California Watch November 27, 2017 Medicaid Health

CALIFORNIA WATCH NOVEMBER 27, 2017

California Healthline: California Winces at Trump’s Turn Back to ‘Bad Old Days’ of Health Plan Associations Just a few decades ago, small businesses in California often banded together to buy health insurance on the premise that a bigger pool of enrollees would get them a better deal. California’s dairy farmers did it; so did car dealers and accountants. But after a string of these “association health plans” went belly up, sometimes in the wake of fraud, state lawmakers passed sweeping changes in the 1990s that consigned them to near extinction. (Bartolone, 11/27)

Ventura County Star: Seniors drawing Food Stamps at Record Levels in wake of Downturn Ventura County residents over age 60 are drawing food stamps in what appear to be record numbers, the figure rising by two-thirds in the past few years alone. Officials say the growth in the program renamed CalFresh conflicts with the pattern they have seen in the past. Many low-income seniors rejected the nutritional program because they saw it as welfare or felt it was too small a benefit to make the paperwork worth it, human services managers said. (Wilson, 11/25)

MEDICAID

The Hill: States Preparing for Children's Health Insurance Program to Run out of Funding Nearly a dozen states are readying for the Children’s Health Insurance Program (CHIP), which provides insurance to low-income children, to run out of funding, according to a report from The Washington Post. Five states are at risk of running out of funding for their individual programs by late December, according to the report. Other states reportedly have enough money to keep their programs afloat for a few more months at least. (Manchester, 11/26)

HEALTH LAW

Kaiser Health News: Marketplace Confusion Opens Door to Questions About Skinny Plans Consumers coping with the high cost of health insurance are the target market for new plans claiming to be lower-cost alternatives to the Affordable Care Act that fulfill the law’s requirement for health coverage. But experts and regulators warn consumers to be cautious — and are raising red flags about one set of limited benefit plans marketed to individuals for as little as $93 a month. Offered through brokers and online ads, the plans promise to be an “ACA compliant, affordable, integrated solution that help … individuals avoid the penalties under [the health law].” (Appleby, 11/27)

Los Angeles Times: Republicans' Latest Plan to Repeal Obamacare's Insurance Requirement Could Wreak Havoc in Some Very Red States The Senate Republican plan to use tax legislation to repeal the federal requirement that Americans have health coverage threatens to derail insurance markets in conservative, rural swaths of the country, according to a Los Angeles Times data analysis. That could leave consumers in these regions — including most or all of Alaska, Iowa, Missouri, Nebraska, Nevada and Wyoming, as well as parts of many other states — with either no options for coverage or health plans that are prohibitively expensive. (Levey, 11/27)

Reuters: Sign-Up Pace Slows in Third Week of 2018 Obamacare Enrollment The pace slowed in the third week of enrollment for 2018 Obamacare individual insurance as nearly 800,000 people signed up through the federal government website HealthCare.gov, down about 75,000 people from the previous week, a U.S. government agency reported on Wednesday. There was an increase, however, in the number of new consumers to the program created by former President Barack Obama, to 220,323 from 208,397 in the previous week, the U.S. Department of Health and Human Services said. (Hummer, 11/22)

MARKETPLACE

Kaiser Health News: Taken For a Ride? Ambulances Stick Patients with Surprise Bills One patient got a $3,660 bill for a 4-mile ride. Another was charged $8,460 for a trip from one hospital that could not handle his case to another that could. Still another found herself marooned at an out-of- network hospital, where she’d been taken by ambulance without her consent. These patients all took ambulances in emergencies and got slammed with unexpected bills. Public outrage has erupted over surprise medical bills — generally out-of-network charges that a patient did not expect or could not control — prompting 21 states to pass laws protecting consumers in some situations. (Bailey, 11/27)

Kaiser Health News: Surprise Ambulance Bills: A Consumer’s Guide What’s a surprise ambulance bill? When the ambulance service that picks you up is out-of-network, your insurer pays what it considers fair. And then — surprise! — the ambulance service sends you a bill for the rest. (Bailey, 11/27)

PUBLIC HEALTH AND EDUCATION

NPR: Light Therapy Might Help People with Bipolar Depression As the months grow colder and darker, many people find themselves somewhat sadder and even depressed. Bright light is sometimes used to help treat the symptoms of seasonal affective disorder, or SAD. Researchers are now testing light therapy to see if it also can help treat depression that's part of bipolar disorder. It's unclear how lack of light might cause the winter blues, although some suggest that the dark days affect the production of serotonin in the skin. (Neighmond, 11/27)

The Washington Post: Having Trouble Sleeping? It is not Just Because of Aging Many older adults have sleep problems that can be caused by aging. But other issues also contribute to the prevalence of sleep complaints, and they should be discussed and investigated, experts say. A national poll conducted by the University of Michigan and released in October found that almost half of those 65 and older have trouble getting to sleep, and more than a third are taking prescription or over-the- counter sleep aids. (Sadick, 11/26)

NPR: Human Brains Have Evolved Unique 'Feel-Good' Circuits A brain system involved in everything from addiction to autism appears to have evolved differently in people than in great apes, a team reports Thursday in the journal Science. The system controls the production of dopamine, a chemical messenger that plays a major role in pleasure and rewards. "Humans have evolved a dopamine system that is different than the one in chimpanzees," says Nenad Sestan, an author of the study and a professor of neuroscience at Yale. (Hamilton, 11/23)

EDITORIALS AND OPINIONS

Huffington Post: The GOP Crusade against Obamacare’s Mandate says a lot about how the Party Changed Senate Republicans are set to vote next week on tax legislation that would eliminate the financial penalty for people who don’t get health insurance, often called the “individual mandate.” And plenty of Republicans seem positively giddy about the prospect. ... Republicans and their supporters have been bashing the individual mandate so loudly and so vociferously that it’s easy to forget this outrage is a relatively recent phenomenon. Not so long ago, it was easy to find GOP officials and conservative intellectuals who supported the mandate, and not simply because they thought it was the smart thing to do. They also thought it was the right thing to do. In fact, they were the ones who first put the idea on the political agenda. (Jonathan Cohn, 11/25)

DHNR is a daily compilation of news stories from GCHP’s Communications Department. Certain news organizations are protected via a paywall requiring the purchase of a subscription to view their content.

CALIFORNIA WATCH NOVEMBER 28, 2017

California Healthline: Putting Money Where its Mouthpiece is: Calif. Outspends U.S. to Market Obamacare The marketing blitz is on. Californians are getting barraged with online pop-up ads, radio spots and television commercials, all aimed at persuading them to sign up for Affordable Care Act health plans during this year’s open-enrollment season. (Ibarra and Heredia Rodriguez, 11/28)

Kaiser Health News: Heated and Deep-Pocketed Battle Erupts over 340B Drug Discount Program A 25-year-old federal drug discount program has grown so big and controversial that it faces a fight for survival as federal officials and lawmakers furiously debate the program’s reach. The program, known as 340B, requires pharmaceutical companies to give steep discounts to hospitals and clinics that serve high volumes of low-income patients. (Tribble, 11/28)

Ventura County Star: Gold Coast Health Plan: National Alzheimer's Disease Awareness Month: Offering support Debilitating. Frightening. Demoralizing. That is Alzheimer’s disease, a degenerative and ultimately fatal brain disease, and the most common cause of dementia, affecting one in 10 people age 65 and older. An estimated 5.5 million Americans of all ages have Alzheimer's, reports the Alzheimer’s Association. Most are 65 and older, with 200,000 under 65, and almost two-thirds are women. (Nelson, 11/27)

Los Angeles Times: San Diego's Hepatitis A Update: Case Count Climbs, but Death Total Holds at 20 Though they continue to see fewer cases and no new deaths have been reported since Oct. 31, San Diego County supervisors on Monday chose to continue the local health emergency status for the region’s ongoing hepatitis A outbreak. Supervisor Ron Roberts noted that, while he considered the latest hepatitis A report from the county Health and Human Services Agency good news, the emergency won't be truly over until new-case rates shrink further. (Sisson, 11/27)

CAPITOL HILL WATCH

The Hill: Lawmakers Making Progress in Talks on Children's Health Care Congressional negotiators are making progress towards a bipartisan deal to reauthorize children’s health insurance and several other important health-care programs, sources say. Staff from the relevant committees in both parties and chambers met over the Thanksgiving break and are getting closer to an agreement, according to lobbyists and aides. (Sullivan and Roubein, 11/27)

MEDICAID

Modern Healthcare: CMS Moves to Reduce Medicaid Spending on Medical Equipment The CMS will ask the White House for permission to impose a new data collection requirement on Medicaid agencies that will help it reduce their spending on medical equipment. In a Federal Register notice scheduled to publish Tuesday, the CMS said the new program would require Medicaid agencies to submit data showing they are not paying a higher rate than Medicare for durable medical equipment. ... The move is part of the CMS' plan to implement part of the 21st Century Cures Act, which requires the HHS secretary to cap Medicaid reimbursement for durable medical equipment at Medicare payment amounts starting Jan. 1. (Dickson, 11/27)

PUBLIC HEALTH AND EDUCATION

Bloomberg: How Opioids Started Killing Americans More than half of all people who succumbed to an overdose between 2001 to 2007 were chronic pain sufferers who filled an opioid prescription and sometimes even saw a doctor in the month before they died. Only 4 percent were ever diagnosed as having an abuse problem, said Dr. Mark Olfson, one of five researchers who conducted a massive study of the crisis and its causes for Columbia University Medical Center. The findings of the new study, published Tuesday in the American Journal of Psychiatry, split the epidemic into two groups: those who were diagnosed with chronic pain and those who weren’t. In the year before they died, about two-thirds of those studied were diagnosed with chronic pain and prescribed an opioid. (Rausch, 11/28)

EDITORIALS AND OPINIONS

Los Angeles Times: On Children's Health Coverage, Congressional Inaction has brought us to the 'Nightmare Scenario' Child healthcare advocates have been warning, and warning, and warning that Congress' delay on reauthorizing funds for the Children's Health Insurance Program places health coverage for as many as 9 million children and pregnant women at risk. But since the funding expired Sept. 30, there has been no action by Congress. (Michael Hiltzik, 11/27)

Forbes: Maine's Medicaid Mistake Could Cost Lives Maine made history earlier this month by becoming the first state to adopt Obamacare's Medicaid expansion via ballot initiative. The vote could inspire progressive activists in other states to push for similar referenda. Expanding Medicaid to cover childless, able-bodied adults would blow a hole in state budgets while yielding few, if any, public health gains. That's because Medicaid provides such low-quality care that its beneficiaries often experience worse health outcomes than people with no health insurance. (Sally Pipes, 11/27)

CALIFORNIA WATCH NOVEMBER 29, 2017

California Healthline: Marketplace Confusion Opens Door to Questions about Skinny Plans Regulators are scrutinizing claims by companies that their alternative, slimmed-down health plans satisfy Obamacare coverage requirements. California Insurance Commissioner Dave Jones said his agency will investigate whether one of those companies is selling such plans in California in violation of state law. (Appleby, 11/29)

CAPITOL HILL WATCH

Politico: Trump's Pick for Health Secretary Messages He's No Tom Price To Republicans, President Donald Trump’s pick for Health and Human Services secretary is competence personified — an able manager who can get the agency back on track after the tumult of Tom Price’s brief tenure and forced resignation. To Democrats, Alex Azar is a pharmaceutical industry shill who knows a lot more about raising drug prices than lowering them. (Cancryn, 11/29)

Bloomberg: Trump Backs Bipartisan Obamacare Market Bill, Boosting Tax Plan President Trump told Republican senators on Tuesday he supports an Obamacare market stabilization bill offered by Republican Lamar Alexander and Democrat Patty Murray, which may help bolster support for the tax-cut legislation headed for a vote this week. Senator Mike Rounds of South Dakota quoted Trump as telling Republican senators, “I support the Alexander-Murray bill.” (Kapur and Edney, 11/28)

ADMINISTRATION NEWS

Bloomberg: Trump’s Birth-Control Insurance Plan is Unconstitutional, Democrats Say The Trump administration’s plan to roll back a requirement for employers to include birth control in their health insurance plans is an unconstitutional endorsement of religion, a group of 19 Democratic state attorneys general said. Allowing employers with religious or moral objections to contraception to block their employees from receiving coverage violates the constitutional separation of church and state and encourages illegal workplace discrimination against women, the states said in a brief filed Tuesday in federal court in Philadelphia. More than 55 million women in the U.S. have access to birth control with no out-of-pocket costs through the Affordable Care Act, the states said. (Larson, 11/28)

HEALTH LAW

The New York Times: Millions Pay the Obamacare Penalty Instead of Buying Insurance. Who are They? The Senate Republican tax bill includes the repeal of the Affordable Care Act’s individual mandate, the requirement that all Americans purchase qualifying health insurance or pay a penalty. The move could deal a serious blow to the health law. The repeal of the mandate could result in an estimated 13 million more people without insurance within 10 years, but may potentially lead to federal savings of $338 billion, money that would be used to help pay for broad tax cuts for individuals and businesses. Here’s who pays the mandate’s penalty and how much it costs. (Lai and Parlapiano, 11/28)

MARKETPLACE

Kaiser Health News: Doctors Make Big Money Testing Urine for Drugs, Then Ignore Abnormal Results Medicare and other insurers pay for urine tests with the expectation that clinics will use the results to detect and curb dangerous abuse. But some doctors have taken no action when patients are caught misusing pharmaceuticals, or taking street drugs such as cocaine or heroin. Federal pain guidelines say doctors should discuss test results with patients and taper medication if necessary. (11/29)

ProPublica: A Hospital Charged $1,877 to Pierce a 5-Year-Old’s Ears. This is Why Health Care Costs So Much. Two years ago, Margaret O’Neill brought her 5-year-old daughter to Children’s Hospital Colorado because the band of tissue that connected her tongue to the floor of her mouth was too tight. ... During a pre-operative visit, the surgeon offered to throw in a surprising perk. Should we pierce her ears while she’s under? O’Neill’s first thought was that her daughter seemed a bit young to have her ears pierced. Her second: Why was a surgeon offering to do this? ... Only months later did O’Neill discover her cost for this extracurricular work: $1,877.86 for “operating room services” related to the ear piercing — a fee her insurer was unwilling to pay. (Allen, 11/28)

PUBLIC HEALTH AND EDUCATION

The New York Times: How Running May or May Not Help the Heart If 50 men run 3,510 marathons over the course of three decades, will their heart health suffer or improve? A new study delving into precisely that question concludes that the answer is simultaneously reassuring and complicated, with long years of endurance training seeming not to harm runners’ hearts, but also not necessarily to benefit them in the ways that the runners themselves probably expected. (Reynolds, 11/29)

Kaiser Health News: Teaching Teens the Perils of Pot as Marketplace Grows After Yarly Raygoza attended the drug prevention program at the Boys & Girls Club here last year, she used what she learned to talk a few friends out of using marijuana. The 14-year-old took the class again this year but worries that counseling her friends will become more difficult. Recreational marijuana is now legal in California, which could bring a massive boom in drug sales and advertising when stores can begin selling the drug to adults without a prescription in January. (Gorman, 11/29)

The Washington Post: Former DEA Officials Call for Repeal of Law that Weakened Enforcement Three former DEA officials urged Democratic lawmakers Tuesday to repeal a 2016 law that effectively took away the agency’s most potent weapon against distributors and manufacturers of prescription opioids. The trio said the authority to instantly freeze shipments of powerful painkillers was the DEA’s most effective tool against giant companies that ignored legal requirements to report suspicious orders of the pills by pharmacies, doctors and others who diverted them for illegal use. Those “immediate suspension orders” not only protected the public from the most egregious abuse but deterred other companies as well, they said at a session held by Senate Democrats. (Bernstein and Higham, 11/28)

Reuters: WHO Fears Complacency as Progress against Malaria Stalls Progress in the global fight against malaria has stalled amid signs of flatlining funding and complacency that the mosquito-borne disease is less of a threat, the World Health Organization said on Wednesday. Malaria infected around 216 million people in 91 countries in 2016, an increase of 5 million cases over the previous year, the WHO said in its annual World Malaria Report. It killed 445,000 people, about the same number as in 2015. (Kelland, 11/28)

Los Angeles Times: About 15% of Americans with HIV Don't Know They're Infected, CDC Report Says Half of the Americans recently diagnosed with HIV had been living with the virus for at least three years without realizing it, missing out on opportunities for early treatment and in some cases spreading it to others, according to a new report by the Centers for Disease Control and Prevention. (Healy, 11/28)

PHARMACEUTICALS

CNBC: Here’s Why Apple, Big Pharma are Paying Close Attention to a Supreme Court Case Over a Fracking Patent When Tribal Chief Eric Thompson first heard about a new venture to get the Saint Regis Mohawks into the business of intellectual property, he was hesitant. "I had never heard of an IPR," Thompson recalled, referring to a system of challenging patents called inter partes review. Most people haven't — IPR resides among the intricacies of patent law that generally don't surface outside legal circles — but the system has been steadily increasing in popularity since it was introduced in 2011, championed by giants of the technology industry, such as Apple, Google and Facebook. They see it as a more efficient way of dismantling bad patents, often held by so-called patent trolls. It's come to be despised by many big pharmaceutical companies. (Tirrell, 11/27)

EDITORIALS AND OPINIONS

San Francisco Chronicle: 6.2 Million Californians Risk Losing Care through Community Health Centers In September, House Speaker Paul Ryan let the Community Health Center Fund lapse. Now, unless Congress acts to renew this funding, our health centers are bracing for a 70 percent budget cut. (Barbara Lee, 11/28)

CALIFORNIA WATCH NOVEMBER 30, 2017

California Healthline: Whistleblower: Medicaid Managed-Care Firm Improperly Denied Care to Thousands An explosive report prepared by a SynerMed executive alleges the California firm, which oversaw care for 1.2 million patients, fabricated documents and violated state and federal regulations for years. The state says it left low-income patients on Medicaid managed care in “imminent danger.” (Terhune, 11/30)

Los Angeles Times: What Happens if Congress Doesn't Fund the Health Insurance Used by Almost 2 Million Kids and Pregnant Women in California? Unless Congress comes to an agreement fast, federal funding for a program that provides health insurance to 2 million California children and pregnant women will run out around the end of the year. After that, California could be on the hook for hundreds of millions of dollars because the state is required to offer the insurance even if the federal funds don’t show up. (Wire, 11/29)

Ventura County Star: Valley Fever Disease Rises in Ventura County A valley fever disease with symptoms often mistaken as flu is surging across California and has been linked to more illness in Ventura County this year than over the same time frame in the two previous years combined. Data from the California Department of Public Health shows 103 confirmed and probable cases of the fungal disease emerged in the county from January through October. If all the valley fever cases are confirmed, the tally would be the highest since at least 2010. (Kisken, 11/29)

CAPITOL HILL WATCH

Kaiser Health News: Patients with Rare Diseases and Congress Square Off Over Orphan Drug Tax Credits As President Donald Trump talked tax reform on Capitol Hill Tuesday, Arkansas patient advocate Andrea Taylor was also meeting with lawmakers and asking them to save a corporate tax credit for rare disease drug companies. Taking the credit away, Taylor said, "eliminates the possibility for my child to have a bright and happy future." (Tribble, 11/30)

USA Today: Senators Question Commitment of HHS Secretary Nominee to Lower Drug Prices Azar faced questions from both Democrats — and even some Republicans — about Lilly’s pricing practices and his commitment to lowering costs. (Groppe, 11/29)

Bloomberg: Stabilization Bill Couldn’t Fix the Damage of Repealing Obamacare’s Mandate Passing a bipartisan Obamacare stabilization bill wouldn’t do much to cushion the blow from repealing the health law’s requirement that all individuals buy health insurance, the Congressional Budget Office said. The CBO has estimated that scrapping the mandate would result in 4 million people losing health coverage in 2019 and premiums in the individual market to increase by 10 percent. On Wednesday, the nonpartisan Congressional agency said a stabilization proposal backed by some Republican Senators would have no impact on its calculations. (Tracer, 11/29)

HEALTH LAW

Reuters: Sign-Up Pace Much Slower in Week 4 of 2018 Obamacare Enrollment The pace of people signing up for individual insurance under Obamacare slowed significantly during the fourth week of 2018 enrollment, as nearly 37 percent fewer people signed up for the healthcare plans than in the previous week, a U.S. government agency reported on Wednesday. The U.S. Department of Health and Human Services said that 504,181 people signed up for 2018 Obamacare individual insurance in the 39 states that use the federal government website HealthCare.gov for the week ended Nov. 25, down from 798,829 people in the previous week. New consumer sign-ups fell to 152,243 from 220,323 in the previous week. (11/29)

PUBLIC HEALTH AND EDUCATION

The Hill: Justice Department Announces New Steps to Combat Opioid Epidemic Attorney General Jeff Sessions announced Wednesday that the Justice Department will award $12 million in grants to help law enforcement agencies combat the opioid crisis and create a new office in the Appalachian region to crack down on illicit drug trafficking. Sessions is also ordering all U.S. attorneys' offices to designate an opioid coordinator to work with prosecutors and other federal, state, tribal and local law enforcement officials to coordinate opioid prosecutions. (Hellman, 11/29)

Los Angeles Times: Australia's Flu Season Has U.S. Health Officials Bracing for a Bad Winter — and Wishing for a New Vaccine The flu season is just getting underway in North America, but if Australia’s experience with influenza is any guide, we’re in for a miserable winter. Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, warned Wednesday that the United States could experience a “relatively severe influenza season.” If so, it would extend a run of bad luck that began in 2014, when the available flu vaccines proved to be a poor match for the most common viruses in circulation. (Healy, 11/29)

Health News Florida: Rapid Zika Test Possible for 2018 Hospitals and health departments could have a new tool in 2018 to detect Zika – a test that is cheap, portable and fast. The test involves a drop of blood, can get results in 20 minutes and doesn’t require blood be sent out to a lab. It was developed by a team of University of Central Florida researchers led by Qun Treen Huo. Huo said the test is ideal for rural and low-income areas because it’s cheap and portable. (Aboraya, 11/29)

USA Today: 'Scary' Prediction For U.S. Kids: 57% Could Be Obese By Age 35 A whopping 57% of the nation’s children and teens will be obese by age 35 if current trends continue, according to a sobering new study out Wednesday. The research, published in the New England Journal of Medicine, goes beyond previous studies suggesting unhealthy childhood weights often lead to adult obesity. It suggests that while heavy children face the highest risk, even those who make it to age 20 in good shape face substantial peril in a world where obesity could soon be the new normal. (Painter, 11/29)

The Washington Post: Quitting Smoking is Hard. FDA Wants New Nicotine-Replacement Therapies to Help. The Food and Drug Administration said Wednesday it is taking new steps to encourage the development of innovative nicotine-replacement therapies to wean smokers off conventional cigarettes. In a blog post on the agency's website, three top officials said they want to ensure the FDA has the right policies to advance new products to help smokers. ... The post said a new Nicotine Steering Committee made up of senior FDA officials will explore the agency's handling of smoking-cessation products. (McGinley, 11/29)

PHARMACEUTICALS

Bloomberg: Drug Charity May Shutter after U.S. Faults Pharma Influence A medical charity that received hundreds of millions of dollars from pharmaceutical companies lost a crucial stamp of approval from the U.S. government, after allowing its donors improper influence over how the nonprofit was run. For the last decade, Caring Voice Coalition has been one of the biggest patient assistance charities in the U.S. The Mechanicsville, Virginia-based foundation helps patients afford expensive drugs by funding health insurance co-payments that can otherwise total more than $10,000 a year. Without the charity, which is funded almost entirely by drugmakers, many patients might not be able to afford life-saving medicine. (Langreth and Elgin, 11/29)

EDITORIALS AND OPINIONS

Los Angeles Times: Time is Running Out on Children's Health Insurance Program The Republicans who control Congress allowed the [Children's Health Insurance Program's] authorization to lapse in September, shutting off the spigot of federal dollars. The main issue holding up reauthorization has been a fight over how to cover the program’s price tag. Let’s be clear: any sign of fiscal responsibility in Washington is welcome. Nevertheless, the hand-wringing over children’s health insurance, which costs $8 billion a year, stands in sharp contrast to the GOP’s eagerness to pass a package of tax cuts that would cost an estimated $1.4 trillion over the coming decade. (11/30)

CALIFORNIA WATCH DECEMBER 1, 2017

CALmatters: Diabetes Hits Hard as California Spends Billions on Treatment, Little on Prevention A teenage girl walks the hardscrabble streets of Richmond, a Bay Area city, rapping about the challenges of drugs, violence—and diabetes. Here, she says, big dreams are “coated in sugar,” and innocence is “corrupted with Coke bottles and Ho cupcakes.” She’s performing in a video by a local youth group that counts diabetes, a national epidemic that has hit California hard, as one of the killers in her neighborhood. Type 2 diabetes, which is spreading and driving up health costs, now impacts more than half the state’s adults, especially people of color and the poor. (Aguilera, 11/27)

CAPITOL HILL WATCH

Kaiser Health News: Congress Isn’t Really Done with Health Care — Just Look at What’s in the Tax Bills Having failed to repeal and replace the Affordable Care Act, Congress is now working on a tax overhaul. But it turns out the tax bills in the House and Senate also aim to reshape health care. Here are five big ways the tax bill could affect health policy. (12/1)

The Hill: Collins: Health-Care Fix Will Pass Before Tax Bill Sen. Susan Collins (R-Maine) said early Thursday that she expects legislation to lower health-care premiums to pass Congress before senators take a final vote on a $1.5 trillion tax-reform bill that would repeal the Affordable Care Act's individual mandate. Collins, speaking to reporters at a Christian Science Monitor breakfast, said it’s a mistake to scrap the individual mandate without making other reforms to the health-care system. (Bolton, 11/30)

ADMINISTRATION NEWS

The Associated Press: Trump Donates Third-Quarter Salary to Health Department President Donald Trump has donated his third-quarter salary to the Department of Health and Human Services to help fight the opioid epidemic. Acting Health Secretary Eric Hargan on Thursday accepted a check from the president in the amount of $100,000. Trump previously donated salary in the amounts of $78,333 and $100,000 to the National Park Service and the Education Department, respectively. (Superville, 12/1)

The Associated Press: Health Nominee Azar is No Stranger to Management Controversy Alex Azar, who’s in line to replace a Trump Cabinet secretary who was forced out in controversy, is no stranger to sticky management problems. In Washington, he’s been nominated to replace Tom Price, who resigned in September over questions about his use of private jets. Back in Indiana, Azar was an influential member of a public airport board, tasked with oversight of human resources matters, when he defended the conduct of the airport CEO who was under fire for spending public money on travel, golf fees, steak dinners and Super Bowl tickets. (Slodysko, 12/1)

HEALTH LAW

Kaiser Health News: Desperate for Coverage: Are Short-Term Plans Better Than None at All? When one of Cindy Holtzman’s clients told the Woodstock, Ga., broker he was considering dropping his ACA plan because next year’s cost approached $23,000 for his family of four, she suggested a new option: a back-to-back set of four, 90-day short-term plans, which would effectively give them a modicum of medical coverage for 2018. An Obama administration rule limited short-term coverage to three months at a time because it was meant as a stopgap between more substantial policies. But several insurers, including big players Golden Rule and National General, now are sidestepping that rule by packaging three or four consecutive 90-day plans, with a one-time medical review upfront. (Appleby, 12/1)

MARKETPLACE

Bloomberg: CVS Nears Deal to Acquire Health Insurer Aetna CVS Health Corp. is nearing an agreement to acquire health insurer Aetna Inc. for more than $65 billion, in a deal that could reshape the pharmacy and health insurance industries. An announcement could come as soon as Monday. CVS is likely to agree to pay at least $200 a share for Aetna, with more than 30 percent paid for with cash. Talks could still be delayed or fall apart. (Langreth and Tracer, 11/30)

Bloomberg: Express Scripts CEO Open to Insurer Deal, Ties with Amazon Express Scripts Holding Co.’s chief executive said he’s open to a deal with a health insurer or partnering with Amazon.com Inc. CEO Tim Wentworth’s pharmacy benefits company has been battered by departing clients and the vague specter of Amazon’s entry into the drug business. If a major insurer was interested in a deal, “I would be open to it,” Wentworth said. (Langreth, 11/30)

PUBLIC HEALTH AND EDUCATION

The Associated Press: More US Kids in Foster Care; Parental Drug Abuse a Factor The number of children in the U.S. foster care system has increased for the fourth year in a row, with substance abuse by parents a major factor, according to new federal data released on Thursday. The annual report from the Department of Health and Human Services counted 437,500 children in foster care as of Sept. 30, 2016, up from about 427,400 a year earlier. (Crary, 12/1)

Bloomberg: Purdue Pharma Discloses Negotiations with AGs on Opioids Purdue Pharma LP acknowledged in a letter that the maker of the opioid painkiller Oxycontin is in “negotiations’’ with state attorneys general over lawsuits accusing the company of creating a public-health crisis with its mishandling of the drug. Maria Barton, Purdue’s general counsel, chastised Ohio Attorney General Mike DeWine for pulling out of a multistate probe of the drugmaker by 41 of his fellow attorneys general. He did so shortly after signing an agreement to preserve his state’s legal claims “while the investigation and negotiations were conducted,’’ according to a copy of the Nov. 28 letter provided by Purdue officials. (Feeley and Hopkins, 11/30)

The Associated Press: US Approves Monthly Injection for Opioid Addiction U.S. health officials on Thursday approved the first injectable form of the leading medication to treat patients recovering from addiction to heroin, prescription painkillers and other opioids. The Food and Drug Administration approved once-a-month Sublocade for adults with opioid use disorder who are already stabilized on addiction medication. (Perrone, 11/30)

Kaiser Health News: If Your Insurer Covers Few Therapists, is That Really Mental Health Parity? It’s been nearly a decade since Congress passed the mental health parity act, with its promise to make mental health and substance abuse treatment just as easy to get as care for any other condition. Yet today, in the midst of the opioid epidemic and a spike in the rate of suicide, patients still struggle to access treatment. (Gold, 11/30)

PHARMACEUTICALS

Reuters: Exclusive: U.S. Health Regulator Verma Eyes New Methods for Drug Pricing The U.S. government is considering setting new payment methods aimed at curbing costs for Medicare and Medicaid coverage of breakthrough medical treatments with very high prices, particularly novel gene- based therapies for cancer and other diseases, a top health official said on Thursday. (Humer, 11/30)

Los Angeles Times: National Science Panel Calls for Aggressive Steps to Control Drug Prices The U.S. must take urgent steps to rein in the out-of-control cost of prescription drugs, including aggressive government intervention to negotiate lower prices for American patients, a panel of the National Academies of Sciences, Engineering, and Medicine recommended Thursday in a sweeping new report on pharmaceutical pricing. (Levey, 11/30)

EDITORIALS AND OPINIONS

Los Angeles Times: Sen. Rubio Tells a Secret: After Giving a Tax Cut to the Rich, GOP Will Cut Social Security and Medicare Advocates for seniors and the middle class have been warning for weeks that the Republican drive to cut taxes for the wealthy is the prelude to a larger attack on Social Security and Medicare. In a videotaped interview with two Politico reporters Wednesday, Sen. Marco Rubio (R-Fla.) said the quiet parts out loud. Asked by interviewers Anna Palmer and Jake Sherman how to address the federal deficit, he replied: “We have to do two things. We have to generate economic growth which generates revenue, while reducing spending. That will mean instituting structural changes to Social Security and Medicare for the future.” (Michael Hiltzik, 11/30)