From Medicine and Health

Americans Are Now More Likely To Die In An Accidental Opioid Overdose Than A Car Crash

But most Americans are still most likely to die of natural causes such as heart disease or cancer. In other news on the opioid crisis: a mass drug overdose in California leaves at least one dead and more than a dozen in care; Purdue asks the court to review a decision about unsealing the company’s secret records; can medical marijuana help in the fight against the epidemic; and more.

Scientists Take Issue With Anti-Abortion Movement’s ‘Pro Life Is Pro Science’ Slogan

The “pro-science” emphasis is a somewhat new one for the anti-abortion advocates, who are gearing up for the March for Life on Friday, but March leaders say now is the perfect time to embrace the slogan. Scientists in the field, however, say the movement’s vocal opposition to fetal tissue research is at fundamental odds with the “pro-science” branding.

How Reselling Unused Test Strips For Blood Glucose Is Driving An Unusual Trade Online And On The Streets

Often the sellers of the strips are insured and paid little out of pocket for them, while the buyers may be underinsured or uninsured, and unable to pay retail prices, which can run well over $100 for a box of 100 strips. Unlike the resale of prescription drugs, which is prohibited by law, it is generally legal to resell unused test strips.

House Dems Open Investigation Into Pharma’s Drug Pricing Strategies, Calling The Probe One Of The Broadest In Decades

House Oversight and Reform Committee Chairman Elijah Cummings sent letters to drugmakers requesting detailed information about their pricing practices, focusing on drugs that are the costliest to Medicare Part D as well as drugs that have had the largest increases over a five-year period. The move is just the latest in a flurry of legislation and congressional action taken on the topic of high drug prices this year.

California’s Top Lawyer Cements His Role As Health Care Defender-In-Chief

SACRAMENTO, Calif. — Xavier Becerra, the political savvy Democratic attorney general of California, has sued the Trump administration 45 times in the past two years, often with much fanfare.

In winning a legal challenge Sunday against new government rules limiting birth control, he once against cemented himself as a national figure leading a fight against the administration across a range of issues — especially health care.

The 12 other states and the District of Columbia that had joined Becerra’s lawsuit also gained a last-minute reprieve from the federal regulations that would have taken effect Monday. They would have allowed most employers to refuse to provide insurance coverage for workers’ birth control by raising a religious or moral objection.

Those rules were also halted for the rest of the country on Monday when a Pennsylvania judge granted a nationwide injunction in a similar lawsuit.

The contraception case is one of several fronts where Becerra has led state coalitions to defend the Affordable Care Act in lawsuits in Texas, California and Washington, D.C.

“The Trump administration is trying to chip away at those protections,” said Andrew Kelly, an assistant professor at the Department of Health Sciences at California State University-East Bay. “It’s left to states like California and Attorney General Becerra in taking a lead in confronting these efforts.”

Becerra is perhaps best known for leading the opposition to the Texas v. U.S. lawsuit. In that suit, the Texas attorney general argued that the Affordable Care Act should be rendered unconstitutional because Congress eliminated the tax penalty on the uninsured. A federal judge last month sided with Texas, ruling that the federal health care law is unconstitutional.

Becerra, who said he helped write the health care law, said he felt compelled to step in when the Trump administration decided not to defend the law. Sixteen states and the District of Columbia joined that lawsuit, which is now on appeal.

The multistate strategy is one that attorneys general have used often in the past few decades when they don’t agree with policies coming out of Washington, legal and political experts say. And it’s not unique to one political party.

Republican attorneys general, for example, sued the Obama administration to block the expansion of Medicaid in their states. When George W. Bush was president, the state of Massachusetts led Democratic states in an effort to force the Environmental Protection Agency to regulate greenhouse gas emissions from cars.

The legal tit for tat is what Nicholas Bagley, a professor at the University of Michigan Law School, described as a disconcerting “militarization” of the state attorneys general offices to press an agenda in the courts.

“At a time of polarized politics, there’s every incentive to pull whatever levers are available to you to try to advance your goals,” Bagley said. “Over time, the state attorneys general have come to the view that the courts are an important forum to have these fights over important questions.”

The behavior of the attorneys general also comes in response to an administration that is using its executive authority to push initiatives that it can’t get Congress to approve.

President Donald Trump is left “to try to use either the regulatory process or executive order to accomplish his goals,” said Gerald Kominski, a professor of health policy at UCLA. “Anyone who opposes those goals has to proceed through the legal process to challenge them.”

Becerra, the first Latino to serve as California attorney general, has sued the Trump administration on a wide range of issues: health care, immigration, the Muslim travel ban, citizenship questions on the census, the border wall, climate change and clean-water rules.

When the former congressman was sworn in to his second term last week, he declared that he had “been a little busy keeping the dysfunction and insanity in Washington, D.C., from affecting California,” and defending the state from the “overreach of the federal government.” And he doesn’t have any plans to let up.

“Whether it’s the criminals on our streets or the con man in the boardrooms or the highest office of the land,” Becerra said, “we’ve got your back.”

But Becerra’s record has been mixed.

The victory in court Sunday was limited. Oakland-based U.S. District Judge Haywood Gilliam Jr. blocked the rules from taking effect in the District of Columbia and the 13 states that challenged them, but he refused to stop them from taking effect in the rest of the country. That national reprieve came a day later in a Pennsylvania court, with U.S. District Judge Wendy Beetlestone describing the harm to women as “actual and imminent.”

If the administration appeals, as expected, Pennsylvania, along with California and its legal coalition would move ahead with their cases to permanently throw out the rules, arguing that the Affordable Care Act guaranteed women no-cost contraception as part of their preventive health care, a provision that they say has benefited more than 62 million women since 2012, when the regulations went into effect.

The Trump rules, California argued in legal filings, would “transform contraceptive coverage from a legal entitlement to an essentially gratuitous benefit wholly subject to an employer’s discretion.” In its proposed regulations, the U.S. Department of Health and Human Services described the exemption as narrow and one that would affect a fraction of women — no more than 127,000.

That’s a number Becerra disputes.

In claiming victory on the birth control lawsuit, Becerra said Sunday that his coalition will continue to advocate for women’s access to reproductive health care.

How much more will Becerra fight during the next four years? Addressing the crowd who gathered this month to see him sworn in to a second term, he conveyed a simple response:

“The sky is the limit.”


This story was produced by Kaiser Health News, which publishes California Healthline, a service of the California Health Care Foundation.

California’s Top Lawyer Cements His Role As Health Care Defender-In-Chief

SACRAMENTO, Calif. — Xavier Becerra, the political savvy Democratic attorney general of California, has sued the Trump administration 45 times in the past two years, often with much fanfare.

In winning a legal challenge Sunday against new government rules limiting birth control, he once against cemented himself as a national figure leading a fight against the administration across a range of issues — especially health care.

The 12 other states and the District of Columbia that had joined Becerra’s lawsuit also gained a last-minute reprieve from the federal regulations that would have taken effect Monday. They would have allowed most employers to refuse to provide insurance coverage for workers’ birth control by raising a religious or moral objection.

Those rules were also halted for the rest of the country on Monday when a Pennsylvania judge granted a nationwide injunction in a similar lawsuit.

The contraception case is one of several fronts where Becerra has led state coalitions to defend the Affordable Care Act in lawsuits in Texas, California and Washington, D.C.

“The Trump administration is trying to chip away at those protections,” said Andrew Kelly, an assistant professor at the Department of Health Sciences at California State University-East Bay. “It’s left to states like California and Attorney General Becerra in taking a lead in confronting these efforts.”

Becerra is perhaps best known for leading the opposition to the Texas v. U.S. lawsuit. In that suit, the Texas attorney general argued that the Affordable Care Act should be rendered unconstitutional because Congress eliminated the tax penalty on the uninsured. A federal judge last month sided with Texas, ruling that the federal health care law is unconstitutional.

Becerra, who said he helped write the health care law, said he felt compelled to step in when the Trump administration decided not to defend the law. Sixteen states and the District of Columbia joined that lawsuit, which is now on appeal.

The multistate strategy is one that attorneys general have used often in the past few decades when they don’t agree with policies coming out of Washington, legal and political experts say. And it’s not unique to one political party.

Republican attorneys general, for example, sued the Obama administration to block the expansion of Medicaid in their states. When George W. Bush was president, the state of Massachusetts led Democratic states in an effort to force the Environmental Protection Agency to regulate greenhouse gas emissions from cars.

The legal tit for tat is what Nicholas Bagley, a professor at the University of Michigan Law School, described as a disconcerting “militarization” of the state attorneys general offices to press an agenda in the courts.

“At a time of polarized politics, there’s every incentive to pull whatever levers are available to you to try to advance your goals,” Bagley said. “Over time, the state attorneys general have come to the view that the courts are an important forum to have these fights over important questions.”

The behavior of the attorneys general also comes in response to an administration that is using its executive authority to push initiatives that it can’t get Congress to approve.

President Donald Trump is left “to try to use either the regulatory process or executive order to accomplish his goals,” said Gerald Kominski, a professor of health policy at UCLA. “Anyone who opposes those goals has to proceed through the legal process to challenge them.”

Becerra, the first Latino to serve as California attorney general, has sued the Trump administration on a wide range of issues: health care, immigration, the Muslim travel ban, citizenship questions on the census, the border wall, climate change and clean-water rules.

When the former congressman was sworn in to his second term last week, he declared that he had “been a little busy keeping the dysfunction and insanity in Washington, D.C., from affecting California,” and defending the state from the “overreach of the federal government.” And he doesn’t have any plans to let up.

“Whether it’s the criminals on our streets or the con man in the boardrooms or the highest office of the land,” Becerra said, “we’ve got your back.”

But Becerra’s record has been mixed.

The victory in court Sunday was limited. Oakland-based U.S. District Judge Haywood Gilliam Jr. blocked the rules from taking effect in the District of Columbia and the 13 states that challenged them, but he refused to stop them from taking effect in the rest of the country. That national reprieve came a day later in a Pennsylvania court, with U.S. District Judge Wendy Beetlestone describing the harm to women as “actual and imminent.”

If the administration appeals, as expected, Pennsylvania, along with California and its legal coalition would move ahead with their cases to permanently throw out the rules, arguing that the Affordable Care Act guaranteed women no-cost contraception as part of their preventive health care, a provision that they say has benefited more than 62 million women since 2012, when the regulations went into effect.

The Trump rules, California argued in legal filings, would “transform contraceptive coverage from a legal entitlement to an essentially gratuitous benefit wholly subject to an employer’s discretion.” In its proposed regulations, the U.S. Department of Health and Human Services described the exemption as narrow and one that would affect a fraction of women — no more than 127,000.

That’s a number Becerra disputes.

In claiming victory on the birth control lawsuit, Becerra said Sunday that his coalition will continue to advocate for women’s access to reproductive health care.

How much more will Becerra fight during the next four years? Addressing the crowd who gathered this month to see him sworn in to a second term, he conveyed a simple response:

“The sky is the limit.”


This story was produced by Kaiser Health News, which publishes California Healthline, a service of the California Health Care Foundation.

Providers Walk ‘Fine Line’ Between Informing And Scaring Immigrant Patients

While the Trump administration decides whether to adopt a controversial policy that could jeopardize the legal status of immigrants who use public programs such as Medicaid, doctors and clinics are torn between informing patients about the potential risks and unnecessarily scaring them into dropping their coverage or avoiding care.

“We are walking a fine line,” said Tara McCollum Plese, chief external affairs officer at the Arizona Alliance for Community Health Centers, which represents 176 clinics. “Until there is confirmation this indeed is going to be the policy, we don’t want to add to the angst and the concern.”

However, if immigrants do come to a clinic wondering whether using Medicaid can affect their legal status, trained staff members will answer their questions, she said.

Other providers prefer to prepare their patients proactively in case the proposal is adopted. At Asian Health Services, a clinic group that serves Alameda County, Calif., staff members pass out fact sheets about the proposed changes, provide updates via their patient newsletter and host workshops where patients can speak to legal experts in several Asian languages.

“We can’t just sit back and watch,” said CEO Sherry Hirota. “We allocate resources to this because that’s part of our job as a community health center — to be there not only when they’re covered, but to be there always,” even when that coverage is in jeopardy, she said.

The proposed “public charge” rule, which is awaiting final action by the U.S. Department of Homeland Security, would allow the federal government to consider immigrants’ use of an expanded list of public benefit programs including Medicaid, CalFresh and Section 8 housing as a reason to deny lawful permanent residency — also known as green card status. Medicaid is the state-federal health insurance program for low-income people.

Currently, people are considered public charges if they rely on cash assistance (Temporary Assistance for Needy Families or Supplemental Security Income) or need federal help paying for long-term care.

Should the rule go into effect, it could force patients to choose between health care and their chance at a green card, McCollum Plese said. “And most people will probably not take the services,” she said.

The rule would not be retroactive, meaning it wouldn’t take into account past use of public benefits like Medicaid, according to legal experts.

But health centers and medical providers know that if they tell patients about it now, they risk scaring some of them into premature decisions about their benefits, including dropping coverage.

Some immigrant patients already are skipping medical appointments out of fear stoked by the proposed rule, providers and advocates report.

“For now, our focus has been on correcting misinformation, not necessarily raising awareness among those who haven’t heard about the potential changes,” said Erin Pak, CEO of KHEIR Center, a clinic group with three locations in Los Angeles. “This is a proposal that thrives on fear and misunderstanding, so we wanted to be thoughtful about how and when to engage patients on the issue, given that nothing has passed into law.”

The Department of Homeland Security is reviewing more than 200,000 comments from the public before it issues a final rule. It’s possible the department won’t adopt the rule at all, legal experts say.

At KHEIR Center, the patient population is predominantly Korean immigrants, a group that is highly aware of the proposed public charge rule because of the coverage it has received in Korean-language media, according to Kirby Van Amburgh, the center’s director of external affairs.

Other groups served by the clinic, such as Latino and Bengali immigrants, have asked few questions, she said.

Trained staff address patients’ questions one-on-one, and hand out a fact sheet when needed.

Last month, L.A. Care health plan, which covers more than 2 million Medicaid enrollees in Los Angeles County, hosted a public charge webinar for about 180 providers. David Kane, an attorney at Neighborhood Legal Services of Los Angeles, led the webinar and urged doctors to tell concerned patients that nothing has changed yet, and that most immigrants would not be affected.

He also explained that if the federal government adopts the rule, it would not be effective immediately. There would most likely be a 60-day grace period before the changes take effect, Kane said. After that, implementation could be further delayed in court.

John Baackes, CEO of L.A. Care, who has been critical of the public charge proposal, said his organization offered the webinar because of the estimated 170,000 legal immigrants on his plan who could potentially be affected.

“I think we’ve got to let people know what could come, and try to give them more accurate information so that they don’t act imprudently,” he said. To do that, “we have to stay current.”


This story was produced by Kaiser Health News, which publishes California Healthline, a service of the California Health Care Foundation.

Providers Walk ‘Fine Line’ Between Informing And Scaring Immigrant Patients

While the Trump administration decides whether to adopt a controversial policy that could jeopardize the legal status of immigrants who use public programs such as Medicaid, doctors and clinics are torn between informing patients about the potential risks and unnecessarily scaring them into dropping their coverage or avoiding care.

“We are walking a fine line,” said Tara McCollum Plese, chief external affairs officer at the Arizona Alliance for Community Health Centers, which represents 176 clinics. “Until there is confirmation this indeed is going to be the policy, we don’t want to add to the angst and the concern.”

However, if immigrants do come to a clinic wondering whether using Medicaid can affect their legal status, trained staff members will answer their questions, she said.

Other providers prefer to prepare their patients proactively in case the proposal is adopted. At Asian Health Services, a clinic group that serves Alameda County, Calif., staff members pass out fact sheets about the proposed changes, provide updates via their patient newsletter and host workshops where patients can speak to legal experts in several Asian languages.

“We can’t just sit back and watch,” said CEO Sherry Hirota. “We allocate resources to this because that’s part of our job as a community health center — to be there not only when they’re covered, but to be there always,” even when that coverage is in jeopardy, she said.

The proposed “public charge” rule, which is awaiting final action by the U.S. Department of Homeland Security, would allow the federal government to consider immigrants’ use of an expanded list of public benefit programs including Medicaid, CalFresh and Section 8 housing as a reason to deny lawful permanent residency — also known as green card status. Medicaid is the state-federal health insurance program for low-income people.

Currently, people are considered public charges if they rely on cash assistance (Temporary Assistance for Needy Families or Supplemental Security Income) or need federal help paying for long-term care.

Should the rule go into effect, it could force patients to choose between health care and their chance at a green card, McCollum Plese said. “And most people will probably not take the services,” she said.

The rule would not be retroactive, meaning it wouldn’t take into account past use of public benefits like Medicaid, according to legal experts.

But health centers and medical providers know that if they tell patients about it now, they risk scaring some of them into premature decisions about their benefits, including dropping coverage.

Some immigrant patients already are skipping medical appointments out of fear stoked by the proposed rule, providers and advocates report.

“For now, our focus has been on correcting misinformation, not necessarily raising awareness among those who haven’t heard about the potential changes,” said Erin Pak, CEO of KHEIR Center, a clinic group with three locations in Los Angeles. “This is a proposal that thrives on fear and misunderstanding, so we wanted to be thoughtful about how and when to engage patients on the issue, given that nothing has passed into law.”

The Department of Homeland Security is reviewing more than 200,000 comments from the public before it issues a final rule. It’s possible the department won’t adopt the rule at all, legal experts say.

At KHEIR Center, the patient population is predominantly Korean immigrants, a group that is highly aware of the proposed public charge rule because of the coverage it has received in Korean-language media, according to Kirby Van Amburgh, the center’s director of external affairs.

Other groups served by the clinic, such as Latino and Bengali immigrants, have asked few questions, she said.

Trained staff address patients’ questions one-on-one, and hand out a fact sheet when needed.

Last month, L.A. Care health plan, which covers more than 2 million Medicaid enrollees in Los Angeles County, hosted a public charge webinar for about 180 providers. David Kane, an attorney at Neighborhood Legal Services of Los Angeles, led the webinar and urged doctors to tell concerned patients that nothing has changed yet, and that most immigrants would not be affected.

He also explained that if the federal government adopts the rule, it would not be effective immediately. There would most likely be a 60-day grace period before the changes take effect, Kane said. After that, implementation could be further delayed in court.

John Baackes, CEO of L.A. Care, who has been critical of the public charge proposal, said his organization offered the webinar because of the estimated 170,000 legal immigrants on his plan who could potentially be affected.

“I think we’ve got to let people know what could come, and try to give them more accurate information so that they don’t act imprudently,” he said. To do that, “we have to stay current.”


This story was produced by Kaiser Health News, which publishes California Healthline, a service of the California Health Care Foundation.

In Face Of Blood Shortages, Red Cross Aims To Recruit More Donors With New App

The agency, responsible for nearly half of the nation’s blood supply, says the app helps people understand where there are shortages and where they can give blood. Public health news also focuses on a 22-minute workout; housing reforms for the mentally ill; science with borders; infections from Mexican surgeries; the importance of humility among researchers; suicides on campus; higher cancer death rates among the poor; 26 trillion steps and counting on Fitbit and more.

In Face Of Blood Shortages, Red Cross Aims To Recruit More Donors With New App

The agency, responsible for nearly half of the nation’s blood supply, says the app helps people understand where there are shortages and where they can give blood. Public health news also focuses on a 22-minute workout; housing reforms for the mentally ill; science with borders; infections from Mexican surgeries; the importance of humility among researchers; suicides on campus; higher cancer death rates among the poor; 26 trillion steps and counting on Fitbit and more.