Wednesday, September 21, 2022 – Kaiser Health News

Kaiser Health News Original Stories
Formula May Be Right for Infants, but Experts Warn That Toddlers Don’t Need It
Sales of formulas designed for toddlers increased in recent years, but health experts warn parents that, generally, once children reach their 1st birthday, they are fine with cow or plant milk and don’t need the expensive, high-calorie products. And doctors say toddler formula should not be given to infants. (Christina Szalinski, )
Genetic Tests Create Treatment Opportunities and Confusion for Breast Cancer Patients
Doctors are divided on whether blanket testing of breast cancer patients is warranted, since scientists and physicians are sometimes unsure about how to interpret the results. (Michelle Andrews, )
Covid Still Kills, but the Demographics of Its Victims Are Shifting
Californians were far less likely to die from covid in the first seven months of 2022 than during the first two years of the pandemic. Still, the virus remained among the state’s leading causes of death in July, outpacing diabetes, accidental death, and a host of debilitating diseases. We break down who’s at risk. (Phillip Reese, )
Political Cartoon: 'Abortion Access Travel Package'
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Abortion Access Travel Package'" by Clay Bennett.
Here's today's health policy haiku:
Would you look at that —
The pandemic is over!
Oh wait, no it’s not
– Britta Egeland
If you have a health policy haiku to share, please Contact Us and let us know if we can include your name. Haikus follow the format of 5-7-5 syllables. We give extra brownie points if you link back to a KHN original story.
Opinions expressed in haikus and cartoons are solely the author's and do not reflect the opinions of KHN or KFF.
Mental Health
In A First, Federal Panel Recommends Anxiety Screening For Adults Under 65
The U.S. Preventive Services Task Force began its review before covid-19 hit, but the pandemic greatly exacerbated the issue. Some primary care physicians expressed concern that adding an additional responsibility to their checklist for patient appointments is implausible, The New York Times reported.
The New York Times: Health Panel Recommends Anxiety Screening For All Adults Under 65
A panel of medical experts on Tuesday recommended for the first time that doctors screen all adult patients under 65 for anxiety, guidance that highlights the extraordinary stress levels that have plagued the United States since the start of the pandemic. The advisory group, called the U.S. Preventive Services Task Force, said the guidance was intended to help prevent mental health disorders from going undetected and untreated for years or even decades. It made a similar recommendation for children and teenagers earlier this year. (Baumgaertner, 9/20)
AP: US Adults Should Get Routine Anxiety Screening, Panel Says 
The recommendations are based on a review that began before the COVID-19 pandemic, evaluating studies showing potential benefits and risks from screening. Given reports of a surge in mental health problems linked with pandemic isolation and stress, the guidance is “very timely,” said Lori Pbert, a task force member and co-author. Pbert is a psychologist-researcher at the University of Massachusetts’ Chan Medical School. The task force said evidence for benefits, including effective treatments, outweighs any risks, which include inaccurate screening results that could lead to unnecessary follow-up care. (Tanner, 9/20)
In related news —
The Hill: Nearly 1 In 10 Americans Suffer From Depression, Study Says
A growing number of Americans are struggling with depression and most are not seeking treatment or are undertreated for the mental health disorder, according to a new study. A study published in the American Journal of Preventive Medicine found almost 1 in 10 Americans reported suffering from depression in 2020, with rates of the mental health disorder higher among adolescents and young adults. (Guzman, 9/20)
USA Today: COVID: Stress Levels Among Women Are At 10-Year High, Survey Shows
Levels of stress, anxiety, worry, sadness and anger among women worldwide are at a 10-year high, according to a new report. In one of the largest studies on women’s well-being, analytics firm Gallup and medical tech company Hologic, Inc. teamed up to survey over 66,000 women in 122 countries around the world. (Rodriguez, 9/21)
Fox News: Study Suggests Older Adults Show Greater Mental Well-Being Despite Cognitive Decline
A study published this month in Psychology and Aging by researchers at the University of California San Diego School of Medicine indicates that adults over 60 showed greater mental well-being but worse cognitive performance than younger adults. Adults in their 20s tended to have more experience with anxiety, depression and loneliness than seniors. (Nieto, 9/20)
Also —
The Hill: VA Finds Veterans Suicides Drop In Past Two Years, But Data May Be Lacking
The average number of veteran suicides per day in the United States has fallen to the lowest it’s been since 2006, according to new Department of Veterans Affairs (VA) data, but those figures might not paint the whole picture.  The VA’s National Veteran Suicide Prevention Annual Report, released Monday, found that there were 6,146 veteran suicide deaths in 2020, or about 16.8 a day.  (Mitchell, 9/20)
Administration News
FDA Made Many Missteps During Infant Formula Crisis, Internal Review Finds
Problems included outdated technology at the FDA, limited training on formula among FDA investigators, funding limitations, and gaps in the understanding of cronobacter, the type of bacteria that prompted Abbott’s recall, The Wall Street Journal reported.
ABC News: Internal FDA Report On Infant Formula Crisis Details Shortfalls In Response
An internal review of the Food and Drug Administration's actions leading up to the infant formula crisis finds a combination of human error, antiquated technology, and poor communication and accountability amongst an already threadbare food workforce all contributed to a perfect storm of problems which exacerbated the supply shortage. The issue was only worsened by the FDA's lack of a robust mandate to strong-arm industry players' compliance, the review found. (Pezenik, 9/21)
The Wall Street Journal: FDA Baby Formula Oversight Is Criticized In Internal Review
Problems ranged from outdated technology at the FDA to limited training on formula among FDA investigators, the report said. It said funding limitations and gaps in the understanding of cronobacter, the type of bacteria that prompted Abbott’s recall, impeded the FDA’s response to this year’s incidents and the agency’s ability to regulate and oversee formula. (Newman, 9/20)
Politico: FDA Baby Formula Review Spares Specific Blame Amid Ongoing Shortages 
Some parents and advocates had been looking forward to the review shedding specific light on FDA failures in order to provide accountability, but Califf said in an interview shortly after the report was released that the review was meant to “identify themes of issues” FDA needs to improve going forward. FDA Chief Robert Califf noted that the agency had provided a detailed timeline of its response and that an independent review of the larger FDA foods division is ongoing. “We’re not going to spend a lot of time going back,” Califf said. “We’re going to spend our time taking into account what happened then and moving forward.” (Lee, 9/20)
Also —
KHN: Formula May Be Right For Infants, But Experts Warn That Toddlers Don’t Need It 
Formulas for toddlers are a burgeoning business in the United States: Sales of the drinks more than doubled in recent years as companies convinced parents that their little ones needed the liquid boost. But many experts warn that these products, designed for children ages 1 to 3, fill no nutritional needs beyond what is available in a typical toddler diet, are subject to less regulation than infant formula, and are expensive. In addition, some parents feed the toddler versions to infants even though they do not meet federal standards for infant formula and may not provide babies with adequate nutrients to sustain their growth. (Szalinski, 9/21)
Covid-19 Crisis
Biden Backpedals: Pandemic Is 'Not Where It Was,' Not 'Over'
The president had faced backlash over earlier comments framing the pandemic as essentially over. Sen. Susan Collins, R-Maine, said the president's earlier words didn't align with the administration's actions. And a report shows that covid is still killing people, but in different demographics.
The Hill: Biden Clarifies COVID Comments: Pandemic ‘Basically Is Not Where It Was’ 
President Biden on Tuesday sought to clarify his comments from days earlier that the coronavirus pandemic “is over,” telling guests at a fundraiser that the COVID-19 situation is not as bad as it was. Biden attended a Democratic National Committee fundraiser in New York City ahead of his speech Wednesday to the United Nations General Assembly. At one point, speaking about efforts on the pandemic, Biden referenced his comments to Scott Pelley of CBS last week in which he said the pandemic was “over.” (Samuels, 9/20)
Bangor Daily News: Susan Collins: Joe Biden’s ‘Pandemic Is Over’ Remark Doesn’t Align With Policy
Sen. Susan Collins on Tuesday hit President Joe Biden for calling the COVID-19 pandemic “over,” saying his comments did not align with his administration’s actions. The Democratic president’s comments in an interview aired by CBS’ “60 Minutes” on Sunday reflected his thinking at a time where mask-wearing is uncommon and the disruptions from the pandemic are far less significant than they were at the outset. (Marino Jr., 9/20)
KHN: Covid Still Kills, But The Demographics Of Its Victims Are Shifting 
As California settles into a third year of pandemic, covid-19 continues to pose a serious threat of death. But the number of people dying — and the demographics of those falling victim — has shifted notably from the first two years. Given the collective immunity people have garnered through a combination of mass vaccination and protections built from earlier infections, Californians overall were far less likely to die from covid in 2022, when the omicron variant dominated, than during the first two years of the pandemic, when other variants were largely at play, amplifying a national trend. (Reese, 9/21)
Side Effects Public Media: Why Pediatricians Are Worried About The End Of The Federal COVID Emergency Declaration
Kathreen Friend is a pediatric registered nurse based in Doniphan, Missouri — a small town of about 1,800, just 15 minutes north of the Arkansas border. As the lone pediatric specialist in her county, it’s not unusual for her days to fill up with appointments. (Valdivia, 9/21)
In other pandemic news —
Politico: New York Spent $250M On Tech To Fight Covid That No One Uses 
Forced into a hectic international competition for goods like many states during the early months of the pandemic, New York never procured anywhere close to what it supposedly needed. But the collection it did manage to build hasn’t done much more than gather dust. The state acquired 8,555 ventilators at a cost of $166 million and 1,179 X-ray machines for $86.4 million, state officials told POLITICO this month. And now they’re stacked in warehouses across New York with no plans to distribute them or put them to any immediate use; Covid treatments have largely moved away from ventilators, and hospitals say they have plenty available to deal with their immediate needs. (Spector, 9/20)
The Wall Street Journal: U.S. Charges 47 People In Connection With $250 Million Covid-Aid Fraud 
The Justice Department charged 47 people in connection with an alleged scheme that stole more than $250 million from a federal program that fed low-income children, in what officials called the largest theft yet uncovered from a coronavirus pandemic aid program. Federal prosecutors said those charged created entities that claimed to be providing meals to tens of thousands of children who didn’t exist. (Gurman, 9/20)
As Moderna Booster Supplies Dwindle, FDA Releases Millions Of Delayed Shots
The doses had been delayed after a safety inspection at an Indiana packaging plant, but the government has now released them. Bloomberg reports Moderna boosters are in short supply at some U.S. pharmacies. Plus, vaccine and mask mandates are again in the news.
The Washington Post: FDA Releasing Millions Of Moderna Boosters As States Warn Of Shortages 
The federal government is releasing millions of Moderna booster shots that were delayed by the Food and Drug Administration as a result of a safety inspection at an Indiana packaging plant, even as states report shortages and encourage people to get Pfizer boosters instead. (Diamond, 9/20)
Bloomberg: Where To Get The Moderna Booster Shot? Some US Pharmacies See Shortages
The US government supply of Moderna’s shot is currently limited, causing appointments for the product to vary across the country, a Walgreens Boots Alliance Inc. pharmacy spokesperson said in an emailed statement. Meanwhile, CVS Health Corp. says some of its drugstores have used all of the updated shots they received from the government, and the company is trying to get more doses. (Peebles, Langreth and Edney, 9/20)
On vaccine and mask mandates —
Politico: Supreme Court To Consider New York's Vaccine Mandate 
The U.S. Supreme Court will hear an NYPD detective’s challenge to New York City’s vaccine requirement for municipal workers after all. Last month, liberal Justice Sonia Sotomayor rejected a request by Det. Anthony Marciano to take up his legal challenge — the outcome of which could have significant implications for Mayor Eric Adams’ administration. But Marciano resubmitted the exact same request to conservative Justice Clarence Thomas, and the high court’s press office confirmed Tuesday the case will be deliberated at a conference Oct. 7. (Anuta, 9/20)
Axios: NYC Ends Vaccine Mandate For Private Businesses
Private businesses in New York City will no longer be required to enforce COVID-19 vaccines starting Nov. 1, Mayor Eric Adams announced Tuesday. (Ravipati, 9/20)
Oklahoman: Court Strikes Down School Mask Mandate Ban
The Oklahoma Supreme Court struck down the governor's influence over school mask mandates in an opinion issued Tuesday, ruling in favor of doctors and parents who challenged a state law that at one point effectively blocked masking requirements in public schools. (Martinez-Keel, 9/20)
And Canada may soon drop its vaccine requirement for travelers —
AP: Official: Canada Likely To Drop Vaccine Requirement To Enter
Canada will likely drop the vaccine requirement for people who enter Canada by the end of September, an official familiar with the matter told The Associated Press on Tuesday. Canada, like the United States, requires foreign nationals to be vaccinated when entering the country. It is not immediately known whether the U.S. will make a similar move by Sept. 30.Unvaccinated travelers who are allowed to enter Canada are currently subject to mandatory arrival tests and a 14-day quarantine. (Gillies, 9/20)
After Roe V. Wade
After Roe's End, More States Extend Postpartum Medicaid
Stateline reports Indiana and West Virginia joined 23 other states plus the District of Columbia in extending coverage from two months to a year after birth. In Ohio, a judge extended a temporary stay of a new abortion ban until at least Oct. 12. And in Missouri, a bill aims to repeal the abortion ban.
Stateline: More States Extend Postpartum Medicaid Since Roe's Demise
Indiana and West Virginia, two states that recently banned nearly all abortions, received federal approval this month to offer women Medicaid-funded health care during their pregnancy and for 12 months after they give birth. They join 23 other states and the District of Columbia that already have extended postpartum Medicaid coverage from two months to a full year after childbirth. Eight additional states — Alabama, Arizona, Colorado, Delaware, Georgia, New York, Rhode Island and Vermont — have applications pending. (Vestal, 9/20)
In other abortion news from Ohio and Missouri —
NBC4: Abortion In Ohio: Judge Extends Temporary Halt Of 6-Week Ban
An Ohio judge is extending his temporary halt of the state’s six-week abortion ban, according to a group involved in the case. At a status conference Monday, Hamilton County Common Pleas Court Judge Christian Jenkins said he is extending the temporary restraining order against Ohio’s heartbeat bill until at least Oct. 12, a spokesperson from the ACLU of Ohio told NBC4. Jenkins will determine whether to issue a preliminary injunction against the six-week ban on Friday, Oct. 7. (Walsh, 9/20)
St. Louis Post-Dispatch: Democrat Files Bill To Repeal Missouri Abortion Ban
The top Democrat in the Missouri House filed legislation Tuesday to repeal the law that triggered the state’s near-total abortion ban after the U.S. Supreme Court overturned Roe v. Wade. The measure, sponsored by House Minority Leader Crystal Quade, D-Springfield, is almost certainly dead on arrival during Republican Gov. Mike Parson’s special session on tax relief. (Suntrup, 9/20)
More on abortion rights —
The Hill: Graham Throws Another Wrench Into GOP’s Abortion Messaging 
Sen. Lindsey Graham (R-S.C.) created new headaches for Republicans on Tuesday with his claim that abortion is “not a states’ rights issue,” keeping the debate in the headlines and undercutting the party’s messaging heading into November’s midterms.  (Weaver, 9/20)
CNN: These Male Politicians Are Pushing For Women Who Receive Abortions To Be Punished With Prison Time 
A faction of self-proclaimed “abolitionists” are seeking to make abortion laws more restrictive and the consequences of having the procedure more punitive than ever before. Emboldened by the overturning of Roe v. Wade, they say they will not be satisfied until fetuses are given the same protections as all US citizens — meaning that if abortion is illegal, then criminal statutes should be applied accordingly. While major national anti-abortion groups say they do not support criminalizing women, the idea is gaining traction with certain conservative lawmakers. And the activists and politicians leading the charge are nearly always men, CNN found. (Ellis and Hicken, 9/21)
Politico: What The Numbers Really Say About Abortion And Democrats In The Midterms
Democrats have been on a voter registration tear since the Supreme Court overturned Roe v. Wade. There’s just one problem for them — they are digging out from under major Republican gains in the previous 18 months. For most of the two years leading up to the midterm election, Republicans rather than Democrats were making voter registration gains in key states, a POLITICO analysis of state voter data shows — a signal of GOP momentum heading into a classic backlash election against Democratic control of Washington. (Piper, 20)
Atlanta Journal-Constitution: AJC Poll: Abortion Isn’t Top Issue For Many Georgia Voters
Only a handful of Georgians — 5% — listed abortion as their top issue in the election. And more than half of likely voters indicated that the political divide over abortion won‘t influence their decisions to cast their ballots in November. But the poll also indicated that nearly half of respondents said they’re more likely to vote for a candidate who wants to protect access to abortion. That includes about half of women and 90% of Democrats. (McCaffrey and Bluestein, 9/21)
On contraception and abortion pills —
Detroit Free Press: White House Blasts GOP After Report Of DePerno Likening Plan B To Fentanyl
President Joe Biden's administration on Tuesday blasted a reported comment from Michigan Republican attorney general nominee Matt DePerno likening Plan B to the drug fentanyl, saying he and other GOP officials want to "ban contraception" in the U.S. (Spangler and Boucher, 9/20)
The Atlantic: A Simpler Abortion Pill Regimen Is Effective Too
The second drug, misoprostol, can also safely end a pregnancy on its own. That method has long been considered a significantly less effective alternative to the FDA-approved protocol. But a growing body of research has begun to challenge the conventional thinking. In situations where people use pills to end a pregnancy at home, studies have found far higher rates of success for misoprostol-only abortions than were found in clinical settings. One recent study in Nigeria and Argentina showed misoprostol-only abortion to be 99 percent effective. (Adams, 9/19)
Health Industry
Bill Aims To Make Private Insurance Fully Cover Sex Assault Exams
A new bill introduced in the House of Representatives on Monday would require full coverage for forensic exams for sexual assault survivors, quashing surprise medical bills. Separately, the American Hospital Association and American Medical Association ended one challenge to surprise billing arbitration.
NBC News: New Bill Aims To Curtail Surprise Medical Bills For Sexual Assault Survivors
A bill introduced Monday in the House of Representatives would require private health insurance to cover forensic exams for sexual assault survivors in full. The legislation came after research published last week in the New England Journal of Medicine showed that nearly 18,000 out of 113,000 emergency visits related to sexual violence in 2019 resulted in out-of-pocket costs for the survivors. The average cost was $3,551 per person. (Bendix, 9/20)
More on surprise billing —
Modern Healthcare: AMA-AHA Surprise Billing Lawsuit Dropped
“We have serious concerns that the August 2022 final rule departs from congressional intent just as the September 2021 interim final rule did. Hospitals and doctors intend to make our voices heard in the courts very soon about these continued problems,” the AHA and AMA said in a joint statement. (Goldman, 9/20)
On hospital finances and staffing —
Axios: Rural Hospitals Face Funding Cliff
Rural hospitals that weathered the pandemic are facing a funding cliff, in danger of losing some $600 million in Medicare funding at the end of this month unless Congress intervenes. (Dreher, 9/21)
Modern Healthcare: St. Vincent Charity In Ohio To Lay Off Almost 1,000 Workers
Affected positions range from physicians to nurses, support service aides and physical therapists. Some of the most affected areas include medical/surgical, chemical dependency, dietary, laboratory management and housekeeping. As of 2021, the 162-bed hospital reported more than 800 full-time-equivalent positions. The pending layoffs account for just over 640 FTE positions. (Hudson, 9/20)
Modern Healthcare: Labor Shortage: Hospitals Grow Apprenticeships To Stabilize Workforce
Charnika Wilson has been looking to get more involved in patient care after working as administrative faculty for a community-based clinic in Chicago. Her search led her to Rush University System for Health. Wilson was one of 22 people selected from more than 3,000 applicants for a new medical assistant apprenticeship run by Rush and Harper College, which pays for students’ tuition and books while offering them hourly pay and benefits. (Kacik, 9/20)
In other health care industry news —
Modern Healthcare: DOJ Evaluating Next Steps In Blocking UnitedHealth-Change Healthcare Merger
The Justice Department is weighing whether to appeal a federal judge’s decision that denied its legal challenge to UnitedHealth Group’s $13 billion proposed acquisition of technology company Change Healthcare. (Tepper, 9/20)
Crain's Detroit Business: Trinity Health Acquires North Ottawa Community Health System
Trinity Health, the nation's fifth largest health system, is finalizing its acquisition of the assets of the rural community hospital North Ottawa Community Health System in Grand Haven. (Walsh, 9/20)
Becker's Hospital Review: Will The Cloud Replace Data Centers? Health System IT Execs Weigh In
Even if traditional data-center tasks are all moved to the cloud, there will still be a need for on-site infrastructure that will ultimately require what looks like a traditional data center, according to health system CIOs. Becker's spoke to six health system IT leaders to discuss if the presumption that the cloud will absorb the data center stands true. (Diaz, 9/16)
Lifestyle and Health
Microprotein Mutation Linked With Higher Alzheimer's Risks
Scientists say mutations in one particular microprotein are associated with an increased risk of Alzheimer’s disease, brain atrophy, and changes in energy metabolism. Other reports note that cancer death rates are still falling and that too few children with sickle cell anemia are getting stroke screening.
The Hill: Scientists Identify Mutated Protein Linked To Alzheimer’s Disease Risk 
New research is uncovering the role a specific protein might play in developing Alzheimer’s, a disease that affects 5 million people in the U.S., according to estimates from 2020. In a study published today in Molecular Psychiatry, researchers identified a new gene from mitochondrial DNA that encodes for a “microprotein,” named SHMOOSE. They analyzed the default and mutated versions of this small protein and found that the mutated version is associated with increased risk of Alzheimer’s disease, brain atrophy and changes in energy metabolism. (Hou, 9/20)
On cancer and sickle cell anemia —
NBC News: Cancer Death Rates Continue To Fall, Driven By New Treatments And Improved Screening
“This is a really exciting time in cancer management,” said Dr. Stephen Ansell, the senior deputy director for the Midwest at the Mayo Clinic Comprehensive Cancer Center in Rochester, Minnesota, who wasn’t involved with the report. “We see the death rate from cancer keeps going down.” (Sullivan, 9/21)
AP: Study: Too Few Kids With Sickle Cell Get Stroke Screen, Care 
Too few U.S. kids with sickle cell anemia get a needed screening for stroke, according to a study released Tuesday. The study found fewer than half get the screening and only about half or fewer get a treatment that can help with pain and anemia. The Centers for Disease Control and Prevention released the study, and called for more screening and treatment. (Stobbe, 9/20)
In other health and wellness news —
CBS News: Don't Cook Your Chicken In NyQuil: FDA Issues Warning Against Social Media Challenge
The American Academy of Pediatrics also advised parents to speak with their teens about which challenges are trending on social media or at school. "Sometimes kids are more willing to talk about their peers than themselves. Asking questions about school trends, friends and fads may yield more answers than direct questions about their own activities," the AAP said on its website. (Singh, 9/20)
AP: NTSB Wants All New Vehicles To Check Drivers For Alcohol Use
The National Transportation Safety Board is recommending that all new vehicles in the U.S. be equipped with blood alcohol monitoring systems that can stop an intoxicated person from driving. The recommendation, if enacted by the National Highway Traffic Safety Administration, could reduce the number of alcohol-related crashes, one of the biggest causes of highway deaths in the U.S. (Krisher, 9/20)
The Texas Tribune, ProPublica and NBC News: How Generator Shut-Off Switches Failed To Protect A Family Of Three
The generator industry’s promised fix for deadly carbon monoxide poisoning was put to the test last year on a narrow patio outside Demetrice Johnson’s home after Hurricane Ida plunged much of Louisiana into darkness. (Trevizo and Hixenbaugh, 9/21)
State Watch
Study Says Arsenic May Be Poisoning California Prison's Water
Even people living in neighboring rural communities near the Kern Valley State Prison may be at risk, the study warns, with arsenic levels above regulatory limits for possibly years at a time. Separate reports blast California's water treatment systems, potentially causing long-term health issues.
The Hill: Dangerous Arsenic Levels May Be Lurking In California Prison Water: Study
Incarcerated Californians — and those who live in neighboring rural communities — may be exposed to dangerous levels of arsenic in their drinking water, a new study has found. Arsenic concentrations in the water supply of the Kern Valley State Prison and three nearby Central Valley communities exceeded regulatory limits for months or even years at a time, according to the study, published on Wednesday in Environmental Health Perspectives. (Udasin, 9/21)
Capitol Weekly: California's Water Treatment Systems Not Up To Snuff, Auditor Says 
Already battered by drought, dwindling supplies and climate change, California’s water treatment systems also suffer from problems that raise the specter of long-term health issues, according to a state report. Those findings – and others – were contained in an audit  by Michael Tilden, California’s acting state auditor. The audit, released in July, focused on the State Water Resources Control Board (better known as the Water Board), which regulates the condition of water across California. (Watts, 9/15)
In other health news from across the U.S. —
AP: Senate Leader: NC Hospitals' Medicaid Proposal Not 'Serious' 
North Carolina Senate leader Phil Berger on Tuesday called an offer from state hospitals to expand Medicaid to hundreds of thousands of the working poor “not a serious proposal,” saying loosened regulations for medical construction projects didn’t go far enough. Berger’s dismissal of the proposal late last week from the North Carolina Healthcare Association short-circuited any expectations — though much improved compared to months ago — that a Medicaid expansion agreement could be at hand. Still, Democratic Gov. Roy Cooper, an expansion advocate, urged Berger separately Tuesday to make a counteroffer. (Robertson, 9/20)
The Baltimore Sun: Coronavirus, Inflation Push Up Cost Of Health Insurance In Maryland
Those who buy their own health insurance in Maryland will pay an average of 6.6% more next year, about 4.4% less than the carriers requested, according to the Maryland Insurance Administration, which approved the increases. (Cohn, 9/20)
Public Health Watch: A Free Medical Clinic Opened In Rural East Texas. Thousands Poured In For Help. 
Juanita Franklin was driving through the East Texas town of Gun Barrel City a couple of years ago when she saw a new sign down the road from the Christian Life Center food pantry where she volunteers. It promised something she desperately needed: “Healthcare Access for All!” Franklin, whose left leg is amputated below the knee and has chronic high blood pressure and thyroid problems, is among the 18% of Texans who are trying to survive without health insurance. That’s the highest state rate in the country by far and more than double the national average. The rate is even higher — nearly 30% — among the 6,400 residents of Gun Barrel City. (Krisberg and Leffler, 9/21)
Las Vegas Review-Journal: New Affordable Health Center Opens Near Downtown Las Vegas
Fremont Public Health Center, an arm of the Southern Nevada Health District, is now open and offering primary care and family planning services. Located at 2830 Fremont St., near Charleston Boulevard, the federally qualified health center provides services on a sliding fee scale and accepts insurance, health district representative Jennifer Sizemore said. (Hynes, 9/20)
In monkeypox updates —
CIDRAP: Boston Public Schools Reports First Monkeypox Case
Boston public schools (BPS) yesterday announced the first monkeypox case in an "adult member of the BPS community," according to a letter sent to parents. The school district said the person was isolating at home, and the district was working to identify exposed individuals. (9/20)
Dallas Morning News: John Wiley Price Calls Out Dallas County Health Chief For ‘Unacceptable’ Monkeypox Poster
Dallas County Commissioner John Wiley Price condemned the health department on Tuesday for using a picture of a Black man on a poster about a monkeypox vaccination effort. Posters in both English and Spanish on a free monkeypox pop-up clinic included an illustration of a Black man. Price called the poster “unacceptable” in the regular Dallas County Commissioners Court meeting. (Peterson, 9/20)
Juul Sues FDA For Withholding Scientific Reviews Behind E-Cig Ban
The e-cigarette maker's complaint says the FDA is violating the Freedom of Information Act, Axios reports. In other news, Walgreens acquires Shields Health Solutions, CRISPR gene editing is said to be getting harder, West Virginia announces an opioid settlement, and more.
Axios: Juul Sues FDA Over Documents Supporting E-Cigarette Ban
Juul Labs on Tuesday filed a lawsuit against the Food and Drug Administration over the agency's refusal to disclose documents supporting its order to take Juul's e-cigarettes off the shelves in the U.S. market. (Ravipati, 9/20)
Modern Healthcare: Walgreens To Acquire Shields Health Solutions
Walgreens Boots Alliance has agreed to spend $1.37 billion to acquire the remaining 30% of specialty pharmacy company Shields Health Solutions that it didn't already own. In September 2021, Walgreens spent $970 million to become a majority stakeholder in Shields, and the company will acquire the remaining stake from other equity holders. The transaction is expected to close by the end of 2022, the companies said Tuesday. (Devereaux, 9/20)
Stat: After Early Wins, CRISPR Gene Editing Is About To Get A Lot Harder
The short history of CRISPR gene editing in humans has, with rare exception, been a history of triumphant progress: A patient apparently cured of sickle cell in 2019, six patients with toxic DNA knocked out of their liver last year, another six patients with a different strand of toxic liver DNA knocked out last week. The next era of CRISPR may not be so smooth. (Mast, 9/21)
KHN: Genetic Tests Create Treatment Opportunities And Confusion For Breast Cancer Patients 
The past decade has witnessed a rapid expansion of genetic tests, including new instruments to inform patients who have been diagnosed with breast cancer about the risk of recurrence and to guide their treatment. But the clinical significance of many of the inherited mutations that can now be identified remains unclear, and experts are torn on when and how to deploy all the new tests available. Patients are sometimes left paying out-of-pocket for exams that are not yet the standard of care, and even the most up-to-date oncologists may be uncertain how to incorporate the flood of new information into what used to be standard treatment protocols. (Andrews, 9/21)
On opioids and drug use —
AP: W.Va. Announces $147M Opioid Settlement With CVS, Walmart 
Walmart and CVS Pharmacy have settled with the state of West Virginia for a combined total of $147 million in a lawsuit over the companies’ roles in contributing to the oversupply of prescription drugs that fueled the opioid epidemic in the country’s most impacted state, Attorney General Patrick Morrisey announced Tuesday. Walmart and CVS were two lawsuits that were part of a larger trial that was pushed back to June of next year along with Kroger and Walgreens. Morrisey recently announced a settlement with Rite Aid for up to $30 million to resolve similar litigation. (Willingham, 9/20)
Stat: To Stem Overdoses, Canada Is Offering Safer Opioids. Will The U.S., Too?
Jouvence Tshiyoyo Bukumba, a nurse, asked Kim, 46, about her cardiology appointment and Chris, 54, about his nerve pain. Then came “the SOS questions” — safer opioid supply. How were their doses? Did they feel any cravings or withdrawal? (Joseph, 9/21)
USA Today: Aaron Rodgers Insists Ayahuasca Is 'Not A Drug' And Says He May Be 'Called' To Take It Again
According to the Alcohol and Drug Foundation, ayahuasca is a liquid-based psychedelic that can cause a person to hallucinate. The active chemical in ayahuasca is dimethyltryptamine (DMT). DMT is a Schedule I controlled substance in the United States, which means it is illegal to manufacture, buy, possess, or distribute the drug. (Kuhagen, 9/20)
Prescription Drug Watch
How To Improve Antibiotic Access, Use, And Stewardship
Read about the biggest pharmaceutical developments and pricing stories from the past week in KHN's Prescription Drug Watch roundup.
CIDRAP: Experts Lay Out Antibiotic Stewardship Lessons From COVID-19 
A panel of experts with the Society for Healthcare Epidemiology of America (SHEA) published a statement last week on ways to improve antibiotic use and stewardship during infectious disease pandemics and outbreaks. The statement, published in Infection Control & Hospital Epidemiology, addresses widespread inappropriate antibiotic use during the COVID-19 pandemic. The height of unnecessary antibiotic use took place in the early stages of the pandemic, when hospitals were flooded with severely ill patients, diagnostic tests were unavailable or took several days to return results, no treatments were available, and healthcare providers wanted to do something to help. (Dall, 9/19)
CIDRAP: WHO: Refugees, Migrants Face Barriers To Antibiotic Access 
A new report from the World Health Organization (WHO) indicates that, while data on antibiotic use and access among the world's migrants and refugees are scarce, multiple factors may be keeping these vulnerable populations from obtaining and using antibiotics appropriately. (Dall, 9/20)
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USA Today: New Uses For Old Drugs? Every Cure Offers Hope For People With Rare Diseases
"No one is responsible for ensuring that drugs are fully utilized for all diseases they can help," said Every Cure co-founder Dr. David Fajgenbaum. "We're taking on that responsibility." Every Cure aims to raise $55 million to coordinate drug data, identify generics that might offer hope for patients with a rare disease and bring the most promising drugs through clinical trials. (Weintraub, 9/18)
Stat: Patients For Affordable Drugs Taps New Leader 
One of Washington’s most prominent drug pricing patient groups is tapping an advocate who has fought for access to medicines for nearly two decades as its new leader. (Cohrs, 9/19)
Stat: Intellia's CRISPR Treatment Corrects DNA Of 6 Patients With Rare Disease
Intellia Therapeutics said Friday the first six patients to receive its CRISPR-based treatment for a genetic swelling disorder have safely had small, corrective changes made to dysfunctional DNA inside their liver cells. (Molteni, 9/16)
CIDRAP: Using Tamiflu In Hospitalized Children Tied To Shorter Stay For Flu
A study across 36 US pediatric tertiary hospitals finds that early use of the antiviral oseltamivir (Tamiflu) in hospitalized children was associated with a shorter hospital stay, lower odds of 7-day readmission, and lower rates of severe outcomes. The study was published yesterday in JAMA Pediatrics. (9/20)
ScienceDaily: Gel Treats Gum Disease By Fighting Inflammation
A topical gel that blocks the receptor for a metabolic byproduct called succinate treats gum disease by suppressing inflammation and changing the makeup of bacteria in the mouth, according to a new study. (New York University, 9/20)
New England Journal of Medicine: Polypill Strategy In Secondary Cardiovascular Prevention 
A polypill that includes key medications associated with improved outcomes (aspirin, angiotensin-converting–enzyme [ACE] inhibitor, and statin) has been proposed as a simple approach to the secondary prevention of cardiovascular death and complications after myocardial infarction. (Castellano, M.D., Ph.D., 9/15)
Perspectives: Justices' Ruling Will Help Clarify Opioid Prescription Practices
Read recent commentaries about drug-cost issues.
Scientific American: A Recent Supreme Court Ruling Will Help People In Pain 
Days after the Supreme Court overturned Roe v. Wade, it made a much less publicized ruling on prescription opioids—one that was far more welcome in the medical community. In a rare 9–0 decision in Ruan v. United States, the court ruled in favor of several doctors who were criminally convicted of acting as drug dealers by overprescribing pain medications. (Maia Szalavitz, 9/19)
Modern Healthcare: Cutting Out-Of-Pocket Costs
I hear from constituents in Wisconsin every day who struggle to afford the rising price of medications. Otis from Manitowoc lives with diabetes, among other health conditions that require prescription drugs. (Sen. Tammy Baldwin (D-Wis.), 9/19)
Wall Street Journal: Hope For New ALS Treatment After All
Few diseases are as cruelly debilitating as amyotrophic lateral sclerosis (ALS). But a Food and Drug Administration advisory committee this week gave patients a glimmer of hope by backing a new treatment that can slow their decline and provide precious more time to live. (9/15)
The Baltimore Sun: Maryland Pharmacies Have Proven Their Value As Health Centers 
When the COVID-19 pandemic was at its peak and many doctors’ offices were not providing in-person visits for routine appointments, Marylanders were able to get their vaccination needs met at their local pharmacy. Not only did this speed up the process for those who chose to get the COVID-19 vaccine, but thanks to the PREP Act, families were also able to keep their children’s vaccinations up to date at the pharmacy if they couldn’t get in with a pediatrician. (9/15)
Los Angeles Times: Prevent A Legal Catch-22 That Could Push Thousands Of Generic Drugs Off The Market 
Carvedilol could be the poster child for how to lower drug prices. Since 2007, over 20 million patients with cardiovascular conditions have enjoyed generic versions of the popular beta-blocker, which cost 2 cents a dose compared with $4.81 for the brand-name product. Patents on the drug Coreg, dating back to 1978, have long expired, enabling these price-saving generics. (Michael A. Carrier, Charles Duan and S. Sean Tu, 9/21)
Los Angeles Times: Pharma's Lack Of Diversity Hurts Women, People Of Color 
If you’re a woman or person of color, your health is being hurt by a lack of diversity in healthcare. I suddenly realized that a few years ago at a conference for pharma executives. (Lindsay Androski, 9/15)
New England Journal of Medicine: Pushing Back With Pills — Enhancing Access To Reproductive Health Drugs After Dobbs 
The U.S. Supreme Court’s June 24, 2022, decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade, has underscored the increasingly critical role that drugs (and therefore drug regulation) will play in the future of reproductive rights. (Lewis A. Grossman, J.D., Ph.D., 9/17)
Editorials And Opinions
Viewpoints: Caregiving Profession Needs Overhaul; Youth In America Are Struggling With Mental Health
Editorial writers tackle caregiving, mental health and insurance issues.
USA Today: COVID Great Reckoning Hastens A Crisis Of Caregivers Shortage
Epitomizing these concerns are those workers who provide caregiving support and services to older adults and people with disabilities, at poverty-level wages. Even prior to the pandemic, turnover was high: 1 in 4 nursing assistants and 1 in 5 home health aides reported that they were looking for new jobs. (Ai-jen Poo and April Verrett, 9/20)
USA Today: Caregivers In America Need Help: Time For Paid Federal Family Leave
I knew that having a baby wasn't supposed to be easy, but I never imagined that it would be this hard. After a cesarean section that resulted in medical complications, however, I was in tremendous physical pain. (Carli Pierson, 9/20)
Modern Healthcare: In The Mental Health Crisis, Black Children Remain At Heightened Risk
As America works to adapt its healthcare services and public policy to meet the needs of children suffering from the current mental health epidemic, it is important that history does not repeat itself—with Black children being left behind. (Michelle Wimes, 9/20)
Los Angeles Times: The Mental Health System Failed Our Son, But We Hold On To Hope
We haven’t seen our son in 66 days, and counting. Hopefully by the time you read this, we’ll have seen his face — probably too skinny, probably scared, hopefully not still angry — at his next mental health court hearing or with a conservatorship in hand. Until then, we hope he is safe as he can be on the seventh floor of high-observation housing at L.A. County’s Twin Towers jail in Chinatown, there on a vandalism charge after being arrested in Walnut for breaking a bus window. (Edward and Bea Stricklan, 9/20)
Stat: Preventive Services To Improve Americans' Health Are Now On Trial
The ACA remains under legal attack, and one key part of it is in jeopardy. In early September, a U.S. district judge in Texas ruled in a lawsuit, Braidwood Management Inc. et al. v. Becerra, that a part of the popular provision guaranteeing preventive care services without cost-sharing for those in most private health plans violates the Appointments Clause of the U.S. Constitution. (Anand Parekh, 9/20)
Dallas Morning News: Medicaid Reform In Texas Can Help More Than 400,000 Children Get Coverage
While our organizations, the Texas Public Policy Foundation and Texans Care for Children, do not always agree on every policy issue, we do strive to collaborate on policy solutions where we can. In this case, we agree that the Texas Legislature has a unique opportunity to fix unintended bureaucratic barriers in Medicaid that are hurting the children for whom much of the program was intended. (David Balat and Alec Mendoza, 9/21)
Different Takes: Overturning Roe Has Alarming Consequences; Why Is The Covid Death Rate Still So High?
Opinion writers weigh in on reproductive rights and covid.
The Atlantic: Old Anti-Abortion Laws Are Taking On Unintended Meanings 
Abortion opponents seem not to have expected some of the more draconian consequences of the Dobbs decision—that anti-abortion laws would prevent pregnant women who were not seeking abortions from receiving needed treatment for miscarriages, or that women facing dire medical complications from their pregnancies would not be able to get proper care. (Daniel K. Williams, 9/20)
Stat: Dobbs Decision Threatens Safest Course For High-Risk Pregnancies 
Ava was excited about her pregnancy. As her rheumatologists, we were anxious about it. Her death left a newborn without its mother, shattered a family, and may be a harbinger of what’s to come for pregnant people with serious medical conditions. (Jammie Law, Michael Pillinger and Julie Nusbaum, 9/21)
The Washington Post: Chrissy Teigen Had An Abortion. Yet Some Are Still In Denial
Two years ago, Chrissy Teigen’s pregnancy with her third child ended in tragedy. She and her husband, John Legend, had named the baby Jack and lost him at 20 weeks — on what she called, in an Instagram post featuring somber images from the hospital room, the “darkest of days.” (Kate Cohen, 9/20)
The Star Tribune: National 15-Week Abortion Ban Would Be A Nightmare
When the Supreme Court overturned Roe v. Wade in June, striking down a constitutionally guaranteed right to abortion and directing decisions on abortion to be made by the states, Republican lawmakers hailed that approach. But no one — neither abortion rights supporters nor abortion opponents — expected GOP members of Congress to stop the assault on reproductive rights, no matter what they said. (9/20)
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Bloomberg: Who Is Still Dying From Covid? The CDC Can’t Answer That 
Earlier this week, President Joe Biden seemed to commit one of his trademark gaffes by saying “The pandemic is over.” The backlash was swift. That’s understandable, given that hundreds of people are still dying from Covid every day. But President Biden may be doing what comes naturally to many of us — judging the situation by our own experiences. (Faye Flam, 9/20)
The Star Tribune: Pandemic Isn't Over, Mr. President
President Joe Biden spent part of the summer isolating at the White House after developing COVID-19, testing positive on July 21 and then again later that month when his viral levels rebounded after taking Paxlovid. (9/20)
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