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Morning Briefing

Summaries of health policy coverage from major news organizations

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Thursday, Mar 16 2023

Ńîšóĺú´ŤĂ˝Ň•îl Health News Original Stories 2

  • The US Remains a Grim Leader in Preterm Births. Why? And Can We Fix It?
  • Listen to ‘Tradeoffs’: Medical Debt Delivers 'A Shocking Amount of Misery'
  • Political Cartoon: 'Testing Their Patience?'

Medicare 1

  • Biden Administration Maps Out Drug Price Negotiation Process

After Roe V. Wade 1

  • Judge Sounds Receptive To Challenge Of FDA's Abortion Pill Approval

Women’s Health 1

  • Maternal Deaths Spiked 40% In 2021, Dropped in 2022

Health Industry 1

  • Analysis: 30% Of Patients Get Care Without Seeing Primary Provider

Covid-19 1

  • What The End Of Covid Health Emergency Means

State Watch 1

  • Unwinding Of Medicaid Coverage Will Affect Millions

Science And Innovations 1

  • Northwestern Medicine Succeeds With Novel Double Lung Transplants

Public Health 1

  • Industrial Trichloroethylene Possibly Linked To Parkinson's Disease

Opioid Crisis 1

  • Mississippi To Decriminalize Fentanyl Testing Kits

Health Policy Research 1

  • Research Roundup: Covid; Autism; Infection Control; Time Perception

Editorials And Opinions 1

  • Viewpoints: Ending Roe Is Making Women Forgo Pregnancy Altogether; Total Abortion Bans Are Deadly

From Ńîšóĺú´ŤĂ˝Ň•îl Health News - Latest Stories:

Ńîšóĺú´ŤĂ˝Ň•îl Health News Original Stories

The US Remains a Grim Leader in Preterm Births. Why? And Can We Fix It?

American women are more likely to deliver their babies prematurely than women in most developed countries. It’s a distinction that coincides with high rates of maternal and infant death, billions of dollars in costs, and even lifelong disabilities for the children who survive. ( Sarah Varney , 3/16 )

Listen to ‘Tradeoffs’: Medical Debt Delivers 'A Shocking Amount of Misery'

Medical debt in America pushes families to the edge. Ariane Buck and his wife, Samantha, were denied care at their doctor's office because of an unpaid bill of less than $100. A trip to the emergency room added thousands of dollars to their health care debt, which topped $50,000 by the time they filed for bankruptcy. ( Noam N. Levey , 3/16 )

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Political Cartoon: 'Testing Their Patience?'

Ńîšóĺú´ŤĂ˝Ň•îl Health News provides a fresh take on health policy developments with "Political Cartoon: 'Testing Their Patience?'" by Dave Coverly.

Here's today's health policy haiku:

REGULATION OF DENTAL DEVICES IN THE SPOTLIGHT

No authority?
Dental device link to harm?
FDA — game on

— Kathleen K. Walsh

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 an original story.

Opinions expressed in haikus and cartoons are solely the author's and do not reflect the opinions of Ńîšóĺú´ŤĂ˝Ň•îl Health News or KFF.

Summaries Of The News:

Medicare

Biden Administration Maps Out Drug Price Negotiation Process

The federal government will select the Medicare program's 10 costliest prescription medicines based on gross spending. As part of a multi-step negotiation process it will then negotiate price cuts that will go into effect in 2026.

The Biden administration on Wednesday began fleshing out how it will implement drug-pricing provisions in the Inflation Reduction Act, including a multi-step negotiation process for selected Medicare drugs starting next year. (Bettelheim, 3/16)

U.S. President Joe Biden on Wednesday said his administration would subject 27 drugs to inflation penalties, a move that will reduce out-of-pocket costs for Medicare recipients by as much as $390 per dose, and he pledged more drug price cuts were coming. ... Drugmakers hiked the price for 27 drugs last quarter higher than the rate of inflation, and will have to pay the difference on those medicines to Medicare, the government healthcare program for those age 65 and older and the disabled. (Aboulenein and Holland, 3/15)

The U.S. government will select the Medicare program's 10 costliest prescription medicines based on gross spending for negotiating price cuts that will go into effect in 2026, the U.S. Centers for Medicare and Medicaid Services (CMS) said on Wednesday. CMS will only accept one formal written counter offer during the negotiation process, but will allow up to three additional in-person or virtual negotiation meetings, the agency said in initial guidance issued on Wednesday for its Medicare drug price negotiation program. (Aboulenein and Erman, 3/15)

In a press briefing, Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure said her agency will invoice the drugmakers for these rebates beginning in 2025. “The Medicare prescription drug inflation rebate program is strengthening Medicare by making prescription drugs affordable for millions of people and discouraging drug companies from increasing prices faster than inflation,” Brooks-LaSure said. “It’s also protecting Medicare for our children and grandchildren.” (Choi, 3/15)

Medicare laid out Wednesday in the greatest detail yet how it will choose which drug prices it will negotiate in its brand-new program, and how it will figure out what the government’s opening offer will be. (Cohrs, 3/15)

On Biden's fiscal battle with Republicans —

President Joe Biden on Wednesday said his administration was focused “intensely” on lowering health care costs and took aim at “MAGA” Republicans who he said are intent on dialing back Medicare coverage for millions of Americans. Biden used a speech in Las Vegas where he was wrapping a three-day Western swing to make the case there are stark differences in how Democrats are tackling skyrocketing drug prices compared to their Republican counterparts. (Seitz and Miller, 3/15)

He criticized Republicans for opposing the sweeping climate, healthcare and tax law passed last year, which featured several provisions meant to lower drug prices, including the measure that gave the government authority to negotiate prices for Medicare beneficiaries. The president urged Congress to pass additional policies on drug prices, calling for capping the cost of insulin at $35 for all Americans. The law caps insulin prices for people who rely on Medicare. Most Senate Republicans voted to strip a provision out of Democrats’ climate and healthcare bill that would have capped costs at $35 for patients with private insurance. (Restuccia and Collins, 3/15)

First, it was passing the Affordable Care Act. Then, it was defending it. Then it was allowing Medicare to negotiate drug prices. But with those big boxes checked, it's not clear what congressional Democrats' next big health care goal is. (Sullivan, 3/16)

In related news about Medicare —

There are few things that get lawmakers in Washington salivating more than a wonky policy that saves the federal government a whole lot of money. As debate in the Capitol rages about the future of the Medicare program, hospitals are worried that lawmakers could finally be considering a change they hate — so-called site neutral payment policy. It’s somewhat of a unicorn on Capitol Hill — it saves the federal government tens of billions of dollars, reduces patient costs, and it’s gained bipartisan support over the years. (Cohrs, 3/16)

After years of struggling to regulate the drug middlemen that create pharmacy networks, the federal government could lean on states to rein them in — even, potentially, in Medicare. The Department of Justice has until next month to tell a federal appeals court where the administration stands on the issue. (Wilkerson, 3/15)

One in five Medicare recipients currently uses medical marijuana, according to an April 2022 poll by the Medicare Plans Patient Resource Center, an organization that provides Medicare guidance and information. And nearly a quarter have used it in the past. Two-thirds of Medicare recipients think Medicare should cover it, the poll found. But Medicare doesn’t cover medical marijuana because it’s not federally legal and not approved by the Food and Drug Administration. Here’s where the situation stands. (Ashford, 3/15)

After Roe V. Wade

Judge Sounds Receptive To Challenge Of FDA's Abortion Pill Approval

In a Texas court Wednesday, U.S. District Judge Matthew Kacsmaryk heard arguments from a coalition of anti-abortion medical groups and doctors and the Justice Department in a case that could have broad repercussions for access to a medicated abortion in the U.S. The FDA's approval process for mifepristone and ability to mail the drug were considered during the hearing.

The federal judge who could upend access to a key abortion medication seemed open on Wednesday to the argument that the drug had not been properly vetted and could be unsafe — claims the Food and Drug Administration and leading health organizations strongly contest. While the antiabortion group challenging the drug acknowledged there is no precedent for a court to order the suspension of a long-approved medication, U.S. District Judge Matthew Kacsmaryk questioned whether mifepristone has met the rigorous federal standard necessary to be prescribed to patients in the United States. He asked a lawyer for the group whether the court could unilaterally withdraw FDA approval for a drug, and engaged with attorneys for both sides about whether mailing the pills should be prohibited because of a 19th-century law that bans sending articles “for any indecent or immoral use” through the Postal Service. (Stein, Kitchener and Marimow, 3/15)

During the four-hour hearing, U.S. District Judge Matthew Kacsmaryk appeared sympathetic to arguments from the lawyers for a coalition of anti-abortion groups called the Alliance for Hippocratic Medicine. Their goal in filing the suit was to overturn the Food and Drug Administration’s approval of the pills used to terminate pregnancies, which account for more than half of abortions in the U.S. (Victoria Lozano, Burns, Bendix and Siemaszko, 3/15)

Kacsmaryk has a number of options, from leaving the drug on the market to restoring rules around mifepristone that the FDA and the Biden administration have eased. Recent changes include allowing mifepristone to be mailed or dispensed by retail pharmacies. And in 2016, the agency decided to allow mifepristone to be used during the first 10 weeks of pregnancy, up from seven weeks. During the hearing, Kacsmaryk appeared to be considering whether he should order the drug to be taken off the market right away or order the FDA to take some other action. (Chappell and McCammon, 3/15)

Toward the end of the court hearing, which lasted more than four hours, Judge Kacsmaryk asked a lawyer for the plaintiffs, a coalition of anti-abortion groups and doctors, if they expected that “the court itself can order a withdrawal or suspension.” When the lawyer, Erik Baptist, said yes, the judge replied, “What gives the court that authority?” At another point in the session, the judge asked a Justice Department lawyer representing the defendant in the case, the Food and Drug Administration, if the fact that 22 conservative states had written a brief supporting the plaintiffs’ case showed that revoking the abortion pill would be beneficial for public policy. The lawyer, Julie Straus Harris, replied, “An injunction here would interfere with every state in the country” and could make abortion access difficult even in cases of nonviable pregnancies and rape. That seemed to make an impression on the judge, who noted, “This isn’t a case where we’re comparing 22 versus 28 states, but rather, all 50 states, especially in some of those other circumstances, right?” (Belluck and McCann, 3/15)

The lawsuit was filed last year by the Alliance Defending Freedom against the FDA on behalf of three physician groups that belong to the Alliance for Hippocratic Medicine — the American Association of Pro-Life Obstetricians and Gynecologists, the American College of Pediatricians and the Christian Medical and Dental Associations — and four individual physicians. ... ADF’s attorneys argued that since “pregnancy” is not a disease, mifepristone should not have been considered eligible to be evaluated under the FDA’s accelerated approval program and is unsafe, per an Associated Press report. (Raman, 3/15)

Also —

When the Supreme Court reversed federal abortion rights last June, Justice Samuel Alito’s majority opinion stressed that “It is time to heed the Constitution and return the issue of abortion to the people’s elected representatives.” Justice Brett Kavanaugh went further, separately emphasizing that the controversy would now be one for state officials and that judges would no longer undertake the “difficult moral and policy questions” related to when a woman is allowed to end a pregnancy. But the drama Wednesday in a Texas courtroom over medication abortions demonstrates that judges remain at the center of access to abortion in America and reinforces the possibility that another battle over reproductive rights could soon land at the high court. (Biskupic, 3/16)

More abortion news from Utah, Tennessee, Wisconsin, and Ohio —

Abortion clinics will be banned in Utah starting next year after Gov. Spencer Cox signed a bill Wednesday. The law will also impose other restrictions on abortion as the state’s trigger ban is held up in court. Rep. Karianne Lisonbee’s, R-Clearfield, HB467, was among the more controversial bills passed this legislative session. It passed out of both the Utah House and the Senate along party lines. (Anderson Stern, 3/16)

Tennessee Republican lawmakers on Wednesday took another swing at adding a narrow exemption to one of the strictest abortion bans in the United States. Nearly a month ago, a Republican legislative panel defied political threats made by the state’s influential anti-abortion lobbying group and advanced legislation clarifying situations where abortion could be allowed in Tennessee. (Kruesi, 3/15)

Republicans who control the Wisconsin Legislature unveiled a bill Wednesday that would create rape and incest exceptions to the state’s 1849 abortion ban and clarify when abortions that protect the health of the mother would be allowed. But the bill would not return the same rights that were in place under Roe v. Wade. The measure drew immediate bipartisan opposition, however. (Bauer, 3/15)

As proponents of abortion access start collecting signatures for a possible constitutional amendment, opponents announced a $5 million ad campaign to fight it. The new group, Protect Women Ohio, was formed in February to fight the abortion ballot campaign. Its board members include representatives from the Right to Life Action Coalition of Ohio, the Center for Christian Virtue and Ohio Right to Life. (Balmert, 3/15)

Women’s Health

Maternal Deaths Spiked 40% In 2021, Dropped in 2022

More than 1,200 U.S. women died in 2021 during pregnancy or shortly after childbirth, according to a final tally by the Centers for Disease Control and Prevention. In 2022, there were 733 maternal deaths, though AP reports that number is likely to rise.

The number of women who died during pregnancy or shortly after rose 40% to 1,205 in 2021, compared with 861 in 2020 and 754 in 2019, the National Center for Health Statistics said Thursday. The increase pushed the maternal-mortality rate to 33 deaths per 100,000 live births, the highest since 1965, compared with 24 in 2020 and 20 in 2019. (Toy, 3/16)

Deaths of pregnant women in the U.S. fell in 2022, dropping significantly from a six-decade high during the pandemic, new data suggests. More than 1,200 U.S. women died in 2021 during pregnancy or shortly after childbirth, according to a final tally released Thursday by the Centers for Disease Control and Prevention. In 2022, there were 733 maternal deaths, according to preliminary agency data, though the final number is likely to be higher. (Stobbe, 3/16)

Experts say COVID-19 likely contributed to the increases, but that the sobering rates continue to reveal deep flaws in health systems, such as structural racism, implicit bias and communities losing access to care. “A roughly 40% increase in preventable deaths compared to a year prior is stunning news,” Dr. Iffath Abbasi Hoskins, president of the American College of Obstetricians and Gynecologists, said in a statement to USA TODAY. (Hassanein, 3/16)

Tammy Cunningham doesn’t remember the birth of her son. She was not quite seven months pregnant when she became acutely ill with Covid-19 in May 2021. By the time she was taken by helicopter to an Indianapolis hospital, she was coughing and gasping for breath. The baby was not due for another 11 weeks, but Ms. Cunningham’s lungs were failing. The medical team, worried that neither she nor the fetus would survive so long as she was pregnant, asked her fiancé to authorize an emergency C-section. ... New government data suggest that scenes like this played out with shocking frequency in 2021, the second year of the pandemic. (Rabin, 3/16)

In related news about pregnancy —

Women who experience COVID-related stress during pregnancy have worse mental health 1.5 years after giving birth, and their babies show more distress and irritability, finds a follow-up study published yesterday in JAMA Network Open. (Van Beusekom, 3/15)

Pregnant women are particularly vulnerable to Covid-19, and new government data show that maternal mortality rose sharply in 2021, the second year of the pandemic. Here’s what women need to know to keep themselves safe. (Rabin, 3/16)

KHN: The US Remains A Grim Leader In Preterm Births. Why? And Can We Fix It? 

Tamara Etienne’s second pregnancy was freighted with risk and worry from its earliest days — exacerbated by a first pregnancy that had ended in miscarriage. A third-grade teacher at an overcrowded Miami-Dade County public school, she spent harried days on her feet. Financial worries weighed heavy, even with health insurance and some paid time off through her job. (Varney, 3/16)

Health Industry

Analysis: 30% Of Patients Get Care Without Seeing Primary Provider

A FAIR Health analysis, reported by Axios, shows that of all patients who received medical services between 2016 and 2022 nearly 30% did not see a primary care physician. The Texas Tribune, meanwhile, reports on how rural Texans must travel long distances for basic health needs.

Nearly 30% of all patients who received medical services between 2016 and 2022 did not see a primary care physician, a FAIR Health analysis provided first to Axios shows. Primary care providers are supposed to manage patients' day-to-day health needs and provide preventative care, and evidence shows it can drive down costs and improve outcomes. But many people are clearly getting their care elsewhere — if they're getting it at all. (Reed, 3/15)

On a map, this small town in the South Plains seems well positioned for residents to find health care. With nearly 1,700 residents, Ralls is nestled between Crosbyton, about 10 miles away, and Lubbock, about 30 miles away, both of which have hospitals and emergency rooms. But being neighbors with a larger city has made getting health care harder. With Lubbock quickly growing and in reach, the city has inadvertently sapped patients, physicians and businesses from nearby towns. (Lozano, 3/16)

On the affordability of health care —

In the summer of 2011, Anna was visiting her parents in rural Texas when they told her about a new health fad that they’d heard about at church: Miracle Mineral Solution. The family didn’t have insurance, so took MMS much like a vitamin supplement. They believed it would help them stay healthy. (Brown, 3/15)

KHN: Listen To ‘Tradeoffs’: Medical Debt Delivers ‘A Shocking Amount Of Misery’

The numbers that tell the story of medical debt in the U.S. are staggering: Around 100 million Americans have health care debt, and together they owe at least $140 billion. And research suggests this debt can have striking consequences on people’s financial, physical, and mental health. In this episode of the “Tradeoffs” podcast, Dan Gorenstein talks about the pain and possible solutions to medical debt with KHN senior correspondent Noam N. Levey and UCLA researcher Wes Yin. (Levey, 3/16)

New pants to replace Alex Morisey’s tattered khakis will have to wait. There’s no cash left for sugar-free cookies either. Even at the month’s start, the budget is so bare that Fixodent is a luxury. Now, halfway through it, things are so tight that even a Diet Pepsi is a stretch. “How many years do I have left?” asks 82-year-old Morisey, who lives in a Philadelphia nursing home. “I want to live those as well as I can. But to some degree, you lose your dignity.” Across the U.S., hundreds of thousands of nursing home residents are locked in a wretched bind: Driven into poverty, forced to hand over all income and left to live on a stipend as low as $30 a month. In a long-term care system that subjects some of society’s frailest to daily indignities, Medicaid’s personal needs allowance, as the stipend is called, is among the most ubiquitous, yet least known. (Sedensky, 3/15)

In other industry updates —

Officials at the Advanced Research Projects Agency for Health are moving ahead with plans to set up an office in the Washington, D.C. area — though they aren’t saying whether that means the city proper or somewhere in Maryland or Virginia. The choice, however vague, all but guarantees the location will be a quick drive from the headquarters of the National Institutes of Health campus in Bethesda, Md., despite explicit instructions from Congress not to house the new, multi-billion-dollar health agency on the actual campus. (Owermohle and Cohrs, 3/15)

An appeal of a landmark jury verdict that awarded nearly $15 million to five people who lost embryos and eggs in a fertility clinic mishap has settled out of court. The amount of the agreement is confidential, according to a court filing. ... More than 2,500 embryos and 1,500 eggs belonging to more than 400 people were in the cryo-preservation tank at Pacific Fertility Center in San Francisco when it malfunctioned in March 2018, according to a court filing. It is unclear how many of those people will share in what may be a substantial monetary settlement. (Bernstein, 3/15)

Seven sheriff’s deputies in Virginia have been charged with second-degree murder in the death of a Black man with a history of mental illness who died after the officers smothered him as he lay on the ground in handcuffs and leg shackles at a hospital, his family’s lawyer and a county prosecutor said on Wednesday. The man, Irvo Otieno, 28, of Henrico County, Va., whose family emigrated from Kenya when he was 4 years old, appeared to have died from asphyxiation, or oxygen deficiency, on March 6 at Central State Hospital in Dinwiddie County, his family’s lawyer, Mark Krudys, said in an interview. His family says Mr. Otieno was deprived of medication while in jail that he needed for his mental illness. (Medina, 3/15)

In corporate news —

Nonprofit hospitals received $28 billion in taxpayer subsidies in 2020 but only provided $16 billion in free or discounted care, a new analysis found. (Kacik, 3/15)

Bright Health Group's financial headaches are worse than previously known, as Florida regulators revealed the company has been under supervision for six months and unable to spend money without clearance from the Sunshine State. (Tepper, 3/15)

Sparrow Health reported Wednesday a $171.5 million loss for 2022, adding to a growing list of poor financial performers across the healthcare industry. The eighth-largest health system in the state reported a loss on revenue of $1.47 billion, compared to a loss of $67.8 million on revenue of $1.5 billion in 2021, according to the Lansing-based system's annual reporting. (Walsh, 3/15)

Covid-19

What The End Of Covid Health Emergency Means

The federal government and various states are outlining what happens as the public health emergency winds to a close in May.

Massachusetts Gov. Maura Healey announced on Wednesday that the state's COVID-19 public health emergency will end on May 11. The state's vaccine requirement for Executive Branch employees will also end at that time. The date of the public emergency ending aligns with the federal declaration also expiring on May 11. Healey said she also plans to file legislation that would extend some flexibilities, largely around staffing for the health care industry and EMS. (3/15)

Dr. Daniel Kuritzkes said he does not expect much to change for patients at his hospital. (3/15)

Department of Health and Human Services (HHS) Secretary Xavier Becerra asked a room full of insurers—a group he has clashed with in recent weeks—for help convincing states to share key health data. Becerra spoke Tuesday during AHIP’s 2023 Medicare, Medicaid, Duals & Commercial Markets Forum in Washington, D.C., on a range of topics. The HHS secretary specifically called for insurers to help him to convince states on sharing data after the agency’s mandatory authority goes away with the COVID-19 public health emergency that ends May 11. (King, 3/14)

Changes are expected to occur after a three-year-long federal health emergency comes to an end, signifying the country's shift in the COVID-19 pandemic. The Biden Administration announced on Jan. 30 it will end the federal public health emergency on May 11. It's expected to have a domino effect on COVID-related services people sought for free in the past three years. "We will always live with COVID," said Sparrow Health System Chief Clinical Officer and Dr. Paul Entler. "There'll be new variants, potentially new vaccines, new therapeutics. So, we understand that with like any other virus, that will always be here with us." (Nurse, 3/15)

The end of the COVID-19 public health emergency could bring new barriers to trans men undergoing hormone therapy, in the way it would eliminate telehealth prescribing of controlled substances including testosterone. (Gonzalez, 3/15)

In other covid news —

Are you six months out from your Covid-19 bivalent booster and wondering when you’ll be able to get another shot? If you live in the United Kingdom or Canada, you already have your answer. The Canadian and U.K. governments, acting on recommendations from expert committees, plan to offer spring booster shots for people at highest risk of getting severely sick from Covid. But in the United States, there’s been radio silence from the Food and Drug Administration on the question of spring boosters, creating frustration among a small but determined group of people who are keen not to have to wait until the autumn to get another dose of Covid vaccine. (Branswell, 3/16)

Mercy and SSM Health no longer are requiring visitors, patients and medical staff to wear masks at their medical facilities, becoming on Wednesday the first major hospital systems with facilities in the St. Louis area to drop the key protective measure used during the COVID-19 pandemic. (Munz, 3/15)

State Watch

Unwinding Of Medicaid Coverage Will Affect Millions

Various news outlets discuss the reenrollment of Medicaid beneficiaries as the end of the public health emergency ends. Also various report from across the country on gender identity.

Medicaid enrollees and the health insurance companies that cover them face major disruptions in the coming months as states resume removing people who no longer qualify from the program. (Tepper and Broderick, 3/15)

About 15 million people may drop off Medicaid rolls in the coming year as states redetermine program eligibility with the end of the COVID-19 public health emergency, a Kaiser Family Foundation survey of state officials found. (Dreher, 3/16)

From New Mexico to Maine, a handful of states have pending waiver requests to tap Medicaid funds for food in pilot programs. This signals growing support for "food is medicine" and food-based health interventions that are being echoed at both federal and state levels, despite mixed pilot reviews. (Horn-Muller, 3/16)

On transgender health care —

Transgender people at Arkansas public schools would not be able to use restrooms that correspond with their gender identity under a bill lawmakers sent to Gov. Sarah Huckabee Sanders on Wednesday. The bill approved by the majority-Republican House applies to multi-person restrooms and locker rooms at public schools and charter schools serving prekindergarten through 12th grades. The House, which approved an earlier version of the bill last month, passed the bill on a 77-15 vote without any debate. (DeMillo, 3/15)

Health insurance providers may soon be required to cover treatments for gender-affirming care under a bill heard by Nevada lawmakers Wednesday morning. (Avery, 3/15)

A Florida Board of Medicine rule that bans gender-affirming care, such as puberty blockers, for most minors goes into effect Thursday. On Monday, a bill that codifies those rules advanced through a state Senate committee. As lawmakers prepared to hear the bill, hundreds of transgender people and their supporters filled the Capitol’s fourth floor. They were people like Paula Pifer, whose daughter Hunter is a model pictured wearing Valentino in this month’s issue of Vogue. "She’s as beautiful on the inside as she is on the outside. You would never know that this young woman was born in the wrong body," Pifer said. (McCarthy, 3/15)

Attorney General Ken Paxton, in an appeal, is asking the courts to lift an injunction that stopped the state from conducting child abuse investigations over transition-related medical care for transgender youth. Paxton argued that the families — belonging to PFLAG, an LGBTQ advocacy group — did not suffer injuries as a result of the Department of Family and Protective Services’ investigations. (Melhado, 3/15)

In other health news from across the U.S. —

North Las Vegas veteran Gerald Mayes says psilocybin — hallucinogenic fungi also known as “magic mushrooms” — helped him with his post-traumatic stress disorder and alcoholism. (Hill, 3/15)

Folded into versions of the governor's broad education bill are changes to schools' health curriculum that would remove the requirement to teach students about certain sexually transmitted infections, including HPV. Iowa school districts would still need to maintain a health curriculum that includes "age-appropriate and research-based information regarding the characteristics of sexually transmitted diseases." (Ramm, 3/15)

Bay Area pollution regulators Wednesday voted to embark on the most ambitious plan in the country to phase out two types of home appliances — gas-powered water heaters and furnaces — that foul the air. The target is smog-forming nitrogen oxides, also called NOx, churned out by appliances run on natural gas. The Bay Area Air Quality Management District moved to slash these emissions, which means that in as soon as six years, those trusty gas furnaces won’t be available to buy. (Johnson, 3/15)

Science And Innovations

Northwestern Medicine Succeeds With Novel Double Lung Transplants

News outlets report on a new treatment for certain late-stage lunch cancers, with successful procedures carried out on two patients at Northwestern Medicine in Chicago. In other news, a push to subject medical devices to placebo tests in the same way drugs are investigated for effectiveness.

A novel treatment for certain late-stage lung cancers has succeeded in the first two patients to undergo the operation. Using knowledge learned during the Covid pandemic, surgeons at Northwestern Medicine in Chicago successfully performed double lung transplantations in two patients with stage 4 cancer. Both patients are alive and well. (Sullivan and Snow, 3/15)

When traditional treatments such as chemotherapy and radiation fail, lung cancer can be a death sentence for many patients. That, however, may be changing, with Northwestern Medicine leading the way. Northwestern plans to begin regularly performing double lung transplants on patients with terminal lung cancer, after successfully transplanting lungs into two patients who would have otherwise died of the disease, the health system announced Wednesday. (Schencker, 3/15)

In other research and pharma news —

It’s the gold standard in medicine: taking a treatment, and putting it head-to-head against a placebo to confidently declare whether it actually works. But for most medical devices, placebo trials have never been done. (Lawrence, 3/16)

Alberto Ascherio began his career as a young doctor treating tropical diseases in South American rainforests and parts of Africa. Over the next quarter-century, he made his way to what is now his wheelhouse: studying the links between viruses and neurodegenerative diseases. (Cueto, 3/16)

Before there was CRISPR, aspiring genome editors relied on an island of misfit, less elegantly named enzymes: Zinc-finger nucleases, TALENs, recombinases. Many of these once beloved tools were tossed aside when CRISPR came along, having helped few actual patients but driven plenty of graduate students to exhaustion. They were stubborn, inflexible enzymes, requiring endless engineering. CRISPR, by contrast, lets you cut almost any stretch of DNA with a simple chemical code. The field moved on, and one German researcher was left alone in his lab, whittling away at a pet protein most of his contemporaries abandoned. (Mast, 3/16)

Victoria Gray was wandering through the British Museum in London last week when she spotted a small wooden cross hanging on the wall. "It's nice seeing all the old artifacts, especially the cross," Gray said. "Religion is something that I hold close to my heart, and my faith is what brought me this far." (Stein, 3/16)

Bad things happen to a human body in zero gravity. Just look at what happens to astronauts who spend time in orbit: Bones disintegrate. Muscles weaken. So does immunity. “When you go up into space,” says Saïd Mekari, who studies exercise physiology at the University of Sherbrooke, in Canada, “it’s an accelerated model of aging.” (Wapner, 3/15)

Public Health

Industrial Trichloroethylene Possibly Linked To Parkinson's Disease

New research identifies risks from trichloroethylene, which is widely used to degrease aviation components and heavy machinery. It could be linked to Parkinson's. CNN, separately, reports on pesticide contaminant levels in fruits and vegetables.

A cancer-causing chemical that is widely used to degrease aviation components and heavy machinery could also be linked to Parkinson’s disease, according to a new research paper that recommends increased scrutiny of areas long contaminated by the compound. (Briscoe, 3/15)

Blueberries, beloved by nutritionists for their anti-inflammatory properties, have joined fiber-rich green beans in this year’s Dirty Dozen of nonorganic produce with the most pesticides, according to the Environmental Working Group, a nonprofit environmental health organization. (LaMotte, 3/15)

In other health and wellness news —

An analysis of mpox-related TikTok videos found the quality was low and the information provided was frequently incomplete and inaccurate, researchers reported yesterday in BMJ Global Health. Using a hashtag-based search strategy, the researchers identified 2,462 mpox-related videos from January 1 to August 11, 2022, and analyzed 85, evaluating them for content on features and treatment of mpox. (Dall, 3/15)

Last summer, the highly contagious strain of avian influenza that had been spreading through North American birds made its way into marine mammals, causing a spike in seal strandings along the coast of Maine. In June and July, more than 150 dead or ailing seals washed ashore. Now, a study provides new insight into the outbreak. Of the 41 stranded seals tested for the virus, nearly half were infected with it, scientists reported on Wednesday in the journal Emerging Infectious Diseases. It is likely that wild birds introduced the virus to seals at least twice, the researchers concluded. In several seals, the virus had mutations that are associated with adaptation to mammals. The risk to humans remains low, and the seal outbreak waned quickly, the scientists said. (Anthes, 3/15)

Exercise as a treatment for severe depression is at least as effective as standard drugs or psychotherapy and by some measures better, according to the largest study to date of exercise as “medicine” for depression. The study pooled data from 41 studies involving 2,265 people with depression and showed that almost any type of exercise substantially reduces depression symptoms, although some forms of exercise seemed more beneficial than others. (Reynolds, 3/15)

Researchers at the University of Texas at Austin have developed a temporary “e-tattoo” for the palm that can track excitement and stress using the skin’s electrical conductivity. The e-tattoo could be a reliable way for people with conditions such as anxiety or depression to track their emotions. (Ramakrishnan, 3/16)

Opioid Crisis

Mississippi To Decriminalize Fentanyl Testing Kits

Gov. Tate Reeves signed a new House bill Monday that will decriminalize illegal-drug testing kits effective July 1. Meanwhile, in Texas, the Senate passed a bill allowing fentanyl distributors to be charged with murder, and in Mexico, the president suggested a ban on using fentanyl in medicine.

Mississippi will decriminalize materials that allow people to test illegal drugs to detect if they are spiked with fentanyl, a highly powerful synthetic opioid painkiller. Republican Gov. Tate Reeves signed House Bill 722 on Monday, and it becomes law July 1. (3/15)

The Texas Senate passed a "Combating Fentanyl" bill Wednesday that would open the door for state prosecutors to charge fentanyl distributors with murder. Senate Bill 645, introduced by Sen. Joan Huffman, a Republican representing the Houston area, would change the classification of drug overdoses to "poisonings," according to the Texas Tribune. (Richard, 3/16)

Mexico’s president called anti-drug policies in the U.S. a failure Wednesday and proposed a ban on using fentanyl in medicine — even though little of the drug crosses from hospitals into the illegal market. President Andrés Manuel López Obrador has grappled in recent days with the issue of fentanyl, which has become a major security concern. López Obrador has denied that Mexico produces fentanyl, which causes about 70,000 U.S. overdose deaths per year. (3/15)

More on the opioid crisis —

Thirteen inmates overdosed on fentanyl at Elmwood Correctional Facility, and three staff members were impacted after being exposed to the drug while treating the inmates, according to the Santa Clara County Sheriff’s Office. (Gaines, 3/15)

Two Florida law enforcement officers who have worked with the Drug Enforcement Administration are now facing drug charges, according to the U.S. District Court for the Middle District of Florida. Both 44-year-old Joshua Earrey and 37-year-old James Darrell Hickox, who combine for nearly 40 years of law enforcement experience, have been charged, the district said. They were accused of buying or confiscating drugs from DEA sources or suspects and, in the case of Hickox, selling the narcotics, court documents show. (Martin, 3/15)

The fentanyl-opioid crisis is hitting young people hard and some of the highest death rates are in Native American communities. The Cherokee Nation is working to help families recover. (Mann, 3/16)

It's a cold winter night in Patterson, New Jersey. There's still snow on the ground from the latest storm, and on a corner, under the neon lights of a liquor store, a group of people are gathered. Some are homeless, many are opioid users, and most have had brushes with death. "I just lost a good friend of mine right now. It hurts," says Rob De Maria. He is a boyish young man, with dimples and dark circles under his eyes. De Maria says he lived out here for two years while addicted to opiates. He's now tapering off, he says, because it got too scary for him. (Garsd, 3/14)

In news about marijuana and alcohol use —

Eight children were sickened at a Los Angeles school on Wednesday after eating marijuana gummies, authorities said. (3/15)

“Alcohol is the great dirty little secret of the pandemic,” said Dr. Robin Henderson, the chief executive for behavioral health for the Providence health system in Oregon. She said alcohol is a significant cause of visits to Providence emergency departments. “We put a lot of effort into the opioid crisis and I don’t mean to diminish that at all, but we’re not having those same conversations about alcohol,” Henderson said. (Templeton, 3/15)

Health Policy Research

Research Roundup: Covid; Autism; Infection Control; Time Perception

Each week, KHN compiles a selection of recently released health policy studies and briefs.

An observational study of nearly 400,000 nonhospitalized adults in California finds a low rate of venous thromboembolism (VTE, or a blood clot in a vein) in the 30 days after COVID-19 diagnosis and an even lower rate in the following 30 days. (Van Beusekom, 3/13)

To help provide an insight into the possible ASD-cardiometabolic diseases link, researchers conducted a systematic review and meta-analysis. The results indicated that ASD was associated with greater risks of developing diabetes overall, including both type 1 and type 2 diabetes. (Texas Tech University Health Sciences Center, 3/14)

A survey of healthcare facilities in the United States and seven other countries found that infection prevention and control (IPC) and antibiotic stewardship program (ASP) interventions requiring staff, time, and specialized training were implemented less frequently in 2021, researchers reported today in Infection Control and Hospital Epidemiology. (Dall, 3/14)

It is a truism that time seems to expand or contract depending on our circumstances: In a state of terror, seconds can stretch. A day spent in solitude can drag. When we’re trying to meet a deadline, hours race by. A study published this month in the journal Psychophysiology by psychologists at Cornell University found that, when observed at the level of microseconds, some of these distortions could be driven by heartbeats, whose length is variable from moment to moment. (Barry, 3/14)

Editorials And Opinions

Viewpoints: Ending Roe Is Making Women Forgo Pregnancy Altogether; Total Abortion Bans Are Deadly

Editorial writers examine these public health topics.

The post-Dobbs antiabortion laws have reached far beyond mothers trying to end their pregnancies voluntarily. They are also inhibiting access to healthcare for women like me who want to have a viable pregnancy. The political advocates responsible for the new laws proclaim themselves to be protecting human life, yet their laws can have the opposite effect. (Jennifer Shinall, 3/16)

Before the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization, I did not consider myself an abortion provider. Ninety-five percent of my work as a high-risk obstetrician was helping women through complex pregnancies to achieve healthy outcomes for both them and their babies. (Sarah Osmundson, 3/16)

By the end of 2021, Americans were dying three years sooner, on average, than they were before Covid-19, with life expectancy falling from 79 years to 76 years, according to the Centers for Disease Control and Prevention’s most recent statistics. (Atul Gawande, 3/16)

It's been more than two years since a rule promulgated during the Trump administration requiring hospitals to disclose their prices took effect. Yet according to a new study, most hospitals aren't complying. (Sally C. Pipes, 3/15)

In February, President Biden announced the reboot of the Cancer Moonshot and vowed to reduce cancer mortality by 50 percent in the next 25 years. It’s a goal that’s both lofty and achievable — but only if the advances in science are accompanied by progress in controlling costs and innovations in financing cancer treatment. (Jeff Levin-Scherz, 3/16)

We have known about the physical effects of smoking for several years. However, there is an increasing body of knowledge linking smoking to mental health issues and stress. According to the Centers for Disease Control and Prevention, smoking is more common among adults with mental health conditions, such as depression and anxiety, than in the general population. (Greg Kesterman, 3/15)

I’ve seen and experienced the toll dementia takes on a loved one. And I’m far from alone: One in three seniors dies with Alzheimer’s or other forms of dementia. But the symptoms and decline usually happen in private, which can make figuring out a way to live with the illness isolating and frustrating — both for people with dementia and the people who care for them. (Lulu Garcia-Navarro, 3/16)

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