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The Arizona Supreme Court’s long-awaited ruling on whether virtually all abortions performed in the Grand Canyon State should be outlawed will be released Tuesday morning. In December, the high court heard oral arguments in an appeal launched by an anti-abortion doctor hoping to reinstate a near-total ban from 1864 — nearly six decades before Arizona became a state — that prohibits all abortions except for those to save the life of the mother. The legal challenge seeks to overturn the decision from a lower court that determined the 1864 law shouldn’t overrule nearly 50 years of new laws, and a more recent 15-week gestational ban, passed in 2022, should be upheld instead. (Gomez, 4/8)

On Thursday afternoon, in an important lawsuit seeking to clarify which religious objectors will be taken seriously when they seek legal exemptions, a group of plaintiffs in Indiana scored a notable win: A three-judge panel on the Indiana Court of Appeals agreed to enjoin Indiana’s near-total abortion ban, as applied against a class of religious plaintiffs who had argued that the ban violates a state law protecting religious freedom. In its unanimous 76-page opinion, authored by Judge Leanna K. Weissmann, the panel determined that a preliminary injunction granted to a group of plaintiffs who had alleged that Indiana’s abortion law violated their rights under the state’s Religious Freedom Restoration Act could remain in place. The case now proceeds to trial, or more likely to a direct appeal to the state Supreme Court. (Lithwick and Schwartzman, 4/8)

The fatigue and pangs of pregnancy have made many women feel older than their years. Now there’s new research that suggests pregnancy may, in fact, accelerate the aging process. Two new studies of genetic markers in the blood cells of pregnant women suggest that their cells seem to age at an exaggerated clip, adding extra months or even years to a woman’s so-called biological age as her pregnancy progresses. (Reynolds, 4/8)

More than half of U.S. babies born in 2023 had birth mothers in their 30s and older, according to provisional CDC data. Why it matters: In the last few years, age 35 has gone from the start of "geriatric pregnancy" to potentially a maternal-age sweet spot. (Mallenbaum, 4/8)

A sibling can change your life — even before you're born. That's because when males and females share a womb, sex hormones from one fetus can cause lasting changes in the others. It's called the intrauterine position phenomenon, or intrauterine position effects, and different versions of it have been observed in rodents, pigs, sheep — and, probably, humans. ... The phenomenon is more than a scientific oddity. It helped establish that even tiny amounts of hormone-like chemicals, like those found in some plastics, could affect a fetus. (Hamilton, 4/9)

There's a battle brewing in Modesto over a sex education curriculum and whether it actually complies with California law. ... California Attorney General Rob Bonta said his office has received complaints from parents that the curriculum may contain religious doctrine when it comes to the topic of abortions. "Access to unbiased and comprehensive sexual education for students is not just a matter of choice; it is a fundamental necessity that builds a foundation of success for our children," Bonta said in a press release Monday. (Ramos, 4/8)

�������ýҕ�l Health News: Readers Speak Up About Women's Health Issues, From Reproductive Care To Drinking

Letters to the Editor is a periodic feature. �������ýҕ�l Health News gives readers a chance to comment on a recent batch of stories. (4/9)

Republicans, usually happy to fall in line with the de facto leader of their party, started to publicly disagree with him. “I respectfully disagree with President Trump’s statement that abortion is a states’ rights issue,” tweeted Senator Lindsey Graham of South Carolina, who had introduced legislation for a national abortion ban. “Dobbs does not require that conclusion legally and the pro-life movement has always been about the wellbeing of the unborn child – not geography.” (Villa de Petrzelka, 4/8)

Former President Trump on Monday pushed back against Sen. Lindsey Graham (R-S.C.) and other conservatives who were critical of his statement on abortion earlier in the day, in which Trump declined to take a position on federal legislation limiting the procedure. In a lengthy post on Truth Social, Trump wrote that Graham was “doing a great disservice to the Republican Party, and to our Country” and argued others who publicly favor stricter abortion laws were committing political malpractice. “Terminating Roe v. Wade was, according to all Legal Scholars, a Great Event, but sometimes with Great Events come difficulties,” Trump wrote. (Samuels, 4/8)

Four years ago, the vast majority of the Senate GOP voted for a federal abortion ban after 20 weeks of pregnancy, with Donald Trump in office. On Monday, the former president effectively finished off congressional Republicans’ movement for national abortion restrictions. After Trump’s much-teased announcement that it is “up to the states to do the right thing” on abortion, which also urged Republicans to take his position in order to win this November, few GOP senators expressed interest in breaking explicitly with him. That includes the Republicans who still supported federal limits after Roe v. Wade got overturned. (Everett, Diaz and Perano, 4/8)

President Biden argued that Trump was all talk in his statement Monday. "With all his empty words on fertility treatments, Trump doesn't tell you the MAGA Republicans he controls in Congress have put forward bills that could ban fertility treatments and that the speaker of the House he empowered is one of the strongest supporters for a national abortion ban in the nation," Biden wrote. (Hagstrom, 4/8)

Donald Trump’s video statement on abortion Monday — saying the legalities around the procedure should be up to the states — came after months of his publicly and privately discussing the possibility of a federal abortion ban. Trump’s positions on abortion have been a roller coaster for decades. At one point in 2015, during his run for president, he took “five positions on abortion in three days,” according to The Washington Post and as NBC News detailed at the time. (Korecki, 4/8)

Change Healthcare is allegedly being extorted by a second ransomware gang, mere weeks after recovering from an ALPHV attack. RansomHub claimed responsibility for attacking Change Healthcare in the last few hours, saying it had 4 TB of the company's data containing personally identifiable information (PII) belonging to active US military personnel and other patients, medical records, payment information, and more. The miscreants are demanding a ransom payment from the healthcare IT business within 12 days or its data will be sold to the highest bidder. (Jones, 4/8)

“This comes as no surprise. We had previously outlined this scenario in our blog post, foreseeing the potential for such alliances in the cybercriminal ecosystem,” Ngoc Bui, a cybersecurity expert at Menlo Security, told SC Media in an email. “The involvement of a middleman, typical in ransomware-as-a-service (RaaS) attacks, adds another level of complexity and risk. It complicates the direct line of negotiation and payment to the threat actors with the data that was stolen.” RansomHub began a countdown of just over 12 days for UnitedHealth to make a ransom payment before the dataset is sold. (French, 4/8)

More than 144 million Americans' medical information was stolen or exposed last year in a record-breaking number of health care data breaches, a USA TODAY analysis of Health and Human Services data found. (Garzella, 4/9)  

Health care data breaches soared to record-breaking levels in 2023, fueled by a surge in ransomware attacks and increased targeting of the third-party vendors hospitals and other health care providers use. Exposure of protected health information and personally identifiable information can put patients at risk of identity theft or insurance fraud. “Be careful not to share sensitive information over e-mail, text messages or other communication paths that might not be so secure,” said Errol Weiss, chief security officer at the Health Information Sharing and Analysis Center. (Garzella, 4/9)

Senators Josh Hawley (R-Missouri) and Richard Blumenthal (D-Connecticut) announced Friday that they wrote to UnitedHealth Group Chief Executive Officer Andrew Witty asking a series of questions relating to what they called UHG's lack of "sufficient redundancy to prevent an outage," a timeline of events relating to the February 21 ransomware attack and how UHG is filling the revenue gap providers are experiencing The senators requested responses by April 15. (Fox, 4/8)

�������ýҕ�l Health News: After Public Push, CMS Curbs Health Insurance Agents’ Access To Consumer SSNs

Until last week, the system that is used to enroll people in federal Affordable Care Act insurance plans inadvertently allowed access by insurance brokers to consumers’ full Social Security numbers, information brokers don’t need. That raised concerns about the potential for misuse. (Appleby, 4/9)

Federal lawmakers, including Sens. Elizabeth Warren (D-Mass) and Edward Markey (D-Mass), urged the Federal Trade Commission and the Justice Department to heavily scrutinize UnitedHealth Group subsidiary Optum's proposed acquisition of Steward Health Care's physician group and block the deal if it gives UnitedHealth Group too much market power. ... Warren, Markey and others raised concerns the deal would reduce competition in the area and give UnitedHealth Group more of a monopoly in Massachusetts and other states. (DeSilva, 4/8)

Like other major universities, the University of Southern California has poured resources into expanding its health system. But it’s coming at a cost. Moody’s Ratings downgraded USC a notch to Aa2 last month, citing underperformance from its growing health system. Similarly, the agency lowered its outlook for Emory University to negative in January, citing “current and expected future weak operating performance stemming largely from Emory Healthcare.” (Coleman-Lochner, 4/8)

�������ýҕ�l Health News: City-Country Mortality Gap Widens Amid Persistent Holes In Rural Health Care Access

In Matthew Roach’s two years as vital statistics manager for the Arizona Department of Health Services, and 10 years previously in its epidemiology program, he has witnessed a trend in mortality rates that has rural health experts worried. As Roach tracked the health of Arizona residents, the gap between mortality rates of people living in rural areas and those of their urban peers was widening. (Orozco Rodriguez, 4/9)

Zuckerberg San Francisco General hospital is conducting a policy review and additional security training with staff after a medical logbook went missing in December, creating a privacy breach, according to a Friday press release. There is no evidence that the information from the breach has been misused or used to access patient health or financial information. (4/8)

Hospitals must report their compliance with new safety and quality measures, from maternal care practices to diagnostic error prevention, after a series of changes to the 2024 Leapfrog Hospital Survey. The survey, which opened to hospitals April 1, is completed by more than 2,300 facilities annually and assesses hospitals’ safety, quality and efficiency based on national performance measures set by the Leapfrog Group. (Devereaux, 4/8)

Over the past decade, R.I.P. Medical Debt has grown from a tiny nonprofit group that received less than $3,000 in donations to a multimillion-dollar force in health care philanthropy. It has done so with a unique and simple strategy to tackling the enormous amounts that Americans owe hospitals: buying up old bills that would otherwise be sold to collection agencies and wiping out the debt. ... But a study published by a group of economists on Monday calls into question the premise of the high-profile charity. (Kliff, 4/8)

A cancer patient with more than $700,000 in medical bills did not know if she could continue her treatments. Another patient had to take a heart failure medicine her doctor considered not as effective because it was less costly than another he preferred. And a third patient with a $15,000 debt faced years of paying back Bronson Healthcare, a 747-bed nonprofit, community-governed health system with four hospitals in southwest and central Michigan. Fortunately, Bronson’s financial counselors reduced or eliminated the problems the three patients faced by helping them apply for the hospital’s various financial aid programs, enrolling them in nonprofit financial aid programs or switching their Medicare plans to lower their out-of-pocket costs. (Anstett, 4/7)

Millennials and Generation Z are experiencing a new wave of anxiety when it comes to medical costs. According to a new study, 67% of Gen Z and 62% of millennials avoid seeking healthcare because of the price, compared to 46% of Americans overall. The study was commissioned by insurance firm, Assurance IQ. (4/8)

In recent years insurers have ratcheted up their use of prior authorization, causing delays and denials of care that are harming or even killing people, many doctors and patients say. In the past couple of years, more than two dozen states have considered legislation designed to minimize prior authorization delays and denials, and nine states have enacted new laws, according to the American Medical Association, which has advocated for them. (Chatlani, 4/8)

Nursing home operators are bracing for another financial setback: the possibility of lower reimbursements from Medicare Advantage plans next year. The Centers for Medicare and Medicaid Services’ 0.16% base payment rate cut to Medicare Advantage payers in 2025 is ringing alarm bells among nursing home industry trade groups as some insurers said the cut could prompt them to reduce payments to providers. (Eastabrook, 4/8)

Google searches about “hurt eyes” spiked Monday afternoon, just after many U.S. communities experienced the total solar eclipse. The searches suggest some people in the sun’s path were worried they’d glanced at it too long. It’s a valid concern, eye experts said. Looking at the sun without protective equipment can harm your vision, and complaints of eye issues have been documented after past eclipse events. However, cases of long-term damage after eclipses aren’t common. (Bush and Bendix, 4/9)

Staring at anything for long enough can lead to eye discomfort. But the stakes are higher for anyone who watched Monday’s solar eclipse sweep across North America. After much of the country spent the afternoon gazing up at the searing rays of the sun, it’s worth distinguishing between a bout of dry eyes and the more severe retinal damage that unprotected exposure can cause. (Wu, 4/9)

Checking air quality and staying indoors when smoke inundates the Seattle area has become second nature during Washington’s wildfire season in recent years. But new research highlights how wildfires can affect a less visible aspect of well-being: mental health. A University of Washington study published in late February found an increase in prescriptions to treat depression and anxiety or stabilize mood in the six weeks after wildfires. The study used prescription data, commercial insurance claims and pharmacy records to examine the impact of 25 large California wildfires from 2011 to 2018. (Blatchford, 4/8)

The legalization of cannabis in the United States—the biggest change in policy for an illegal substance since Prohibition ended—has been an unqualified success for approximately no one. True, the drug is widely available for commercial purchase. ... But a significant part of the market is still underground, medical research is scant, and the aboveground market is not exactly thriving. Longtime marijuana activists are unhappy. Entrepreneurs are unhappy. So are people who buy weed, as well as those who think weed should never have been legal in the first place. (Hu, 4/8)

G Kumar's vaping addiction peaked in college at the University of Colorado, when flavored, disposable vapes were taking off. The disposables would have more than a thousand puffs in them. "I'd go through, let's say, 1,200 puffs in a week," said Kumar, who goes by they/them pronouns. Vaping became a crutch. ... They got sick often, including catching COVID — and vaping through all of it. Kumar, now 24, did end up quitting. But many of their generation can't shake the habit. (Daley, 4/9)

Transgender Catholics — as well as a priest who welcomes them to his parish — expressed disappointment Monday with a new Vatican document rejecting the fundamental concept of changing one’s biological sex. In essence, it was a restatement of longstanding Catholic teaching, but the dismay was heightened because recent moves by Pope Francis had encouraged some trans Catholics to hope the church might become more accepting. (Crary, 4/8)

White House press secretary Karine Jean-Pierre faced questions about Pope Francis' declaration condemning gender theory on Monday, ultimately affirming President Biden's support for the transgender community. A reporter pressed Jean-Pierre regarding the Pope's Monday document, which formally reaffirms and expands on the Catholic Church's assertion that attempts to alter an individual's immutable gender are ultimately misguided attempts to play God. Jean-Pierre declined to say what Biden thought of the document specifically, but added that he does support the transgender community. (Hagstrom, 4/8)

The National Association of Intercollegiate Athletics on Monday voted to bar transgender women from competing in women’s sports competitions. NAIA’s Council of Presidents unanimously voted in favor of the policy that says “only students whose biological sex is female” may participate in women’s sports. But all student athletes may participate in men’s sports. (Quilantan, 4/8)

Wading into a national debate, the Legislature on Monday advanced a bill to ban transgender people from school bathrooms, domestic violence shelters and other spaces that align with their gender identity — despite warnings the bill would put at risk millions of dollars in federal funding for shelters. The House Committee on Civil Law and Procedure agreed to advance House Bill 608 by Rep. Roger Wilder, R-Denham Springs, to the full House. The bill, which would require facilities to set aside bathrooms and sleeping areas for a specific sex, resembles so-called bathroom bills that have popped up in red states across the country. (Friedmann, 4/8)

Synchron Inc, a rival to Elon Musk's Neuralink brain implant startup, is preparing to recruit patients for a large-scale clinical trial required to seek commercial approval for its device, the company's chief executive told Reuters. Synchron on Monday plans to launch an online registry for patients interested in joining the trial meant to include dozens of participants, and has received interest from about 120 clinical trial centers to help run the study, CEO Thomas Oxley said in an interview. (Taylor, 4/8)

Innovation in healthcare can take many forms. Sometimes it means creating artificial intelligence-powered software that alerts clinicians when individuals need extra attention, developing a novel surgical technique or rolling out an app to facilitate seamless patient engagement. ... The individuals and organizations named to Modern Healthcare’s Innovators Awards list this year have one thing in common: They think outside the box and are propelling the industry forward. (4/8)

Clinics around the country are starting to offer patients a new service: having their mammograms read not just by a radiologist, but also by an artificial intelligence model. The hospitals and companies that provide these tools tout their ability to speed the work of radiologists and detect cancer earlier than standard mammograms alone. ... Experts are excited by the prospect of improving the accuracy of screening for breast cancer, which 300,000 women are diagnosed with each year in the United States. But they also have concerns about whether these A.I. tools will work well across a diverse range of patients and whether they can meaningfully improve breast cancer survival. (Sheikh, 4/8)

For years now, there has been immense excitement for liquid biopsies—blood tests that can detect cancer early. Eventually, tests like the Galleri developed by Grail could revolutionize the practice of medicine by allowing patients to catch and treat the disease early. When it comes to colon cancer, though—the second biggest cause of cancer deaths behind lung cancer—blood-based tests have proved disappointing. The latest setback came last week, after privately held Freenome announced top-line results from a clinical study for the early detection of colon cancer among average-risk adults. The results failed to impress investors. (Wainer, 4/8)

To spot breast cancer early, there are mammograms. To find colon cancer early, there are colonoscopies. But there is no standard test to detect early cases of pancreatic cancer, before cancer cells have spread and when surgery is more likely to be helpful. Finding pancreatic cancer early could help increase a patient’s chances of survival. Although pancreatic accounts for just about 3% of all new cancer cases in the United States, it’s the third leading cause of cancer deaths and is projected to become the second leading cause of cancer deaths by the end of this decade. (Howard, 4/8)

Late last month, the San Francisco-based startup HeHealth announced the launch of Calmara.ai, a cheerful, emoji-laden website the company describes as “your tech savvy BFF for STI checks.” ... Calmara describes the free service as “the next best thing to a lab test for a quick check,” powered by artificial intelligence. ... Since its debut, privacy and public health experts have pointed with alarm to a number of significant oversights in Calmara’s design. (Purtill, 4/7)

Teenagers don’t get arthritis. That’s what Tiffany Peterson kept hearing as that dreadful feeling in her 17-year-old wrists and knees grew excruciating. So she tried to ignore it, popping over-the-counter pain medicines and keeping her head in science textbooks, her hands full in the evening with extracurriculars and a half dozen younger siblings to care for. Then came the hair loss, and a menstrual cycle gone haywire: bleeding three months straight. This was not normal. But without health insurance, and at a time when online health information wasn’t easily found — Google was only 4 years old — Peterson was left wondering for years what was the matter. It took a breaking point in college for her to marshal the resources to get care and a diagnosis: lupus, a disease she knew little about, and nobody with. (Cueto, 4/9)

The U.S. Centers for Disease Control and Prevention (CDC) said on Monday bird flu risk to the public remains low even as it asked the state public health officials to be prepared to respond. The agency asked for plans to quickly test and provide treatment to potentially impacted farm workers following positive results among cattle herds. It also encouraged state health officials to communicate about any challenges they are facing. (4/8)

While an infected hen could pass the virus to an egg, the chance of being exposed to bird flu through eggs bought from the grocery store is incredibly low, according to the Food and Drug Administration (FDA). In a 2010 United States Department of Agriculture (USDA) report on the bird flu and the estimated risk of human exposure, if the avian influenza were detected in a flock of egg-laying hens, more than 99.99% of eggs that are hypothetically infected with the virus would be identified and removed before getting to store shelves. Those eggs “would still be in the distribution chain at the time of diagnosis and not yet be available for consumers to purchase,” the report says. (Jones, 4/8)

Researchers investigating the dairy farm infections in Texas did discover, however, that cows and one human were not the only mammalian victims of the recent outbreak: three cats found dead at the facilities prompted some further investigation into the spread. ... The short answer? Yes, cats can contract bird flu if they interact with infected birds. (Walrath-Holdridge and Cuevas, 4/8)

The Indiana Department of Natural Resources (DNR) late last week confirmed the state's first detection of chronic wasting disease (CWD), which involves a male white-tailed deer harvested in La Grange County in the northeastern region of the state. ... No human cases have been reported, but health officials urge people to avoid eating the meat of infected animals and to take precautions when field-dressing or butchering cervids. (Schnirring, 4/8)

A new Mayo Clinic study finds rural COVID-19 patients were 22% likelier to die after a hospital stay than their urban counterparts and that disparities persisted despite the rollout of coronavirus vaccines. Why it matters: The findings underscore how the U.S. rural population is one of the most medically vulnerable groups, often having limited access to high-quality post-acute, primary, and specialty care, researchers wrote. (Bettelheim, 4/9)

Fake Botox injections may have led to the hospitalizations of two people in Illinois, the state's Public Health Department said Monday. "Illinois residents should exercise caution when considering cosmetic treatment," Dr. Sameer Vohra, the state's public health director, said in a media statement. "Receiving these treatments in unlicensed, unapproved settings can put you or your loved ones at serious risk for health problems." (Edwards, 4/8)

Gov. Ron DeSantis on Friday signed seven bills, including a measure requiring health insurance plans for state workers to cover skin-cancer screenings. DeSantis also signed a bill that designates April as “Hot Car Death Prevention Month” (HB 591). Lawmakers last month unanimously passed the skin-cancer screening bill (HB 241) after limiting it to state employees. (Mayer, 4/8)

In an effort to free up more mental health bed space in the state’s overwhelmed criminal justice system, the Wisconsin Department of Health Services is sending more of its mental health patients to a facility that has traditionally treated sex offenders. In February, the Department of Health Services established an inpatient unit at Sand Ridge Secure Treatment Center, a treatment facility in Mauston traditionally meant for sexually violent persons. (Wen, 4/8)

Potentially toxic chemicals called PFAS (perfluoroalkyl and polyfluoroalkyl substances) are found in surface and groundwaters around the world at levels much higher than many international regulators allow, a new study found. ... Even in locations with no known source of contamination, 31% of ground water samples exceeded threshold limits proposed in March 2023 by the US Environmental Protection Agency, according to the study, and nearly 70% exceeded standards set by Health Canada. (LaMotte, 4/8)

New California legislation seeks to permanently ban paraquat, a powerful and widely used weedkiller that has been linked to Parkinson’s disease and other serious health issues. Assembly Bill 1963, introduced recently by Assemblymember Laura Friedman (D-Glendale), would sunset the use of paraquat beginning in January 2026. The herbicide, which is described by the U.S. Environmental Protection Agency as highly toxic, is regularly sprayed on almonds, grapes, cotton and other crops in the state. (Smith, 4/8)

If you’ve lived in North Carolina for the past seven years, especially in regions that get water from the Cape Fear River Basin, you’ve likely become familiar with the acronym PFAS, which stands for per- and polyfluoroalkyl substances. More than likely, you also know the term can trigger a strong reaction if mentioned in conversation. “You know, [the conversation], it’s tough in this space because it’s complicated. I try to tell folks there’s more we don’t know than we do about PFAS,” said Jeff Warren, executive director of the North Carolina Collaboratory. (Atwater, 4/9)

The push to legalize marijuana at the federal level has gained ground ever since California legalized it for medical use nearly 30 years ago. Recreational marijuana is now permissible in 24 states and Washington, D.C. Only four states still outlaw marijuana with no medical exceptions. (Dr. Phil McGraw and Dr. John Whyte, 4/9)

Who is "Baby Olivia," and why is she giving students inaccurate information? That's what I had to find out. “Meet Baby Olivia,” a three-minute video produced by the anti-abortion group Live Action, is the foundation of the latest bill that some states are considering to further dissuade people from having the procedure. The bills would have students watch the video in health class. In Tennessee, the legislation is a Senate vote away from landing on the governor’s desk. In Missouri, the bill would require the video be shown by the time students reach third grade. It is also being considered in Iowa and Kentucky. (Sara Pequeño, 4/7)

When Texas forces a woman pregnant with a fatally ill fetus to carry it to term — even at the risk of suffering uterine rupture and infertility — that is a consequence of the Trump presidency. When a 10-year-old rape victim in Ohio must travel across state lines to have an abortion, that is a testament to Trump’s legacy. When Alabama disrupts fertility services by declaring that embryos have the same rights as people, those frozen bunches of cells have Trump to thank. (Eric Levitz, 4/8)

Pro-life groups were urging Trump to support federal legislation, and in recent months it sounded as though Trump might come out in favor of a national 15-week abortion ban. What prompted the change to his new leave-it-to-the-states position? (Eugene Robinson, 4/8)

Nearly two-thirds of Americans support legal abortion in most or all cases — the constitutional status quo under Roe v. Wade and Planned Parenthood v. Casey. To leave abortion rights up to the states is, as we’ve seen since the Supreme Court’s decision two years ago in Dobbs v. Jackson Women’s Health Organization, to give state legislatures broad discretion to restrict and limit the bodily autonomy of anyone within their borders. (Jamelle Bouie, 4/9)