safely and in moderation. But a steady annual increase in trips made to emergency rooms as a result of drinking alcohol added up to 61 percent more visits in 2014 compared with 2006, according to a study published this month in the journal Alcoholism: Clinical and Experimental Research. Visits to hospital emergency rooms for alcohol-related issues rose rapidly over a nine-year period, though it's unclear why. (Lloyd, 1/11)

Los Angeles Times: Distrusting China’s Medical System, Patients Turn To U.S. Doctors Online
The doctor told Renee Gao's parents that the tumor in their teenager's chest wasn't disappearing. The girl would need a costly operation that could leave her sterile — if she survived. Then he ushered them out.Gao Jiang and Yu Wenmei had dragged their ailing daughter across this capital city of southern Yunnan province, then north to the best cancer hospitals in Sichuan and Beijing. The family stood in hours-long lines and called in favors from colleagues at Gao's life insurance company to speed up the wait. But no one would tell them why the cure for their 16-year-old's lymphoma might threaten her life. (Meyers, 1/11)

NPR: A Scientist's Gender Can Skew Research Results
The results of an IQ test can depend on the gender of the person who's conducting the test. Likewise, studies of pain medication can be completely thrown off by the gender of the experimenter. This underappreciated problem is one reason that some scientific findings don't stand the test of time. Colin Chapman found out about this problem the hard way. He had traveled to Sweden on a Fulbright scholarship to launch his career in neuroscience. And he decided to study whether a nasal spray containing a hormone called oxytocin would help control obesity. The hormone influences appetite and impulsive behavior in obese men. (Harris, 1/10)

The New York Times: Antacids During Pregnancy Tied To Asthma In Children
Using antacids during pregnancy is linked to asthma in offspring, a systematic review of research has found. Researchers pooled data from eight observational studies and concluded that the risk of asthma in childhood increased by 34 percent when the mother used proton pump inhibitors and by 57 percent with the use of histamine-2 receptor antagonists. The study is in Pediatrics. (1/11)

The New York Times: Fresh Embryos As Good As Frozen Ones For In Vitro Fertilization
For most women undergoing in vitro fertilization, fresh embryos work just as well as frozen ones. Previous trials have suggested that using only frozen embryos might improve pregnancy rates in women with polycystic ovary syndrome, or PCOS, a hormonal disorder that affects about 10 percent of women. (Women with this condition ovulate irregularly and typically have a poorer response to IVF treatment.) But in two large randomized trials published in the New England Journal of Medicine, researchers found using fresh or frozen embryos makes no difference for the majority of women who do not have PCOS. (Bakalar, 1/10)

The Washington Post: He Was 21 And Fit. He Tried To Push Through The Flu — And It Killed Him.
Kyler Baughman seemed to be the face of fitness. The 21-year-old aspiring personal trainer filled his Facebook page with photos of himself riding motorbikes and lifting weights. He once posted an image of a kettlebell with a skeleton, reading: “CrossFit, hard to kill.” So when he came down with the flu last month, his mother said, he possibly assumed he simply needed some rest. (Bever, 1/10)

Los Angeles Times: Experts Help Public Combat Flu In First Installment Of USC VHH ‘Doc Talk’ Series
With one of the nastiest flu seasons in recent history gaining steam, USC Verdugo Hills Hospital experts shared some free tips Wednesday on how to recognize the symptoms of influenza and what to do if you think you’ve been hit. In the first of a series of free lunchtime “Doc Talks” being held at the Crescenta-Cañada YMCA every second Wednesday through November, Mary Virgallito, director of patient safety for the local hospital, discussed the different strains of influenza and how the virus can be spread from up to 6 feet away. (Cardine, 1/10)

The Washington Post: Video Shows Apparently Incapacitated, Half-Naked Woman Put Out In Cold By Baltimore Hospital
A Baltimore hospital said it was investigating Wednesday after video posted online showed an apparently incapacitated woman put out in the cold wearing nothing but a hospital gown. On Wednesday, a man who said he was a psychotherapist and a student at the University of Maryland Medical Center Midtown Campus posted a video of the woman being hustled out of the hospital by staff and left at a bus stop, her possessions strewn on the street. The woman appeared to have a wound on her forehead, and was wearing a hospital gown that was falling off. She grunted and shouted, and appeared to say at one point: “Please help me!” (Moyer, 1/10)

The Associated Press: Sheriff Criticizes Mental Health System As Inmate Found Dead
A Virginia sheriff says an inmate who died in jail was mentally ill, and he’s criticizing the state’s mental health system. Sheriff Ken Stolle said in a statement that 69-year-old Joseph Sisson Jr.’s mental illness was the cause of his incarceration. He called Virginia’s mental health system “broken and ill-equipped to help all those who need it.” The Virginia Beach Sheriff’s Office said in a statement that a deputy and a medical technician attempted to wake Sisson to administer medication Monday night, but he didn’t respond and resuscitation attempts were unsuccessful. (1/10)

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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