Tuesday, November 19, 2024 ​ on November 19, 2024 at 1:45 PM Morning Briefings Archive – KFF Health News

The New York Times:
Wyoming’s Abortion Bans Are Unconstitutional, Judge Rules 

A Wyoming judge ruled on Monday that two state abortion bans — including the first state law specifically banning the use of pills for abortion — violated the Wyoming Constitution and could not be enforced. Judge Melissa Owens of Teton County District Court wrote in her ruling that both the ban on medication abortion and a broader ban against all methods of abortion “impede the fundamental right to make health care decisions for an entire class of people, pregnant women.” Enforcement of the two abortion bans, passed last year, had been temporarily halted by Judge Owens while the court case proceeded. Her decision on Monday blocks the laws permanently, although the state is expected to appeal. (Belluck, 11/18)

Newsweek:
Judge Turns Tables On Wyoming Republicans To Block Abortion Ban 

The judge who struck down Wyoming’s near-total abortion ban did so using a constitutional amendment that Republicans made in 2012. (King, 11/19)

More abortion news —

Bloomberg:
The Future Of Abortion Rights Could Be Decided By Accident 

While a majority of Nebraskans seemed to support abortion rights, they failed to actually vote for them. The muddled run-up to Election Day, and voters’ difficulty distinguishing between dueling initiatives, help explain why that happened. (Suddath, 11/19)

Politico:
The Abortion-Rights Movement Grapples With Trump’s Return: ‘Voters Just Didn’t Care’ 

The abortion-rights movement did everything it could to convince voters that Donald Trump was too dangerous to allow back into the White House. It didn’t work. As the magnitude of Democrats’ defeat becomes clear, abortion-rights leaders and candidates who made the issue central to their campaigns are struggling to understand how millions of people could have voted for ballot initiatives restoring or expanding access to the procedure while also voting for Trump and other Republicans with a history of curtailing those rights. (Ollstein, 11/18)

OPB:
How A Republican Trifecta Could Reshape Abortion Access In A Deep Blue State Like Oregon

On the issue of abortion, Oregon is — quite literally — as liberal as a state can get. The state has among the strongest protections for abortion rights and the fewest limits on the procedure of any in the nation. Current state law guarantees the right to abortion, without a waiting period or gestational limit, for anyone who’s pregnant and 15 years or older. For most Oregonians, including those on Medicaid — the public program that provides health care to low-income individuals and families — the cost of abortion is covered by health insurance. The state remains controlled by Democrats, but at the federal level, Republicans have won a trifecta, giving them control of the presidency and both chambers of the U.S. Congress.
That has abortion providers in Oregon planning for changes they say could make it harder for them to operate, regardless of protective state laws. (Templeton, 11/18)

KFF Health News:
Idaho Calls Abortion ‘Barbaric And Gruesome’ In Trial Challenging Strict Ban

Physicians are expected to take the stand in Idaho’s capital on Tuesday to argue that the state’s near-total prohibition of abortion care is jeopardizing women’s health, forcing them to carry fetuses with deadly anomalies, and preventing doctors from intervening in potentially fatal medical emergencies. Their testimony is scheduled to lead off the second week of a closely watched trial concerning one of the nation’s strictest abortion bans. (Varney, 11/18)

The Washington Post:
Trump Allies Eye Overhauling Medicaid, Food Stamps In Tax Legislation

President-elect Donald Trump’s economic advisers and congressional Republicans have begun preliminary discussions about making significant changes to Medicaid, food stamps and other federal safety net programs to offset the enormous cost of extending Trump’s 2017 tax cuts next year. Among the options under discussion by GOP lawmakers and aides are new work requirements and spending caps for the programs, according to seven people familiar with the talks, many of whom spoke on the condition of anonymity because they were not authorized to speak publicly. Those conversations have included some economic officials on Trump’s transition team, the people said. (Bogage, Stein and Diamond, 11/18)

Politico:
States Rush Medicaid Requests Before Trump Return

States are racing to have their Medicaid requests approved before the Trump administration takes power. The new administration is expected to have a very different view of Medicaid than the Biden administration, and GOP lawmakers in Congress are eyeing major changes. Some states want waivers that will impact their states’ budgets, but others seek to allow Medicaid to pay for social services, a Biden administration innovation that links health to social well-being. (Leonard and Cirruzzo, 11/18)

Politico:
New York Presses For Medicaid Approvals Before Trump’s Inauguration

The clock is ticking as New York awaits word from the Centers for Medicare & Medicaid Services on the fate of a lucrative tax meant to fund Medicaid reimbursement rate increases for health care institutions. And it’s not the only policy proposal that state officials hope the Biden administration will green-light in the weeks before handing over the reins to President-elect Donald Trump, whose administration is certain to have a very different view of Medicaid spending. (Kaufman, 11/18)

On Trump and the opioid crisis —

The Wall Street Journal:
Can Trump’s Hardball Tactics On China Ease America’s Fentanyl Crisis?

When Trump takes office in January, he promises to take a combative position with China over its role in the fentanyl crisis, ditching the Biden administration’s efforts at diplomacy and compromise. On the campaign trail, Trump vowed “to tariff the hell out of” China unless it helps to stop the flow of illicit drugs into the U.S. The threat raises the stakes for China to shut down a supply chain that is enabling the underground production of fentanyl and other narcotics. But it also risks backfiring for the U.S. if China’s leader Xi Jinping concludes he can’t be seen as caving to pressure from Washington. (Spegele, 11/19)

Politico:
One Reason Overdose Deaths Are Dropping

Mexican drug cartels are mixing weaker batches of illicit fentanyl, a likely reason behind the nearly 15 percent drop in overdose deaths in the last year, according to DEA Administrator Anne Milgram. Milgram claimed credit before a gathering Friday of family members of those who have died from fentanyl poisoning from counterfeit pills or overdoses, citing pressure the Drug Enforcement Administration is putting on the cartels by targeting their criminal networks — from their chemical supply chains in China to their money-laundering operations. (Paun, Reader, Payne and Schumaker, 11/18)

NBC News:
RFK Jr.’s No. 1 Hurdle To Take On Unhealthy Food: Money

The FDA’s food division, poised to play a significant role in Robert F. Kennedy Jr.’s ambitions, operates on a tight budget. Unlike the agency’s drug division, which sustains itself largely through user fees charged to pharmaceutical companies when they apply for drug approval, its food division relies more heavily on funding from Congress, said Jerold Mande, a former FDA senior adviser and former deputy undersecretary for food safety at the Department of Agriculture. (Separately, Kennedy has suggested he wants to end user fees, arguing the system creates a conflict of interest.) (Lovelace Jr., 11/18)

NPR:
Some Farm Experts See ‘Danger’ In Trump’s Embrace Of Kennedy And Tariffs 

President-elect Donald Trump won farm country by wide margins in this month’s election, with rural voters helping fuel his return to the White House. But some farmers, economists, analysts and others in the agriculture industry are voicing alarm over Trump plans that could disrupt America’s $1.5 trillion food industry. Trump moved this past week to put Robert F. Kennedy Jr. in charge of the Department of Health and Human Services, which includes the Food and Drug Administration. A nomination requires confirmation by the U.S. Senate. (Mann, 11/17)

On RFK Jr. and vaccine policy —

Stat:
RFK Jr.’s Vaccine Lawsuit History Offers Clues On His Policy Making

Robert F. Kennedy Jr. took leave as chairman of Children’s Health Defense, a nonprofit known for spreading doubt about vaccines, to run for president last year. But he is still fighting in court alongside the group, putting him in an unusual position for someone nominated as Secretary of Health and Human Services. (Cueto, 11/19)  

The New York Times:
Five Ways R.F.K. Jr. Could Undermine Lifesaving Childhood Vaccines 

Legal and public health experts agree that Robert F. Kennedy Jr. would not have the authority to take some of the most severe actions, such as unilaterally banning vaccines, which Mr. Kennedy has said he has no intention of doing. “I’m not going to take anyone’s vaccines away from them,” he wrote on social media last month. “I just want to be sure every American knows the safety profile, the risk profile, and the efficacy of each vaccine.” But Mr. Kennedy, who has said that he wants federal researchers to pull back from studying infectious diseases, could exert his influence in many other ways. His actions could reduce vaccination rates, delay the development of new vaccines and undermine public confidence in a critical public health tool. (Anthes and Baumbaertner, 11/19)

The Hill:
American Public Health Association Warns Against RFK Jr. For HHS

A leading public health organization is sounding the alarm over Robert F. Kennedy Jr., President-elect Trump’s pick to lead the Department of Health and Human Services. The American Public Health Association (APHA) said Kennedy “fails on all fronts” as a candidate to lead the nation’s top health agency. “We urge President-elect Trump to select a qualified health leader that is properly trained and has the management skills to be the nation’s top health official,” APHA President Georges Benjamin said. (Weixel, 11/18)

On Vivek Ramaswamy and Elon Musk —

Axios:
RFK Jr. Vs. Vivek: Trump World’s Two Paths For Pharma Regulation

Between Robert F. Kennedy Jr. and Vivek Ramaswamy, the incoming Trump administration has divergent views on regulating the pharmaceutical industry. Why it matters: Both influential MAGA allies say there are deep problems with America’s drug development system. But RFK Jr., the Health and Human Services secretary designee, is calling for more oversight of drugs and vaccines and diminished federal funding for R&D. Ramaswamy, a biotech entrepreneur who will lead a new “Department of Government Efficiency” with Elon Musk, is a small government aficionado who’s called for fewer barriers to bringing drugs to market. (Goldman, 11/19)

Axios:
Musk, Top Trump Adviser Clash Over Cabinet Picks

Elon Musk, who fueled Trump’s election effort by giving at least $119 million, has quickly become an influential figure in President-elect Trump’s inner circle, but there are signs of tension between Musk and a longtime Trump adviser over Cabinet appointments to the new administration. The friction between Musk and Boris Epshteyn — a top adviser who’s pushed for Cabinet picks that include Matt Gaetz for attorney general — surfaced in public last week. It signaled a rivalry stemming from Musk’s growing influence on the president-elect, to the dismay of some Trump loyalists. (Cai, 11/18)

The New York Times:
Elon Musk Asked People To Upload Their Health Data. X Users Obliged 

Over the past few weeks, users on X have been submitting X-rays, MRIs, CT scans and other medical images to Grok, the platform’s artificial intelligence chatbot, asking for diagnoses. The reason: Elon Musk, X’s owner, suggested it. “This is still early stage, but it is already quite accurate and will become extremely good,” Musk said in a post. The hope is that if enough users feed the A.I. their scans, it will eventually get good at interpreting them accurately. Patients could get faster results without waiting for a portal message, or use Grok as a second opinion. (Passarella, 11/18)

AP:
Western North Carolina’s Water System Is Finally Back Online After Helene

More than 100,000 residents in western North Carolina were allowed to drink and bathe using water from their home faucets on Monday, nearly two months after Hurricane Helene destroyed much of the local water system. Clay Chandler, a spokesman for the city of Asheville’s Water Resources Department, said at a briefing Monday that water tests “were all clear” and a boil-water notice was lifted. Flooding from Helene tore through the city’s water system in late September, destroying so much infrastructure that officials at the time said repairs could take weeks. (11/18)

Politico:
White House Asks Congress For $100B In Aid For Hurricanes, Other Disasters

The Biden administration on Monday sent Congress a roughly $100 billion emergency funding request to rebuild communities hit by hurricanes Helene and Milton, along with a slew of other disasters nationwide. Top lawmakers plan to spend the next few weeks finalizing a bipartisan bill that fulfills at least some of that request, with a goal of final passage sometime between Thanksgiving and Christmas. Since Congress also faces a government shutdown deadline on Dec. 20, it’s possible disaster aid gets tied into a spending patch or broader funding package. (Scholtes, 11/18)

KFF Health News:
Nationwide IV Fluid Shortage Could Change How Hospitals Manage Patient Hydration

Hospitals around the country are conserving critical intravenous fluid supplies to cope with a shortage that may last months. Some hospital administrators say they are changing how they think about IV fluid hydration altogether. Hurricane Helene, which hit North Carolina in September, wrecked a Baxter International facility that produces 60% of the IV fluids used in the U.S., according to the American Hospital Association. (Fortiér, 11/19)

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

Axios:
A Record 1 In 8 NYC Students Experienced Homelessness Last School Year

About one in eight children in America’s most populous city experienced homelessness last school year, according to a report released on Monday. Student homelessness, which tracks with worsening federal homelessness trends, is nationally linked to higher rates of chronic absenteeism and drop outs. (Rubin, 11/18)

The Colorado Sun:
Colorado Prepares Rollout Of Psychedelic-Assisted Therapies In 2025

Colorado regulators are making final tweaks to a pioneering program overseeing licensed facilitators and manufacturers who will launch the state into the rarified realm of psychedelic-assisted therapies next year. (Blevins, 11/19)

WUSF:
Anonymous $6.5 Million Gift Will Help USFs Byrd Institute Support Alzheimer’s Mission

The University of South Florida’s Byrd Alzheimer’s Center & Research Institute received a $6.5 million estate gift this week from a recently deceased benefactor who had regularly made smaller donations since 2002. The facility will be able to use the money in whatever way “best serves our needs in priority areas,” said Gopal Thinakaran, the institute’s CEO. (Miller, 11/18)

Stat:
Bird Flu Risk To Humans: Canadian Case Has Unsettling Viral Mutations

The genetic sequence of the H5N1 bird flu virus that infected a teenager in British Columbia shows that the virus had undergone mutational changes that would make it easier for that version of H5N1 to infect people, scientists who have studied the data say. (Branswell, 11/18)

CIDRAP:
Hawaii Reports First Avian Flu Outbreak In Poultry As Surge Continues On California Farms 

In the wake of a recent H5 avian flu detection in wastewater on Oahu, the Hawaii Department of Agriculture (HDOA) on November 15 announced that state and federal tests have confirmed the virus in ducks and geese that died on a backyard farm. The outbreak is Hawaii’s first and appears to be part of a surge in poultry outbreaks in US states that are along the Pacific flyway, where wild birds are migrating south. (Schnirring, 11/18)

Newsweek:
Bird Flu Map Shows States Where H5N1 Has Spread

Hawaii could become the eighth U.S. state to see human cases of bird flu, after the state’s Department of Health issued a warning on Sunday to members of the public who attended a pet fair. The Centers for Disease Control and Prevention (CDC) has so far confirmed 52 human cases of bird flu—otherwise known as avian influenza H5N1—during this year’s outbreak: 26 in California, 11 in Washington, 10 in Colorado, two in Michigan and one each in Missouri, Oregon and Texas. This figure has grown from 46 cases last week, with Oregon reporting its first case on Friday, showing the outbreak is spreading. (Willmoth, 11/18)

On vaccines —

Axios:
More Kindergartners Are Getting Vaccine Exemptions

The share of U.S. kindergartners with vaccine exemptions increased in 40 states plus Washington, D.C., during the 2023-24 school year, according to recently updated CDC data. The trend is a reflection of increased vaccine skepticism, which has lingered in some parenting corners for years but gained considerable steam during the COVID-19 pandemic. (Fitzpatrick, 11/18)

FiercePharma:
VBI Recalls Hepatitis B Shot As It Winds Down Operations

Months after filing for bankruptcy, VBI Vaccines is taking the next step in shuttering operations with the voluntarily withdrawal of its hepatitis B vaccine, PreHevbrio. The company alerted healthcare providers and the FDA that it would be looking to pull PreHevbrio last month. When it originally detailed plans to file for Chapter 15 bankruptcy in the U.S. in July, VBI had been looking to initiate a sale and investment solicitation process for its assets. (Becker, 11/18)

AP:
Poland Urges Polio Vaccinations For Children After The Virus Is Detected In Sewage In Warsaw

Poland’s health authorities on Monday urged polio vaccinations for children after the virus was detected in Warsaw’s sewage during regular tests this month. The state Main Sanitary Inspectorate in a statement said the presence of the virus does not necessarily mean people have been sick, but those who have not been vaccinated against polio could be at risk. The vaccinations are free in Poland for people under 19. (11/18)

Fox News:
COVID-19 Virus Could Attack Cancer Cells And Shrink Tumors, New Study Suggests 

COVID-19 can cause a long list of health issues, including flu symptoms, respiratory problems and even organ damage, according to medical experts — but a new study suggests that the virus could have a surprising impact on cancer. The study, which was published in the Journal of Clinical Investigation on Friday, found that COVID infection was linked to cancer regression, which could serve as a foundation for new cancer treatments in the future. (Rudy, 11/19)

The New York Times:
Pancreatic Cancer Surge May Be Less Worrisome Than It Seemed 

A rise in the disease in younger people was not followed by an increase in deaths, a study found, and might be a sign of overdiagnosis. (Kolata, 11/18)

Stat:
FDA Approves Syndax Drug Revuforj For Advanced Leukemia 

The Food and Drug Administration approved on Friday a new drug developed by Syndax Pharmaceuticals to treat patients with a genetically defined form of  advanced leukemia. The pill, called Revuforj, is the first medicine in a class of drugs called menin inhibitors to reach the market. (Feuerstein, 11/18)

In other pharmaceutical news —

Reuters:
US Supreme Court Declines To Hear Patent Dispute Over Bausch Blockbuster Diarrhea Drug

The U.S. Supreme Court turned away on Monday a bid by Alvogen’s subsidiary Norwich Pharmaceuticals to sell a generic version of Canada-based Bausch Health’s (BHC.TO), blockbuster diarrhea drug Xifaxan. The justices declined to hear an appeal by Norwich Pharmaceuticals of a lower court’s ruling that its proposed generic would infringe patents owned by Bausch unit Salix Pharmaceuticals for using Xifaxan to treat the liver-related brain disorder hepatic encephalopathy. In doing so, the justices let the lower court’s ruling stand. (Brittain, 11/18)

Reuters:
Lilly Pill Cuts Genetic Form Of Cholesterol Nearly 86% In Study

The highest dose of an experimental pill developed by Eli Lilly (LLY.N), dramatically lowered an inherited form of high cholesterol in a mid-stage trial, according to data presented at a medical meeting on Monday. The drug, muvalaplin, reduced levels of lipoprotein(a), or Lp(a), by 70% using a traditional blood test and by nearly 86% based on a more specific test developed by the company, researchers reported at the American Heart Association meeting in Chicago. (Steenhuysen, 11/19)

Stat:
2 Drugs Target Common Genetic Heart Risk Factor Lipoprotein(A)

Lipoprotein(a) is a risk factor for cardiovascular disease you may not hear about in your annual physical. Like LDL, or “bad” cholesterol, too much of the LDL-like particle can create plaque that clogs arteries, creating potential blockages that lead to heart attacks or strokes. It’s also implicated in aortic stenosis, when the aortic valve narrows, pinching blood supply to the rest of the body. (Cooney, 11/18)

The Wall Street Journal:
Makers of Weight-Loss Drugs Want Your Employer to Pay for Them

Lilly and Novo Nordisk are hoping to win over employers on the idea that obesity and its complications are already a huge cost in terms of healthcare, workers’ compensation and disability. By offering employees coverage for the weight-loss drugs Zepbound and Wegovy, companies can save money in the long run, the messaging goes. Whether these efforts succeed will help shape the size of the anti-obesity drug market, which some analysts predict could top $100 billion in annual sales. It is an unconventional approach for pharmaceutical companies. (Lofus, 11/19)

Bloomberg:
Novo Nordisk Launches Wegovy In China With Prices Below US

Novo Nordisk A/S is launching its top-selling Wegovy obesity drug in China at a fraction of the US price, a key step in unlocking a big, fast-growing market for its blockbuster franchise. The first prescription was issued on Monday to a 40-year-old man at Shanghai’s prestigious public Zhongshan Hospital, according to Chinese media outlet The Paper. (Tong, 11/18)

Also —

Stat:
Generative AI In Focus As FDA’s Digital Health Committee Meets

Robert Califf has made no secret of the Food and Drug Administration’s struggles to regulate generative AI. Large language models and their application to health care “provide a massive example of a technology with novel needs,” FDA commissioner Califf said in an address earlier this year to the Coalition for Health AI. This week, the agency will turn toward that challenge, focusing the first-ever meeting of its Digital Health Advisory Committee on the question of whether and how generative AI should be regulated by the FDA. (Palmer and Ross, 11/19)  

USA Today:
Surgeon General Report Finds Disparities On Smoking Rates, Deaths

Adult and youth smoking rates this decade have dipped to the lowest levels on record. Despite this progress, the nation’s top doctor is warning about stubborn disparities that remain among the 36 million adults and 760,000 kids who smoke. U.S. Surgeon General Vivek Murthy released a report Tuesday saying that cigarette smoking is more common among American Indian and Alaska Native people than other racial and ethnic groups. People living in poverty are more than twice as likely to smoke than those who earn non-poverty wages. Black people, lower-income populations and people with less education are more likely to be exposed to secondhand smoke. (Alltucker, 11/19)

The Washington Post:
Over 4 Percent Of U.S. Adults Have Undiagnosed Diabetes

From August 2021 to August 2023, 4.5 percent of adults in the United States had undiagnosed diabetes, the Centers for Disease Control and Prevention says in a recent report. And a little over 11 percent of U.S. adults had been diagnosed with the condition as of the same time period, the CDC says. The study looked at how total, diagnosed and undiagnosed diabetes differed across demographics including age, weight and educational attainment. (Docter-Loeb, 11/18)

Consumer Reports:
How Plastic Can Harm Your Health

CR’s recent tests of nearly 100 foods found two types of chemicals used in plastic, bisphenols and phthalates, in a wide variety of packaged foods. These findings are concerning because there’s clear evidence linking exposure to these particular chemicals to a number of health effects, including disruptions of the endocrine or hormone system. … According to one new study, diseases that have been linked to exposure to plastic-related chemicals cost the U.S. approximately $250 billion in healthcare costs in 2018. (Loria, 11/18)

CNN:
Sitting Too Much Linked To Heart Disease –– Even If You Work Out, According To New Study

Sitting at your desk all day may put you at greater risk for heart disease –– even if you work out in your spare time, according to new research. “Our findings really emphasize the importance of avoiding excess sitting… whether or not you’re physically active,” said first study author Dr. Ezim Ajufo, a cardiology fellow at Brigham and Women’s Hospital in Boston. (Holcombe, 11/18)

Axios:
988 Suicide Prevention Hotline Awareness Low But Growing, Survey Finds

Public awareness of the 988 national suicide prevention hotline is growing but still low, new survey data from University of Pennsylvania found. Calls and texts to 988 are increasing. Still, the hotline can’t help someone if they don’t know about it, said Kathleen Hall Jamieson, director of University of Pennsylvania’s Annenberg Public Policy Center. (Goldman, 11/19)

If you need help —

Dial 988 for 24/7 support from the Suicide & Crisis Lifeline. It’s free and confidential.

CNN:
More Than 1 In 3 Surgical Patients Has Complications, Study Finds, And Many Are The Result Of Medical Errors

Despite decades of calls for more attention to patient safety in hospitals, people undergoing surgery still have high rates of complications and medical errors, a new study finds. More than a third of patients admitted to the hospital for surgery have adverse events related to their care, and at least 1 in 5 of these complications is the result of medical errors, the researchers found. (Goodman, 11/15)

In other health care industry updates —

AP:
CVS Health Bulks Its Board Up To 16 Members, Adds Hedge Fund CEO

CVS Health has added four new board members, including the CEO of a hedge fund that has been critical of the struggling health care giant. The company said Monday that it expanded its board to 16 members following “productive discussions” with shareholder Glenview Capital Management. The hedge fund holds about a 1% stake in the company according to the data firm FactSet. Glenview has said CVS Health, which has cut its forecast several times this year, is operating well below its potential. (Murphy, 11/18)

Modern Healthcare:
Ascension Wisconsin To Close Waukesha Micro-Hospital

Ascension Wisconsin plans to close a hospital in Waukesha and consolidate a few lines of service among other facilities in the southeast region of the state. The Waukesha “micro-hospital,” which offers emergency and low-acuity care services, is slated to shut down in January, said Ascension Wisconsin Senior Director of External Relations Mo Moorman on Monday. (DeSilva, 11/18)

Chicago Tribune:
Endeavor Health Spending Up To $453M To Settle Sexual Abuse Claims

Endeavor Health is spending up to $453 million to settle patients’ claims alleging one of its former doctors sexually abused them, the Chicago-area hospital system disclosed in its latest financial statement Monday. (Hoerner, 11/18)

Modern Healthcare:
Aveanna Healthcare, Addus Homecare Plan For Acquisitions In 2025

Acquisitions in the home care industry are poised to take off in 2025, fueled by lower interest rates and President-elect Donald Trump’s incoming administration. Large home care providers including Addus HomeCare, Aveanna Healthcare and the Pennant Group said during third quarter earnings calls they would aggressively look for deals next year to gain scale and better compete for hospital referrals. The interest in deal-making is an about-face for an industry that has been burdened by labor shortages, rising costs and battles with Medicare Advantage organizations over better rates. (Eastabrook, 11/18)

ProPublica:
How UnitedHealth’s Playbook for Limiting Mental Health Coverage Puts Countless Americans’ Treatment at Risk

United’s practices were deemed illegal in three states. But that hasn’t stopped the company from policing mental health care with arbitrary thresholds and cost-driven targets. (Waldman, 11/19)

Modern Healthcare:
Shared Savings ACOs To See Prepaid Savings Option In 2025

Accountable care organizations in Medicare’s permanent value-based care program are saving more than ever. But they’re looking for more tools from the government to boost their savings. The Medicare Shared Savings Program saved $2.1 billion in 2023, the highest level since the program launched more than a decade ago and up 16.7% from last year, the Centers for Medicare and Medicaid Services announced in late October. (Early, 11/18)

Crain’s Grand Rapids Business:
Blue Cross Blue Shield Of Michigan Drops Humira Coverage

Blue Cross Blue Shield of Michigan intends to drop coverage for Humira, AbbVie’s popular but costly autoimmune drug, in favor of a lower-cost alternative. The move represents the first coverage change to the state’s largest health insurer plans as high-cost specialty drugs come off patent in the years ahead and new, lower-cost biosimilar medications come to market to treat the same conditions. (Sanchez, 11/18)

The New York Times:
The World Is Watching The U.S. Deal With Bird Flu, And It’s Scary

As a virus scientist in South Africa, I’ve been watching with dread as H5N1 bird flu spreads among animals in the United States. The pathogen poses a serious pandemic threat and has been detected in over 500 dairy herds in 15 states — which is probably an undercount. And yet, the U.S. response appears inadequate and slow, with too few genomic sequences of H5N1 cases in farm animals made publicly available for scientific review. (Tulio de Oliveira, 11/19)

Stat:
RFK Jr. Is Most Certainly An Anti-Vaxxer

If he can make it past the Senate, Robert F. Kennedy Jr. will be the next secretary of Health and Human Services. Since the position was created, each secretary has had significant experience in public health, health care administration, or related government work. None has listed “spreading vaccine misinformation” as their primary health care experience. (Jonathan M. Berman, 11/18)

Stat:
FDA Is Short-Sighted On Compounding GLP-1s

When Makena, a drug designed to prevent preterm births, hit the market in 2011 at $1,500 per dose, it drew rife backlash. The drug was based on an active ingredient that had been available for many years at a much lower cost. Confronted with the public outcry, the FDA took an unusual step: It allowed pharmacies to continue making their own copies of the drug through the practice of pharmacy compounding, selling it at a fraction of Makena’s price. (Former FDA Commissioner Scott Gottlieb, 11/19)

USA Today:
Healthcare Has Failed Us. Hold Insurance Company Accountable 

BCBS insures a third of the U.S. population, and over a quarter in Arizona, so their decision to no longer provide coverage for Phoenix Children’s Hospital (PCH) – one of the nation’s best children’s hospitals – will severely affect access to essential health care services for thousands of children and their families. (Kelsey Denham, 11/17)

Modern Healthcare:
Medicare Advantage Insurers Should Focus On Quality, Not Ratings 

With rising competition and a reduction in the number of health plans achieving ratings at four stars and above in the federal government’s Star Ratings program, many Medicare Advantage plans are feeling pressure to change what they have considered their tried and true approaches. (Andrew Toy, 11/18)