Friday, May 3, 2019, Kaiser Health News

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Kaiser Health News Original Stories

In its latest update to the Nursing Home Compare website, the government gave 1,638 homes its lowest star rating for staffing — one star on its five-star scale. Most were downgraded because payroll records reported no registered-nurse hours at all for at least four days. (Jordan Rau and Elizabeth Lucas, 5/3)

Use this tool to see staffing levels at skilled nursing homes in the U.S. (5/2)

Lack of access means that people with physical and cognitive disabilities have a heavier burden of dental disease. (David Tuller, 5/3)

As dockless electric scooters run roughshod through cities nationwide, the Centers for Disease Control and Prevention issues its first assessment on injuries and safety. It studied the injuries linked to riding e-scooters in Austin, Texas, from September through November. More than 200 people were hurt in scooter crashes and mishaps — with nearly half suffering head injuries. (Sharon Jayson, 5/2)

Margot Sanger-Katz of The New York Times, Paige Winfield Cunningham of The Washington Post and Erin Mershon of Stat News join KHN’s Julie Rovner to discuss the latest in news about the Trump administration’s effort to overturn the Affordable Care Act, a historic hearing on “Medicare-for-all” and the Kansas Supreme Court’s ruling that the state constitution protects a woman’s right to abortion. Also, Rovner interviews KHN’s Carmen Heredia Rodriguez about the latest “Bill of the Month” feature. (5/2)

Kaiser Health News provides a fresh take on health policy developments with “Political Cartoon: ‘Anti-Vaxxer?'” by Mike Luckovich.

Here’s today’s health policy haiku:

You Know It’s Bad When.

Even doctors are
disheartened by rampant flaws
Of ‘broken’ system.

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.

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Summaries Of The News:

The HHS rule is designed to protect the religious rights of health care providers and religious institutions by allowing them to opt out of procedures such as abortions, sterilizations and assisted suicide. But critics say that the broad scope of the policy will allow for discrimination against women and members of the LGBTQ community.

Reuters: U.S. Health Agency Finalizes Conscience And Religious Freedom Rule
The U.S. Department of Health and Human Services on Thursday released a final rule allowing doctors, nurses and other health workers to opt out of procedures such as abortions and sterilizations which violate their personal or religious beliefs. The rule, proposed more than a year ago, reinforces a set of 25 laws passed by Congress that protect “conscience rights” in healthcare, HHS said. Those laws allow health providers and entities to opt out of providing, participating in, paying for or referring for healthcare services that they have personal or religious objections to, HHS said. (5/2)

The Associated Press: Trump Defends Clinicians’ Right To Refuse To Do Abortions
“Just today we finalized new protections of conscience rights for physicians, pharmacists, nurses, teachers, students and faith-based charities,” Trump told an interfaith audience in the White House Rose Garden. “They’ve been wanting to do that for a long time.” The conscience rule was a priority for religious conservatives who are a key part of Trump’s political base, but some critics fear it will become a pretext for denying medical attention to LGBT people or women seeking abortions, a legal medical procedure. (Alonso-Zaldivar, 5/2)

The New York Times: Trump Administration Strengthens ‘Conscience Rule’ For Health Care Workers
The rule was issued by the Department of Health and Human Services’s Office for Civil Rights, which has been substantially expanded under President Trump. The administration has created a conscience and religious freedom division within the office, and the president’s budget sought to expand its funding. It is part of a portfolio of policy changes meant to broaden religious exemptions for certain types of medical practice. The administration has already created new exemptions for the Affordable Care Act’s requirement that employer health plans cover contraceptive care, though that change has been delayed in court. Another rule, still in its proposed stage, would modify civil rights requirements that bar discrimination by hospitals and insurance companies against transgender patients and women with a history of abortion. (Sanger-Katz, 5/2)

NPR: New Conscience Rule Protects Health Care Workers Who Refuse To Give Care
“This rule ensures that healthcare entities and professionals won’t be bullied out of the health care field because they decline to participate in actions that violate their conscience, including the taking of human life,” OCR Director Roger Severino said in a written statement. “Protecting conscience and religious freedom not only fosters greater diversity in healthcare, it’s the law.” (Kodjak, 5/2)

The Washington Post: National Day Of Prayer: Trump Touts New Faith-Based Protections For Health Care Workers
Conservative groups welcomed what they call “conscience protections” for health care workers and others, while LGBTQ and women’s groups warned the rule would reduce services and potentially harm patients if providers refuse to deliver certain care, or treat gay and transgender people. “Religious liberty is a fundamental right, but it doesn’t include the right to discriminate or harm others,” said Louise Melling, deputy legal director at the American Civil Liberties Union. “This rule threatens to prevent people from accessing critical medical care and may endanger people’s lives. … Medical standards, not religious belief, should guide medical care.” (Cha, Bailey and Goldstein, 5/2)

The Wall Street Journal: White House Unveils Rule To Protect Health Workers’ Religious, Moral Beliefs
Consumer advocacy groups said Thursday that they planned lawsuits to block the rule, setting the stage for a pitched legal fight against the Trump administration and religious-rights advocates. California Attorney General Xavier Becerra, who vowed litigation, said the rule jeopardizes crucial funding and exceeds the administration’s legal authority. “We won’t go back to the days when Americans seeking healthcare faced discrimination simply because they were female or LGBTQ,” he said, referring to lesbian, gay, bisexual, transgender and queer patients. (Armour, 5/2)

The Associated Press: San Francisco Sues Donald Trump Over Conscience Rights
The city of San Francisco is suing the Trump administration over its new regulation allowing health care professionals to opt out of providing treatments they oppose. City Attorney Dennis Herrera filed the lawsuit in U.S. District Court for Northern California on Thursday, hours after President Donald Trump made the announcement. He argues the U.S. Department of Health and Human Services exceeded its statutory authority when it created the rule. (5/2)

Politico: Trump Strengthens Protections For Religious Health Workers
The first conscience protections were passed 46 years ago, as lawmakers sought to accommodate health care workers who had objections to theRoe v. Wade Supreme Court decision that legalized abortion nationwide. Those measures and subsequent laws have been at the center of political battles in recent years — George W. Bush’s administration pushed to expand conscience protections for religious workers, and the Obama administration rolled them back. (Diamond, 5/2)

The Hill: Trump Administration Creates New Religious, Moral Protections For Health Workers
California Attorney General Xavier Becerra hinted the state may sue over the new rule. “It’s 2019, not 1920. We won’t go back to the days when Americans seeking healthcare faced discrimination simply because they were female or LGBTQ. California stands ready to take any and all legal action to prove the Trump Administration wrong,” Becerra said in a statement. (Weixel, 5/2)

CQ: HHS Finalizes Religious Freedom Rule Affecting Abortion
The administration has not always successfully navigated the line between promoting religious freedom in a legally defensible way while maintaining access to health services. Two other HHS final rules that would allow any employer to cite a religious or moral exemption to avoid covering contraceptives were temporarily blocked by a federal judge earlier this year. Oral arguments in that case are June 6. (Raman, 5/2)

Modern Healthcare: HHS Finalizes Faith-Based Protections For Healthcare Workers
HHS said it received more than 242,000 public comments regarding the proposed version of the conscience rule it released in 2018. At the time, the department said it issued the proposed rule after hearing reports of healthcare providers being made to perform abortion, sterilization or euthanasia procedures despite their faith and moral objections. (Cohen, 5/2)

Prosecutors systematically built a case highlighting how John Kapoor, the founder of Insys Therapeutics, lured doctors into writing more Subsys prescriptions with sexy sales reps, lap dances and lavish dinners. The sensational details that emerged during the trial painted a picture of corporate greed at the heart of an epidemic that has held the country in its grips. The verdict comes as opioid makers, distributors and others involved in the supply chain are facing multiple court fights.

The Associated Press: Pharmaceutical Exec Guilty Of Bribing Doctors To Push Opioid
A pharmaceutical company founder accused of paying doctors millions in bribes to prescribe a highly addictive fentanyl spray was convicted Thursday in a case that exposed such marketing tactics as using a stripper-turned-sales-rep to give a physician a lap dance. John Kapoor, the 76-year-old former chairman of Insys Therapeutics, was found guilty of racketeering conspiracy after 15 days of jury deliberations. Four ex-employees of the Chandler, Arizona-based company, including the former exotic dancer, were also convicted. (Richer, 5/2)

Reuters: Founder, Execs Of Drug Company Guilty In Conspiracy That Fed Opioid Crisis
Kapoor’s 2017 arrest came on the same day U.S. President Donald Trump declared the epidemic that has caused tens of thousands of overdose deaths annually a public health emergency. Kapoor, 76, was found guilty of running a wide-ranging scheme to bribe doctors nationwide by retaining them to act as speakers at sham events at restaurants ostensibly meant to educate clinicians about its fentanyl spray, Subsys. (5/2)

The New York Times: Top Executives Of Insys, An Opioid Company, Are Found Guilty Of Racketeering
During the 10-week trial, federal prosecutors had detailed Insys’s audacious marketing plan — which included paying doctors for sham educational talks and luring others with lap dances — to spur sales of Subsys, an under-the-tongue spray approved to treat patients with cancer. Company executives were accused of paying doctors to write prescriptions for a much wider pool of patients than the drug was approved for, and of misleading insurance companies so they would cover the potent and pricey medication. With the drug’s sales soaring, Insys became a darling of Wall Street, generating annual sales at one point of more than $300 million. (Emanuel and Thomas, 5/2)

The Wall Street Journal: Insys Co-Founder, Former Employees Convicted Of Opioid Conspiracy
“Today’s convictions mark the first successful prosecution of top pharmaceutical executives for crimes related to the illicit marketing and prescribing of opioids,” said Andrew E. Lelling, U.S. Attorney for Massachusetts, whose office prosecuted the case. “Just as we would street-level drug dealers, we will hold pharmaceutical executives responsible for fueling the opioid epidemic.” (Walker, 5/2)

Stat: Kapoor’s Conviction Sends A Signal About Corporate Accountability
Subsys followed a well-trod playbook for powerful opioids. It packaged the pain drug fentanyl, roughly 80 times more potent than morphine, in a mouth spray. It’s like Binaca, but sprayed under the tongue instead of into the throat. The spray allows fentanyl to rapidly be absorbed into the bloodstream, which is important for patients with cancer who have what is known as breakthrough pain: their pain breaks through the high doses of opioids they are already taking. (Herper, 5/2)

Bloomberg: Insys John Kapoor First CEO Convicted Of Opioid Racketeering
Prosecutors — including Assistant U.S. Attorney Fred Wyshak, who made his name targeting organized-crime figures in Boston — methodically built their case over the years, bringing their first charges in 2015 against lower-level executives before charging Kapoor in 2017. The defense painted the government’s witnesses as the real villains, saying it was Burlakoff who came up with the idea of shoveling money to doctors while keeping that information away from Kapoor. (Lawrence, Griffin and Feeley, 5/2)

WBUR: Opioid Executive John Kapoor Found Guilty In Landmark Bribery Case
Calling 39 witnesses, federal prosecutors argued that Kapoor was motivated by money and willing to put patients’ lives at stake to improve his bottom line. They depicted Insys Therapeutics as a struggling company under intense pressure from Kapoor to succeed. Prosecutors outlined a two-step approach that Insys followed to boost sales of its opioid painkiller, Subsys: first, bribe doctors and, then, lie to insurance companies. (Emanuel, 5/2)

The New York Times: The Opioid That Made A Fortune For Its Maker — And For Its Prescribers
Selling drugs is a relationship business. It’s best to do it in person. That is why, on a summer evening in 2012, Alec Burlakoff was out for dinner with Steven Chun, the owner of Sarasota Pain Associates. Burlakoff was a sales manager for Insys Therapeutics, an Arizona-based pharmaceutical company with only one branded product, a new and highly potent opioid painkiller called Subsys. Chun was a doctor who prescribed a lot of opioids. (Hughes, 5/2)

Boone County, W.Va. — with a population of fewer than 25,000 — received 1.2 million doses of hydrocodone and oxycodone between 2007 and 2012, the lawsuit claimed. West Virginia officials said that pharmaceutical distributor McKesson put profit over people when it failed to take proper action over the suspicious orders. The money will support state initiatives including rehabilitation, job training and mental health programs.

Reuters: McKesson To Pay $37 Million To Resolve West Virginia Opioid Lawsuit
Drug distributor McKesson Corp has agreed to pay $37 million to resolve a lawsuit by the state of West Virginia seeking to hold it responsible for contributing to the opioid epidemic, the state’s attorney general said on Thursday. The settlement announced by West Virginia Attorney General Patrick Morrisey resolves one of hundreds of cases McKesson faces by states and local governments alleging it failed to identify suspicious orders by pharmacies of painkillers. (Raymond, 5/2)

The New York Times: McKesson, Drug Distribution Giant, Settles Lawsuit Over Opioids In West Virginia
McKesson, the sixth-largest American company in terms of revenue, reported over $208 billion in the last fiscal year. The giant distributor funneled enough hydrocodone and oxycodone to supply every legitimate patient with nearly 3,000 doses, state officials said. Tiny Boone County, with a population of fewer than 25,000, received 1.2 million doses of hydrocodone and oxycodone between 2007 and 2012, the lawsuit claimed. (Rabin, 5/2)

The Washington Post: West Virginia Reaches $37 Million Opioid Settlement With Drug Shipper McKesson
McKesson distributed nearly 100 million doses of oxycodone and hydrocodone in West Virginia — home to 1.8 million people — between 2007 and 2012, the state charged. That included, for example, 1.3 million doses in Boone County, where 24,629 people lived in 201o. In 2017, West Virginia led the nation with 57.8 drug overdose deaths per 100,000 residents, according to the Centers for Disease Control and Prevention. More than 400,000 people in the United States have died of overdoses to prescription drugs, heroin and illegal fentanyl between 1999 and 2017. (Bernstein, 5/2)

The Wall Street Journal: McKesson To Pay $37 Million To Settle West Virginia Opioid Lawsuit
West Virginia has felt the pains of the opioid epidemic more acutely than other states. It has the highest age-adjusted rate of opioid overdose deaths in the nation, according to the National Institute on Drug Abuse. In 2017, 81.3 opioid prescriptions were written for every 100 people in West Virginia, the institute said, which was the lowest rate there since it began tracking the data in 2006. (Randazzo, 5/2)

In other news on the national drug epidemic —

Modern Healthcare: House Lawmakers Want To Cut DEA Waivers For Buprenorphine Prescriptions
House lawmakers are trying to eliminate a waiver requirement that clinicians must clear before they can prescribe buprenorphine to patients for opioid addiction. Under current law and regulations, clinicians need to apply for a waiver from the Drug Enforcement Agency (DEA) to prescribe the medication-assisted treatment for addiction even though they can readily prescribe it for pain. Several state health departments have asked for federal intervention as they continue to see residents die as a result of the opioid epidemic. (Luthi, 5/2)

The Associated Press: Cocaine Deaths Up In US, And Opioids Are A Big Part Of It
Cocaine deaths have been rising in the U.S., health officials said Thursday in their latest report on the nation’s deadliest drug overdose epidemic. After several years of decline, overdose deaths involving cocaine began rising around 2012. And they jumped by more than a third between 2016 and 2017. (Stobbe, 5/2)

The Wall Street Journal: New York Charges 28 People In Opioid Trafficking Probe
The New York attorney general’s office said it has taken down what it called a 28-person narcotics ring, part of what authorities described as an emerging threat of traffickers who distribute only oxycodone. The alleged trafficking ring sold more than $2 million of pills in the Bronx, Brooklyn, Westchester County and Connecticut during a 10-month investigation, prosecutors said. (Ramey, 5/2)

Miami Herald: FL Lawmakers Vote To Allow Needle Exchanges Statewide
For the last year and a half, injection drug users from across Florida have come to a tan, dented collection of shipping-containers-turned-offices nestled on the corner of a barren dirt lot in Miami’s health district. . What has drawn them is Florida’s only legal needle exchange, where they can turn in used syringes for clean ones to avoid sharing blood-borne diseases. But they can do more than that: The IDEA Exchange, as it’s known, tests for HIV, drains abscesses, dresses their wounds. (Koh and Flechas, 5/2)

2020 presidential candidate Sen. Amy Klobuchar (D-Minn.) introduces a proposal to address three phases of substance abuse: prevention, treatment and recovery. The bill’s $100 billion cost would come largely from opioid manufacturers, with Klobuchar saying the companies should be held responsible for helping create the country’s opioid crisis. But Klobuchar includes a number of ideas that have previously failed to gain support in Congress, so the outlook for her plan is uncertain.

The New York Times: Amy Klobuchar Proposes $100 Billion For Addiction And Mental Health
Senator Amy Klobuchar on Friday released a $100 billion plan to combat drug and alcohol addiction and improve mental health care, focusing one of the first detailed proposals of her presidential campaign on an issue deeply personal to her. Ms. Klobuchar — who has spoken before about her father’s alcoholism, including memorably at Justice Brett M. Kavanaugh’s confirmation hearing — said she had developed the plan and made it an early focus in part because of that personal experience and in part because of the number of addiction-related stories she had heard from voters. (Astor, 5/3)

The Associated Press: Klobuchar Releases $100B Substance Abuse, Mental Health Plan
The wide-ranging plan, released Friday, includes funding for early intervention of mental health disorders and drug use, a national suicide prevention campaign, better access to opioid addiction and other types of treatment and recruitment of health care workers to underserved rural areas and cities with the highest need. Klobuchar also says that as president she would prioritize mental health and substance abuse treatment over incarceration for nonviolent offenders, noting she supported drug courts as an alternative to jail when she was the lead prosecutor of Minnesota’s largest county. (Burnett, 5/3)

Politico: Cheat Sheet: How Sen. Amy Klobuchar Would Address Drug Addiction
The Minnesota Democrat’s plan aims to prevent and treat addiction, particularly to opioids. It commits to improving access to care and mental health facilities, including in-patient programs, as well as funding more research. But the plan doesn’t include specifics about expanding access to treatment for people addicted to opioids, and the price tag would likely spark opposition from fiscal conservatives. (Schneider and Ehley, 5/3)

And another Democratic hopeful enters the crowded field —

The New York Times: Where Michael Bennet Stands On The Issues
Senator Michael Bennet of Colorado, the 21st Democrat to declare his candidacy for president, is known as a moderate who seeks bipartisan compromise. Here’s where he stands on a few key issues. . On health care, he and Senator Tim Kaine of Virginia recently introduced a bill that would create a public option called Medicare-X; Mr. Bennet said that he wanted “universal coverage” but that his model was “more practical” than the single-payer ones many other Democrats have come to support. He has specifically criticized “Medicare for all” proposals that would eliminate private insurance. (Astor, 5/2)

The Wall Street Journal: Colorado Sen. Michael Bennet Enters 2020 Democratic Presidential Race
He has been an ardent defender of the Affordable Care Act, also known as Obamacare: He said during his 2010 Senate race that he was willing to lose his seat over his vote supporting it. But he has diverged from some Senate Democrats on a “Medicare for All” single-payer health-care plan, pressing instead for an expansion of Obamacare to include a government-run public option for people unable to get private insurance through their employer. (Thomas, 5/2)

One in six Americans who get insurance through their jobs say they’ve had to make “difficult sacrifices” to pay for healthcare in the last year, including cutting back on food and taking extra jobs. And it is feeding resentments and deepening inequalities, as healthier and wealthier Americans are able to save for unexpected medical bills while the less fortunate struggle to balance costly care with other necessities.

Los Angeles Times: Health Insurance Deductibles Soar, Leaving Americans With Unaffordable Bills
Soaring deductibles and medical bills are pushing millions of American families to the breaking point, fueling an affordability crisis that is pulling in middle-class households with health insurance as well as the poor and uninsured. In the last 12 years, annual deductibles in job-based health plans have nearly quadrupled and now average more than $1,300. Yet Americans’ savings are not keeping pace, data show. And more than four in 10 workers enrolled in a high-deductible plan report they don’t have enough savings to cover the deductible. (Levey, 5/2)

Los Angeles Times: Three Kids, A Health Plan And $15,000 In Medical Debt: A Working Family Tries To Make Ends Meet
Clarisa Corber hopes someday to get medication for depression and acne. Her husband, Zack, an apprentice pipefitter and former high school football player, needs a doctor to look at his knees, which swell when he climbs too many stairs. The Corbers wish they could put something in a college fund for their three children. Both parents, who are 33, dream of moving the family out of the cramped, 1,000-square-foot house they rent in a crime-plagued Topeka neighborhood known as the Dirty South. (Levey, 5/2)

NPR: High-Deductible Health Plans Keep Some Middle-Class Workers From Needed Care
Workers with a steady paycheck already know that wages have been stubbornly slow to rise. Meanwhile, those who get health insurance through a job have seen their deductibles shoot up. In fact, says Noam Levey, a health care reporter for the Los Angeles Times, deductibles have, on average, quadrupled over the last dozen years. As a result, even some people who have health insurance are having trouble affording medical care. We talked with Levey about his latest reporting into how the issue is affecting workers and their families. (Martin, 5/3)

But the FDA is considering bold warnings for a type of textured breast implant. The agency’s announcement followed a two-day public hearing in March, in which researchers and implant makers presented data, and women described a number of illnesses they developed after getting implants, including lymphoma.

The New York Times: F.D.A. Won’t Ban Sales Of Textured Breast Implants Linked To Cancer
A type of breast implant linked to a rare cancer can still be sold in the United States, even though it has been banned in many other countries, the Food and Drug Administration said on Thursday. The implants, which have a textured or slightly roughened surface, as opposed to a smooth covering, have been associated with a cancer of the immune system called anaplastic large-cell lymphoma. The vast majority of the cases have occurred in women with textured implants, mainly those made by Allergan. But the F.D.A. said that the risk, though increased, was still low, and that there was not enough data to justify banning the implants. (Grady and Rabin, 5/2)

The Associated Press: Breast Implants Tied To Rare Cancer To Remain On US Market
In recent years, the FDA and other regulators around the world have grappled with the recently confirmed link to a rare cancer and the thousands of unconfirmed complaints of other health problems that women attribute to the implants, including arthritis, fatigue and muscle pain. FDA regulators said in a statement that while they don’t have definitive evidence that implants cause those chronic ailments, women considering implants “should be aware of these risks.” To that end, the agency said it will consider adding a boxed warning — its most serious type — to breast implants and a checklist describing various potential harms for patients considering them. (Perrone, 5/2)

The Washington Post: FDA Won’t Ban Breast Implants Linked To Cancer At This Time
As of last Sept. 30, the FDA had identified 457 cases of implant-related lymphoma and nine deaths worldwide. The American Society of Plastic Surgeons reported 16 disease-related deaths worldwide as of Jan. 1, 2019. The FDA officials also addressed “breast implant illness” a constellation of autoimmune problems that includes joint and muscle pain and allergies and fatigue — a topic that was repeatedly raised at the March hearing. The agency said it “doesn’t have definitive evidence demonstrating breast implants cause these symptoms,” but added that evidence supports “that some women experience systemic symptoms that may resolve when their breast implants are removed” — and that women should be made aware of the risk before getting implants. (McGinley, 5/2)

The Wall Street Journal: FDA Won’t Ban Certain Breast Implants Despite Cancer Concerns
The agency said Thursday it doesn’t have definitive evidence demonstrating implants caused such symptoms, but it said some problems may get better when implants are removed. “We believe women considering a breast implant should be aware of these risks.” (Maidenberg and Burton, 5/2)

Bill advocates say such counseling is necessary to inform pregnant women of all resources available to them, but opponents fear that the legislation lacks key protections, like a requirement for the counselor to be a licensed medical professional. Meanwhile, an Alabama lawmaker gets push back over the language he used while criticizing his antiabortion colleagues for not caring for children after they’re born.

Texas Tribune: Texas Abortion Bill Would Require Women To Get Counseling Before Procedure
The Texas Senate advanced a bill on Thursday that would require pregnant people to receive counseling before getting an abortion. Senate Bill 2243 would require a counselor to give pregnant women informational materials that detail the medical risks of the procedure and alternatives to abortion — a pamphlet that opponents say contains false information, although the law requires it to be medically accurate. (Sandaram and Byrne, 5/2)

Austin Statesman: Texas Senate Gives Initial OK To Bill Requiring Counseling Before Abortion
Senate Bill 2243 by Sen. Angela Paxton, R-McKinney, would require a woman to meet with a counselor to discuss available resources for pregnant women in the state, including housing, child care, adoption services and others. Any counseling about abortion would be required to be medically accurate. The counselor also would administer screening for domestic violence and human trafficking. “A lack of information or fear or isolation or feeling alone — all of these are probably the worst reasons or the worst conditions under which any of us would make any big decision,” Paxton said during the debate, noting that the bill would ensure women receive guidance so “they can make a decision that is based on reality, not on fear or lack of information.” (Mekelburg, 5/2)

The Associated Press: Lawmaker: Abortion Comments Meant To Criticize Hypocrisy
An Alabama lawmaker who remarked “kill them now or kill them later” during debate on an abortion bill said he was trying to criticize politicians’ focus on abortion as they neglect social services. The comments by Democratic Rep. John Rogers of Birmingham drew widespread attention on social media — including condemnation from Donald Trump, Jr. — two days after they were made on the floor of the Alabama House of Representatives. (Chandler, 5/2)

The Washington Post: Alabama State Rep. John Rogers On Abortion: ‘Kill Them Now’ Or ‘Kill Them Later.’
Rogers argued Wednesday that “it ought to be a woman’s choice” about terminating a pregnancy, an autonomy that would disappear entirely if the majority-Republican Alabama Senate passes the “Human Life Protection Act” — a bill that would criminalize abortion at any stage of pregnancy. “I’m not about to be the male tell a woman what to do with her body,” he said, repeating a common refrain among abortion-rights advocates. “She has a right to make that decision herself.” (Mettler, 5/2)

And the head of Planned Parenthood talks strategy —

The New York Times: Leana Wen Of Planned Parenthood Wants To Tackle The ‘Fundamental Unfairness In Our System’
When Leana Wen became president of Planned Parenthood last year, she had big shoes to fill. Her predecessor, Cecile Richards, emerged as a major voice on issues involving public health and women’s rights during her 12 years in the job. But Dr. Wen, who is 36, came with her own eye-popping credentials. She was born in Shanghai and immigrated to the United States when she was 7, living first in Utah, then in Los Angeles. She skipped high school and started college when she was 13, aspiring to be a doctor. (Gelles, 5/2)

The Congressional Budget Office concluded that a proposal to curtail rebates in the drug system is unlikely to force drug companies to lower list prices across the board. Instead, they would reimburse pharmacies for discounts provided to individual seniors as they fill their prescriptions. In other pharmaceutical news: an aspiring drugmaker’s battle with federal regulators, Cigna’s strong performance in the pharmacy-benefits business, and more.

The Associated Press: Budget Office: $177B In Added Costs From Trump Drug Plan
The Trump administration’s plan to ease the financial hit of prescription drugs prices for Medicare beneficiaries will cost taxpayers another $177 billion over 10 years, congressional budget experts said on Thursday. The estimates from the nonpartisan Congressional Budget Office could affect prospects for one of the administration’s centerpiece proposals to make prescription drugs more affordable for patients. President Donald Trump and leading lawmakers of both parties want to act before the 2020 elections. (Alonso-Zaldivar, 5/2)

Modern Healthcare: CBO Predicts Drug Rebate Would Increase Medicare, Medicaid Spending
The figure is slightly below the $196 billion in new spending over the next decade that the CMS’ Office of the Actuary predicted earlier this year. The Trump administration proposed replacing the safe harbor for rebates from prosecution under the anti-kickback statute with a new one for discounts at the point of sale, by January 2020. The comment period closed last month. (King, 5/2)

Bloomberg: CBO On Trump’s Drug Rebate Plan
“Rather than lowering list prices, manufacturers would offer the renegotiated discounts” in another form, said the CBO, which performs budgetary and economic analysis for Congress. The proposal would increase spending for Medicare, the U.S. health program for the elderly and disabled, by about $170 billion over 10 years. It would raise federal spending for Medicaid, the shared state-federal health program for low-income people, by about $7 billion in the same period, according to the CBO. (Edney, 5/2)

Stat: Can A Drug Maker Make Amends With FDA After Dissing Inspectors?
Sometimes, small companies can give regulators the biggest headaches. Take Immunomedics (IMMU). Last August, executives at the aspiring drug maker locked horns with investigators from the Food and Drug Administration, who sought to examine records pertaining to a quality-control problem at a company facility, but were denied access to all of the records. Why? The company cited attorney-client privilege. (Silverman, 5/2)

The Wall Street Journal: Cigna Posts Strong Results For First Full Quarter After Express Scripts Deal
Cigna Corp. raised its earnings projection for the year, saying first-quarter results showed strong performance for its health-insurance and pharmacy-benefits businesses. Cigna’s first-quarter profit rose by 50%, reflecting its $54 billion acquisition of Express Scripts Holding Co., which closed in December. The earnings beat analysts’ expectations. The company became the latest managed-care firm to report strong results, though share prices in the industry have been dragged down by investor concern about policy issues, including drug rebates and some Democrats’ discussion of universal government coverage. (Wilde Mathews and Chin, 5/2)

Stat: Biotech Runs On Venture Capital. But Not All VC Models Are Created Equal
Venture capital dollars are flooding into biotech, totaling $8.5 billion in 2017 alone. But there’s no one way to fund a startup. Biotech’s boom has given rise to disparate funding and investment models within the venture capital world, and those nuances have an outsized impact on exactly what kinds of scientific advancements will progress, what kinds will flounder, and how fast any potential treatments can come to market. (Sheridan, 5/3)

Detroit Free Press: CVS Closing 46 Stores Nationwide, Including 1 Detroit Location
CVS Health is closing 46 of its stores, saying the locations were “underperforming” as the drugstore chain continues to shift more of its retail presence toward health care services. One store in Michigan, at 10301 Woodward Ave. in Detroit, is on the list. The store has already closed. Phone calls to the pharmacy are being redirected to another location in Highland Park. The move will cost CVS about $135 million as a “store rationalization charge” in its first-quarter earnings report. (Bomey, 5/2)

“I’m here today with a message for the people of Wisconsin: I’m going to fight like hell for Medicaid expansion and I need your help to get it done,” said Gov. Tony Evers (D-Wis.) Meanwhile, CMS finalizes a rule on union dues, Tennessee lawmakers are at an impasse over block grants, a nonprofit must return Medicaid funds to Delaware, and the number of uninsured kids is on the rise.

Milwaukee Journal Sentinel: Tony Evers Says He’s Not Giving Up On Obamacare Expansion
Under Evers’ plan, the state would expand its BadgerCare Plus health program for low-income people to 82,000 more residents using funding available through the Affordable Care Act, which is also known as Obamacare. Evers noted Republicans disclosed their plan to strip his health care proposal out of the state budget on a day when hundreds of doctors tried to lobby lawmakers on the issue. Many top Republicans were in Washington for a $1,000-per-person fundraiser. (Marley, Romell and Beck, 5/2)

Modern Healthcare: CMS Stops Medicaid From Paying Home Health Union Dues
The CMS finalized a rule on Thursday to no longer allow unions for home healthcare workers to get dues paid via state Medicaid payments. The rule, which overturns a 2014 rule, no longer allows a state to divert payments from Medicaid to anyone but the provider with few exceptions. The agency charges that the 2014 rule that allowed unions to get dues from payments stretches the meaning of the federal statute and must be struck down. (King, 5/2)

Nashville Tennessean: Tennessee Lawmakers At Impasse Over TennCare Block Grant Proposal
A bill that would have drastically changed how the state receives federal funding for its Medicaid program hit a major road block Thursday — one that could jeopardize the potential for the legislative session to end. A newly appointed 10-member conference committee tasked with settling the differences between the House and Senate version of a Medicaid block grant bill has hit an impasse. (Ebert, 5/2)

The Associated Press: Medicaid Provider To Return $4.5 Million To Delaware
A Maryland-based nonprofit organization that serves people with developmental disabilities in the mid-Atlantic region has agreed to return $4.5 million in Medicaid funds to Delaware following a two-year investigation of its billing practices. Delaware’s attorney general’s office said Thursday that in returning the money, Chimes is not admitting any liability. (Chase, 5/2)

Marketplace: After Falling For Years, The Number Of Uninsured Children Is Rising
The percentage of uninsured children in the U.S. has been in decline for years. But a new study by the University of Minnesota finds that it’s moving upward again. The rate increased across demographic groups, and the study estimates that some 4 million U.S. kids are now uninsured. (Adams, 5/3)

Public Health And Education

In the midst of the country’s largest measles outbreak in decades, parents with very young babies are stuck in limbo. “It’s just maddening, because I shouldn’t have to worry about measles,” one mother tells The New York Times. Meanwhile, public health officials say that stable vaccination rates over the past years have masked the fact that there’s an ever growing population of children and young adults who aren’t protected.

The New York Times: Parents Of Babies Too Young To Vaccinate Feel Trapped By Measles Outbreak
Roberta Traini gritted her teeth through the small talk at the Barnes & Noble checkout, grabbed her purchases and hustled her 5-month-old daughter, Gretha, into the chilly April air, where it was safer to breathe. “I was freaking out in there,” Ms. Traini said, jabbing her finger at the store. “I needed to buy a present for a birthday, so I was forced to go. I was nervous the whole time.” This is life during a measles outbreak for parents of babies: a maelstrom of fear, isolation, truncated plans and, not infrequently, unfiltered fury. (Bosman, 5/2)

Stat: As Measles Cases Spread, The Tinder For More Outbreaks Is Growing
U.S. health officials are putting all they have into extinguishing measles outbreaks, many of them raging in cities throughout the country. The reality, though, is that there is a growing amount of tinder afoot, a fact that will make it increasing difficult to battle these blazes, experts fear. In recent years, the percentage of children who have received one or more doses of measles-containing vaccine has remained relatively stable, according to the Centers for Disease Control and Prevention. (Branswell, 5/3)

And in other news —

The Washington Post: Colorado Vaccine Bill: Kyle Mullica, Lawmaker Behind Controversial Bill, Gets A Death Threat
Kyle Mullica, a freshman member of Colorado’s House, came into office this past January with a sense of mission. An emergency-room nurse, he had run a campaign based on his experience in the world of medicine, in an era where anxiety about health care is high. Even with his experience, he was surprised when during an introductory meeting with an official from the state’s Department of Public Health and Environment, he was told that Colorado was at the bottom nationwide for the percentage of children in kindergarten who were vaccinated against diseases such as measles, mumps and rubella. He had seen people coming into the ER with “vaccine-preventable” diseases like whooping cough, he said, but he was still shocked. (Rosenberg, 5/2)

Reuters: Maine Senate Rejects Ending Religious Exemptions For Vaccinations
An effort to end all non-medical exemptions for childhood vaccinations in Maine was in limbo on Thursday after the state Senate voted to amend it to allow parents to keep opting out on religious grounds. The bill had passed the Democratic-controlled state House of Representatives last month, making Maine one of at least seven states considering ending non-medical exemptions amid the worst outbreak of measles in the United States in 25 years. (5/2)

The CT Mirror: CT Health Officials Set To Release School-Level Data On Unvaccinated Children
For the first time, the state Department of Public Health will release to the public details about how many children at each school in the state are vaccinated. The release comes amidst the worst outbreak of measles the United States has experienced since it was eliminated 19 years ago. There have been over 700 confirmed measles cases in the U.S. so far this year, including three in Connecticut. (Hardman, 5/2)

The international court making the decision that impacts the 800 meter runner Caster Semenya is trying to level the playing field in sports, but medical experts and others say testosterone levels vary naturally and some women have higher levels than men. Public health news looks at a shortage of primary care physicians, organ transplants, scooter injuries, Facebook’s cardiologist, gene editing, unqualified trainers of service dogs and more.

The Washington Post: Caster Semenya Ruling Uses An Unscientific Definition Of Who Is Female, Critics Say
In ruling against Olympic gold medalist Caster Semenya, the highest court in international sports effectively imposed an exacting definition of who should be considered male or female based on a single factor — testosterone levels. The Wednesday decision by the Court of Arbitration for Sport has prompted an outcry from human rights groups and medical researchers who call the idea “unscientific” and say it sets a dangerous precedent for using biological measures to justify discrimination. (Cha, 5/2)

The Philadelphia Inquirer: Primary Care Physicians Help Increase Life Expectancy. So Why Is There A Shortage Of PCPs?
It makes sense that being cared for by an internist, family physician, or pediatrician helps keep patients healthy; allows for early diagnosis of diseases that if left undetected, could lead to more serious (and expensive) conditions later; and results in better coordination of care with other specialists. That’s the good news. Here’s the bad: per capita PCP supply (the number of PCPs per person in a county) decreased between 2005 and 2015. It’s estimated that there will be a shortage of between 14,800 and 49,300 primary care physicians by 2030. (Doherty, 5/3)

Modern Healthcare: Senators Call For Additional Review Of Liver Allocation Policy
The congressional battle over a new national liver allocation policy heated up Thursday as opponents of the change used HHS’ brief delay of the new system to put pressure on the Trump administration. Sens. Roy Blunt (R-Mo.) and Jerry Moran (R-Kan.) have asked U.S. Comptroller General Gene Dodaro to conduct a thorough review of the new rule. Simultaneously, they are seeking another delay to its implementation from HHS Secretary Alex Azar until the Government Accountability Office’s review is complete. (Luthi, 5/2)

The Washington Post: CDC Urges Helmet Use To Prevent Severe Head Injuries While Riding Scooters
Head trauma tops the list of severe injuries involving the use of electric scooters — injuries that in many cases could have been prevented with the use of a helmet, according to an investigation by the Centers for Disease Control and Prevention and the Austin public health department. Almost half of the riders identified in the study had a severe injury, such as a broken leg, and half reported that a surface condition such as a pothole or crack in the street may have contributed to their injury, according to the report, released Thursday. Fewer than 1 percent of those injured were wearing a helmet. (Lazo, 5/2)

Kaiser Health News: With Head Injuries Mounting, Will Cities Put Their Feet Down On E-Scooters?
Almost half of the injured Austin scooter riders identified by the Centers for Disease Control and Prevention in its first-ever study of dockless electric scooters suffered a head injury, with 15% experiencing a traumatic brain injury. The report, presented Thursday both in Austin and Atlanta, where the CDC is headquartered, covers 87 days last fall in Austin when almost 200 people were injured in scooter crashes. Just one of the riders wore a helmet and 33% of those riders were hurt on their first scooter ride. (Jayson, 5/2)

Stat: Facebook As ‘The Alternative Clinic Visit’: A Conversation With The Social Media Giant’s Cardiologist
Facebook employs about 38,000 full-time people. Only a few of them are physicians. Just one is a cardiologist. That’s Dr. Freddy Abnousi, the social media giant’s head of health care research. He’s in the role at a time when Facebook’s rivals in Big Tech have been making ambitious pushes into health and medicine. . So far, Facebook has mostly kept quiet about its health care research. But Abnousi has begun to emerge as a public face for that work. He recently put out an opinion piece in JAMA, co-authored with several academics, calling for social media data to be considered alongside the more traditional data sources that are used to understand the health factors known as social determinants of health. (Robbins, 5/3)

NPR: Editing Genes To Change Human Traits Is A Tall Order
Scientists continue to speak out against the prospect of producing engineered embryos that could lead to “designer babies.” Leaders of the American Society of Gene and Cell Therapy sent a letter on April 24 to Alex Azar, the secretary of health and human services, adding their voices to the call for a moratorium on experiments that could alter the genes passed down to future generations. This move follows a widely criticized experiment in China last year that apparently produced children with edited genomes. (Harris, 5/2)

The Washington Post: In ‘Lawless’ World Of Service Dogs, Many Families Suffer
All the counseling, therapy and medication did little to ease 9-year-old Sobie Cummings’ crippling anxiety and feelings of isolation. A psychiatrist suggested that a service dog might help. To Glenn and Rachel Cummings, Mark Mathis seemed like a dream come true. His kennel, Ry-Con Service Dogs, was just a couple of hours away, and he, too, had a child with autism. But what clinched the decision were Mathis’ credentials. “In 2013, Mark was certified as a NC state approved service dog trainer with a specialty in autism service dogs for children,” stated an online brochure. (Breed, 5/3)

California Healthline: For Those With Developmental Disabilities, Dental Needs Are Great, Good Care Elusive
When Ava Terranove began feeling oral pain last July, her parents took her to her regular dentist. The dentist determined that Ava, who has an autism-like condition, needed two root canal procedures to treat infected teeth. Because of her developmental disability, Ava, now 15, requires general anesthesia for non-routine dental work. The dentist, like most of his peers, was not equipped to provide it. (Tuller, 5/2)

Investigations into Catherine Pugh’s financial deals with health care entities like Kaiser Permanente and the University of Maryland Medical System will continue after she stepped down Thursday, saying she’s sorry for the harm she’s done and that Baltimore deserves a mayor who can lead the city forward. City Council President Bernard C. “Jack” Young takes over as mayor until 2020.

The Associated Press: Baltimore Shifts To New Political Era After Mayor Resigns
After ex-Mayor Catherine Pugh’s rapid collapse amid multiple public corruption investigations, Baltimore city employees are pulling down her official portraits as the city quickly shifts into a new era with Mayor Bernard “Jack” Young at the helm. Young, a fellow Democrat and a longtime leader of the City Council, automatically replaced Pugh after her resignation Thursday afternoon. (5/2)

The Washington Post: Baltimore Mayor Catherine Pugh Resigns Amid ‘Healthy Holly’ Book Scandal, Health Problems
Pugh’s downfall is rooted in her “Healthy Holly” books, which feature illustrations of African American children and parents and promote healthy eating and exercise. She reportedly was paid nearly $800,000 for the series — an enormous amount in the world of children’s literature — by entities that included the University of Maryland Medical System, on whose board she sat. (Schwartzman and Hermann, 5/2)

The Wall Street Journal: Baltimore Mayor Pugh Resigns In Book-Sales Scandal
Ms. Pugh, 69 years old, took a leave of absence from the job April 1 to cope with what her office said was severe pneumonia. City Council President Bernard C. “Jack” Young has filled in as mayor and will finish her four-year term, which ends in 2020. The 15-member council will elect a new president. The book deals, which date to 2011, when Ms. Pugh was in the state Senate, are now the subject of several criminal investigations, including probes by federal law-enforcement officials and the state prosecutor. (Calvert and Kamp, 5/2)

Media outlets report on news from Texas, New Jersey, Ohio, North Carolina, Arizona, New Hampshire, Pennsylvania, California and Missouri.

Texas Tribune: University Of Houston Medical School Gets Approval From Texas Legislature
Texas Gov. Greg Abbott has signed a bill creating a medical school at the University of Houston amid concerns about a physician shortage in the state. Under the legislation signed into law Wednesday, the University of Houston’s College of Medicine will be the 13th medical school in Texas. It will be based in the UH System’s flagship campus in Houston. Nearly half of the Texas medical schools are in the Houston area. (Byrne, 5/2)

ProPublica: Pediatrician Who Treated Immigrant Children Describes Pattern Of Lapses In Medical Care In Shelters
For months, she’d been noticing a lax attitude about the medical needs of children at the federally funded immigrant youth shelters run by the Center for Family Services, a nonprofit based in Camden, New Jersey. So, she decided to review the charts of the 90 CFS patients the community health center had seen. Children, including infants, were showing up as many as 10 weeks late for their booster vaccines, increasing their risk of contracting infectious diseases, she said. (Grabell, 5/3)

Cleveland Plain Dealer: University Hospitals Fertility Case: Appellate Court Rules Lost Embryos Were Not Living Persons
An appellate court Thursday ruled against a couple seeking a legal declaration that their embryos lost in a freezer malfunction last year were living persons and should have been treated as patients, not property. The 8th District Ohio Court of Appeals, in a 2-1 decision, upheld then-Cuyahoga County Common Pleas Judge Stuart Friedman’s ruling that the frozen embryos were not persons. (Caniglia, 5/2)

North Carolina Health News: One Big Request At Teachers Rally: More Mental Health Support Professionals
Thousands of red-clad teachers marched through the streets of Raleigh on Wednesday asking for more resources in their classrooms, but that request extended beyond merely school supplies. For the teachers, one of the big asks was for more of the other school staffers who support their mission of teaching some 1.5 million of the state’s public schoolchildren. One of the biggest priorities many teachers expressed was for help with dealing with the mental health needs of their students, a priority made clear in the stickers on many red shirts reading, “FIRST hire more psychologists,” or “FIRST hire more counselors.” (Hoban, 5/2)

Arizona Republic: Arizona Budget: Documents Show Ducey, Senate GOP Not Close To Deal
Draft documents obtained by The Arizona Republic appear to show Republican lawmakers have a long way to go before reaching agreement on a budget deal with Gov. Doug Ducey. . These are seven key areas where the Senate’s preliminary proposal differs from the governor’s executive budget. Senate President Karen Fann, R-Prescott, declined to comment on the disparities, while a spokesman for the governor said Ducey preferred not to “negotiate the budget through the media.” (Polletta, Leingang and Altavena, 5/2)

NH Times Union: Lawmakers Approve $20M In New Funding For Child Protection, Mental Health
Legislation to pay for a major expansion of the state’s child protective workforce cleared the House on Thursday, 272-87, as 59 Republicans joined Democrats in approving Senate Bill 6. The legislation funds 77 new positions at the Division for Children, Youth and Families over two years at a cost of $8.6 million, consisting of 57 new child protective service workers and 20 new supervisors. The bill passed the Senate 23-0 on Feb. 14. (Solomon, 5/2)

New Hampshire Public Radio: More Women Say They Were Raped, Assaulted In Dartmouth Neuroscience Department
Two additional women have joined a $70 million class-action lawsuit against Dartmouth College stemming from allegations of sexual misconduct and assault in the school’s prestigious Psychological and Brain Sciences Department. The women, identified anonymously in an amended complaint filed Wednesday, say they were harassed by tenured faculty over a number of years. (Greene, 5/3)

The Associated Press: Panel Raises Questions About $13M In Tax Credits To Hospital
A Camden hospital chaired by one of New Jersey’s most powerful Democrats collected $13 million in state tax incentives by claiming it was considering moving some of its operations to Philadelphia when that was apparently not an option, a task force found on Thursday. The task force, which is investigating the state Economic Development Authority’s use of business tax credits, presented its findings on the Cooper Health System at it second public hearing since Democratic Gov. Phil Murphy established it earlier this year. The roughly seven-hour hearing included testimony from current and former officials at the authority as well as other experts. (5/2)

Sacramento Bee: Toxic Drinking Water In California Prisons Costs Taxpayers Millions
An inmate’s death in Stockton from Legionnaires’ disease marks the third time in four years the rare form of pneumonia has struck California’s state prisons – and has laid bare a history of contamination and other problems plaguing water supplies in the corrections system. Incidents of tainted water have spawned inmate lawsuits, expensive repairs, hefty bills for bottled water and fines, putting a multimillion-dollar burden on the taxpayer-funded corrections system, according to documents and court records reviewed by McClatchy. (Sabalow, Kasler and Venteicher, 5/3)

Austin American-Statesman: Local ERs Eye Legislation To Address Fee Transparency
Texas House Bill 2041 seeks to require freestanding emergency rooms to disclose, by posting and providing written notice to patients, that they may be an out-of-network health plan provider and to state for which health plans the facility is an in-network provider. On April 29, the bill was placed on the general state calendar for consideration by the full house. If passed, the measure will become law Sept. 1. (Bassman, 5/2)

Modern Healthcare: SSM Health Selling Home Health And Hospice Agencies In Missouri
SSM Health entered a deal to sell home health and hospice agencies to a joint venture that includes LHC Group, the health system said Thursday. The agencies, located in in Jefferson City and Mexico, are affiliated with hospitals Catholic-sponsored SSM is in the process of selling to University of Missouri Health Care in a deal announced in August. The home health and hospice operations were originally slated to be included in that deal. (Bannow, 5/2)

North Carolina Health News: Outsiders Help Solve Health Care Access Problems In Charlotte
If you lack health insurance and have a medical problem, there are many people in Charlotte who can help you. . Since the early 2000s, members of the safety-net provider consortium MedLink have wrangled with how to get residents to services they need the first time before patients appear at a less-appropriate clinic’s doors. . The winning solution had two parts. MedLink providers will use a health “heatmap” to see the issues in any census tract, such as diabetes or high blood pressure, and what services to treat them are available in those areas to plan their deployment of new services. Clients will input their health issues, location and insurance information into a mobile app, which will output which provider could best serve them. (Duong, 5/3)

Each week, KHN’s Shefali Luthra finds interesting reads from around the Web.

Ozy: Forced To Divorce: Americans With Disabilities Must Pick Marriage Or Health Care
Susan approached her husband, heart thumping, as he sat in their living room. Days earlier, on Valentine’s Day, she had been diagnosed with colon cancer. Now, her world was about to further unravel. Susan mustered up all her courage and told her husband that they needed to divorce. (Carly Stern, 4/25)

BuzzFeed News: We Asked All Of The 2020 Presidential Candidates Their Thoughts On Vaccines. Here’s What They Said.
Eleven Democrats provided answers to BuzzFeed News, describing vaccines as necessary, but taking different approaches to exemptions. Others have supported vaccines but have not publicly spoken about who should be able to refuse immunity — a topic that’s prompted heated debate and protests in some communities as low vaccination rates have put more people at risk of infection. (Claudia Kerner, 5/1)

Undark: When Measles Arrives: Breaking Down The Anatomy Of Containment
On an otherwise normal Thursday in November 2018, the doors to the Lowell Community Health Center in Massachusetts opened at 8 a.m., as they always do, and the first of 802 patients who would walk through those doors began trickling in. (Apoorva Mandavilli, 4/29)

Business Insider: What It’s Like To Use One Medical For Primary Care In New York
To understand how healthcare is changing, I tried to get all my healthcare done via startups that promise to make getting care easier. That included picking out a place to get primary care. (Lydia Ramsey, 5/1)

Editorials And Opinions

Editorial writers weigh in on the quality and high costs of health care.

BuzzFeed: We Can’t Compromise On Medicare For All
A decade ago, when I introduced legislation guaranteeing medical care to every American, the proposal was cast as a “radical” and “unrealistic” measure, and I could not convince a single senator to cosponsor the bill. Ten years later, our Medicare for All bill has widespread support in the House and Senate, and polls show Medicare for All is supported by a majority of Americans, including a majority of Republicans. (U.S. Sen. Bernie Sanders, 5/3)

The Wall Street Journal: State Medicaid Tax Trap
Medicaid expansion under ObamaCare was sold as a free federal lunch for the states, but the bill is now coming due. Witness Gov. Gina Raimondo’s plan to tax businesses that employ low-income workers to fund Rhode Island’s booming Medicaid case load. Look for this soon in a state near you. Ms. Raimondo has proposed a 10% payroll tax on businesses with more than 300 workers for each employee who enrolls in Medicaid. ObamaCare requires businesses with more than 50 full-time workers to offer health insurance and duns employers $3,750 for each employee who purchases a plan on the exchanges with a federal subsidy. (5/2)

Stat: Aim Your Baloney Detector At The BS In Health Care
Health care has an acute BS problem, in part because BS can sometimes fill the bill. Suppose you are asked to address an ageless problem in health care: reduce costs while simultaneously raising quality. If you were knowledgeable to begin with or did some research, you would know there is no easy solution. You could respond with a message of failure or a discussion of inevitable trade-offs. (Lawton R. Burns and Mark K. Pauly, 5/3)

Opinion writers express views on these health topics and others.

The New York Times: Why Advertising Quit Smoking, And Started Vaping
Twenty years ago, as a creative director, I helped create a commercial for the Truth campaign to introduce its effort to prevent cigarette smoking by young people. The spot was simply footage of tobacco executives all testifying, “I believe nicotine is not addictive.” All we did was add a laugh track.The effect of my campaign and others was to help a generation of young people see the tobacco companies as they really were. Companies that lied not just to the government but the public, with misleading ad campaigns aimed at teenagers, their “growth market.” Now they’re doing it again, but in a new, slick, high-tech guise that is harder to combat. (Alex Bogusky, 5/3)

Bloomberg: Measles Vaccine Risks And Anti-Vaxxers: Shift The Conversation
To understand why some parents have chosen not to protect their kids from measles, consider why parents shun another well-tested vaccine, which would protect children from a number of devastating forms of cancer. While more than 700 people have been infected by this latest measles outbreak, thousands of young people are unnecessarily being infected with cancer-associated strains of HPV, or human papillomavirus. These will slowly, quietly, cause cancer in some of them years later.“ The anti-vaxxers really hate the HPV vaccine,” said Stewart Lyman, a cancer researcher who wrote a provocative opinion piece in the medical website STAT, connecting opposition against vaccines to an often-deserved public distrust of the pharmaceutical industry. He included a long list of breaches of trust — from high drug prices to bungled clinical trails to lies about the alleged safety of opioids. (Faye Flam, 5/2)

The Hill: CDC: Herd Immunity Helps To Protect The Entire Community
Heraclitus, the 6th century B.C. pioneer of wisdom, said that no one ever steps in the same river twice. Yet, as World Immunization Week (WIW) ends, we must confront how fragile the gains in preventing and eliminating diseases can be.Consider, for example, preliminary World Health Organization data released on April 15, which documents a 300 percent rise in measles globally from 2018 to 2019 and an increase in 2019 of more than 20,000 cases each month. While never the same, we are wading in familiar waters with measles outbreaks occurring in every region of the world. (Rebecca Martin, 5/2)

The Washington Post: Diets Are Not One-Size-Fits-All. So Why Do We Treat Dietary Guidelines That Way?
The Dietary Guidelines for Americans are the single most powerful influence on American food choices. They drive dozens of public and private programs, from school lunches to meals for the elderly, the military, hospitals and more. They’re also adopted as the “gold standard” by health-care practitioners for sick and well alike. When your doctor or nutritionist or diabetes educator hands you a diet to follow for a particular disease, you are given the guidelines. Yet at the kickoff meeting for the next Dietary Guidelines, government officials made clear that this policy is only appropriate for healthy people. The 60 percent of our population diagnosed with nutrition-related diseases — obesity, diabetes, dementia — is excluded. On this path, there’s little question that the government’s guidelines will do virtually nothing to reverse the epidemics of these diseases. (Nina Teicholz, 5/2)

The New York Times: The Thin Line Between Surgery And Mutilation
Last month, many were up in arms about the news that the Justice Department would not defend a federal prohibition on female genital mutilation that was thrown out by a lower court last fall. On Twitter, Hillary Clinton called the decision “outrageous”; hundreds seconded her tweet with words of disgust. The department’s legal reasoning for not defending the prohibition is technical, but the response highlights the degree to which there is consensus about the abhorrent nature of female genital mutilation, which the World Health Organization defines as cutting of the external female genitalia, or other injury to the female genital organs, for non-medical reasons. (Afshan Jafar, 5/2)

The Washington Post: Think Biden And Trump Are Too Old To Be President? Take A Look Around.
Having spent private time with both former vice president Joe Biden and President Trump, I can personally attest that they have greater physical stamina than most people half their age, but that reality is clouded by cliches. (Jeffrey Sonnenfeld, 5/2)

Dallas Morning News: ’13 Reasons Why’ Hurts Teenagers And Netflix Should Drop The Show
According to the American Foundation for Suicide Prevention, in the United States, suicide is the 10th leading cause of death, killing nearly 45,000 Americans annually. Despite this, Netflix is planning to release a third season of its original show 13 Reasons Why, which many studies say correlates with an increase in the number of online searches for “how to commit suicide.”13 Reasons Why should not only drop this third season, but it should be taken off Netflix entirely. The show is damaging. (Pramika Kadari, 5/2)

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