<![CDATA[NBC New York - Health News - [NY Feature Page] Health]]>Copyright 2017http://www.nbcnewyork.com/news/healthen-usMon, 20 Nov 2017 03:18:38 -0500Mon, 20 Nov 2017 03:18:38 -0500NBC Local Integrated Media<![CDATA[White House: True Cost of Opioid Epidemic Tops $500 Billion]]>Sun, 19 Nov 2017 19:07:28 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-5172396281.jpg

The White House says the true cost of the opioid drug epidemic in 2015 was $504 billion, or roughly half a trillion dollars.

In an analysis to be released Monday, the Council of Economic Advisers says the figure is more than six times larger than the most recent estimate. The council said a 2016 private study estimated that prescription opioid overdoes, abuse and dependence in the U.S. in 2013 cost $78.5 billion. Most of that was attributed to health care and criminal justice spending, along with lost productivity.

The council said its estimate is significantly larger because the epidemic has worsened, with overdose deaths doubling in the past decade, and that some previous studies didn't reflect the number of fatalities blamed on opioids, a powerful but addictive category of painkillers.

The council also said previous studies focused exclusively on prescription opioids, while its study also factors in illicit opioids, including heroin.

"Previous estimates of the economic cost of the opioid crisis greatly underestimate it by undervaluing the most important component of the loss — fatalities resulting from overdoses," said the report, which the White House released Sunday night.

Last month at the White House, President Donald Trump declared opioid abuse a national public health emergency. Trump announced an advertising campaign to combat what he said is the worst drug crisis in the nation's history, but he did not direct any new federal funding toward the effort.

Trump's declaration stopped short of the emergency declaration that had been sought by a federal commission the president created to study the problem. An interim report by the commission argued for an emergency declaration, saying it would free additional money and resources.

But in its final report earlier this month, the panel called only for more drug courts, more training for doctors and penalties for insurers that dodge covering addiction treatment. It did not call for new money to address the epidemic.

More than 64,000 Americans died from drug overdoses last year, most involving a prescription painkiller or an illicit opioid like heroin.

Copyright Associated Press / NBC New York



Photo Credit: Photo by John Moore/Getty Images]]>
<![CDATA[CTE Turned Ex-NFL Star From Top Lawyer to ‘Other Person']]>Sun, 19 Nov 2017 18:54:12 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-822512332.jpg

After completing an NFL career that included two Super Bowls, Fred McNeill got an advanced law degree and practiced law. But within just a few years, he began to fall apart, losing his temper, losing his memory and losing job after job, NBC News reported.

“Here is this person who was so kind, so intelligent, so special, so loving, so easygoing. He made things look easy. And then he flipped to be this other person,” Tia McNeill, Fred McNeill’s widow, said in an interview.

McNeill died in 2015. He was bankrupt, unable to eat or care for himself. A positron emission tomography (PET) brain scan done in 2012 showed he had chronic traumatic encephalopathy or CTE — the degenerative brain disease being linked increasingly to professional football and to head injuries sustained in combat.

The confirmation comes too late to help McNeill. But if the findings hold up in other patients with similar symptoms, such a scan may be able to diagnose CTE in time to give patients hope for recourse while they are still alive and, perhaps, eventual treatment.



Photo Credit: Jeff Siner/Charlotte Observer/MCT]]>
<![CDATA[No Correlation Between Mental Health, Mass Shooting: Experts]]>Sat, 18 Nov 2017 23:03:20 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-874617738.jpg

Kevin Neal’s family knew he was mentally ill, but they never thought he would kill five people and attack an elementary school in rural northern California. But Neal committed both those acts on Tuesday, and it has left his family asking some very difficult questions, NBC News reported.

Sheridan Orr, Neal’s sister, said her brother made threats for nearly 20 years. Though they continued to pressure him to receive help for his mental health, he seemed unwilling to pursue treatment.

Experts say it is difficult to know what to do in those situations, but Dr. James Fox, an expert on gun violence and author of “Extreme Killing: Understanding Serial and Mass Murder,” said it's dangerous to assume that the mentally ill tend to commit these shootings.

"There’s not really a correlation," said Fox, who maintains a database on mass shootings. "We like to think that these people are different from the rest of us. We want a simple explanation and if we just say they’re mentally ill, case closed. Because of how fearful dangerous and deadly their actions are, we really want to distance ourselves from it and relegate it to illness."



Photo Credit: Randall Benton/Sacramento Bee/TNS via Getty Images, File]]>
<![CDATA[Owning a Dog May Help You Live Longer: Swedish Scientists]]>Fri, 17 Nov 2017 12:26:59 -0500https://media.nbcnewyork.com/images/215*120/Screen+Shot+2017-11-17+at+8.59.02+AM.png

According to a new study in Sweden, owning a dog could help you live longer. Scientists followed more than 3 million adults for 12 years.]]>
<![CDATA[Climate Nemesis Carbon Could Soon Be Valuable Resource]]>Fri, 17 Nov 2017 10:08:51 -0500https://media.nbcnewyork.com/images/213*120/AP_17321337018651-MS-Innogy-Methanol-Powered-Boat.jpg

On a dreary November morning, a small party of visitors from around the world boards a boat for an hour-long ride around what was once one of the most polluted waters in the Ruhr valley.

Lake Baldeney has become a symbol for the efforts Germany is making to revive its western industrial heartland, and the gleaming white vessel is meant to showcase where the journey is heading: toward a cleaner, sustainable future.

The boat is the first in the world to be fitted with an electric engine powered by a fuel cell containing methanol — a form of alcohol that inevitably prompts "booze cruise" jokes among passengers. What makes the boat really stand out, though, is the fact that the methanol is produced using a chemical process which draws carbon out of the air.

The technology, though still relatively new, is being touted by some as a weapon in the fight against man-made climate change, caused to a large degree by carbon emissions from fossil fuel use.

Levels of carbon dioxide in the atmosphere have steadily increased since the industrial revolution, contributing to the greenhouse effect that is spurring global warming.

The U.N.'s panel of scientific advisers on climate change has predicted that unless carbon emissions peak within the coming years, average temperatures around the world will rise by more than 2 degrees Celsius (3.6 Fahrenheit) with potentially catastrophic results.

The boat is one of three prototypes designed to show that carbon converted to methanol — in this case with power from a nearby hydroelectric plants — can serve as an eco-friendly fuel of the future. The others are a car than can run for 500 kilometers (310 miles) on methanol and a house capable of producing and storing all the electricity it needs to be self-sufficient.

Similar projects are springing up around the world and several were showcased on the sidelines of the global climate meeting in Bonn, Germany, while delegates were hammering out rules needed to implement the landmark Paris climate accord. The 2015 agreement, since denounced by President Donald Trump but backed by every other government on the planet, set a goal of keeping global warming significantly below 2 degrees Celsius, but didn't lay down many of the practical details needed to ensure the treaty works.

Among the pioneers that have been getting the most attention is Swiss company call Climeworks, which operates a site near Zurich that draws carbon dioxide from the air and pumps it to a nearby plant nursery. While the saplings would naturally absorb CO2, Climeworks is effectively providing them with fertilizer and speeding up the removal of carbon at the same time.

Daniel Egger, the company's head of sales, said the operation should break even within two years and can be scaled up easily. Climeworks is also experimenting with a different type of carbon capture at a site in Iceland, where CO2 is harvested from the air and pumped deep underground. There, it bonds with limestone to form a solid that stays safely out of the atmosphere.

Analysts such as Andrew Jones say such systems can at best make a small contribution to achieving the Paris goals.

"If your basement is flooding, your top priority is to turn off the faucets, not reach for the mops and buckets," said Jones, who is co-director of Climate Interactive, a think tank that uses computer models to simulate solutions to global warming.

Jones said that removing 10 billion tons of carbon dioxide from the atmosphere each year, as some models suggest will be necessary, would require the energy equivalent of 1,200 new nuclear plants, or more than all of the wind and solar power forecast by the International Energy Agency to be available by 2040.

"While we should study these machines, the world runs the risk of being distracted by the fantasy of large-scale carbon dioxide removal when the priority should be a war-scale effort at preventing greenhouse gas emissions in the first place," he said.

Doing so, however, would mean ending all use of fossil fuels by the year 2050 at the latest, a plan that few governments and businesses are willing to get behind.

To most, the notion of going "carbon neutral" by the middle of the century will require a broad mix of measures, from reducing emissions to recapturing some and even using technologies that haven't been invented yet.

A half-hour drive from Lake Baldeney lies one of Europe's oldest steelworks. The site in Duisburg, next to the Rhine river, was founded in 1891 and to this day a vast mesh of pipes, railways and chimneys covers the 10-square-kilometer (four-square-mile) site.

It is operated by Thyssenkrupp, a company that once made cannons for the German kaiser but is now struggling to compete against cheaper rivals from India and China. One solution, according to its chief technology officer, Reinhold E. Achatz, has been relentless innovation. Recently, that has included devising a way to utilize the carbon dioxide released in the steelmaking process and turning it into fuel, fertilizer or plastic.

A new facility scheduled to open in April will cut down 10 million tons of CO2 emissions a year, Achatz said. Replicated across steel plants worldwide, the process could save 50 times as much while providing a raw material that would cut down on the need for oil.

"Carbon dioxide isn't a waste," Achatz said. "It's a resource."

Copyright Associated Press / NBC New York



Photo Credit: Frank Jordans/AP]]>
<![CDATA[NBC 4 New York & NY Giants Health & Fitness Expo]]>Thu, 07 May 2015 17:17:38 -0500https://media.nbcnewyork.com/images/225*120/300x160_HFE.jpg]]><![CDATA[CTE Found in Living Ex-NFL Player for 1st Time: Study]]>Fri, 17 Nov 2017 09:52:15 -0500https://media.nbcnewyork.com/images/213*120/AP_764021564440-Fred-McNeill-NFL-Player.jpg

The "unique pattern" of chronic traumatic encephalopathy, the debilitating brain disease known as CTE, has been found for the first time in a patient before he died, NBC News reported.

It was detected in a brain scan of former Minnesota Vikings linebacker Fred McNeill, according to the doctors behind a study published in the journal Neurosurgery last week. The scan could lead to the development of treatments for the incurable disease.

CTE is caused by repeated blows to the head, and has been found in many dead NFL players' brains, including former New England Patriots star Aaron Hernandez, who killed himself in April before a murder conviction against him was cleared.

So far, the only way to definitively diagnose CTE is by looking at the brain after death, but a 2012 scan of McNeill's brain that seemed to show protein deposits characteristic of CTE was confirmed in an autopsy after McNeill died last year.



Photo Credit: AP Photo, File]]>
<![CDATA[Congress' Delay Risks Millions of Kids' Health Insurance]]>Fri, 17 Nov 2017 07:09:02 -0500https://media.nbcnewyork.com/images/213*120/pll_20171118_chip_russo_10_fc7316e06197590903fff4b9d54d55a9.nbcnews-ux-2880-1000.jpg

The Children's Health Insurance Program covers annual check-ups and more medical procedures for nearly 9 million kids in low-income families, but congressional bickering is putting it at risk, NBC News reported.

The program has enjoyed bipartisan support since it was created in 1997, but legislators have let this year's reauthorization deadline pass in the debate over repealing and replacing the Affordable Care Act. Now funding in 11 states will run out by the end of the year, according to the Kaiser Family Foundation, and 21 more states by March.

CHIP gives health insurance to children and pregnant mothers who don't qualify for Medicaid but can't afford private insurance, and Census data shows the rate of uninsured children has dropped from 14 to about 4.5 percent in the past 20 years, experts say.

It's helped Roland Williams, 11, a St. Louis boy with an extremely rare form of lung cancer whose mother was told last year that "he would make it to see his 10th birthday."



Photo Credit: Eva Russo / for NBC News]]>
<![CDATA[FDA OKs New Therapy for Some Hemophilia Patients]]>Thu, 16 Nov 2017 13:55:38 -0500https://media.nbcnewyork.com/images/213*120/hemophiliadrug_1200x675.jpg

U.S. regulators have approved the first new treatment in nearly two decades to prevent internal bleeding in certain patients with hemophilia, an inherited blood-clotting disorder.

The Food and Drug Administration on Thursday approved Hemlibra (hem-LEE'-bruh), a weekly injection for hemophilia A patients who have developed resistance to standard medicines.

Genentech, the drug's developer, says the list price will be about $482,000 for the first year and slightly less after that.

Genentech, a subsidiary of Swiss drugmaker Roche, says that's half the cost of the only other option for patients with this resistance. That treatment requires an IV drip several times a week.

Hemophilia mostly affects males.

Copyright Associated Press / NBC New York



Photo Credit: AP/Genentech, Inc.]]>
<![CDATA[Couples Sue Fertility Clinic Over Eggs With Genetic Defect]]>Fri, 17 Nov 2017 11:16:04 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-846110442.jpg

Two couples are suing a New York fertility doctor and his clinic after giving birth to children with a genetic abnormality later traced back to donated eggs.

The two children, both born in 2009, have Fragile X syndrome, a genetic condition that can lead to intellectual and developmental impairments. The parents, identified by initials and last names in legal papers, argue the doctor and the clinic failed to test the women who donated the eggs to determine whether they were carriers for Fragile X. They're seeking damages for the added expenses of raising a disabled child.

The New York Court of Appeals heard oral arguments in the case on Wednesday. A decision is expected next year.

The outcome is likely to hinge on the statute of limitations in the state's medical malpractice law, which gives plaintiffs two-and-a-half years to sue following an alleged act of malpractice - or a patient's last treatment by the physician.

Attorneys for the Reproductive Medicine Associates clinic and physician Alan Cooperman argue the suit was filed too late, because the state of limitations began counting down when the women ended fertility treatment after becoming pregnant - and not when the children were born or when the genetic abnormality was diagnosed.

The parents filed the lawsuits two years after the children were born. In court on Wednesday, their attorneys argued the parents couldn't sue before the condition became apparent in the children. Attorney James LiCalzi said it makes no sense to expect the parents to file a lawsuit before they even knew about the abnormality.

"A claim didn't exist here until this child was born alive," he said.

But attorneys for the clinic said it's outside the power of the court to extend the statute of limitations in this case. Attorney Caryn Lilling said that it should be up to elected lawmakers - and not the court - to change the rules.

"The statute of limitations must run from the time of the act until the Legislature decrees otherwise," she said.

According to court papers, the donors of the eggs were tested after the children were born. Both were found to be carriers of the Fragile X mutation.

According to its website, Reproductive Medicine Associates has offices in Manhattan, Brooklyn and Long Island and in Westchester and Orange counties. A message left with Copperman was not immediately returned Thursday.

Copyright Associated Press / NBC New York



Photo Credit: Photo by Joe Raedle/Getty Images]]>
<![CDATA[Pope: Health Care Is Too Tied to People’s Finances]]>Thu, 16 Nov 2017 12:51:01 -0500https://media.nbcnewyork.com/images/213*120/AP_17320573986552-Pope-Francis.jpg

Pope Francis on Thursday urged lawmakers to ensure that health care laws protect the "common good," decrying the fact that in many places only the privileged can afford sophisticated medical treatments.

The comments came as U.S. lawmakers in Washington, D.C., have been debating how to overhaul the nation's health insurance laws.

In a message to a medical association meeting at the Vatican, Francis expressed dismay at what he called a tendency toward growing inequality in health care. He said in wealthier countries, health care access risks being more dependent on people's money than on their need for treatment.

"Increasingly, sophisticated and costly treatment are available to ever more limited and privileged segments of the population, and this raises questions about the sustainability of health care delivery and about what might be called a systemic tendency toward growing inequality in health care," the pope said.

"This tendency is clearly visible at the global level, particularly when different countries are compared," Francis said. "But it is also present within the more wealthy countries, where access to health care risks being more dependent on individuals' economic resources than on their actual need for treatment."

Without citing any countries, Francis said health care laws must take a "broad and comprehensive view of what most effectively promotes the common good" in each situation, including looking out for society's most vulnerable people.

The Vatican meeting explored end-of-life issues and Francis repeated decades-old church teaching forbidding euthanasia.

He also reiterated Vatican teaching that says "not adopting, or else suspending, disproportionate measures, means avoiding overzealous treatment. From an ethical standpoint, it is completely different from euthanasia, which is always wrong."

In addressing end-of-life issues, the pope said, countries must "defend the fundamental equality whereby everyone is recognized under law as a human being."

Using his nearly five-year-old papacy to highlight the plight of the poor, Francis later made a surprise visit to an area near St. Peter's Basilica where volunteer doctors can give poor people medical exams as part of the church's first-ever World Day of the Poor, to be held Sunday.

Copyright Associated Press / NBC New York



Photo Credit: L'Osservatore Romano/Pool Photo via AP]]>
<![CDATA[American Scientists Try 1st Gene Editing in the Body]]>Thu, 16 Nov 2017 08:19:28 -0500https://media.nbcnewyork.com/images/213*120/US-Zinc-Fingers-Protein-CR_1200x675_1097272387645.jpg

Scientists for the first time have tried editing a gene inside the body, a bold attempt to permanently change a person's DNA to try to cure a disease. The experiment was done on Monday in California on a patient with an inherited metabolic disorder.]]>
<![CDATA['Obamacare' Enrollment Is Up Over Same Period in 2016]]>Thu, 16 Nov 2017 08:03:12 -0500https://media.nbcnewyork.com/images/213*120/NC_budgetbattle0927_1500x845.jpg

The government has rolled back the amount of time to select a health care plan under the Affordable Care Act this year, but enrollment is already up over the same period last year. NBC's Tracie Potts reports.]]>
<![CDATA[Millions Will Forgo Coverage If 'Obamacare' Mandate Repealed]]>Thu, 16 Nov 2017 04:09:21 -0500https://media.nbcnewyork.com/images/213*120/HatchAP_17319724366604.jpg

Millions are expected to forgo coverage if Congress repeals the unpopular requirement that Americans get health insurance, gambling that they won't get sick and boosting premiums for others.

The drive by Senate Republicans to undo the coverage requirement under former President Barack Obama's health care law is a sharp break from the idea that everyone should contribute to health care.

And just as important, it fits neatly with the effort by President Donald Trump's administration to write new regulations allowing for skimpier plans with limited benefits and lower premiums.

Put the two together and the marketplace for about 18 million people buying their own health insurance could look very different in a few years. Consumers would have new options with different pluses and minuses. They'd notice a shift away from health plans that cover a broad set of benefits. New winners and losers would emerge.

Defending the GOP's move, the Senate's chief tax writer said Wednesday that the "Obamacare" fines on people who go without coverage amount to a tax on working people. "It's a terribly regressive tax that imposes harsh burdens on low- and middle-income taxpayers," said Finance Committee Chairman Orrin Hatch, R-Utah.

But Sen. Patty Murray of Washington, the ranking Democrat on the Health, Education, Labor and Pensions Committee, said repealing the requirement will undermine insurance markets and raise costs, particularly for those who need care. She accused Republicans of "sneaking devastating health care changes into a partisan bill at the last minute."

The Congressional Budget Office has estimated that repeal of the insurance requirement would save the government $338 billion through 2027, mainly because fewer people would seek subsidized coverage. That would give GOP lawmakers money to offset some of the tax cuts they're proposing.

The CBO estimates the number of uninsured would rise by 13 million in 2027, reversing coverage gains seen under former President Barack Obama. Because fewer people would be paying into the insurance pool, premiums for individual plans would rise about 10 percent. Little impact was expected on employer coverage.

Repealing the mandate would be like taking away the stick that nudges people to get comprehensive health insurance, while the skimpier plans envisioned by the Trump administration's regulation writers would be like new carrots introduced into the marketplace, said Katherine Hempstead, who directs health insurance work for the nonpartisan Robert Wood Johnson Foundation.

The result would be higher premiums for people who need comprehensive health insurance, often those who are older or coping with chronic conditions. "It's going to leave a lot of people poorly served," Hempstead said.

GOP economist Douglas Holtz-Eakin said he thinks the predictions of dire consequences are overstated and that repealing the mandate would be more like a safety valve for a health insurance market that's pricing out solid middle-class people not entitled to subsidies.

"In the individual market, this is all about getting premiums down so people will want to buy, as opposed to making them have to buy," Holtz-Eakin said. A former CBO chief, Holtz-Eakin said he thinks the agency's current estimates give too much weight to the coverage mandate.

He points to nearly 30 million Americans still uninsured. "We made it illegal to be uninsured, we're paying people to get insured, and we still have many uninsured," Holtz-Eakin said. "I don't think it's very effective."

A poll released Wednesday by the nonpartisan Kaiser Family Foundation found that 55 percent of Americans support eliminating the mandate as part of the GOP tax overhaul while 42 percent are opposed.

Julian Rostain, a cook from the Philadelphia area, said for him the mandate meant paying about $350 to the IRS for being uninsured during part of last year.

"I feel like I'm in good shape, and if I went a few months without health insurance, I wouldn't be terribly worried," said Rostain, in his late 20s. "I don't think it's fair when you penalize people who can't really afford it in the first place. It doesn't make sense."

But insurers, hospitals and doctors say some kind of requirement is needed.

"You really have to make sure that we have enough healthy people who are paying their premiums so that those who are facing significant chronic diseases are not left having to pay higher costs," said Dr. Michael Munger, president of the American Academy of Family Physicians. "I would say to younger, healthier people: 'You need to have coverage for when the unforeseen happens.'"

If the GOP succeeds in repealing the mandate, lawmakers may soon be looking for an alternative. "Ultimately, they'll need to have a nudge," said Republican health economist Gail Wilensky. "If they want to provide the protections for pre-existing conditions, they'll have to come up with something."

Associated Press writer Marcy Gordon contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: J. Scott Applewhite/AP]]>
<![CDATA[Big House Victory for GOP Tax Plan, But Senate Fate Unclear ]]>Fri, 17 Nov 2017 04:53:49 -0500https://media.nbcnewyork.com/images/213*120/874170156-Paul-Ryan-Tax-Cuts.jpg

Republicans have stretched closer to delivering the first big legislative victory for President Donald Trump and their party, whisking a $1.5 trillion overhaul of business and personal income taxes through the House. Thorny problems await in the Senate, though.

The House passage of the bill Thursday on a mostly party-line 227-205 vote also brought nearer the biggest revamp of the U.S. tax system in three decades.

But in the Senate, a similar measure received a politically awkward verdict from nonpartisan congressional analysts showing it would eventually produce higher taxes for low- and middle-income earners but deliver deep reductions for those better off.

The Senate bill was approved late Thursday by the Finance Committee and sent to the full Senate on a party-line 14-12 vote. Like the House measure, it would slash the corporate tax rate and reduce personal income tax rates for many.

But it adds a key feature not in the House version: repeal of the Affordable Care Act's requirement that everyone in the U.S. have health insurance. Elimination of the so-called individual mandate under the Obama health care law would add an estimated $338 billion in revenue over 10 years that the Senate tax-writers used for additional tax cuts.

The nonpartisan Congressional Budget Office has projected that repeal of the mandate would result in 13 million more uninsured people by 2027, making it a political risk for some lawmakers.

The Senate panel's vote came at the end of four days of often fierce partisan debate. It turned angrily personal for Chairman Sen. Orrin Hatch, R-Utah, as he railed against Democrats' accusations that the legislation was crafted to favor big corporations and the wealthy.

"I come from the poor people. And I've been working my whole stinking career for people who don't have a chance," Hatch insisted.

After the panel's approval, Senate Majority Leader Mitch McConnell declared, "For the millions of hard-working Americans who need more money in their pockets and the chance of a better future, help is on the way."

The analysts' problematic projections for the Senate bill came a day after Wisconsin Sen. Ron Johnson became the first GOP senator to state opposition to the measure, saying it didn't cut taxes enough for millions of partnerships and corporations. With at least five other Republican senators yet to declare support, the bill's fate is far from certain in a chamber the GOP controls by just 52-48.

Even so, Republicans are hoping to send a compromise bill for Trump to sign by Christmas.

"Now the ball is in the Senate's court," Vice President Mike Pence said after the House vote. Speaking at a conservative Tax Foundation dinner in Washington, Pence said, "The next few weeks are going to be vitally important and they're going to be a challenge."

"We're going to get it done" before year's end, he said.

A White House statement that "now is the time to deliver" also underscored the GOP's effort to maintain momentum and outrace critics. Those include the AARP lobby for older people, major medical organizations, realtors — and, in all likelihood, every Senate Democrat.

Despite controlling both chambers of Congress and the White House, the Republicans are still smarting from this summer's crash of their effort to dismantle President Barack Obama's health care law. They see a successful tax effort as the best way to avert major losses in next year's congressional elections. House Republicans concede they are watching the Senate warily.

"Political survival depends on us doing this," said Rep. Kevin Cramer, R-N.D. "One of the things that scares me a little bit is that they're going to screw up the bill to the point we can't pass it."

The House plan and the Senate Finance bill would deliver the bulk of their tax reductions to businesses.

Each would cut the 35 percent corporate tax rate to 20 percent, while reducing personal rates for many taxpayers and erasing or shrinking deductions. Projected federal deficits would grow by $1.5 trillion over 10 years.

As decades of Republicans have done before them, GOP lawmakers touted their tax cuts as a boon to families across all income lines and a boost for businesses, jobs and the entire country.

"Passing this bill is the single biggest thing we can do to grow the economy, to restore opportunity and help those middle-income families who are struggling," said House Speaker Paul Ryan of Wisconsin.

Ryan also said he'd seek to add tax breaks to help Puerto Rico recover from recent hurricanes to a House-Senate compromise.

Democrats said the tax measure would give outsized benefits to the wealthy and saddle millions of moderate-income Americans with tax increases. Among other things, the House legislation would reduce and ultimately repeal the tax Americans pay on the largest inheritances, while the Senate would limit that levy to fewer estates.

The bill is "pillaging the middle class to pad the pockets of the wealthiest and hand tax breaks to corporations shipping jobs out of America," declared House Minority Leader Nancy Pelosi of California.

Thirteen House Republicans — all but one from high-tax California, New York and New Jersey — voted "no" because the plan would erase tax deductions for state and local income and sales taxes and limit property tax deductions to $10,000. Defectors included House Appropriations Committee Chairman Rodney Frelinghuysen, R-N.J., who said the measure would "hurt New Jersey families."

Trump traveled to the Capitol before the vote to give House Republicans a pep talk.

After the vote, Trump tweeted, "Congratulations to the House of Representatives for passing the #TaxCutsandJobsAct — a big step toward fulfilling our promise to deliver historic TAX CUTS for the American people by the end of the year!"

Besides Johnson, Republican Sens. Susan Collins of Maine, Jeff Flake and John McCain of Arizona, Bob Corker of Tennessee and Lisa Murkowski of Alaska have yet to commit to backing the tax measure.

Congress' Joint Committee on Taxation estimated the Senate plan would mean higher taxes beginning in 2021 for many families earning under $30,000 annually. By 2027, families making less than $75,000 would face tax boosts while those making more would enjoy cuts.

Republicans attributed the new figures to two provisions: one ending the measure's personal tax cuts starting in 2026 and the other abolishing the "Obamacare" requirement that people buy health coverage or pay tax penalties.

Ending the personal tax cuts for individuals in 2026, derided as a gimmick by Democrats, is designed to pare the bill's long-term costs to the Treasury. Legislation cannot boost budget deficits after 10 years if it is to qualify for Senate procedures that bar bill-killing filibusters.

Other features:

—Both chambers' bills would nearly double the standard deduction to around $12,000 for individuals and about $24,000 for married couples and dramatically boost the current $1,000 per-child tax credit.

—Both would erase the current $4,050 personal exemption and reduce or cancel other tax breaks. The House would limit interest deductions to future home mortgages of up to $500,000, down from today's $1 million. The Senate would end deductions for moving expenses and tax preparation.

Associated Press writers Kevin Freking, Richard Lardner and Matthew Daly contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: Win McNamee/Getty Images]]>
<![CDATA[CVS Blames Pharmacy Outages on 'Internal Network' Problems]]>Thu, 16 Nov 2017 07:21:18 -0500https://media.nbcnewyork.com/images/180*120/CVS_1200x675.jpg

After major system outages Tuesday CVS Health pharmacies reported there was  an internal network problem, CNBC reported. 

The cause is unknown according to the CVS spokesperson.

CVS non-executive Chairman David Dorman told CNBC Wednesday that top management notified him about the network issue after customers complained about not being able to refill their medications.

Customers took to social media to speak out about their complaints and express their dissatisfaction. 



Photo Credit: Getty ImagesJoe Raedle]]>
<![CDATA['Obamacare' Sign-Ups About 45 Pct Ahead of Last Year's Pace]]>Wed, 15 Nov 2017 13:44:16 -0500https://media.nbcnewyork.com/images/203*120/Screen+Shot+2017-10-30+at+8.37.47+AM.png

Sign-ups for Affordable Care Act health plans are running more than 45 percent ahead of last year's pace, according to government data released Wednesday.

The numbers from the Centers for Medicare and Medicaid Services come as Republican senators are pushing to pay for tax cuts by repealing the "Obamacare" requirement to carry coverage.

The new figures show that nearly 1.5 million consumers picked a plan through Nov. 11, compared to just over 1 million from Nov. 1-12 last year, a period that had included one additional day for consumers to enroll.

The latest data cover 39 states served by the HealthCare.gov website. The overall number of sign-ups is higher because states running their own health insurance markets are not counted in the HealthCare.gov data.

The share of new customers for 2018 coverage stayed at about 23 percent, the report said.

The Obama-era health law offers subsidized private insurance for people who don't get coverage on the job. Sign-ups this year are being closely watched because of efforts by the Trump administration and the Republican-controlled Congress to do away with the law.

At same time, consumers who are eligible for financial assistance are seeing more low-cost plans available. Even though premiums have gone up, that's been offset by increased subsidies.

If Congress repeals the requirement that people buy health insurance, the Congressional Budget Office has estimated that 13 million more people would be uninsured by 2027.

This year's sign-up season is only half as long as last year's. It ends Dec. 15.

Copyright Associated Press / NBC New York



Photo Credit: Healthcare.gov]]>
<![CDATA['Invisible Mending': US Scientists Try 1st in-Body Gene Edit]]>Thu, 16 Nov 2017 10:02:18 -0500https://media.nbcnewyork.com/images/213*120/AP_17317776550106-Gene-Editing-UCSF-Hunter-Syndrome.jpg

Scientists for the first time have tried editing a gene inside the body in a bold attempt to permanently change a person's DNA to try to cure a disease.

The experiment was done Monday in California on 44-year-old Brian Madeux. Through an IV, he received billions of copies of a corrective gene and a genetic tool to cut his DNA in a precise spot.

"It's kind of humbling" to be the first to test this, said Madeux, who has a metabolic disease called Hunter syndrome. "I'm willing to take that risk. Hopefully it will help me and other people."

Signs of whether it's working may come in a month; tests will show for sure in three months.

If it's successful, it could give a major boost to the fledgling field of gene therapy. Scientists have edited people's genes before, altering cells in the lab that are then returned to patients. There also are gene therapies that don't involve editing DNA.

But these methods can only be used for a few types of diseases. Some give results that may not last. Some others supply a new gene like a spare part, but can't control where it inserts in the DNA, possibly causing a new problem like cancer.

This time, the gene tinkering is happening in a precise way inside the body. It's like sending a mini surgeon along to place the new gene in exactly the right location.

"We cut your DNA, open it up, insert a gene, stitch it back up. Invisible mending," said Dr. Sandy Macrae, president of Sangamo Therapeutics, the California company testing this for two metabolic diseases and hemophilia. "It becomes part of your DNA and is there for the rest of your life."

That also means there's no going back, no way to erase any mistakes the editing might cause.

"You're really toying with Mother Nature" and the risks can't be fully known, but the studies should move forward because these are incurable diseases, said one independent expert, Dr. Eric Topol of the Scripps Translational Science Institute in San Diego.

Protections are in place to help ensure safety, and animal tests were very encouraging, said Dr. Howard Kaufman, a Boston scientist on the National Institutes of Health panel that approved the studies.

He said gene editing's promise is too great to ignore. "So far there's been no evidence that this is going to be dangerous," he said. "Now is not the time to get scared."

WOE FROM HEAD TO TOE
Fewer than 10,000 people worldwide have these metabolic diseases, partly because many die very young. Those with Madeux's condition, Hunter syndrome, lack a gene that makes an enzyme that breaks down certain carbohydrates. These build up in cells and cause havoc throughout the body.

Patients may have frequent colds and ear infections, distorted facial features, hearing loss, heart problems, breathing trouble, skin and eye problems, bone and joint flaws, bowel issues and brain and thinking problems.

"Many are in wheelchairs ... dependent on their parents until they die," said Dr. Chester Whitley, a University of Minnesota genetics expert who plans to enroll patients in the studies.

Weekly IV doses of the missing enzyme can ease some symptoms, but cost $100,000 to $400,000 a year and don't prevent brain damage.

Madeux, who now lives near Phoenix, is engaged to a nurse, Marcie Humphrey, who he met 15 years ago in a study that tested this enzyme therapy at UCSF Benioff Children's Hospital Oakland, where the gene editing experiment took place.

He has had 26 operations for hernias, bunions, bones pinching his spinal column, and ear, eye and gall bladder problems.

"It seems like I had a surgery every other year of my life" and many procedures in between, he said. Last year he nearly died from a bronchitis and pneumonia attack. The disease had warped his airway, and "I was drowning in my secretions, I couldn't cough it out."

Madeux has a chef's degree and was part owner of two restaurants in Utah, cooking for US ski teams and celebrities, but now can't work in a kitchen or ride horses as he used to.

Gene editing won't fix damage he's already suffered, but he hopes it will stop the need for weekly enzyme treatments.

Initial studies will involve up to 30 adults to test safety, but the ultimate goal is to treat children very young, before much damage occurs.

HOW IT WORKS
A gene-editing tool called CRISPR has gotten a lot of recent attention, but this study used a different one called zinc finger nucleases. They're like molecular scissors that seek and cut a specific piece of DNA.

The therapy has three parts: The new gene and two zinc finger proteins. DNA instructions for each part are placed in a virus that's been altered to not cause infection but to ferry them into cells. Billions of copies of these are given through a vein.

They travel to the liver, where cells use the instructions to make the zinc fingers and prepare the corrective gene. The fingers cut the DNA, allowing the new gene to slip in. The new gene then directs the cell to make the enzyme the patient lacked.

Only 1 percent of liver cells would have to be corrected to successfully treat the disease, said Madeux's physician and study leader, Dr. Paul Harmatz at the Oakland hospital.

"How bulletproof is the technology? We're just learning," but safety tests have been very good, said Dr. Carl June, a University of Pennsylvania scientist who has done other gene therapy work but was not involved in this study.

WHAT COULD GO WRONG
Safety issues plagued some earlier gene therapies. One worry is that the virus might provoke an immune system attack. In 1999, 18-year-old Jesse Gelsinger died in a gene therapy study from that problem, but the new studies use a different virus that's proved much safer in other experiments.

Another worry is that inserting a new gene might have unforeseen effects on other genes. That happened years ago, when researchers used gene therapy to cure some cases of the immune system disorder called "bubble boy" disease. Several patients later developed leukemia because the new gene inserted into a place in the native DNA where it unintentionally activated a cancer gene.

"When you stick a chunk of DNA in randomly, sometimes it works well, sometimes it does nothing and sometimes it causes harm," said Hank Greely, a Stanford University bioethicist. "The advantage with gene editing is you can put the gene in where you want it."

Finally, some fear that the virus could get into other places like the heart, or eggs and sperm where it could affect future generations. Doctors say built-in genetic safeguards prevent the therapy from working anywhere but the liver, like a seed that only germinates in certain conditions.

This experiment is not connected to other, more controversial work being debated to try to edit genes in human embryos to prevent diseases before birth — changes that would be passed down from generation to generation.

MAKING HISTORY
Madeux's treatment was to have happened a week earlier, but a small glitch prevented it.

He and his fiancee returned to Arizona, but nearly didn't make it back to Oakland in time for the second attempt because their Sunday flight was canceled and no others were available until Monday, after the treatment was to take place.

Scrambling, they finally got a flight to Monterey, California, and a car service took them just over 100 miles north to Oakland.

On Monday he had the three-hour infusion, surrounded by half a dozen doctors, nurses and others wearing head-to-toe protective garb to lower the risk of giving him any germs. His doctor, Harmatz, spent the night at the hospital to help ensure his patient stayed well.

"I'm nervous and excited," Madeux said as he prepared to leave the hospital. "I've been waiting for this my whole life, something that can potentially cure me."

Copyright Associated Press / NBC New York



Photo Credit: Eric Risberg/AP]]>
<![CDATA[How Law Enforcement Uses Narcan to Combat the Opioid Crisis]]>Tue, 14 Nov 2017 14:03:57 -0500https://media.nbcnewyork.com/images/213*120/DIT+NARCAN+EXPLAINER+THUMB2.jpg

As the American opioid crisis reaches near epidemic levels, law enforcement agencies across the country are training their officers how to use Narcan to revive people who have overdosed. The LA County Sheriff’s Department has deployed over 600 deputies with Narcan and is changing the way law enforcement approaches the opioid crisis.]]>
<![CDATA[FDA Warns of Injury, Death With Herbal Supplement Kratom]]>Tue, 14 Nov 2017 13:54:25 -0500https://media.nbcnewyork.com/images/213*120/AP_17318544107694-Kratom-Supplement-.jpg

Federal health authorities are warning about reports of injury, addiction and death with a herbal supplement that has been promoted as an alternative to opioid painkillers and other prescription drugs

The supplement, kratom, made from a plant native to Southeast Asia, has gained popularity in the U.S. as a treatment for pain, anxiety and drug dependence. Users have opposed efforts to regulate the plant, saying it could be a safer alternative to opioid pain pills that have caused an epidemic of abuse.

But the Food and Drug Administration said Tuesday that kratom carries similar risks, including addiction and death, and the agency is working to block shipments.

The FDA said it is aware of 36 deaths involving products made with kratom and hundreds of calls to poison control centers, which increased tenfold between 2010 and 2015. In some cases, kratom is mixed with opioids like oxycodone, the ingredient in OxyContin, according to the agency.

"The FDA must use its authority to protect the public from addictive substances like kratom, both as part of our commitment to stemming the opioid epidemic and preventing another from taking hold," FDA Commissioner Scott Gottlieb, said in a statement .

Gottlieb said the agency has seized and destroyed shipments of kratom at international mail facilities.

Kratom remains legal under federal law although some states have banned the plant, including Alabama, Arkansas, Indiana, Tennessee and Wisconsin. It is sold in various forms, including capsules and powders.

The Drug Enforcement Administration had planned to ban the plant by adding it to a list of illegal drugs that includes marijuana, heroin and LSD. But the agency backed away from that plan last October after a flood of public complaints including a letter signed by 62 members of Congress and a protest at the White House organized by the American Kratom Association.

A spokesman for the group could not immediately provide comment Tuesday morning.

The group has said categorizing kratom as an illegal substance would stymie medical research into its potential therapeutic uses. The DEA said last October it would delay a decision until the FDA issued a recommendation.

Despite Tuesday's warning about the risks of kratom an FDA spokeswoman said the agency's scientific review is ongoing. There is no timetable for completing the review.

Copyright Associated Press / NBC New York



Photo Credit: Mary Esch/AP, File]]>
<![CDATA[FDA Approves First Digital Tracking Pill]]>Tue, 14 Nov 2017 10:52:55 -0500https://media.nbcnewyork.com/images/213*120/505030334-Digital-Doctor.jpg

The Food and Drug Administration has approved the first drug in the United States with a digital ingestion tracking system, in an unprecedented move to ensure that patients with mental illness take the medicine prescribed for them.

The drug Abilify MyCite was developed by Otsuka Pharmaceutical Co., Ltd. The drug Abilify was first approved by the FDA in 2002 to treat schizophrenia, and the ingestible sensor, made by Proteus Digital health, was approved for marketing in 2012. The FDA said in a statement Monday that the digitally enhanced medication "works by sending a message from the pill's sensor to a wearable patch."

"Being able to track ingestion of medications prescribed for illness may be useful for some patients," said Dr. Mitchell Mathis, director of the division of Psychiatry Products in the FDA's Center for Drug Evaluation and Research. "The FDA supports the development and use of new technology in prescription drugs and is committed to working with companies to understand how this technology might benefit patients and prescribers."

Green-lighting the new medication, however, came with some caveats. Among them, the FDA said it was important to note that Abilify MyCite's labeling asserts "the ability of the product to improve patient compliance with their treatment regimen has not been shown."

"Abilify MyCite should not be used to track drug ingestion in 'real-time' or during an emergency," the statement said, "because detection may be delayed or may not occur."

In a portion of the statement that appeared to address privacy concerns, the FDA said the wearable patch that comes with the medication "transmits the information to a mobile application so that patients can track the ingestion of the medication on their smart phone. Patients can also permit their caregivers and physician to access the information through a web-based portal."

In a statement issued last May at the time the FDA accepted submission of product for review, Otsuka Pharmaceutical, Ltd. Of Toyko and Proteus Digital, of Redwood City, California, said that "with the patient's consent, this information could be shared with their healthcare professional team and selected family and friends, with the goal of allowing physicians to be more informed in making treatment decisions that are specific to the patient's needs."

The companies said the Proteus Ingestible sensor "activates when it reaches stomach fluids and communicates with the patch."

The FDA said the product is designed for the treatment of schizophrenia, acute treatment of manic and mixed episodes associated with a bipolar disorder and for use as an add-on treatment for depression in adults."

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/iStockphoto]]>
<![CDATA[Is There a Link Between Rising Teen Suicide, Social Media?]]>Tue, 14 Nov 2017 06:24:31 -0500https://media.nbcnewyork.com/images/213*120/SocialMediaDepressionGettyImages-75298626.jpg

An increase in suicide rates among U.S. teens occurred at the same time social media use surged and a new analysis suggests there may be a link.

Suicide rates for teens rose between 2010 and 2015 after they had declined for nearly two decades, according to data from the federal Centers for Disease Control and Prevention. Why the rates went up isn't known.

The study doesn't answer the question, but it suggests that one factor could be rising social media use. Recent teen suicides have been blamed on cyberbullying, and social media posts depicting "perfect" lives may be taking a toll on teens' mental health, researchers say.

"After hours of scrolling through Instagram feeds, I just feel worse about myself because I feel left out," said Caitlin Hearty, a 17-year-old Littleton, Colorado, high school senior who helped organize an offline campaign last month after several local teen suicides.

"No one posts the bad things they're going through," said Chloe Schilling, also 17, who helped with the campaign, in which hundreds of teens agreed not to use the internet or social media for one month.

The study's authors looked at CDC suicide reports from 2009-15 and results of two surveys given to U.S. high school students to measure attitudes, behaviors and interests. About half a million teens ages 13 to 18 were involved. They were asked about use of electronic devices, social media, print media, television and time spent with friends. Questions about mood included frequency of feeling hopeless and considering or attempting suicide.

The researchers didn't examine circumstances surrounding individual suicides. Dr. Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention, said the study provides weak evidence for a popular theory and that many factors influence teen suicide.

The study was published Tuesday in the journal Clinical Psychological Science.

Data highlighted in the study include:

  • Teens' use of electronic devices including smartphones for at least five hours daily more than doubled, from 8 percent in 2009 to 19 percent in 2015. These teens were 70 percent more likely to have suicidal thoughts or actions than those who reported one hour of daily use.
  • In 2015, 36 percent of all teens reported feeling desperately sad or hopeless, or thinking about, planning or attempting suicide, up from 32 percent in 2009. For girls, the rates were higher — 45 percent in 2015 versus 40 percent in 2009.
  • In 2009, 58% of 12th grade girls used social media every day or nearly every day; by 2015, 87% used social media every day or nearly every day. They were 14% more likely to be depressed than those who used social media less frequently.

"We need to stop thinking of smartphones as harmless," said study author Jean Twenge, a psychology professor at San Diego State University who studies generational trends. "There's a tendency to say, 'Oh, teens are just communicating with their friends.' Monitoring kids' use of smartphones and social media is important, and so is setting reasonable limits, she said.

Dr. Victor Strasburger, a teen medicine specialist at the University of New Mexico, said the study only implies a connection between teen suicides, depression and social media. It shows the need for more research on new technology, Strasburger said.

He noted that skeptics who think social media is being unfairly criticized compare it with so-called vices of past generations: "When dime-store books came out, when comic books came out, when television came out, when rock and roll first started, people were saying 'This is the end of the world.'"

With its immediacy, anonymity, and potential for bullying, social media has a unique potential for causing real harm, he said.

"Parents don't really get that," Strasburger said.

AP reporter P. Solomon Banda contributed to this story.

SUICIDE PREVENTION HELP: The National Suicide Prevention Hotline (1-800-273-8255) is open 24 hours a day, 7 days a week.

Copyright Associated Press / NBC New York



Photo Credit: Chris Jackson/Getty Images, File]]>
<![CDATA[Half of US Adults Have High Blood Pressure in New Guidelines]]>Mon, 13 Nov 2017 18:29:26 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-684910284.jpg

New guidelines lower the threshold for high blood pressure, adding 30 million Americans to those who have the condition, which now plagues nearly half of U.S. adults.

High pressure, which for decades has been a top reading of at least 140 or a bottom one of 90, drops to 130 over 80 in advice announced Monday by a dozen medical groups.

The change means an additional 14 percent of U.S. adults have the problem, but only an additional 2 percent will need medication right away; the rest should try healthier lifestyles, which get much stronger emphasis in the new advice. Poor diets, lack of exercise and other bad habits cause 90 percent of high blood pressure.

"I have no doubt there will be controversy. I'm sure there will be people saying 'We have a hard enough time getting to 140,'" said Dr. Paul Whelton, a Tulane University physician who led the guidelines panel.

But the risk for heart disease, stroke and other problems drops as blood pressure improves, and the new advice "is more honest" about how many people have a problem, he said.

Currently, only half of Americans with high blood pressure have it under control.

The upper threshold for high blood pressure has been 140 since 1993, but a major study two years ago found heart risks were much lower in people who aimed for 120. Canada and Australia lowered their cutoff to that; Europe is still at 140 but is due to revise its guidance next year.

The guidelines were announced Monday at an American Heart Association conference in Anaheim.

WHAT THE CHANGES MEAN
The guidelines set new categories and get rid of "prehypertension":

—Normal: Under 120 over 80

—Elevated: Top number 120-129 and bottom less than 80

—Stage 1: Top of 130-139 or bottom of 80-89

—Stage 2: Top at least 140 or bottom at least 90

That means 46 percent of U.S. adults have high pressure (stages 1 or 2) versus 32 percent under the old levels.

How common it is will roughly triple in men under 45, to 30 percent, and double in women of that age, to 19 percent.

For people over 65, the guidelines undo a controversial tweak made three years ago to relax standards and not start medicines unless the top number was over 150. Now, everyone that old should be treated if the top number is over 130 unless they're too frail or have conditions that make it unwise.

"The evidence with this is so solid, so convincing, that it's hard to argue with the targets," said Dr. Jackson Wright, a guidelines panel member from University Hospitals Cleveland Medical Center. Older people "have a 35-to-50-fold higher risk of dying of a heart attack or stroke compared to younger people."

But the Cleveland Clinic's Dr. Steven Nissen said he's worried.

"Some more vulnerable patients who get treated very aggressively may have trouble with falls" because too-low pressure can make them faint, he said.

WHO NEEDS TREATMENT
Certain groups, such as those with diabetes, should be treated if their top number is over 130, the guidelines say. For the rest, whether to start medication will no longer be based just on the blood pressure numbers. The decision also should consider the overall risk of having a heart problem or stroke in the next 10 years, including factors such as age, gender and cholesterol, using a simple formula to estimate those odds.

Those without a high risk will be advised to improve their lifestyles — lose weight, eat healthy, exercise more, limit alcohol, avoid smoking.

"It's not just throwing meds at something," said one primary care doctor who praised the new approach, the Mayo Clinic's Dr. Robert Stroebel. If people continue bad habits, "They can kind of eat and blow through the medicines," he said.

The guidelines warn about some popular approaches, though. There's not enough proof that consuming garlic, dark chocolate, tea or coffee helps, or that yoga, meditation or other behavior therapies lower blood pressure long-term, they say.

The government no longer writes heart guidelines, leaving it to medical groups. Unlike previous guideline panels, none on this one have recent financial ties to industry, although some on a panel that reviewed and commented on them do.

The guidelines were published in two journals — Hypertension and the Journal of the American College of Cardiology.

HOW AND WHEN TO CHECK IT
Blood pressure should be checked at least once a year by a health professional, and diagnosing high pressure requires 2 or 3 readings on at least two occasions.

The common way uses a cuff on the upper arm to temporarily block the flow of blood in an artery in the arm and gradually release it while listening with a stethoscope and counting sounds the blood makes as it flows through the artery. But that is prone to error, and many places now use automated devices.

The guidelines don't pick a method, but recommend measuring pressure in the upper arm; devices that work on fingers or are worn on wrists "aren't ready for prime time," Whelton said.

Home monitoring also is recommended; devices cost as little as $40 to $60.

WHAT ABOUT KIDS?
Unlike adults, numbers for normal pressure in children vary with age, height and gender. Kids should be checked at least once a year for high pressure, say guidelines announced in August by the American Academy of Pediatrics.

After age 13, the levels defining high pressure are the same as for adults, said a member of the pediatrics panel, Dr. Elaine Urbina of Cincinnati Children's Hospital Medical Center.

"When you turn 18 years and one minute, you shouldn't suddenly have a new definition," she said.

Copyright Associated Press / NBC New York



Photo Credit: Spencer Platt/Getty Images, File]]>
<![CDATA[Global Carbon Pollution Rises After 3-Straight Flat Years]]>Mon, 13 Nov 2017 05:04:48 -0500https://media.nbcnewyork.com/images/213*120/CarbonEmissionsGettyImages-871575562.jpg

Global carbon pollution rose this year after three straight years when levels of the heat-trapping gas didn't go up at all, scientists reported Monday.

Preliminary figures project that worldwide carbon dioxide emissions are up about 2 percent this year, according to an international team of scientists. Most of the increase came from China.

The report by the Global Carbon Project team dashed hopes that emissions from the burning of coal, oil and gas had peaked.

"We hoped that we had turned the corner... We haven't," said study co-author Rob Jackson, an Earth scientist at Stanford University.

Carbon dioxide emissions rose steadily and slowly starting in the late 1880s with the Industrial Revolution, then took off dramatically in the 1950s. In the last three years, levels had stabilized at about 40 billion tons of carbon dioxide (36.2 billion metric tons).

Estimates for 2017 put it at about 40.8 billion tons (37 billion metric tons). Sixty years ago, the world spewed only 9.2 billion tons (8.3 billion metric tons).

"It's a bit staggering," said co-author Ralph Keeling, a Scripps Institution of Oceanography scientist, noting in an email that levels have increased fourfold since he was born in the 1950s. "We race headlong into the unknown."

Man-made carbon dioxide is causing more than 90 percent of global warming since 1950, U.S. scientists reported this month.

This year's increase was mostly spurred by a 3.5 percent jump in Chinese carbon pollution, said study co-author Glen Peters, a Norwegian scientist. Declines in the United States (0.4 percent) and Europe (0.2 percent) were smaller than previous years. India, the No. 3 carbon polluting nation, went up 2 percent.

The 2017 estimate comes to on average of 2.57 million pounds (1.16 million kilograms) of carbon dioxide spewing into the air every second.

The study was published Monday and is being presented in Bonn, Germany, during climate talks where leaders are trying to come up with rules for the 2015 Paris deal. The goal is to limit temperature rise to 2 degrees Celsius (3.6 degrees Fahrenheit) since preindustrial times, but it's already warmed half that amount.

"It was tough enough and if this paper is indicative of long-term trends, it just got tougher," said Princeton University climate scientist Michael Oppenheimer, who wasn't part of the team of 76 scientists who wrote the report.

While he called the study authoritative, Pennsylvania State University climate scientist Michael Mann said he sees no need to do figures for 2017 that are not complete, saying it may be "jumping the gun a bit."

Jackson said the team — which produces these reports every year in November — has confidence in its 2017 report because it is based on real data from top polluting nations through the summer and in some cases through October. Plus, he said past estimates have been correct within a couple tenths of a percentage point.

The top five carbon polluting countries are China, the United States, India, Russia and Japan. Europe taken as a whole, would rank third. 

Copyright Associated Press / NBC New York



Photo Credit: Sean Gallup/Getty Images, File]]>
<![CDATA[Study Suggests Women Less Likely to Get CPR From Bystanders]]>Mon, 13 Nov 2017 13:28:48 -0500https://media.nbcnewyork.com/images/213*120/AP_17303626860083.jpg

Women are less likely than men to get CPR from a bystander and more likely to die, a new study suggests, and researchers think reluctance to touch a woman's chest might be one reason.

Only 39 percent of women suffering cardiac arrest in a public place were given CPR versus 45 percent of men, and men were 23 percent more likely to survive, the study found.

It involved nearly 20,000 cases around the country and is the first to examine gender differences in receiving heart help from the public versus professional responders.

"It can be kind of daunting thinking about pushing hard and fast on the center of a woman's chest" and some people may fear they are hurting her, said Audrey Blewer, a University of Pennsylvania researcher who led the study.

Rescuers also may worry about moving a woman's clothing to get better access, or touching breasts to do CPR, but doing it properly "shouldn't entail that," said another study leader, U Penn's Dr. Benjamin Abella. "You put your hands on the sternum, which is the middle of the chest. In theory, you're touching in between the breasts."

The study was discussed Sunday at an American Heart Association conference in Anaheim.

Cardiac arrest occurs when the heart suddenly stops pumping, usually because of a rhythm problem. More than 350,000 Americans each year suffer one in settings other than a hospital. About 90 percent of them die, but CPR can double or triple survival odds.

"This is not a time to be squeamish because it's a life and death situation," Abella said.

Researchers had no information on rescuers or why they may have been less likely to help women. But no gender difference was seen in CPR rates for people who were stricken at home, where a rescuer is more likely to know the person needing help.

The findings suggest that CPR training may need to be improved. Even that may be subtly biased toward males — practice mannequins (they're not called "woman-nequins") are usually male torsos, Blewer said.

"All of us are going to have to take a closer look at this" gender issue, said the Mayo Clinic's Dr. Roger White, who co-directs the paramedic program for the city of Rochester, Minnesota. He said he has long worried that large breasts may impede proper placement of defibrillator pads if women need a shock to restore normal heart rhythm.

The Heart Association and the National Institutes of Health funded the study.

Men did not have a gender advantage in a second study discussed on Sunday. It found the odds of suffering cardiac arrest during or soon after sex are very low, but higher for men than women.

Previous studies have looked at sex and heart attacks, but those are caused by a clot suddenly restricting blood flow, and people usually have time to get to a hospital and be treated, said Dr. Sumeet Chugh, a cardiologist at Cedars-Sinai Heart Institute in Los Angeles. He and other researchers wanted to know how sex affected the odds of cardiac arrest, a different problem that's more often fatal.

They studied records on more than 4,500 cardiac arrests over 13 years in the Portland area. Only 34 were during or within an hour of having sex, and 32 of those were in men. Most already were on medicines for heart conditions, so their risk was elevated to start with.

"It's a very awkward situation, and a very horrifying situation to be one of the two people who survives," but more would survive if CPR rates were higher, Chugh said.

Results were published in the Journal of the American College of Cardiology.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Rogelio V. Solis]]>
<![CDATA[Why Men Force Women to Watch Them Masturbate: Experts]]>Sat, 11 Nov 2017 23:24:54 -0500https://media.nbcnewyork.com/images/213*120/ckckck.jpg

Power, control, and a pathological desire to elicit fear all play into why a man might engage in exhibitionism, sex therapists say, in the wake of bombshell revelations against comedian Louis C.K. Experts told NBC News masturbating in front of women without their permission is typically about exerting control, not an attempt at seduction.

"The shock on a woman's face that he's torturing is where the arousal lies. It's in her humiliation, said sex therapist Dr. Alexandra Katehakis, clinical director of the Center for Healthy Sex in Los Angeles, who has not treated Louis C.K.

Two female comedians told the New York Times that Louis C.K. masturbated in front of them in 2002. Three other women told the Times about other instances of sexual misconduct by the creator of the FX series "Louie."

"These stories are true," Louis C.K. said in a statement on Friday. "At the time, I said to myself that what I did was okay because I never showed a woman my dick without asking first, which is also true. But what I learned later in life, too late, is that when you have power over another person, asking them to look at your dick isn’t a question. It’s a predicament for them. The power I had over these women is that they admired me. And I wielded that power irresponsibly."



Photo Credit: Photo by Andrew H. Walker/Getty Images, File]]>
<![CDATA[More May Have Been Exposed to Hep A in NY: Health Officials]]>Fri, 10 Nov 2017 23:39:46 -0500https://media.nbcnewyork.com/images/213*120/LMX___COLLETTI+HEPATITIS+A+RESTAURANT+WC+FOLO+PKG+530_WNBC_0000.jpg

Patrons of a historic country club in Westchester may have been exposed to hepatitis A amid a small outbreak of the serious viral infection, health officials warned Friday.

Last month, an infected employee at Bartaco in Port Chester led to thousands of people being treated against hepatitis A. That employee ended up exposing five people to hepatitis A, the Westchester Health Department said, and apparently one of those people infected an employee of the Sleepy Hollow Country Club.

The country club has fully cooperated with an investigation and voluntarily closed its kitchens Friday to sanitize them, according to health officials. It's also vaccinating all of its 80 to 100 employees against hepatitis A. 

“We ask for everyone’s patience while we scrub the club from top to bottom to insure a safe place for our members and their guests to dine,” said Eric Rule, the club's general manager, in a statement. 

Patrons of Sleepy Hollow’s Grill Room are most at risk, but health officials are warning anyone who ate or drank at the country club between Oct. 27 and Nov. 4 to seek preventative treatment immediately out of an abundance of caution (more information below). 

People who visited the country club between Oct. 21 and Oct. 26 may have also been exposed, but health officials say preventative treatment is only effective within two weeks of exposure. Those who visited the club before Oct. 27 should monitor themselves for symptoms and contact their health provider if symptoms appear. 

Hepatitis A is transmitted by consuming food or drinks that have been handled by an infected person. Symptoms include fatigue, fever, poor appetite, abdominal pain, diarrhea, dark urine, light colored stool and jaundice, according to Health Commissioner Sherlita Amler. Those infected will normally notice symptoms within 28 days of exposure, but they can appear in as little as 15 days or as many as 50 days.

Free preventative treatment will be offered at 134 Court St. in White Plains on Friday from 4 to 7 p.m. and on Saturday from 10 a.m. to 4 p.m. You can register for treatment at this health.ny.gov page.

]]>
<![CDATA[How Sexual Harassment Damages a Person’s Health: Experts]]>Sat, 11 Nov 2017 00:15:42 -0500https://media.nbcnewyork.com/images/213*120/AP_110507143342.jpg

Sexual harassment not only have negative mental effects on victims and survivors, it can also have physical effects as well, experts tell NBC News Better.

Dr. Colleen Cullen, a licensed clinical psychologist, notes that for victims of sexual harassment, the most common diagnoses are depression, anxiety, and even post-traumatic stress disorder (PTSD).

When the mental effects become too overwhelming, experts call it somatizing, "a long state can turn into physical symptoms," says Dr. Nekeshia Hammond, a licensed psychologist.

These physical symptoms can run the gamut, manifesting as muscle aches, headaches, or even chronic physical health problems such as high blood pressure and problems with blood sugar.



Photo Credit: AP Photo/Josh Reynolds]]>
<![CDATA[Narcan Explained: What Is It and How Do You Use It?]]>Fri, 10 Nov 2017 13:34:04 -0500https://media.nbcnewyork.com/images/213*120/DIT+NARCAN+EXPLAINER+THUMB3.jpg

Ninety-one people in the U.S. die every day from opioid-related overdoses, but there’s a tool that can reverse the effects of an overdose that more and more law enforcement agencies and paramedics are now carrying with them as part of their standing operating protocol. It’s called Narcan, and here is what you need to know about what it is, how it works and how to use it.]]>
<![CDATA[Researcher: Aaron Hernandez's Brain Was Severely Impacted by CTE]]>Mon, 13 Nov 2017 12:19:02 -0500https://media.nbcnewyork.com/images/177*120/GettyImages-1772117051.jpg

Former New England Patriots player Aaron Hernandez suffered substantial damage to parts of the brain that affect memory, judgment and behavior from the most severe case of a degenerative disease linked to head blows ever found in someone so young, a researcher said Thursday.

Dr. Ann McKee, director of Boston University's CTE Center, stressed that she could not "connect the dots" between the brain disease chronic traumatic encephalopathy and the behavior of the 27-year-old who hanged himself in April while serving life in prison for murder.

But McKee said CTE had significantly impacted key parts of Hernandez's brain, including the hippocampus — which is associated with memory — and the frontal lobe, which is involved in impulse control, judgment and behavior.

The next youngest person whose brain they've examined that showed such serious CTE damage was 46 years old, McKee said.

"These are very unusual findings to see in an individual of this age," McKee said. "We've never seen this in our 468 brains, except in individuals some 20 years older."

Hernandez inherited a genetic profile that may have made him more susceptible to the disease, McKee said.  

"We can say collectively, in our collective experience, that individuals with CTE — and CTE of this severity — have difficulty with impulse control, decision-making, inhibition of impulses or aggression, often emotional volatility and rage behaviors," said McKee, who has studied hundreds of brains from football players, college athletes and even younger players, donated after their deaths.

Hernandez hanged himself in prison days after he was acquitted in the 2012 drive-by shootings of two men in Boston and just hours before his former teammates visited the White House to celebrate their latest Super Bowl victory.

Prosecutors contended he gunned the two men down after one accidentally spilled a drink on him in a nightclub — and then got a tattoo of a handgun and the words "God Forgives" to commemorate the crime.

He had been serving a life sentence without parole in the 2013 killing of semi-professional football player Odin Lloyd when he killed himself.

Hernandez, who said he was innocent, did not raise CTE in his defense at either trial.

CTE, which can only be diagnosed in an autopsy, has been found in former members of the military, football players and boxers and others who suffered repeated head trauma.

BU researchers confirmed in September that Hernandez was diagnosed with Stage 3, out of 4, of the disease. But McKee had not publicly discussed her findings until a conference at the university on Thursday.

After Hernandez's CTE diagnosis, his attorneys filed a lawsuit against the NFL and football helmet maker Riddell, accusing them of failing to warn Hernandez about the dangers of football. The lawsuit, which seeks damages for Hernandez's young daughter, said he experienced a "chaotic and horrendous existence" because of his disease.

While the outside of Hernandez's brain appeared normal, the inside was riddled with CTE, she said. There was evidence of previous small hemorrhages, which experts associate with head impacts, she said. Other parts, like the hippocampus, had begun to shrink and large holes were found in his brain's membrane, McKee said.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Is it an Emergency? Insurer Makes Patients Question ER Visit]]>Thu, 09 Nov 2017 12:03:53 -0500https://media.nbcnewyork.com/images/213*120/insurersER_1200x675.jpg

Alison Wrenne was making waffles for her two young children one morning when abdominal pain forced her to the floor. A neighbor who is a physician assistant urged her to go to the emergency room.

Wrong decision, according to her health insurer. Wrenne was diagnosed with a ruptured ovarian cyst, but Anthem said that wasn't an emergency and stuck her with a $4,110 bill.

"How are you supposed to know that?" said the 34-year-old from Lexington, Kentucky. "I'm not a doctor ... that's what the emergency room is for."

In an effort to curb unnecessary and costly ER visits, the Blue Cross-Blue Shield insurer has told customers in a few U.S. states to go to the hospital only in a real emergency such as a heart attack, stroke and major bleeding — or they could wind up footing the bill.

Anthem, the nation's second-largest insurer, wants patients to consider alternatives like drugstore clinics, nurse advice hotlines or telemedicine. Insurers for years have been raising ER co-payments to try to deter unnecessary — and expensive — visits, and Anthem's policy marks another round in this long-standing fight.

Even doctors agree the ER — an important revenue source for hospitals — isn't the best option for minor complaints like sinus infections, rashes or ankle sprains. They say it's better in those cases to see a family doctor who knows a person's medical history.

But some also worry that Anthem's clampdown will scare patients away from the ER in an actual emergency, especially in cases where major problems may not seem serious at first.

"I think it's completely unfair to patients," said Dr. Jesse Pines, who teaches emergency medicine at George Washington University. "It runs the risk of really hurting some people."

Customers in Missouri and Georgia received letters earlier this year from Anthem warning them that minor complaints should be checked out at places like clinics or urgent care centers, where visits can cost $85 and $190, respectively. By comparison, Anthem says a typical ER visit costs around $1,200.

The ER should be used "as it was designed — to treat life-threatening illness," said Dr. Craig Samitt, Anthem's chief clinical officer. "This is in no way meant to compromise a member's determination of whether they've got an emergency."

The push began in 2015 in Kentucky and will expand to Indiana next year and possibly other states that have seen a rise in unnecessary visits. Those involve "common medical ailments" that the average person knows should not be seen in an emergency room, according to Samitt.

Indianapolis-based Anthem Inc. says it wants to steer patients into using the right locations for their care. It has a similar policy for MRIs that pushes some patients away from getting scans at more expensive hospital locations.

There are many exceptions to the ER rule: Patients won't get dinged when there isn't an urgent care center nearby, if they need help on a Sunday or major holiday, if a doctor recommends going to the ER or if someone is under age 14.

Samitt also said Anthem isn't simply rejecting every non-urgent ER claim it receives. The insurer has a physician review a case before issuing a denial, and will consider a patient's circumstances. Anthem said it may cover a patient who arrives with chest pains that turn out to be indigestion instead of a heart attack.

However, hospital officials in Missouri say many of Anthem's reviews haven't been this thorough. The insurer has rejected some claims in only a couple days and hasn't requested patient records before making a decision, said Daniel Landon, a senior vice president with the Missouri Hospital Association.

U.S. emergency department visits are expected to climb to around 150 million this year, up from 141.4 million in 2014. The rise is due partly to coverage expansions under the Affordable Care Act, an aging population and an increase in opioid overdoses, according to the American College of Emergency Physicians.

Other insurers also review ER use but not as aggressively as Anthem, said Laura Wooster of the emergency doctor group. The group has asked Anthem to stop immediately.

"I would hope that other insurers would take a look at this ... and realize it's a dangerous enforcement mechanism to consider," she said.

Anthem spokeswoman Joyzelle Davis said the insurer has met with representatives of the doctor group, but it has no plans to stop its program.

Anthem said it has seen a drop in unnecessary ER visits in Kentucky since it started its review there and has rejected only around 1 percent of all claims as avoidable.

In Wrenne's case, the letter from Anthem said: "We do not believe that a person with an average knowledge of health and medicine would think that this needed care right away" to avoid a serious problem. The insurer said she could have been treated safely in a doctor's office or clinic.

The hospital whittled Wrenne's bill down to several hundred dollars. But now she's nervous about using the ER again.

"It's just frustrating to be a reasonable person and have to weigh the cost of ... going to the ER or not because you have no idea what the bill would be," she said.

Judy Kurtz also is worried about future emergency care. The 62-year-old Maysville, Kentucky, resident was hit with a $1,600 bill a couple years ago after the insurer rejected an ER visit.

A doctor had told her to seek emergency help after an antibiotic reaction made her throat and face swell. She said Anthem eventually paid the claim. But it took about a dozen phone calls and six months to get the insurer to change its mind.

The retired school teacher doesn't want to go through that again and has set a high bar for going to the ER.

"It would have to be terribly life-threatening if I were to go," Kurtz said. "I would probably have to be (unconscious) and someone would have to carry me out."

Copyright Associated Press / NBC New York



Photo Credit: AP/Jacquelyn Martin]]>
<![CDATA['Obamacare' Sign-Ups Top 600K in First Week]]>Thu, 09 Nov 2017 13:20:24 -0500https://media.nbcnewyork.com/images/213*120/Screen-Shot-2017-11-01-at-3.15.46-PM.jpg

More than 600,000 people signed up for coverage under the Affordable Care Act in the first week of open enrollment, the government said Thursday. That pace tracks with previous years despite persistent political turmoil over the health law.

Figures released by the Centers for Medicare and Medicaid Services showed that 601,462 people signed up Nov. 1-4 in the 39 states served by the federal HealthCare.gov website. Of those, about 77 percent were returning customers renewing their coverage, and about 23 percent were new consumers, a split that also mirrors previous years.

Sign-ups for states running their own health insurance markets are not usually included in the early data snapshot. That means that nationally, overall enrollment is higher than reflected in Thursday's statistics. Enacted under former President Barack Obama, the health law offers subsidized private insurance plans to people who don't have health coverage on the job.

Enrollment numbers are being closely watched this year because of the Trump administration's open disdain for the program.

President Donald Trump has repeatedly tweeted that "Obamacare" is collapsing or imploding, and abruptly stopped payments that reimburse insurers for providing lower copays and deductible, contributing to a spike in premiums for next year. His administration cut the sign-up season in half, slashed the advertising budget, and dialed back on counselors that help consumers enroll.

But despite all the uproar, some independent analysts said they don't detect any dramatic impact on the program, at least not yet.

"If there was sabotage, you would expect to see these numbers substantially lower in the beginning of the year, because people wouldn't know it was open enrollment season," said Chris Sloan, a senior manager with the health industry consulting firm Avalere Health.

The numbers don't seem to indicate a surge in consumer interest either, he added. "If there was a surge, you would expect these numbers to be substantially higher," Sloan said.

Separately, a study of the federal HealthCare.gov website for The Associated Press by the technology firm Catchpoint Systems found it running smoothly. Catchpoint monitors consumer experience with major business websites.

The seemingly drama-free start to sign-up season doesn't mean an end to concerns about the Trump administration's stewardship of the program.

"There was a lot of confusion going into this open enrollment period," said Larry Levitt of the nonpartisan Kaiser Family Foundation.

Open enrollment ends much earlier this year, on Dec. 15. Since there's usually a surge of procrastinators at the end, what happens in the last week of sign-up season will be critical.

In counterpoint to the Trump administration's efforts to unravel "Obamacare," a quirk this year means that millions of consumers who are eligible for income-based financial assistance will have access to basic "bronze" plans for no monthly premium. Some experts have said that could lead to increased enrollment, but it's still too early to tell.

Copyright Associated Press / NBC New York



Photo Credit: Healthcare.gov]]>
<![CDATA[Frozen Green Beans Recalled in 12 States Over Listeria Risk]]>Wed, 08 Nov 2017 17:05:55 -0500https://media.nbcnewyork.com/images/213*120/frozen-green-beans.jpg

Nature's Touch Frozen Foods has issued a voluntary recall of its Organic Fine Whole Green Beans because of possible contamination with a bacteria called Listeria monocytogenes, which can cause infections.

The product was distributed in stores in Connecticut, Delaware, Maine, Massachusetts, Maryland, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont and Virginia.

“At Nature’s Touch, our passion is finding the highest-quality frozen foods for our consumers and we are deeply committed to food safety at every production stage,” Nature’s Touch said in a press release. “This voluntary recall reflects our dedication to ensuring the safety of our consumers while enjoying our products.” 

Nature’s Touch Frozen Foods issued the recall after a routine sampling program in Connecticut found one positive result of the bacteria in one bag of green beans, the company said in the press release. The company says it has stopped production and distribution of the products and is working with the Food and Drug Administration on the recall. 

All affected retailers have been contacted to make sure the product is removed from store shelves and no other products were affected, the company says. The product that is the subject of the recall is the 10-ounce size, with "best before" dates of June 4, 2017 to June 21, 2019.

Listeria is a serious infection most likely to affect pregnant women and newborns, elderly adults, and individuals with weakened immune systems, according to the Centers for Disease Control. 

No illnesses associated with the green beans have been reported. 

All affected retailers have been contacted
to ensure that the recalled product is removed from store shelves. Other products of Nature’s Touch
Frozen Foods LLC. are not affected. 

Consumers who have bought Nature’s Touch Frozen Organic Fine Whole Green Beans are advised to throw them out or return them for a full refund.

The company’s Consumer Service Team is available to answer questions at 1-877-850-2664 or by email at: info@naturestouch.ca.



Photo Credit: Photo Courtesy of Nature's Touch Frozen Foods]]>
<![CDATA[Democrats Win Big With Obamacare's Medicaid Expansion]]>Wed, 08 Nov 2017 16:18:11 -0500https://media.nbcnewyork.com/images/213*120/Barack+Obama+Ralph+Northam+GettyImages-863220768.jpg

Barack Obama may not be running for anything these days, but his signature health care law was a big winner in Tuesday’s elections, as voters rebelled against Republican lawmakers who have blocked Obamacare's Medicaid expansion.

Democrats are hopeful their victories are a harbinger of further gains as they look to capitalize on the law's rising popularity in polls — and repeal legislation's deep unpopularity — with more ballot initiatives, legislative efforts and campaign messages.

In Maine, voters passed a ballot initiative that would expand Medicaid to an estimated 70,000 residents by a margin of 18 points, 59-to-41, doing an end run around Gov. Paul LePage, a Republican who has vetoed five bills to do so.

LePage is already threatening to block the measure unless legislators can find a way to finance it without raising taxes, saying in a statement that "this fiscally irresponsible Medicaid expansion will be ruinous to Maine’s budget."



Photo Credit: Photo by Alex Wong/Getty Images]]>
<![CDATA[Boy With Rare Disease Gets Brand New Skin With Gene Therapy]]>Wed, 08 Nov 2017 14:22:44 -0500https://media.nbcnewyork.com/images/208*120/genetherapyskin_1200x675.jpg

Doctors treating a critically ill boy with a devastating skin disease used experimental gene therapy to create an entirely new skin for most of his body in a desperate attempt to save his life.

Two years later, the doctors report the boy is doing so well that he doesn't need any medication, is back in school and even playing soccer.

"We were forced to do something dramatic because this kid was dying," said Dr. Michele De Luca of the University of Modena in Italy, who got a call for help from the German doctors treating the boy.

The boy, then 7, was hospitalized in June 2015 with blisters on his limbs, back and elsewhere. He quickly lost about 60 percent of the outer layer of his skin and was put into an induced coma to spare him further suffering. Doctors at Children's Hospital at Ruhr University in Bochum, Germany, tried skin grafts from his father and donor skin, but all failed.

"He was in severe pain and asking a lot of questions," the boy's father said in a video provided by the hospital "Why do I suffer from this disease? Why do I have to live this life? All children can run around and play, why am I not allowed to play soccer? I couldn't answer these questions."

The boy's parents asked about experimental treatments, and De Luca and his colleagues were contacted. They had previously used gene therapy to produce a small piece of skin in a similar case. They told the family that the boy's precarious state meant that he might not survive the complicated surgeries needed to save him.

"It was a tough decision for us, but we wanted to try for (our son)," the boy's father said. The family asked that their names not be used to protect the boy's privacy.

The boy had a rare, incurable skin disease called junctional epidermolysis bullosa, caused by genetic mutations. People with the disease lack critical proteins that attach the outer layer of the skin to the inner layer, resulting in fragile skin with almost constant blisters and open sores.

To fix that, the doctors took a small piece of the boy's skin from an area that was OK. In the lab, they added a normal version of his bad gene to his skin cells. They grew sheets of the boy's skin, in much the same way skin grafts are grown for burn victims.

In total, they grew close to a square meter of skin (3 square feet.) The lab-grown skin was then transplanted onto the boy in three operations, ultimately covering 80 percent of his body. Ten days later, the new skin was already beginning to grow, De Luca said. After eight months, the doctors said that nearly all of the boy's skin had been generated by the modified stem cells.

So far, no problems have been detected. De Luca said the boy will be monitored closely for skin cancer and other potential issues.

"This kid is back to his normal life again," one of the German doctors, Dr. Tobias Rothoeft, said Wednesday. "That's what we dreamed of doing and it was possible."

Details of the case were published Wednesday in the journal Nature.

"This takes us a huge step forward," said Dr. Peter Marinkovich of Stanford University School of Medicine, who has done related work. He said it was impressive that De Luca and colleagues were able to make such large amounts of viable skin after correcting the genetic defect.

But he noted the approach might not help in more serious cases, which often have tricky complications, like skin blistering in the lungs. Marinkovich said many patients don't survive beyond age 2 and that using the treatment for babies could be even riskier.

Dr. Holm Schneider warned that some severely ill patients might have an extreme reaction to skin transplants with an added gene.

"The immune system might recognize this new gene as something foreign to be attacked and destroyed," said Schneider, of the University Hospital Erlangen in Germany. Still, he said the approach was worth trying in dying patients.

The boy and his family later visited De Luca and the other Italian doctors involved in his treatment.

"The parents are very grateful and say their life has completely changed," De Luca said, recalling how the boy spontaneously began taking off his clothes. "The boy was so happy with his new skin that he wanted to show off."


Copyright Associated Press / NBC New York



Photo Credit: AP/Mirko Wache]]>
<![CDATA[Study: Pain Relievers Worked as Well as Opioids ]]>Tue, 07 Nov 2017 11:27:46 -0500https://media.nbcnewyork.com/images/213*120/ibuprofen_1200x675.jpg

Emergency rooms are where many patients are first introduced to powerful opioid painkillers, but what if doctors offered over-the-counter pills instead? A new study tested that approach on patients with broken bones and sprains and found pain relievers sold as Tylenol and Motrin worked as well as opioids at reducing severe pain.

The results challenge common ER practice for treating short-term, severe pain and could prompt changes that would help prevent new patients from becoming addicted.

The study has limitations: It only looked at short-term pain relief in the emergency room and researchers didn't evaluate how patients managed their pain after leaving the hospital.

But given the scope of the U.S. opioid epidemic — more than 2 million Americans are addicted to opioid painkillers or heroin — experts say any dent in the problem could be meaningful.

Results were published Tuesday in the Journal of the American Medical Association.

Long-term opioid use often begins with a prescription painkiller for short-term pain, and use of these drugs in the ER has risen in recent years. Previous studies have shown opioids were prescribed in nearly one-third of ER visits and about 1 out of 5 ER patients are sent home with opioid prescriptions.

"Preventing new patients from becoming addicted to opioids may have a greater effect on the opioid epidemic than providing sustained treatment to patients already addicted," Dr. Demetrios Kyriacou, an emergency medicine specialist at Northwestern University, wrote in an accompanying editorial.

The study involved 411 adults treated in two emergency rooms at Montefiore Medical Center in New York City. Their injuries included leg and arm fractures or sprains. All were given acetaminophen, the main ingredient in Tylenol, plus either ibuprofen, the main ingredient in Motrin, or one of three opioids: oxycodone, hydrocodone or codeine. They were given standard doses and were not told which drug combo they received.

Patients rated their pain levels before taking the medicine and two hours later. On average, pain scores dropped from almost 9 on a 10-point scale to about 5, with negligible differences between the groups.

Ibuprofen and acetaminophen affect different pain receptors in the body so using the two drugs together may be especially potent, said Dr. Andrew Chang, an emergency medicine professor at Albany Medical College in upstate New York, who led the study.

He noted that a pill combining ibuprofen and acetaminophen is available in other countries; his findings echo research from Canada and Australia testing that pill against opioids for pain relief.

___

Follow AP Medical Writer Lindsey Tanner on Twitter at @LindseyTanner. Her work can be found here.


Copyright Associated Press / NBC New York



Photo Credit: AP/Patrick Sison]]>
<![CDATA[1 Reason Flu Vaccines Are So Lousy: They're Grown in Eggs]]>Tue, 07 Nov 2017 13:31:06 -0500https://media.nbcnewyork.com/images/213*120/flu-shot.jpg

Last year's influenza vaccine reduced the number of flu-related visits to the doctor by 42 percent, and the vaccine reduced a specific strain of flu virus by even less, according to the Centers for Disease Control and Prevention.

One important reason flu shots don't usually work very well is because they're grown in chicken eggs, a slow and tricky process that can go wrong easily, researchers told NBC News.

"We need to get away from the antiquated production model, which the egg is," said Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases.

He thinks that vaccines made using insect cells could be better at protecting people from the flu.



Photo Credit: AP, File]]>
<![CDATA['Unusually Severe' Plague Sickens 1,800 in Madagascar]]>Fri, 03 Nov 2017 11:43:01 -0500https://media.nbcnewyork.com/images/213*120/plague-cdc.jpg

More than 1,800 people in Madagascar have contracted plague in what the World Health Organization deemed an "unusually severe" outbreak, but it's unlikely to spread beyond the island, NBC News reported.

The infection is easily treated with antibiotics if caught early enough and is now rare in developed countries, but it's an ongoing problem in Madagascar, where 187 people have died in the latest outbreak.

"Based on available information and response measures implemented to date, WHO estimates the risk of potential further spread of the plague outbreak at national level remains high," according to a WHO report.

Screening for the disease has been stepped up at airports, the agency said, which will help stop people from bringing the infection beyond the island's shores.



Photo Credit: National Institute of Allergy and Infectious Diseases]]>
<![CDATA[Obama Touts Open Enrollment for 'Obamacare' ]]>Wed, 01 Nov 2017 14:20:05 -0500https://media.nbcnewyork.com/images/213*120/Screen-Shot-2017-11-01-at-3.15.46-PM.jpg

A new deadline, rising prices and fewer options for help will greet health insurance shoppers as the Affordable Care Act's main enrollment window opens Wednesday.

Also in store: Befuddlement.

"Confusion seems to be one of the key words to describe what we're facing now," said Nicholas Moriello, a Delaware-based broker.

Among the things Moriello has found he needs to clear up with customers: That the Obama-era law still exists.

Even former President Barack Obama took to Twitter Wednesday to deliver a short video reminding people that it's time to pick coverage for next year.

The health care law has survived funding cuts and congressional repeal attempts so far. Most Americans are still required to get health insurance, and they can find plans — including some generous subsidies — through state-based marketplaces or exchanges, including HealthCare.gov .

That said, some prices have skyrocketed and choices have narrowed in many markets, in part because of political bickering over the health law.

Here's what's new, what's the same, and some important points to consider when searching for 2018 coverage.

LESS TIME TO DECIDE
The main enrollment window has been sliced in half. It starts Nov. 1 and ends Dec. 15 in most states. Last year, you had until after the holidays to sign up.

Don't wait until the last minute to shop. The search can take a few hours without assistance, and websites that process applications can slow under a deadline rush.

"It's a very delicate subject when you're dealing with someone's health and if the plan doesn't work, you're stuck with it for the next year," said Dallas-based broker Tanya Boyd.

FEWER HELPERS AVAILABLE
It may be harder to find someone willing to answer questions.

President Donald Trump's administration has slashed funding for "navigator" positions created to help people enroll. It also has ended contracts for another program that brought assistance into libraries and neighborhoods in 18 cities.

There may even be fewer agents willing to help, because of an industry-wide move to reduce commissions.

The federal HealthCare.gov website has a "Find Local Help" button on its home page. Customers also can call 1-800-318-2596.

PRICES: EXPECT HIKES
Premiums for popular "silver" level plans are climbing an average of 34 percent in the 39 state marketplaces that operate through HealthCare.gov, according to the consulting firm Avalere. That pushes the average monthly bill to $743 from $554 this year for single coverage for a 50-year-old shopper.

The average price for more expensive gold coverage is rising 16 percent. Cheaper bronze plans will climb 18 percent.

Average premiums, or the price of coverage, will climb in most markets, but the size of price changes will vary widely.

MORE FINANCIAL ASSISTANCE
Income-based tax credits are calculated based on the cost of silver plans, so those credits are expected to climb, and that will funnel more help to people, especially those with lower incomes.

In some cases, credits might climb high enough to cover the entire bill for bronze plans, which usually require customers to pay a deductible of several thousand dollars before most coverage begins.

Shoppers who make too much to qualify for tax credits could face the biggest price hikes.

Those customers should check for options outside the marketplaces, where people can still buy insurance but without tax credit help.

There, insurers in some states are expected to sell cheaper versions of the silver plans, said Karen Pollitz, a senior fellow at the Kaiser Family Foundation, which studies health care issues.

DON'T BLOW IT OFF
The health law still requires most Americans to buy coverage that complies with the law or face a penalty that can top $1,000 depending on income.

The IRS is paying attention, said Kelley Turek of the trade group America's HealthInsurance Plans. She noted that the federal agency is reminding income tax filers that it will reject or suspend any returns that don't indicate whether the taxpayer had coverage.

LIKE ALWAYS: SHOP CAREFULLY
Don't just shop based on price.

The premium is only one indicator of a health plan's affordability. There's also the deductible and co-insurance, which is the percentage of the bill a patient pays after the deductible is met.

Plans also can change the doctors and medications they cover. Check on that before you renew coverage.

Copyright Associated Press / NBC New York



Photo Credit: Healthcare.gov
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<![CDATA[NJ Sues OxyContin Maker, Alleges 'Direct Link' to Opioid Crisis]]>Tue, 31 Oct 2017 11:41:41 -0500https://media.nbcnewyork.com/images/213*120/AP_201601271555460000.jpg

New Jersey filed a lawsuit Tuesday against the company that manufactures OxyContin, claiming a "direct link" between the state's opioid crisis and the firm's deceptive marketing practices.

State Attorney General Christopher Porrino says the five-count lawsuit against Connecticut-based Purdue Pharma and two of its entities seeks undisclosed monetary damages for fraud and false claims.

Purdue Pharma issued a statement saying it "vigorously denies" the allegations. The company said it's deeply troubled by the opioid crisis and is dedicated to being part of the solution.

"As a company grounded in science, we must balance patient access to FDA-approved medicines, while working collaboratively to solve this public health challenge," it said.

Prescription opioids have long been linked to the rise in heroin abuse. Federal drug enforcement officials have characterized prescription painkillers as a "feeder system" for the opioid epidemic.

More than 1,600 people died from opioid overdoses in 2015, according to the most recent reporting available from state health officials.

In 2016, 38,334 New Jerseyans underwent treatment for an addiction to opioids.

The state claims Purdue exploited vulnerable new markets, including the elderly and the "opioid-naïve," to boost profits. It claims Purdue aggressively marketed opioids and duped doctors and the public into believing they should be the primary treatment option for chronic conditions — like arthritis and migraines — despite the lack of any studies examining treatment periods longer than 12 weeks.

"When we point the finger of blame for the deadly epidemic that has killed thousands in New Jersey, Purdue is in the bull's-eye of the target," Porrino said. "Today, my office took the first step toward holding them legally and financially responsible for their deception."

The suit includes three counts alleging violations of the state's Consumer Fraud Act and one count alleging violations of its False Claims Act. It also includes a charge of creating a public nuisance.

More than two dozen states, cities and counties have sued the pharmaceutical companies.

New Jersey's Republican Gov. Chris Christie has made addiction services a priority in his final year in office. He also chairs President Donald Trump's commission on opioids.

Trump last week declared opioid abuse a national public health emergency and announced new steps to combat what he described as the worst drug crisis in U.S. history.

The U.S. Centers for Disease Control and Prevention found that, in 2015, drug overdoses killed more than 52,000 Americans. Most involved prescription opioids such as OxyContin or Vicodin or related illicit drugs such as heroin and fentanyl. People with addictions often switch among the drugs.

Copyright Associated Press / NBC New York



Photo Credit: Toby Talbot/AP, FIle]]>
<![CDATA[Major Recall Affects Chocolate Sold at Wegmans in 23 States]]>Tue, 31 Oct 2017 09:55:54 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-56960813.jpg

A New York-based company is recalling a bunch of chocolate products, most of which were sold at Wegmans stores in nearly two dozen states, because they contain milk not declared on the list of ingredients, which could be extremely dangerous, even life-threatening, to people allergic to it. 

First Source announced the voluntary recall Monday. Both packaged chocolate, coffee beans and almonds and items sold in self-service bins are affected by the recall. 

The following 10 packaged items are affected:

  • Wegmans Dark Chocolate Almonds 23oz tub
  • Wegmans Dark Chocolate Almonds 11.5oz tub
  • Wegmans Dark Chocolate Almonds with Sea Salt and Turbinado Sugar 12oz tub
  • Wegmans Dark Chocolate Cherry-Infused Cranberries 12oz tub
  • Wegmans Dark Chocolate Strawberries 13.5oz tub
  • Alpine Valley Dark Chocolate Almonds 11.5oz tub
  • Circle K Favorites Dark Chocolate Covered Almonds 3.25oz bag
  • Tops Dark Chocolate Covered Almonds 11.5oz tub
  • Tops Dark Chocolate Coffee Beans 12oz tub
  • 7 Select Dark Chocolate Turbinado Almonds with Sea Salt 2.25oz bag 

Those were sold in 23 states including New York, New Jersey, Pennsylvania, California, Florida, Illinois, Maryland, Texas, Vermont and Virginia from Jan. 1, 2016, to the present. 

The following products sold in bulk self-service bins at grocery stores between Jan. 1, 2016, and Oct. 30, 2017, are also affected: 

  • 15 LBS Dark Chocolate Peanuts distributed to Wegmans Food Markets, Dryden Food Market, New Brighton Food Land, Punxsutawney Country Market, and Trumansburg Shur Save,
  • 20 LBS Dark Chocolate Almonds to Wegmans Food Markets, Giant Food Store, Martin’s Food Market, and Stop N Shop
  • 25 LBS Dark Chocolate Coffee Beans Giant Food Store, Giant Food Mart, Martin’s Food Market, Wegmans Food Market, Dryden Food Market, Orchard Fresh, Stop N Shop, and Punxsutawney Country Market 

Those products were distributed in New York, New Jersey, Maryland, Massachusetts, Pennsylvania, Virginia and West Virginia. 

No illnesses or reactions have been reported, and First Source says it is issuing the recall out of an abundance of caution. It found out about the issue after a supplier issued its own recall because of the milk allergen. Anyone with questions can call First Source at 1-716-389-0200.



Photo Credit: File-Stephen Chernin/Getty Images]]>
<![CDATA[Global Warming Is Hitting People's Health: Medical Study]]>Tue, 31 Oct 2017 06:02:30 -0500https://media.nbcnewyork.com/images/213*120/AP_17303594477117-Dengue-Fever.jpg

Global warming is hurting people's health a bit more than previously thought, but there's hope that the Earth — and populations — can heal if the planet kicks its coal habit, a group of doctors and other experts said.

The poor and elderly are most threatened by worsening climate change, but there remains "glimmers of progress" especially after the 2015 Paris agreement to limit heat-trapping carbon dioxide emissions, according to a new big study published Monday in the British medical journal Lancet.

Comparing the report to a health checkup, four researchers and several outside experts described Earth's prognosis as "guarded."

"There are some very severe warning signs, but there are some hopeful indicators too," said co-author Dr. Howard Frumkin, a professor of environmental health at the University of Washington. "Given the right treatment and aggressive efforts to prevent things from getting worse, I think there's hope."

The report highlighted health problems stemming from more frequent heat waves, disease spread by insects, air pollution and other woes. While the disasters have been costly, deaths haven't been increasing because society is doing a better but more expensive job adjusting to the changing conditions, the researchers noted.

A team of 63 doctors, public health officials and scientists from around the world wrote what they considered the first of a regular monitoring of the health of the planet, similar to having a "finger on the pulse of the patient," said Dr. Hugh Montgomery, an intensive care specialist and director of the University College of London's Institute for Health and Performance.

Based on 40 indicators, the study said "the human symptoms of climate change are unequivocal and potentially irreversible."

While other disease rates are dropping, cases of dengue fever — a mosquito-borne disease — has doubled every decade since 1990 with 58.4 million cases and 10,000 deaths in 2013. Frumkin, a former environmental health director at the U.S. Centers for Disease Control and Prevention, said climate change, which allows mosquitoes to live in more places and stay active longer with shorter freeze seasons, is part but not all of the reason.

The same goes for the increase in tick-borne Lyme disease in the United States, Frumkin said, adding "the ticks do better with warmer weather."

Between 2000 and last year, the number of vulnerable people — those over 65 or with chronic disease — exposed to heat waves increased by about 125 million, the study said.

It also highlighted the increasing likelihood of food shortages as climate change worsens.

Columbia University's Madeline Thomson, who wasn't part of the study team, praised the work, saying "climate is a stress multiplier" so it is important to monitor this way.

Acting on climate can have side benefits, Frumkin said. Cutting coal takes smog and soot out of the air, while eating less meat and bicycling and walking more to use less electricity means fewer accidents and reduced obesity, he said.

Copyright Associated Press / NBC New York



Photo Credit: Muhammad Sajjad/AP, File]]>
<![CDATA[FDA Moves to Ax Claim for Heart Benefits From Soy Foods]]>Tue, 31 Oct 2017 05:18:57 -0500https://media.nbcnewyork.com/images/213*120/soybeaningredients_1200x675.jpg

U.S. regulators want to remove a health claim about the heart benefits of soy from cartons of soy milk, tofu and other foods, saying the latest scientific evidence no longer shows a clear connection.

Monday's announcement by the Food and Drug Administration marks the first time the agency has moved to revoke a health food claim since it began approving such statements in 1990. The claim that soy protein can reduce heart disease appears on about 200 to 300 products in the U.S., according to industry figures, including popular brands like Silk soy milk.

Calls to WhiteWave Foods Company, which markets Silk brand soy products, were not immediately returned Monday.

The FDA first approved the language about the benefits in 1999 based on studies suggesting soy protein lowered a type of heart-damaging cholesterol in the bloodstream. But some later studies have failed to show a clear link.

One 2005 study by the U.S. government's Agency for Healthcare Research and Quality found that soy products had little effect on bad cholesterol. The FDA began reevaluating the food claim in 2007 and said Monday "the totality of the evidence is inconsistent and not conclusive."

The agency will take comments on its proposal for 75 days before moving ahead. If the language is removed, companies may still be able to use a less definitive statement about soy's benefits by including a disclaimer or description of the mixed evidence.

Consumer advocates backed the proposal, arguing that earlier research misinterpreted soy's effect on cholesterol.

Bonnie Liebman, a nutrition scientist at the Center for Science in the Public Interest, explained that a person might benefit by replacing red meat with soy, but the benefit would be from the reduction in red meat, not because of anything special in the soy protein.

The FDA estimates it will cost companies between $370,000 and $860,000 in upfront costs to re-label their products, according to a federal filing posted online.

An industry group for soy manufacturers disputed the FDA's decision and pointed to 12 other countries, including Canada, that have approved health labeling claims making the link between soy protein and heart benefits. The group, Soyfoods Association of North America, said it would make its case to the FDA during the comment period.

Copyright Associated Press / NBC New York



Photo Credit: AP/Patrick Sison, File]]>
<![CDATA['Obamacare' Curveball: Free Insurance in 1,500-Plus Counties]]>Mon, 30 Oct 2017 15:40:09 -0500https://media.nbcnewyork.com/images/203*120/Screen+Shot+2017-10-30+at+8.37.47+AM.png

In an odd twist, low-income people in about half of U.S. counties will now be able to get a taxpayer-subsidized "Obamacare" policy for free, according to a new study that suggests some actions by President Donald Trump against the health law could backfire.

Monday's analysis of government data by the nonpartisan Kaiser Family Foundation runs counter to the perception of staggering across-the-board increases in costs for consumers under the Affordable Care Act. It could become a springboard for marketing pitches by insurers as they try to sign up more consumers when open enrollment starts Nov. 1.

The study found that in 1,540 counties a hypothetical 40-year-old making $25,000 a year can get a basic "bronze" plan under the ACA next year for zero monthly premium.

It's partly as a result of administration actions that raised the underlying cost of insurance, leading to higher federal spending for premium subsidies.

The final number of counties with available free plans is certain to be higher because the Kaiser study only examined the 39 states using the federal HealthCare.gov website for sign-ups. In those states, nearly 60 percent of counties will have free bronze plans.

"Because of the way that premiums are set this year, people have to shop around to make sure they are getting a plan that makes sense for them," said Gary Claxton, a co-author of the report. "Telling people that the choice is to pay a penalty (for being uninsured) or take a free plan, is a pretty attractive proposition."

Separately, the government also released official numbers Monday. The Health and Human Services department said sticker-price premiums are going up 37 percent for a hypothetical young adult buying a type of midrange "silver" plan.

HHS said insurer participation is down, with 29 percent of current "Obamacare" customers having just one carrier next year in their community. And the government noted that subsidies for premiums are also rising — about 45 percent, on average.

The Kaiser study illustrates what's happening under the hood as the complicated moving parts of the health law's different subsidies and coverage levels respond to actions by the administration. The president is still vowing to repeal and replace "Obamacare."

Trump recently shut off government subsidies to insurers for providing lower copays and deductibles to people with modest incomes, citing legal questions about whether those payments were properly approved by Congress.

But insurers have raised premiums, which are also subsidized.

Think of pushing down on one end of a see-saw and the other end goes up.

Because consumers can use their premium subsidy to buy any level of coverage, that money can be enough to cover the full price of a lower-cost bronze plan.

This year consumers in some areas had access to zero-premium bronze plans, but Claxton said for 2018 it will be many more people.

Bronze plans are not for everybody, since they typically have annual deductibles of $6,000 or more. But they may appeal to younger people or those who expect to have just a few doctor visits over a year.

Rising premium subsidies also can make "gold" plans more affordable. Those offer a higher level of coverage, comparable to what employers provide.

Enrollment figures for the current year show the lure of the no-cost bronze plans.

According to an Associated Press analysis, there were multiple no-cost bronze plans on the market in states with the highest percentage of bronze customers.

That indicates that many consumers were willing to take those plans where they were offered.

It could bring a huge shift in enrollment patterns for 2018 in many states.

In Texas, for instance, roughly 80 percent of counties will have a zero-premium bronze plan in 2018. Currently more than a quarter-million current ACA enrollees in those counties have low incomes that could potentially qualify them for a no-cost plan. But no Texas counties had a no-cost plan in 2017.

In Florida, which will also have no-cost bronze plans for the first time, almost one million current enrollees have low incomes that could qualify them and live in a county where a no-cost plan will be offered.

Because of other considerations, like age, not all of them will qualify for a no-cost plan - but many will.

"The availability of zero-dollar or ultra low-cost plans has a huge impact on consumer decision making," said Joshua Peck, a former Obama administration official involved with an independent campaign to promote sign-ups. "The chief question is whether consumers will know that they exist."

Sign-up season starts Wednesday and ends Dec. 15. About 9 million to 10 million people currently have private plans through the ACA, with more than 8 in 10 customers getting subsidies.

Copyright Associated Press / NBC New York



Photo Credit: Healthcare.gov]]>
<![CDATA[2,900 Treated for Hepatitis After Visiting Popular NY Eatery]]>Sat, 28 Oct 2017 21:15:39 -0500https://media.nbcnewyork.com/images/213*120/WNBC+5PM+AIRCHECK+M-F+-+17565827_WNBC_000000018399608.jpg

Thousands of people were treated against Hepatitis A this week after officials warned customers of a popular Port Chester restaurant that they may have been exposed to the serious infection.

The Westchester Health Department said 2,911 people were treated on Thursday, Friday and Saturday in connection with five cases of Hepatitis A traced to the Bartaco restaurant on Willett Avenue. About 900 were treated Thursday, 800 on Friday and 1,187 on Saturday, with more expected on Monday and Tuesday. 

Lines for the free treatments stretched outside Westchester County Center on Friday.

“I love tacos. It was my first time trying a portobello, and this happened,” Clifton Newton said. “So, you know, what can I do?”

Customers who ate or drank at the restaurant from Oct. 12 to Oct. 23 could have been exposed, according to health officials. They say an employee worked there while infected with the illness.

Those who ate at the restaurant during the affected dates can still be inoculated Monday and Tuesday (details below). 

Preventative treatment is only effective within two weeks of exposure, so anyone who ate at the restaurant since Oct. 12 is advised to seek treatment immediately.

Those outside the window have to wait and see if they develop symptoms, said Westchester County Health Commissioner Sherlita Amler. She says those with symptoms should contact their health care provider as soon as possible. 

Hepatitis A affects the liver and can cause symptoms ranging from fever to extreme fatigue, abdominal pain and jaundice.

Bartaco was up and running again Friday as customers mulled whether to return.

Some customers were hesitant.

“You’re going there for a nice experience and the experience is going to be hepatitis, I don’t think you want that,” Edith Rivera said.

Other customers said they respected the restaurant’s accountability after learning about the infected employee.

“Just the fact that they informed everybody about this and took this step, kind of earns my trust a little more,” August Abatecola said.

The restaurant says it’s fully cooperating with health officials and that it cares about the health and safety of its customers.

Preventive treatment will also be available by appointment only on Monday and Tuesday at the Health Department’s White Plains clinic at 134 Court St. Appointments are available on Monday from 9 a.m. to 6 p.m. and Tuesday from 9 a.m. to 3:30 p.m. To register, go to www.health.ny.gov/go2clinic/60



Photo Credit: NBC 4 New York]]>
<![CDATA[Synthetic Opioids Rising as Deadly Overdoses Top 60K: CDC]]>Fri, 27 Oct 2017 10:51:31 -0500https://media.nbcnewyork.com/images/213*120/fentanyl+painkiler.jpg

More than 60,000 Americans died of drug overdoses last year, and synthetic opioids played a larger role than ever, CNBC reported.

Deaths from those extremely strong drugs, like fentanyl, increased fivefold, and some analogs of fentanyl, like the large animal tranquilizer carfentanil, are increasinly being implicated in opioid deaths, according to a new report from the Centers for Disease Control and Prevention.

"The increased mixing or co-use of fentanyl, heroin, cocaine, and varying fentanyl analogs might contribute to increased risk for overdose because persons misusing opioids and other drugs are exposed to drug products with substantially varied potency," the report's authors wrote.

Fifty to 100 times more powerful than morphine, fentanyl was introduced into the market in 2013. That year it was implicated in just over 3,000 overdose deaths; in 2016, it was involved in 20,000, according to the report, which the CDC said was the first to use "toxicologic and scene evidence from multiple states to characterize opioid overdose deaths."



Photo Credit: NBC10]]>
<![CDATA[Billionaire Drug Maker Charged With Pushing Powerful Opioid]]>Fri, 27 Oct 2017 07:48:25 -0500https://media.nbcnewyork.com/images/213*120/AP_17300061042969-Opioid-Conspiracy-Charges.jpg

U.S. prosecutors leveled charges Thursday against the billionaire founder of an opioid medication maker that has faced increasing scrutiny from authorities across the country over allegations of pushing prescriptions of powerful painkillers amid a drug epidemic that is claiming thousands of lives each year.

The fraud and racketeering case against Insys Therapeutics founder John Kapoor came the same day President Donald Trump declared the opioid crisis a nationwide public health emergency.

The case naming Kapoor follows indictments against the company's former CEO and other executives and managers on allegations that they provided kickbacks to doctors to prescribe a potent opioid called Subsys.

In the new indictment, Kapoor, 74, of Phoenix, and the other defendants are accused of offering bribes to doctors to write large numbers of prescriptions for the fentanyl-based pain medication that is meant only for cancer patients with severe pain. Most of the people who received prescriptions did not have cancer.

It also alleges that they conspired to mislead and defraud insurance providers who were reluctant to approve payment for the drug when it was prescribed for patients without cancer.

U.S. prosecutors in Boston brought the case as they vowed to go after problem opioid makers similar to how they target "cartels or a street-level drug dealer."

"In the midst of a nationwide opioid epidemic that has reached crisis proportions, Mr. Kapoor and his company stand accused of bribing doctors to overprescribe a potent opioid and committing fraud on insurance companies solely for profit," said Acting U.S. Attorney William D. Weinreb in Boston.

A judge set bail at $1 million for Kapoor, saying he must wear electronic monitoring and surrender his passports. Kapoor, who was arrested earlier Thursday, entered court in basketball shorts, tennis shoes and a T-shirt, his long, gray hair disheveled.

"He is not guilty of these charges, he intends to fight it vigorously," defense attorney Brian T. Kelly said outside court. Kelly is a high-profile Boston lawyer and former federal prosecutor who successfully tried imprisoned gangster James "Whitey" Bugler.

Kapoor came to the U.S. from India to get his Ph.D. in medicinal chemistry from the University of Buffalo, where the pharmacy school is named for him and his wife to honor their longtime philanthropy.

Kapoor, whose worth Forbes estimated at $1.75 billion, also founded a company that operates seven restaurants including the Japanese eatery Roka Aker in Scottsdale.

In Massachusetts, former Insys CEO Michael L. Babich and five other former executives and managers are set to go to trial in October 2018 and have pleaded not guilty. The latest indictment brings new charges against Babich and others.

Several former Insys employees and health care providers have pleaded guilty to felony charges around the country, including in Alabama and Connecticut. A Rhode Island doctor pleaded guilty Wednesday to accepting kickbacks in return for prescribing the highly addictive fentanyl spray.

A spokesman for Arizona-based Insys said this week that the company is under new management and has replaced nearly all its original sales staff. It says it takes responsibility for the actions of its former employees.

"We have taken necessary and appropriate steps to prevent past mistakes from happening in the future, and are committed to conducting business according to high ethical standards and the interests of patients," the company said in a statement Wednesday. "We also continue to work with relevant authorities to resolve issues related to the misdeeds of former employees."

Sen. Claire McCaskill of Missouri said evidence from a congressional probe she launched this year suggested that Insys had "gotten away with fines that amounted to a slap on the wrist for actions that helped fuel a nationwide epidemic that's claimed hundreds of thousands of American lives."

Kapoor was named the drugmaker's president and CEO in November 2015 after Babich resigned without explanation.

Federal authorities apparently have been investigating the company for some time. In late 2013, Insys said it received a subpoena from the Department of Health and Human Services asking for documents tied to the commercialization of Subsys. Nearly a year later, it received a subpoena from U.S. prosecutors in Boston for documents connected with sales and marketing practices for the drug.

In addition to the criminal charges, states have been suing Insys over its marketing practices.

Meanwhile, the company has been active in politics, donating $500,000 last year to an Arizona campaign to defeat a ballot measure to legalize marijuana.

The company's stock price has taken a big tumble in recent months amid the legal issues. Insys stock plunged more than 20 percent Thursday.

Associated Press writers Jacques Billeaud and Geoff Mulvihill contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: Ross D. Franklin/AP]]>
<![CDATA[Aetna Stock Surges on Report of CVS Deal Talks]]>Fri, 27 Oct 2017 06:04:40 -0500https://media.nbcnewyork.com/images/213*120/aetna_cvs_sidebyside3.jpg

Aetna's stock has surged after a news report said CVS Health is in talks to buy the insurer a deal that could be worth more than $60 billion.

The Wall Street Journal reported on the deal talks Thursday. The newspaper cited people familiar with the matter and said CVS might pay more than $200 a share for the nation's third-largest health insurer.

Spokesmen for both companies declined to comment on the report.

Aetna's stock jumped $18.48, or 11 percent, to close Thursday at $180.48.

CVS Health is the nation's second-largest drugstore chain and also processes more than a billion prescriptions annually as a pharmacy benefits manager. Aetna insures more than 22 million people.

CVS Health Corp. is based in Woonsocket, Rhode Island. Aetna Inc. is based in Hartford, Connecticut.

Copyright Associated Press / NBC New York



Photo Credit: NBC Connecticut, File]]>
<![CDATA[President Trump Declares Opioid Epidemic a Public Health Emergency]]>Mon, 30 Oct 2017 11:07:58 -0500https://media.nbcnewyork.com/images/213*120/DIT+TRUMP+OPIOID+SPEECH+THUMB.jpg

President Trump outlined the White House’s plans to curb the opioid epidemic, which he declared a nationwide public health emergency. Trump shared a personal anecdote about his late older brother, who told him to never start drinking.]]>
<![CDATA[Health Dept. Warns of Hep A Exposure at Popular NY Eatery]]>Thu, 26 Oct 2017 08:38:54 -0500https://media.nbcnewyork.com/images/213*120/hospital-generic-1020.jpg

Health officials in Westchester County are sounding the alarm for recent customers at a popular Port Chester restaurant because they may have been exposed to a serious infection that is typically transmitted by consuming food or drinks that have been handled by an infected person.

Diners at bartaco on Willett Avenue are urged by officials to see a doctor because they may have been exposed to Hepatitis A, which affects the liver and can cause symptoms ranging from fever to fatigue, abdominal pain and jaundice.

Customers who ate or drank at the restaurant from Oct. 12 to Oct. 23 could have been exposed, according to health officials. They say an employee worked there while infected with the illness. 

Preventative treatment is only effective within two weeks of exposure, so anyone who ate at the restaurant since Oct. 12 is advised to seek treatment immediately. The Health Department said it will offer preventive treatment on Thursday from 4 p.m. to 7:45 p.m., Friday from 12 p.m. to 4:45 p.m. and Saturday from 8:30 a.m. to 4:45 p.m.

Patrons may also have been exposed to the virus from Aug. 22 to Oct. 11, authorities said. Although outside the two-week window, health officials said those customers are also advised to contact their health care provider immediately if they experience symptoms.



Photo Credit: NBC 7]]>
<![CDATA[Scientists Working Toward Reversible Kind of Gene Editing]]>Thu, 26 Oct 2017 06:58:20 -0500https://media.nbcnewyork.com/images/213*120/crisprfounder_1200x675.jpg

Scientists are altering a powerful gene-editing technology in hopes of one day fighting diseases without making permanent changes to people's DNA.

The trick: Edit RNA instead, the messenger that carries a gene's instructions.

"If you edit RNA, you can have a reversible therapy," important in case of side effects, said Feng Zhang of the Broad Institute of MIT and Harvard, a gene-editing pioneer whose team reported the new twist Wednesday in the journal Science.

A genome editing technique called CRISPR has revolutionized scientific research. It's a biological cut-and-paste tool that lets researchers spot a gene defect inside living cells and use molecular "scissors" to snip that spot, either deleting, repairing or replacing the affected gene.

Researchers are using CRISPR to try to improve crops, develop malaria-resistant mosquitoes, grow transplantable organs inside animals, and develop treatments that one day may help genetic diseases such as sickle cell or muscular dystrophy.

There are challenges for medical use. Because a change to DNA is permanent, accidentally cutting the wrong spot could lead to lasting side effects.

And DNA repair is harder to achieve in certain cells, such as brain and muscle cells, than in others, such as blood cells — so targeting RNA may offer an important alternative, said University of California, San Diego, professor Gene Yeo, who wasn't involved in Wednesday's study. His team is creating its own RNA-targeting version of CRISPR.

Disease can occur when a genetic defect leaves cells making too little or too much of a particular protein, or not making it at all.

RNA, a cousin of DNA, carries the gene's instructions to start the protein-making process. Editing RNA's instructions should result in temporary fixes to abnormal protein production, Zhang explained. Because RNA degrades over time, the changes theoretically would last only as long as the therapy was used.

To start figuring out how, researchers returned to nature.

CRISPR was adapted for use in mammalian cells from a system that evolved in bacteria, and uses as its molecular scissors an enzyme named Cas9. Zhang's team examined relatives in the Cas protein family and found one, Cas13, that could target RNA instead. The researchers engineered a Cas13 variety so it sticks to RNA instead of cutting it. They then fused on another protein to edit that spot and tested it in lab dishes.

The research is in its earliest stages, requiring more work before it even could be tested in animals.

But San Diego's Yeo, who is using a different Cas approach to target RNA, praised the competing work.

"It really tells us that many Cas proteins can truly bind RNA," he said. "The smart thing to do is to test a lot of them." 

Copyright Associated Press / NBC New York



Photo Credit: AP/Susan Walsh]]>
<![CDATA[Premiums Rising 34 Pct. for Most Popular Health Plan: Study]]>Wed, 25 Oct 2017 18:07:57 -0500https://media.nbcnewyork.com/images/213*120/healthcare-dot-gov.jpg

Premiums for the most popular "Obamacare" plans are going up an average of 34 percent, according to a study out Wednesday that confirms dire predictions about the impact of political turmoil on consumers.

Window-shopping on HealthCare.gov went live Wednesday, so across the country consumers going online can see the consequences themselves ahead of the Nov. 1 start of sign-up season for 2018.

The consulting firm Avalere Health crunched newly released government data and found that the Trump administration's actions are contributing to the price hikes by adding instability to the underlying problems of the health law's marketplaces.

President Donald Trump puts the blame squarely on "Obamacare" saying the program is imploding, while ignoring warnings that his administration's actions could make things worse.

The Avalere analysis is for the 39 states using HealthCare.gov. Along with the increase for silver plans, premiums also are going up by double digits for different levels of coverage, including bronze (18 percent), gold (16 percent), and platinum (24 percent).

Many states had higher increases. Avalere found that average plan silver premiums will go up by 49 percent in Florida, 43 percent in Missouri, and 65 percent in Wyoming.

Consumers eligible for income-based tax credits will be protected from rising premiums but those who pay full-cost face a second consecutive year of sharp premium increases.

Only three states will see declines — Alaska, Arizona, and North Dakota.

Avalere said market instability is driven by Trump's recent decision to end subsidy payments to insurers, the continued debate over "Obamacare" repeal and replace, and a presidential executive order that could open a path for lower cost plans outside of the Obama-era law.

"You put all that together, and there are a lot of additional forces on top of market forces driving high premium increases for 2018," said Chris Sloan, a senior manager with the health industry consulting firm.

Significant increases also are expected in states that run their own health insurance websites.

Starting Nov. 1, new customers can submit applications, and returning ones can make changes to their coverage. Open enrollment will end early, on Dec. 15, about half the time allotted under Barack Obama's administration.

Sign-up season comes after the president abruptly pulled the plug on federal payments that reimburse insurers for reduced copays and deductibles they're required to provide to people of modest means. That exposes insurers to a potential $1 billion loss for the remainder of this year.

A federal judge in San Francisco on Wednesday denied a request by state attorney's general to order the payments immediately restored. Administration officials say the payments were not properly approved by Congress and Trump is following the U.S. Constitution by denying them.

Bipartisan legislation to resolve the problem is pending, and the Congressional Budget Office on Wednesday said the bill would reduce federal deficits and have no major impact on coverage. But the legislation by Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash. faces an uncertain future. Trump has sent mixed signals about whether he would support it.

Restoring the funds may have little immediate impact on 2018 premiums, but the bill calls for insurers to rebate money to the government and consumers if they collect too much.

Avalere's Sloan said that consumers who receive subsidized premiums would generally be protected from premium increases.

That's not the case, however, for an estimated 7 million unsubsidized customers, most of whom buy individual plans outside the government markets.

"There is a danger that middle-class people who don't get government help in paying their premiums could be increasingly priced out of the market," said Larry Levitt of the nonpartisan Kaiser Family Foundation.

About 10 million people currently have private health insurance through government-sponsored markets like HealthCare.gov. More than 8 in 10 customers receive tax credits to help pay their premiums, and that aid is still available despite the political turmoil.

Unlike the Obama years, the Trump administration has set no enrollment goal for 2018.

"We are really focused on having a smooth consumer experience," said Randy Pate, director of the HHS office that oversees the program. "That is our target for this year."

Administration officials say they have made a series of improvements to the sign-up process unheeded in the acrimonious political debate over health care.

Copyright Associated Press / NBC New York



Photo Credit: AP, File]]>
<![CDATA[Walgreens to Stock Stores Nationwide With Narcan Nasal Spray]]>Thu, 26 Oct 2017 14:49:41 -0500https://media.nbcnewyork.com/images/180*120/GettyImages-866262796.jpg

Walgreens announced this week that it plans to stock all of its stores across the U.S. with Narcan as the nation's opioid epidemic reaches new levels. 

The medication, which is administered via nasal spray and can be used to reverse the effects of opioid drugs like prescription painkillers and heroin, will be available in more than 8,000 pharmacies nationwide, the company said.

“By stocking Narcan in all our pharmacies, we are making it easier for families and caregivers to help their loved ones by having it on hand in case it is needed,” Rick Gates, Walgreens group vice president of pharmacy, said in a statement. “As a pharmacy we are committed to making Narcan more accessible in the communities we serve.”

President Donald Trump is expected to formally declare the opioid epidemic a national emergency this week. 

With an estimated 142 Americans dying every day from drug overdoses, more than 10,000 people have died in the weeks since the president first committed to the plan.

"This action is an important milestone and we applaud Walgreens initiatives to improve access to Narcan Nasal Spray in communities across the U.S.,” Seamus Mulligan, chief executive officer of Adapt Pharma, the manufacturer of Narcan Nasal Spray, said in a statement. “This effort, combined with the opportunity for patients and caregivers to obtain Narcan Nasal Spray without an individual prescription in 45 states, is critical in combating this crisis.”

Last year, Walgreens announced an effort to make naloxone available without a prescription in states where regulations allowed. 

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Bipartisan Health Care Bill Would Slash Deficit: Report]]>Wed, 25 Oct 2017 10:53:54 -0500https://media.nbcnewyork.com/images/213*120/akexanderfeuerherdIII.jpg

A bipartisan proposal to calm churning health insurance markets would slash the federal deficit by nearly $4 billion in the next decade, the Congressional Budget Office announced Wednesday. 

The CBO determined the Bipartisan Health Care Stabilization Act, sponsored by Republican Sen. Lamar Alexander of Tennessee and Democratic Sen. Patty Murray of Washington, would shrink the deficit by $3.8 billion between 2018 and 2027 without significantly reducing the amount of people receiving health insurance. 

The bill's main goal is to stabilize insurance markets by restoring payments to insurers for copays and deductibles abruptly terminated by President Donald Trump.

It also would allow for broader availability of low-premium plans.

Earlier Republican efforts to repeal "Obamacare" would have made millions uninsured.

The CBO score comes as consumers can now begin previewing 2018 plans and premiums for health insurance under the Affordable Care Act, even as President Donald Trump continues his push to dismantle the Obama-era law.

Open enrollment begins Nov. 1.

Officials at the Health and Human Services department said Wednesday that plans and premiums for the coming year were posted on HealthCare.gov. Starting next week, new customers can begin submitting applications, and returning ones can make changes to their coverage. Open enrollment will end early, on Dec. 15, about half the time allotted under Barack Obama's administration.

The Trump administration's launch comes after the president abruptly pulled the plug on federal payments that reimburse insurers for reduced copays and deductibles they're required to provide to people of modest means. That exposes insurers to a potential $1 billion loss for the remainder of this year, and state regulators have been approving premium increases for next year to compensate.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Jacquelyn Martin]]>
<![CDATA[Trump Readies Opioid Plan, But Some Worry It Won't Be Enough]]>Thu, 26 Oct 2017 14:49:15 -0500https://media.nbcnewyork.com/images/213*120/865892540-Donald-Trump.jpg

President Donald Trump's long-awaited declaration that the opioid epidemic is a national emergency finally arrives this week, but some advocates are worried that it won't be backed with the money and commitment to make much difference.

Trump is expected to make the formal declaration and deliver a major speech on the topic Thursday, more than two months after he first announced that would be his plan.

There is concern the White House actions will be empty talk without a long-term commitment to paying for more addiction treatment: An emergency declaration would lack punch without money, said Andrew Kessler, who represents substance abuse treatment providers as a lobbyist in Washington.

"If there's no new money to expand our treatment infrastructure, I don't know what the punch is going to be," Kessler said. He acknowledged that declaring a national emergency "would put it in the national spotlight. Create buzz. Create talk." But with news coverage of the opioid crisis already saturating front pages and newscasts, he said, "I don't know how much more buzz we can generate."

Some health advocates also are concerned that devoting more public health resources to opioids could pull attention and resources from other health problems such as cancer, diabetes and heart disease. What's needed, they say, are new funding streams and a willingness to work hand-in-hand with states and local governments.

"An emergency declaration without significant new funds will likely be unsuccessful. The problem is enormous and requires a similar investment in a comprehensive strategy that includes primary prevention," said Becky Salay, director of government relations at Trust for America's Health, a Washington-based public health research and advocacy organization.

The idea of declaring a national emergency was first raised in an interim report prepared by an opioid commission chaired by New Jersey Gov. Chris Christie and convened by the president earlier this year.

"The first and most urgent recommendation of this commission is direct and completely within your control. Declare a national emergency," read the report from the group, which argued the move would empower Trump's Cabinet to address the crisis and force Congress to dedicate more money to fighting overdose deaths.

Trump said back in August he planned to adopt the recommendation, and claimed his team was working on documents to formalize the declaration. But his words spurred immediate push-back from some inside his administration who argued it wasn't the best move.

Emergency declarations are typically reserved for natural disaster like hurricanes, infectious diseases like swine flu and bioterrorist threats like anthrax, and Trump's now-departed Health and Human Services Secretary Tom Price argued publicly that the administration could deploy the needed resources without a formal declaration.

As the weeks have passed, Christie appeared to grow impatient, telling an audience in New Jersey earlier this month that it wasn't "good that it hasn't been done yet."

"All I know is, two months is two months and I would have loved to have had the time to have worked on it in that respect," Christie said. "But you know, they're telling me they've got legal issues and hurdles to get over that they haven't gotten over yet. I take them at their word. But if you're asking me, would I have preferred him to sign it August 1st, yeah."

He said the problem was too big to say the delay had made a significant difference, "but I would also say you can't get those two months back."

The Office of National Drug Control Policy defended the administration's handling of the matter, saying Trump's policy advisers, along with relevant government agencies, have been "working tirelessly since the beginning" to respond to the opioid crisis.

With an estimated 142 Americans dying every day from drug overdoses, more than 10,000 people have died in the weeks since the president first committed to the plan.

At a commission meeting last week, no overt reference was made to the president's promise, but members stressed the need to act.

"We ought to be treating this like a FEMA response and getting the necessary medication," said former Rep. Patrick Kennedy, who argued that, if the drug crisis were Ebola, "we'd waive all the rules and we'd say get it done and start saving lives, I mean that's what we need."

"That's what we've been saying," Christie responded. The New Jersey governor later compared the response to the AIDs epidemic.

"I still have not seen the passion for this epidemic that I saw in the AIDS epidemic," Christie said.

The commission had suggested two mechanisms for an emergency declaration: the Public Health Service Act or the Stafford Act. The nation has a public health emergency fund, but it is empty, Kessler said.

If the emergency is declared instead under the Stafford Act, funding could be included with disaster relief for hurricanes and wildfires. But that would put the opioids emergency under the jurisdiction of the Federal Emergency Management Agency, which is under the Department of Homeland Security.

"All that money could go to border security and drug interdiction, rather than toward treatment," Kessler said.

Trump's delays have frustrated observers.

"The failure to follow through is a betrayal of families and I think unconscionable," said Lawrence Gostin, a Georgetown University professor and the director of the World Health Organization Collaborating Center on National & Global Health Law.

Copyright Associated Press / NBC New York



Photo Credit: Chip Somodevilla/Getty Images]]>
<![CDATA[Can the 'Uber of Birth Control' Fix Contraceptive Deserts?]]>Tue, 24 Oct 2017 17:17:05 -0500https://media.nbcnewyork.com/images/213*120/BirthControlGettyImages-151037106.jpg

Often referred to as the "Uber of birth control," Nurx ships birth control directly to a woman's doorstep, bypassing the traditional visit to a clinic or physician typically necessary for getting or renewing a prescription.

Available in 15 states plus Washington D.C., the app may simply be an extra modern-day convenience for some women, NBC News reported.

But for others, it's the difference between having access to birth control and not.

According to the National Campaign to Prevent Teen and Unplanned Pregnancy, nearly 20 million women in America live in so-called "contraceptive deserts": counties where the number of public clinics is not enough to meet the needs of the county's population. The group estimates that more than 19.7 million females ages 13 to 44 lack reasonable access to public clinics that provide birth control, defined as at least one clinic or provider for every 1,000 women.



Photo Credit: UIG via Getty Images, File]]>
<![CDATA[GOP Lawmakers Propose New Conditions on Health Bill]]>Tue, 24 Oct 2017 17:44:42 -0500https://media.nbcnewyork.com/images/213*120/mitchmcconnellfeuerherdINIBN.jpg

Two top Republicans announced a bill Tuesday restoring federal subsidies to insurers while including tough conditions sought by the White House. Senate Democrats have enough votes to kill it, but the measure underscores the changes the Trump administration and congressional conservatives say they want in exchange for resuming the payments.

The proposal seeks changes in President Barack Obama's health care law that go far further than provisions in bipartisan legislation that is stuck in the Senate. That compromise has stalled as President Donald Trump has flashed contradictory signals about whether he supports it and conservatives — especially in the House — have complained it doesn't revamp Obama's statute strongly enough.

Tuesday's GOP alternative — by Senate Finance Committee Chairman Orrin Hatch of Utah and House Ways and Means Committee Chairman Kevin Brady of Texas — highlighted the party's internal differences over the issue.

At a lunch Tuesday with GOP senators, Trump apparently said nothing to indicate which — if either — alternative he preferred. Trump at one point told Sen. Lamar Alexander of Tennessee, the Republican author of the mired bipartisan deal: "Thanks for your great work on health care. It's good, it's good," according to a GOP aide who spoke on condition of anonymity to describe the closed-door comments.

Like the bipartisan Senate bill, the new measure would resume the federal payments to insurers for two years. Trump has halted them, claiming they enrich insurers, but has expressed a willingness to make a deal to resume them.

The plan by Hatch and Brady would temporarily halt tax penalties Obama's health care law imposes on people who don't buy insurance and employers who don't offer coverage to workers. The fine against individuals would be halted from 2017 through 2021, while the penalty on employers would be retroactive, suspended from 2015 through this year.

Those fines are a pillar of Obama's overhaul, prodding healthy people to buy coverage. Ending them is a non-starter with Democrats.

Tuesday's bill also includes "pro-life protections." GOP aides would not describe them, but Republicans have often sought to prevent federal payments from being used to buy health insurance that covers abortions.

The measure would also let people contribute more money to tax-favored health savings accounts.

A written statement from Brady and Hatch said the proposals "can serve as a basis for the types of real reforms" needed to overhaul Obama's law.

Sen. Patty Murray, D-Wash., rejected the latest bill. Murray wrote the Senate's bipartisan measure with Alexander.

"We already know that partisan proposals to take coverage away from millions of people, spike premiums, and inject even more uncertainty into health care markets cannot pass the Senate," Murray said in a written statement.

The payments reimburse insurers for lowering out-of-pocket expenses like deductibles and co-payments for low-earning customers. Obama's law requires the cost reductions and the federal payments to insurers. The reduced costs for customers will continue, leaving insurers and state regulators to decide how carriers will recover their lost income.

Insurers and the nonpartisan Congressional Budget Office have warned that premiums will increase and some insurers could leave unprofitable regions if the reimbursements are not restored. Many insurers have responded by boosting premiums that they and many state regulators have designed in a way that has limited — but not eliminated — the number of people facing higher prices.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/J. Scott Applewhite, File]]>
<![CDATA[Crying Babies Push Same 'Buttons' in Mothers' Brains: Study]]>Tue, 24 Oct 2017 07:01:24 -0500https://media.nbcnewyork.com/images/213*120/512811852-Crying-Baby-Generic.jpg

Crying babies push the same "buttons" in their mothers' brains no matter what their culture, a new study suggests.

The research found that mothers in 11 countries tend to react the same way to their bawling child — by picking up and talking to the baby — and that the way mothers respond seems to be programmed into their brain circuits.

An author of the study said he hopes the results will spur others to study brain responses in women who mistreat their children. Crying is a common trigger for abuse, said Marc Bornstein of the government's National Institute of Child Health and Human Development in Bethesda, Maryland.

The new results were released Monday by the Proceedings of the National Academy of Sciences.

The researchers analyzed videotapes of 684 mothers in 11 countries as they interacted with their infants, who were around 5 months old. The observations were done in Argentina, Belgium, Brazil, Cameroon, France, Kenya, Israel, Italy, Japan, South Korea and the United States.

Analysis showed that the mothers were likely to respond to crying by picking up and talking to the infant. But they were not likely to use other responses such as kissing, distracting, feeding or burping the child. Results were similar across the various countries.

Next, researchers thought about what parts of the brain would likely be involved in the responses they saw. They focused on circuitry that's activated when a person plans to do or say something, other circuitry that could be involved in figuring out the meaning of a cry and on brain parts known to play critical roles in maternal caregiving.

With brain scans, they found those brain areas were activated when 43 first-time mothers in the U.S. listened to recordings of their infants crying. Fifty mothers in China and Italy showed a similar result, with the Chinese moms showing different brain responses when they heard other sounds like infants laughing or babbling.

But brains of six Italian women who were not mothers reacted differently to crying, Bornstein said in an email.

"Mothers, based on their personal experience, could easily have their brains shaped in a matter of a few months to be especially sensitive" to an infant's cry, perhaps because of hormonal changes that occur with parenting, he wrote.

In fact, one contribution of Bornstein's work is that suggestion that brain development can continue beyond young adulthood, with motherhood as a key stimulus, commented Yale University researcher Linda Mayes, who did not participate in the study.

Helena Rutherford of Yale, who also did not participate in the study, said the brain findings make sense, and that the study was significant for showing consistency across cultures in those responses and the behavior of the mothers.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/iStockphoto]]>
<![CDATA[US Uninsured Up 3.5M This Year; Expected to Rise: Survey]]>Fri, 20 Oct 2017 07:55:40 -0500https://media.nbcnewyork.com/images/213*120/AP_937719406365.jpg

The number of U.S. adults without health insurance is up nearly 3.5 million this year, as rising premiums and political turmoil over "Obamacare" undermine coverage gains that drove the nation's uninsured rate to a historic low.

That finding is based on the latest installment of a major survey, released Friday. The Gallup-Sharecare Well-Being Index asks a random sample of 500 people each day whether they have health insurance.

The survey found that the uninsured rate among adults was 12.3 percent during the period from July 1-Sept. 30, an increase of 1.4 percentage points since the end of last year. The increase in the number of uninsured is more striking because it comes at a time of economic growth and low unemployment.

The annual sign-up season for subsidized private insurance plans under the Affordable Care Act starts Nov. 1, but it may not make much of a difference.

President Donald Trump has stopped federal payments that reimburse insurers for lower copays and deductibles that the Obama-era law requires them to provide to people with modest incomes. His administration slashed the advertising budget for 2018 sign-ups, cut the length of open enrollment in half, and sharply reduced federal grants to groups that help consumers navigate the process.

"The number of uninsured Americans likely will continue to rise," the Gallup-Sharecare analysis noted, unless Trump and Congress take steps to stabilize insurance markets. A bipartisan bill to restart the canceled insurer payments faces opposition from conservatives and Trump has sent mixed signals.

While "Obamacare" remains politically divisive, its coverage expansion helped about 20 million people get health insurance, bringing the uninsured rate to a historic low. Continued progress seems unlikely now.

Next year's premiums for plans sold on the health law's marketplaces are expected to increase significantly in many communities, and insurer participation is down sharply, with about half of U.S. counties having only one carrier.

Although consumers who are eligible for ACA subsidies are shielded from price hikes, many who buy individual plans get no financial assistance from the government. All told, more than 17 million people purchase their own policies.

Independent experts who reviewed the Gallup-Sharecare findings said they appear to confirm other available evidence.

"The results make sense and they track with the results of other rapid surveys," said Matthew Buettgens, a senior research analyst with the Urban Institute health policy center. "No one is expecting this open-enrollment period to increase enrollment."

GOP health economist Gail Wilensky said the overall direction of the Gallup-Sharecare results seems reasonable, but she'll await confirmation from government surveys that take longer to produce results, but dig deeper.

"The only thing most Republicans in Congress seem to agree on is that they don't like the ACA," she said. "Hard to build an alternative legislative package without a sounder basis for policy and with the very narrow majority in the Senate."

Except for seniors covered by Medicare, the Gallup-Sharecare survey found that the uninsured rate increased among all major demographic groups.

The loss of coverage was concentrated among middle-aged adults, with the uninsured rate rising by 1.8 percentage points among those 35-64 since the end of 2016. Households making less than $36,000 a year saw their uninsured rate go up by 1.7 percentage points.

Among Hispanics, the rate increased by 1.6 percentage points, and among blacks the increase was 1.5 percentage points.

The Gallup-Sharecare results are based on telephone interviews conducted July 1-Sept. 30, with a random sample of 45,743 adults, aged 18 and older, living in all 50 states and Washington, D.C. The margin of error is plus or minus 1 percentage point.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Andrew Harnik, File]]>
<![CDATA[Pollution Is Deadlier Than War, Disaster, Hunger: Study]]>Fri, 20 Oct 2017 03:52:43 -0500https://media.nbcnewyork.com/images/213*120/AP_17293118232511.jpg

Environmental pollution — from filthy air to contaminated water — is killing more people every year than all war and violence in the world. More than smoking, hunger or natural disasters. More than AIDS, tuberculosis and malaria combined.

One out of every six premature deaths in the world in 2015 — about 9 million — could be attributed to disease from toxic exposure, according to a major study released Thursday in the Lancet medical journal. The financial cost from pollution-related death, sickness and welfare is equally massive, the report says, costing some $4.6 trillion in annual losses — or about 6.2 percent of the global economy.

"There's been a lot of study of pollution, but it's never received the resources or level of attention as, say, AIDS or climate change," said epidemiologist Philip Landrigan, dean of global health at the Icahn School of Medicine at Mount Sinai, New York, and the lead author on the report.

The report marks the first attempt to pull together data on disease and death caused by all forms of pollution combined.

"Pollution is a massive problem that people aren't seeing because they're looking at scattered bits of it," Landrigan said.

Experts say the 9 million premature deaths the study found was just a partial estimate, and the number of people killed by pollution is undoubtedly higher and will be quantified once more research is done and new methods of assessing harmful impacts are developed.

Areas like Sub-Saharan Africa have yet to even set up air pollution monitoring systems. Soil pollution has received scant attention. And there are still plenty of potential toxins still being ignored, with less than half of the 5,000 new chemicals widely dispersed throughout the environment since 1950 having been tested for safety or toxicity.

"In the West, we got the lead out of the gasoline, so we thought lead was handled. We got rid of the burning rivers, cleaned up the worst of the toxic sites. And then all of those discussions went into the background" just as industry began booming in developing nations, said Richard Fuller, head of the global toxic watchdog Pure Earth and one of the 47 scientists, policy makers and public health experts who contributed to the 51-page report.

"To some extent these countries look to the West for examples and discussion, and we'd dropped it," Fuller said.

Asia and Africa are the regions putting the most people at risk, the study found, while India tops the list of individual countries.

One out of every four premature deaths in India in 2015, or some 2.5 million, was attributed to pollution. China's environment was the second deadliest, with more than 1.8 million premature deaths, or one in five, blamed on pollution-related illness, the study found.

Several other countries such Bangladesh, Pakistan, North Korea, South Sudan and Haiti also see nearly a fifth of their premature deaths caused by pollution.

Still, many poorer countries have yet to make pollution control a priority, experts say. India has taken some recent actions, such as tightening vehicle and factory emission standards and occasionally limiting the number of cars on New Delhi's roads. But they have done little about crop burning, garbage fires, construction dust or rampant use of the dirtiest fossil fuels.

A court ban on firework sales before the Diwali festival didn't stop New Delhi residents from firing rockets and lighting crackers throughout Thursday night. They awoke Friday morning to acrid, smoke-filled skies and levels of dangerous, lung-clogging particulate matter known as PM2.5 that went beyond 900 parts per million — 90 times the recommended limit by the World Health Organization, and 22 times higher than India's own limits.

"Even though better pollution norms are coming in, still the pollution levels are continuously increasing," said Shambhavi Shukla, a research associate with the Delhi-based Center for Science and Environment, which was not involved in the Lancet study.

To reach its figures on the overall global pollution burden, the study's authors used methods outlined by the U.S. Environmental Protection Agency for assessing field data from soil tests, as well as with air and water pollution data from the Global Burden of Disease, an ongoing study run by institutions including the World Health Organization and the Institute for Health Metrics and Evaluation at the University of Washington.

Even the conservative estimate of 9 million pollution-related deaths is one-and-a-half times higher than the number of people killed by smoking, three times the number killed by AIDS, tuberculosis and malaria combined, more than six times the number killed in road accidents, and 15 times the number killed in war or other forms of violence, according to GBD tallies.

It is most often the world's poorest who suffer, the study found. The vast majority of pollution-related deaths — 92 percent — occur in low- or middle-income countries, where policy makers are chiefly concerned with developing their economies, lifting people out of poverty and building basic infrastructure. Environmental regulations in those countries tend to be weaker, and industries lean on outdated technologies and dirtier fuels.

In wealthier countries where overall pollution is not as rampant, it is still the poorest communities that are more often exposed, the report says.

"What people don't realize is that pollution does damage to economies. People who are sick or dead cannot contribute to the economy. They need to be looked after" — which is also costly, Fuller said.

"There is this myth that finance ministers still live by, that you have to let industry pollute or else you won't develop," he said. "It just isn't true."

The report cites EPA research showing that the U.S. has gained some $30 in benefits for every dollar spent on controlling air pollution since 1970, when Congress enacted the Clean Air Act, one of the world's most ambitious environmental laws. Removing lead from gasoline has earned the U.S. economy another $6 trillion cumulatively since 1980, according to studies by the U.S. Centers for Disease Control and Prevention.

Some experts cautioned, however, that the report's economic message was murky. Reducing the pollution quantified in the report might impact production, and so would not likely translate into gains equal to the $4.6 trillion in economic losses.

The report "highlights the social and economic justice of this issue," said Marc Jeuland, associate professor with the Sanford School of Public Policy and the Duke Global Health Institute at Duke University, who was not involved in the study.

Without more concrete evidence for how specific policies might lead to economic gains, "policy makers will often find it difficult to take action, and this report thus only goes part way in making the case for action," he said.

Jeuland also noted that, while the report counts mortality by each pollutant, there are possible overlaps — for example, someone exposed to both air pollution and water contamination — and actions to address one pollutant may not reduce mortality.

"People should be careful not to extrapolate from the U.S. numbers on net (economic) benefits, because the net effects of pollution control will not be equivalent across locations," he said.

The study's conclusions on the economic cost of pollution measure lost productivity and health care costs, while also considering studies measuring people's "willingness to pay" to reduce the probability of dying. While these types of studies yield estimates at best, they are used by many governments and economists trying to understand how societies value individual lives.

While there has never been an international declaration on pollution, the topic is gaining traction.

The World Bank in April declared that reducing pollution, in all forms, would now be a global priority. And in December, the United Nations will host its first conference on the topic of pollution.

"The relationship between pollution and poverty is very clear," said Ernesto Sanchez-Triana, lead environmental specialist at the World Bank. "And controlling pollution would help us address many other problems, from climate change to malnutrition. The linkages can't be ignored."

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Manish Swarup]]>
<![CDATA[Grandparents Fill Void as Opioid Crisis Steals a Generation]]>Sun, 22 Oct 2017 00:40:52 -0500https://media.nbcnewyork.com/images/213*120/Screen+Shot+2017-10-20+at+6.28.07+AM.png

Everything his grandpa does, 5-year-old Colton wants to do. Even if it means wearing Crocs with socks.

"If grandpa wears his Crocs with socks, Colton has to wear his Crocs with socks," Pennie Krietemeier, 53, told NBC News. "I have to walk behind them because it's so embarrassing."

Her grandson's idolization of his grandfather Randy, 53, is one of the sweet spots in a childhood that has otherwise been marked by chaos.

As the opioid epidemic forces increasing numbers of children into foster care or otherwise out of their parents' custody, grandparents like the Krietemeiers are stepping in, NBC News reported. Those grandparents face the daunting task of caring for young, vulnerable children while navigating courtrooms and complex child welfare systems, often with little financial or social support — all while coping with their adult offspring's addiction.



Photo Credit: NBC News]]>
<![CDATA[Bipartisan Plan to Curb Health Premiums Gets Strong Support]]>Thu, 19 Oct 2017 19:51:56 -0500https://media.nbcnewyork.com/images/213*120/doctorvisitGettyGeneric_1200x675.jpg

A bipartisan proposal to calm churning health insurance markets gained momentum Thursday when enough lawmakers rallied behind it to give it potentially unstoppable Senate support. As the measure's prospects grew, Republican frustration burst into the open over President Donald Trump's erratic response to the plan.

Republican Sen. Lamar Alexander of Tennessee and Democratic Sen. Patty Murray of Washington appeared together on the Senate floor to announce 24 sponsors, divided evenly between both parties, for resuming federal subsidies to insurers that Trump has blocked. Without the money, insurers are expected to raise premiums for many buying individual coverage and flee unprofitable markets.

Senate Minority Leader Chuck Schumer said all 48 Democrats would back the measure in a vote. That meant that combined with the dozen GOP sponsors there would be 60 votes for the legislation, the number needed to overcome a filibuster, a delaying tactic meant to kill legislation.

"Every Democrat's voting for it. Do the math, baby," an exultant Schumer, D-N.Y., told reporters.

The politically compelling arithmetic raises pressure on Majority Leader Mitch McConnell, R-Ky., who's been noncommittal so far, to let the Senate consider the legislation. A McConnell spokesman said the leader had made no new statement on the bill.

The growing Senate support also improved the chances that the proposal would become law, perhaps later this year as part of a must-pass measure financing the entire government.

The measure would still have to clear the House, where Speaker Paul Ryan, R-Wis., and many conservatives have been cold to the idea, and win Trump's signature.

The GOP sponsors included Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana. They co-sponsored their party's failed effort in September to dismantle President Barack Obama's health care law and instead send federal health care dollars directly to states as block grants. Party leaders have discussed trying anew in 2018.

In a statement, Graham and Cassidy said the compromise to restore insurers' subsidies "will not pass unless concerns of the House are addressed." They said they were trying to get agreement on provisions giving states additional flexibility to ease some of Obama's requirements.

Obama's Affordable Care Act requires insurers to reimburse poorer customers for out-of-pocket costs like deductibles and co-pays. It helps around 6 million people.

The law also obliges the government to repay carriers for those costs, around $7 billion this year. A federal judge concluded that Congress never properly approved the money, but Obama and Trump continued the payments until Trump halted them last week.

"''I do not believe Congress will want to fail to deal with a problem that will hurt millions of Americans if we allow it to continue," Alexander said.

The Alexander-Murray agreement extends the payments for two years. It gives states additional flexibility under Obama's law and allows consumers of any age to buy low-cost catastrophic coverage plans.

Alexander said he spoke by phone twice Wednesday with Trump, who encouraged him to move forward with a bipartisan solution.

When the two senators unveiled their agreement earlier this week, the president initially reacted favorably but then condemned the deal as a bailout for insurers. The president's varying responses frustrated lawmakers of both parties and appeared to have stalled the deal.

Questioned in the Oval Office on Thursday, the president again sounded lukewarm.

"I like people working on plans at all times. I think, ultimately, block grants is the way to go," Trump said, apparently referring to the Senate's failed bill in September.

"It'll be absolutely short term," Trump said of the bipartisan plan, "because, ultimately, we will be, it's going to be repeal and replace."

Trump added, "I don't want the insurance companies making any more money ... than they have to."

Anticipating that Trump would block the subsidies, many insurers have boosted premiums for 2018 policies to make up the difference. Some Republicans say restoring the federal payments would give insurers a windfall.

Alexander and Murray say they've built language into their bill to ensure consumers get the funds and are open to changes to satisfy Trump.

GOP Sen. Ron Johnson of Wisconsin gave voice to frustration with the president's inconsistent response.

"It's always best for the president to be completely consistent in terms of what he's supporting or not supporting," Johnson told reporters at the Capitol. "And let's face it, he's not been particularly consistent here."

Johnson said inaccurate rhetoric about the deal from Trump and others has harmed the legislation's prospects.

"It's unfortunate what's happened over the last day in terms of the rhetoric from all points. 'Bailing out insurance companies' — insurance companies get protected either way," Johnson said.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/Justin Sullivan]]>
<![CDATA[Judge Orders Government to Allow Abortion for Immigrant Teen]]>Wed, 18 Oct 2017 19:45:45 -0500https://media.nbcnewyork.com/images/213*120/generic-gavel.jpg

A federal judge on Wednesday ordered the government to allow a pregnant 17-year-old immigrant, who was detained after entering the country illegally, to undergo an abortion.

After a brief hearing that included a testy exchange with government lawyers, Judge Tanya Chutkan ordered the government to move "promptly and without delay" to transport the teenager or allow her to be transported by others to the nearest abortion provider.

The case originated in Texas, where the teen is being held by federal immigration authorities, and was brought to the U.S. District Court for the District of Columbia by the American Civil Liberties Union.

The teen, whose name has been withheld because she's a minor, has already received a court order permitting her to have the abortion. But officials have refused to transport her or temporarily release her so that others may transport her to the clinic.

Wednesday's hearing largely consisted of a contentious debate between Chutkan and Deputy Assistant Attorney General Scott Stewart, with the judge saying she was "astounded" by the government's position.

Stewart argued that the teenager, referred to in court as either Jane Doe or JD, was free to return to her home country and seek an abortion there, but said "the government is entitled to favor childbirth" and shouldn't be required to facilitate abortions.

She is being held at a facility in Texas administered under a contract from the U.S. Department of Health and Human Services, which is responsible for sheltering children who illegally enter the United States unaccompanied by a parent.

She's believed to be about 15 weeks pregnant. Texas law bans most abortions after the 20th week of pregnancy and requires women seeking an abortion to meet with the doctor who will perform the procedure a day beforehand. The state also requires minors to get the consent of a parent or obtain a waiver from a judge.

Attorneys for the teenager say they obtained the waiver and scheduled several appointments with a doctor, but the facility that's holding her refused to let her go. Instead, she was taken by the facility to a crisis pregnancy center. Such centers try to discourage women from having abortions and are often affiliated with religious groups.

"I do not want to be forced to carry a pregnancy to term against my will," the teen said in a statement filed with the court Friday.

The teenager's advocates argue that HHS has effectively tried to stop all minors in its custody from having abortions.

In one email obtained by the ACLU, Scott Lloyd, director of the HHS office that oversees facilities for unaccompanied children, directs a subordinate that facilities that get agency funding "should not be supporting abortion services," but instead providing "only pregnancy services and life-affirming options counseling."

In another, Lloyd asks about the status of a girl he met during a visit to a facility and offers to connect the teen with "a few good families" who would "see her through her pregnancy."

In Wednesday's hearing, Chutkan noted the government "had no problem transporting her against her will to pregnancy counseling where they attempted to change her mind."

Stewart argued the teen was free to return to her home country and get an abortion there, but the judged challenged him on whether the government had a constitutional right to single out abortions and block immigrants in custody from undergoing the procedure.

"Residents of this shelter receive medical treatment all the time," Chutkan said. "Why is this any different? Why is the fact that this is an abortion any different than if she was getting her tonsils out?"

After the hearing and before the judge issued her verdict, ACLU attorney Brigitte Amiri said it was clear the government had overstepped its bounds. "They took a position that was basically indefensible and they couldn't defend it," Amiri said.

HHS said in a statement last week about the 17-year-old immigrant's case that it was "providing excellent care to the adolescent girl and her unborn child, who remain under our care until the mother's release." It did not respond to several requests for comment on the emails published by the ACLU.

In a court filing Tuesday, HHS argued it had a strong interest in "not providing incentives for pregnant minors to illegally cross the border to obtain elective abortions while in federal custody."

Magistrate Judge Laurel Beeler of the U.S. District Court for the Northern District of California ruled last week that the government couldn't prevent the teen from getting an abortion, but declined to an issue an order forcing officials to step aside. Beeler said her court was the wrong venue for the case, leading lawyers for the teenager to bring the case to the Washington, D.C., federal court.

Copyright Associated Press / NBC New York



Photo Credit: Getty, File]]>
<![CDATA[Ultra-Personal Therapy: Gene Tumor Boards Guide Cancer Care]]>Wed, 18 Oct 2017 08:12:06 -0500https://media.nbcnewyork.com/images/213*120/AP_17262031874660-Tumor-Board-Gene-Therapy.jpg

Doctors were just guessing a decade ago when they gave Alison Cairnes' husband a new drug they hoped would shrink his lung tumors. Now she takes it too, but the choice was no guesswork. Sophisticated gene tests suggested it would fight her gastric cancer, and they were right.

Cancer patients increasingly are having their care guided by gene tumor boards, a new version of the hospital panels that traditionally decided whether surgery, radiation or chemotherapy would be best. These experts study the patient's cancer genes and match treatments to mutations that seem to drive the disease.

"We dissect the patient's tumor with what I call the molecular microscope," said Dr. Razelle Kurzrock, who started a board at the University of California, San Diego, where Cairnes is treated.

It's the kind of care many experts say we should aim for — precision medicine, the right drug for the right person at the right time, guided by genes. There are success stories, but also some failures and many questions:

Will gene-guided care improve survival? Does it save money or cost more? What kind of gene testing is best, and who should get it?

"I think every patient needs it," especially if cancer is advanced, said Kurzrock, who consults for some gene-medicine companies. "Most people don't agree with me — yet. In five years, it may be malpractice not to do genomics."

Few people get precision medicine today, said Dr. Eric Topol, head of the Scripps Translational Science Institute. "The only thing that's gone mainstream are the words."

HOW IT WORKS NOW
If you have a cancer that might be susceptible to a gene-targeting drug, you may be tested for mutations in that gene, such as HER2 for breast cancer. Some breast or prostate cancer patients also might get a multi-gene test to gauge how aggressive treatment should be.

Then most patients get usual guideline-based treatments. If there's no clear choice, or if the disease has spread or comes back, doctors may suggest tumor profiling — comprehensive tests to see what mutations dominate.

That's traditionally been done from a tissue sample, but newer tests that detect tumor DNA in blood — liquid biopsies — are making profiling more common. The tests cost about $6,000 and many insurers consider them experimental and won't pay.

Gene tumor boards analyze what the results suggest about treatment. They focus on oddball cases like a breast cancer mutation in a colon cancer patient, or cancers that have widely spread and are genetically complex. The only options may be experimental drugs or "off-label" treatments — medicines approved for different situations.

But as tumor profiling grows, it's revealing how genetically diverse many tumors are, and that oddball cases are not so rare, said Dr. John Marshall. He heads the virtual tumor board at Georgetown Lombardi Comprehensive Cancer Center that also serves cancer centers in Pennsylvania, North Carolina, Michigan and Tennessee.

"There is a little bit of faith" that testing will show the right treatment, but it's not a sure thing, said Dr. Lee Schwartzberg, who heads one participating center, the West Cancer Center in Memphis.

Dr. Len Lichtenfeld, the American Cancer Society's deputy chief medical officer, is optimistic yet wary. Drugs that target BRAF mutations work well for skin cancers called melanomas, but less well for lung or colon cancers.

"Just because a mutation occurs it doesn't mean that drug is going to work in that cancer," he said.

LUCKY CASES
When it does, results can be dramatic. Cairnes' cancer was between her stomach and esophagus, and had spread to her liver, lungs and lymph nodes. Tissue testing found 10 abnormal genes, but on the liquid biopsy only EGFR popped out as a good target.

Two drugs aim at that gene but aren't approved for her type of cancer. A tumor board advised trying both — Erbitux and Tarceva, the drug her husband also had taken. Within two weeks, she quit using pain medicines. After two months, her liver tumor had shrunk roughly by half. There are signs that cancer may remain, but it is under control. She feels well enough to travel and to take care of her granddaughter.

"I'm very, very grateful to have a targeted therapy," Cairnes said.

"I cannot expect a better outcome than what we're seeing right now," said her doctor, Shumei Kato.

WHAT STUDIES SHOW
But is gene-guided treatment better than usual care? French doctors did the first big test, with disappointing results. About 200 patients with advanced cancer were given whatever their doctors thought best or off-label drugs based on tumor profiling. Survival was similar — about two months.

Another French study, reported in June, was slightly more encouraging on survival but exposed another problem: No drugs exist for many gene flaws. Tests found treatable mutations in half of the 2,000 participants and only 143 got what a tumor board suggested.

Some doctors worry that tumor boards' recommending off-label treatments diverts patients from research that would benefit all cancer patients. For example, the American Society of Clinical Oncology's TAPUR study tests off-label drugs and shares results with their makers and federal regulators.

LETTING PATIENTS CHOOSE
Ann Meffert, who lives on a dairy farm in Waunakee, Wisconsin, endured multiple standard treatments that didn't defeat her bile duct cancer.

"She was going to be referred to hospice; there was not much we could do," said Dr. Nataliya Uboha, who took the case to a tumor board at the University of Wisconsin-Madison. The panel gave several options, including off-label treatment, and Meffert chose a study that matches patients to gene-targeting therapies and started on an experimental one last October.

"Two weeks in, I started feeling better," she said, and when she saw test results, "I couldn't believe the difference."

Many lung spots disappeared and the liver tumor shrank 75 percent. She is not cured, though, and doctors are thinking about next steps. And that could involve a fresh look at her tumor genes.

Copyright Associated Press / NBC New York



Photo Credit: Gregory Bull/AP]]>
<![CDATA[Senators Push Health Deal as Trump Keeps Distance]]>Wed, 18 Oct 2017 19:15:33 -0500https://media.nbcnewyork.com/images/213*120/Sens-health-care-EM.jpg

The authors of a bipartisan plan to calm health insurance markets said Wednesday they'll push the proposal forward, even as President Donald Trump's stance ricocheted from supportive to disdainful to arm's-length and the plan's fate teetered.

"If something can happen, that's fine," Trump told reporters at the White House. "But I won't do anything to enrich the insurance companies because right now the insurance companies are being enriched. They've been enriched by Obamacare like nothing anybody has ever seen before."

The agreement by Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., on a two-year extension of federal subsidies to insurers that Trump has blocked gained an important new foe. The anti-abortion National Right to Life said it opposed the measure because it lacked language barring people from using their federally subsidized coverage to buy policies covering abortion, said Jennifer Popik, the group's top lobbyist.

In another blow, Doug Andres, spokesman for House Speaker Paul Ryan, R-Wis., said Ryan "does not see anything that changes his view that the Senate should keep its focus on repeal and replace of Obamacare." With hard-right conservatives wielding considerable influence and unwilling to prop up President Barack Obama's health care law, it was unclear if Ryan would be willing to even bring the measure to his chamber's floor.

Overall, it was a bad day for the bipartisan accord, with several Republicans conceding that it likely needed Trump's backing to survive.

"Without the president supporting it, I don't think you have the votes in the House or the Senate," No. 3 Senate GOP leader John Thune of South Dakota told reporters, adding, "We're stalled out."

Alexander and Murray shook hands on their agreement this week after months of intermittent talks. Failure to restore the federal payments to insurers could result in higher premiums for millions buying their own individual policies and drive carriers from unprofitable markets. Many in Congress would love to avoid blame for two such tumultuous events.

The compromise has won warm endorsements from Democrats and some Republicans. It includes steps won by Republicans to make it easier for insurers to avoid some coverage requirements under Obama's 2010 overhaul.

But Trump has lambasted the subsidies as insurance company bailouts.

"It's not a full approach and we need something to go a little further," said White House spokeswoman Sarah Huckabee Sanders.

The money reimburses carriers for lowering co-payments and deductibles for about 6 million lower-income customers, which the companies must do under Obama's statute.

Without those funds, insurers would likely boost premiums by an average 20 percent, the nonpartisan Congressional Budget Office has projected. This would especially hit many buying their own health insurance who make too much to qualify for tax credits that help reduce premiums for lower earners.

Confusingly, Trump praised the bipartisan agreement early Tuesday as a "very good solution," only to berate it in an evening speech. Some said his objections Wednesday to enriching insurers could be addressed by strengthening language in the compromise to ensure the money directly benefits customers, not companies.

"We will keep working on it," said Alexander. He said he and Murray would formally unveil the bill Thursday and predicted that "some form of the proposal" would become law by year's end. It could become part of a must-pass bill preventing a federal shutdown due in December.

"The president has had six positions on our bill," Murray told reporters. Asked if the measure was still alive, she said, "Of course it is."

Alexander said Trump called him Wednesday morning and encouraged him to continue his effort, but left wiggle room.

"I may want to add something to it," Alexander said in a brief interview with The Associated Press, describing what Trump told him about the deal. "And it may have to be part of a larger negotiation."

Senate Finance Committee Chairman Orrin Hatch, R-Utah, criticized the plan, saying: "It would last two years and spend a whopping amount of money and not solve the problem and lead us down a path of never getting the problem done." Senate Majority Leader Mitch McConnell, R-Ky., has been non-committal.

Senate Minority Leader Chuck Schumer, D-N.Y., said to address Trump's aversion to enriching insurers, Democrats had offered to delay the measure's impact for a month after enactment to let insurers lower premiums after payments were restored. Insurers in some states have installed higher premiums for next year, anticipating the subsidies would end. Schumer said White House officials rejected that idea.

GOP co-sponsors include Sens. John McCain of Arizona, Lisa Murkowski of Alaska and Tennessee's Bob Corker. Sen. Mike Rounds, R-S.D., said Alexander has eight or nine Republican co-sponsors, and Democrats plan to provide an equal number to build bipartisan pressure.

Also behind the measure were America's Health Insurance Plans, the giant trade group for insurers; AARP representing the elderly; the National Retail Federation, which lobbies for merchants plus doctors, hospitals and patients groups.

___

AP Congressional Correspondent Erica Werner and reporters Ricardo Alonso-Zaldivar, Ken Thomas, Kevin Freking and Jill Colvin contributed.

Copyright Associated Press / NBC New York



Photo Credit: J. Scott Applewhite/AP]]>
<![CDATA[Senators Reach Deal on Resuming Payments to Health Insurers]]>Tue, 17 Oct 2017 18:53:59 -0500https://media.nbcnewyork.com/images/213*120/633173098-Lamar-Alexander-Patty-Murray.jpg

Republican and Democratic senators joined in announcing a plan Tuesday aimed at stabilizing America's health insurance markets in the wake of President Donald Trump's order to terminate "Obamacare" subsidies. Trump himself spoke approvingly of the deal, but some conservatives denounced it as an insurance company bailout, making its future uncertain.

The agreement followed weeks of negotiations between Republican Sen. Lamar Alexander of Tennessee and Democratic Sen. Patty Murray of Washington that sought to address health insurance markets that have been in limbo following GOP failures to repeal and replace the Affordable Care Act. The talks took on added urgency when Trump announced last week that he would end monthly "cost sharing reduction" payments the government makes to help insurance companies reduce costs for lower-income people.

Without that money, premiums for some people buying individual health plans would spike, and some insurers would flee the markets, industry officials warn.

The Alexander-Murray deal would continue the insurer payments for two years, while establishing new flexibility for states under former President Barack Obama's law.

"This would allow the Senate to continue its debate about the long term of health care, but over the next two years I think Americans won't have to worry about the possibility of being able to buy insurance in counties where they live," Alexander said in announcing the deal after a closed-door lunch where he presented it to GOP senators.

"This agreement avoids chaos. I don't know a Republican or Democrat who benefits from chaos," he said.

Alexander said the president had encouraged his efforts in phone calls over the past two weeks. And at the White House, Trump responded positively, expressing optimism that Republicans would ultimately succeed in repealing Obamacare, but until then: "For one year, two years, we're going to have a very good solution."

Trump's position may seem contradictory in that he himself ordered an end to the payments, calling them a bailout, but is now encouraging legislation to reinstitute them. Indeed White House officials had said they would want more in exchange than the additional state flexibility offered in the Alexander-Murray agreement.

Just minutes before Alexander announced the deal, White House legislative director Marc Short emerged from the Senate GOP lunch saying that "a starting point" in exchange for restoring the cost-sharing payments "is eliminating the individual mandate and employer mandate" — the central pillars of Obamacare.

That suggested some disagreement within the administration on the issue. If so, it does not bode well for ultimate passage of Alexander-Murray, since the president's full support will be crucial in persuading Republicans to get on board.

Initially as president, Trump continued making the payments though resisting, but he declared last week he would pull the plug. The payments, which cost around $7 billion this year, lower expenses like co-payments and deductibles for more than 6 million people. But discontinuing them would actually cost the government more money under Obamacare's complicated structure, because some people facing higher premiums would end up getting bigger tax subsidies to help pay for them.

The Alexander-Murray deal does include a host of provisions allowing states faster and easier access to waivers that would allow them to shape their own marketplace plans under Obamacare. It also would provide for a new low-cost catastrophic coverage insurance option for all consumers.

Reaction from the GOP was decidedly mixed. For many conservatives it's practically unthinkable to sign off on federal payments that would arguably prop up a law they've been vowing for seven years to destroy.

Rep. Mark Walker of North Carolina, chairman of the conservative Republican Study Committee in the House, quickly denounced the deal over Twitter: "The GOP should focus on repealing & replacing Obamacare, not trying to save it. This bailout is unacceptable."

Freedom Caucus Chairman Rep. Mark Meadows, who's been at work on a proposal of his own, was slightly more positive, calling the Alexander-Murray bill "a good start" but saying much more work needed to be done.

GOP leaders in the House and Senate have also been cool to the Alexander-Murray negotiations, the more so since after their failures on Obamacare they are eager to turn their full attention to tax overhaul legislation. Senate Majority Leader Mitch McConnell was noncommittal, telling reporters: "We haven't had a chance to think about the way forward yet."

Alexander said he and allies including Sen. Mike Rounds, R-S.D., would spend the next several days trying to build up support with the goal of formally introducing legislation later this week. If the legislation does pass, it would almost certainly be as part of a larger package including must-pass spending or disaster relief bills and that might not be until the end of the year.

Murray lauded the effort, saying, "When Republicans and Democrats take the time ... we can truly get things done" for the American people.

Even more than other aspects of the law, the cost-sharing payments have been in dispute ever since the Affordable Care Act became law. House Republicans sued in 2014 to block the payments, arguing they were illegal because Congress, which has power over government spending under the Constitution, had never specifically authorized them. The Obama administration tried unsuccessfully to get the GOP lawsuit dismissed, but the Republicans won favorable rulings from lower-court judges, putting the payments in legal jeopardy even before Trump won the White House. 

Copyright Associated Press / NBC New York



Photo Credit: Mark Wilson/Getty Images, File
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<![CDATA[Trump's Drug Czar Nominee Withdraws After Critical Reports]]>Tue, 17 Oct 2017 08:36:53 -0500https://media.nbcnewyork.com/images/213*120/610637396-Rep-Tom-Marino.jpg

President Donald Trump's nominee to be the nation's drug czar withdrew his name from consideration, Trump said Tuesday, following reports that the lawmaker played a key role in passing a bill weakening federal authority to stop companies from distributing opioids.

Republican Rep. Tom Marino "has informed me that he is withdrawing his name from consideration as drug czar. Tom is a fine man and a great Congressman!" Trump tweeted.

Trump had told reporters at a Rose Garden news conference Monday that he would look at reports by The Washington Post and CBS News "very closely," adding: "If I think it's 1 percent negative to doing what we want to do, I will make a change."

The Post and CBS' "60 Minutes" reported Sunday on the 2016 law, which weakened the Drug Enforcement Administration's authority to stop companies from distributing opioids. Marino, in his fourth term representing northeastern Pennsylvania, played a key role in the law along with a handful of other Republicans.

Trump called Marino "a good man," but said, somewhat ominously, "We're going to be looking into Tom."

Democrats had called on Trump to withdraw Marino's nomination.

Senate Minority Leader Chuck Schumer said confirming Marino as the nation's drug czar was like "putting the wolf in charge of the henhouse," adding: "The American people deserve someone totally committed to fighting the opioid crisis, not someone who has labored on behalf of the drug industry."

Sen. Joe Manchin, whose home state of West Virginia has been among the hardest-hit by the opioid epidemic, said he was horrified at the accounts of the 2016 law and Marino's role in it.

Manchin scolded the Obama administration for failing to "sound the alarm on how harmful that bill would be for our efforts to effectively fight the opioid epidemic" that kills an estimated 142 people a day nationwide.

In a letter to Trump, Manchin called the opioid crisis "the biggest public health crisis since HIV/AIDS," and said, "we need someone leading the White House Office of National Drug Control Policy who believes we must protect our people, not the pharmaceutical industry."

The Post reported Sunday that Marino and other members of Congress, along with the nation's major drug distributors, prevailed upon the DEA and the Justice Department to agree to an industry-friendly law that undermined efforts to restrict the flow of pain pills that have led to tens of thousands of deaths. President Barack Obama signed the law in April 2016.

The industry worked behind the scenes with lobbyists and key members of Congress, including Marino, pouring more than a million dollars into their election campaigns, the newspaper reported.

Marino's office declined to comment, but Sen. Orrin Hatch, R-Utah, the bill's lead Senate sponsor, defended the measure Monday, calling allegations that he or Marino "conspired" with drug companies "utterly ridiculous." Hatch, a 40-year veteran of the Senate, said he was "no patsy" of the drug industry.

The language affecting DEA enforcement authority was suggested by DEA and the Justice Department, Hatch said, adding that the agencies could have tried to stop the bill at any time — or recommended that Obama veto the measure.

"Let's not pretend that DEA, both houses of Congress and the Obama White House all somehow wilted under Representative Marino's nefarious influences," Hatch said.

A White House commission convened by Trump and led by New Jersey Gov. Chris Christie has called on Trump to declare a national emergency to help deal with the growing opioid crisis. An initial report from the commission in July noted that the approximately 142 deaths each day from drug overdoses mean the death toll is "equal to September 11th every three weeks."

Trump has said he will officially declare the opioid crisis a "national emergency" but so far has not done so. He said Monday he will make the designation next week.

Meanwhile, Sen. Claire McCaskill, D-Mo., said Monday she will introduce legislation to repeal the 2016 law.

The bill was touted as a way to improve enforcement efforts related to prescription drug abuse by altering DEA procedures for revoking or suspending registrations for opioid distributors, McCaskill said, but "the effect of the changes has been to significantly curtail the ability of DEA to bring enforcement actions against drug distributors."

McCaskill, the senior Democrat on the Senate Homeland Security and Governmental Affairs Committee, has been investigating the role of pharmaceutical distributors in fueling the opioid crisis. 

Copyright Associated Press / NBC New York



Photo Credit: Bill Clark/CQ Roll Call, File
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<![CDATA[Trump and McConnell Say GOP Is 'Very Unified' After Meeting]]>Mon, 16 Oct 2017 16:30:06 -0500https://media.nbcnewyork.com/images/213*120/AP_17289640889927.jpg

Donald Trump and Mitch McConnell reaffirmed their alliance of necessity Monday in a raucous Rose Garden news conference that also underscored their sharp differences. The garrulous president claimed they were longtime friends now closer than ever; the reserved Senate Republican leader allowed that they share goals and speak often.

It was a spectacle that mesmerized Washington, as Trump and McConnell appeared side by side for more than a half hour, the president tossing off answers — sometimes mini-speeches — on all topics while McConnell, disciplined as always, delivered brief, scholarly explanations about the legislative process and the risks to their party of nominating candidates who can't win.

At various points, the president denounced the Russia-Trump campaign investigation, lauded himself for his record on judicial nominations, argued wrongly that "it took years for the Reagan administration to get taxes done," and claimed that past presidents hadn't necessarily contacted bereaved family members to mourn lost service members — before backtracking on that assertion when pressed. He also noted, as he often does, that he won the presidential election last fall, and he implored Hillary Clinton to run again.

In front of a hastily assembled White House press corps, jostling each other on the lawn because there wasn't time to bring out chairs, Trump began his remarks by saluting McConnell and, as he described it, their longstanding friendship.

"We're probably now closer than ever before," the president proclaimed as McConnell grinned stiffly at his side. "My relationship with this gentleman is outstanding."

Trump spent August assailing McConnell for his inability to pass legislation to repeal the Affordable Care Act, calling the failure "a disgrace" and ordering McConnell over Twitter to "get back to work." For his part, McConnell has complained that Trump had "excessive expectations" for how quickly Congress could act.

Nevertheless the Kentucky senator seconded the president's latest views.

"Contrary to what some of you may have reported, we are together, totally, on this agenda to move America forward," McConnell said.

Trump defended his former top adviser, Steve Bannon, who is now threatening all-out political war on McConnell and establishment Republicans, including incumbent senators. But the president also suggested he might try to talk Bannon out of some of his threats against Senate Republicans whom McConnell has pledged to defend.

"Some of the people that he may be looking at, I'm going to see if we talk him out of that, because frankly, they're great people," Trump said.

That represented a notable shift from just a couple hours earlier, when Trump had praised Bannon at a Cabinet meeting without suggesting he might step in to protect incumbent Republicans like John Barrasso of Wyoming or Deb Fischer of Nebraska, both of whom Bannon named in a threatening speech over the weekend. Trump's change in tone suggested that McConnell, whose allies regularly do battle with Bannon, might have talked Trump into intervening.

"Just so you understand, the Republican Party is very, very unified," Trump insisted.

McConnell took the opportunity to lay out, for the public and for the audience of one standing beside him, why he and GOP allies work protect Senate incumbents. He listed some conservative Republicans nominated in the 2010 and 2012 cycles, before observing, "They're not in the Senate. And the reason for that was that they were not able to appeal to a broader electorate in the general election."

Trump briefly pursed his lips as McConnell made those remarks, then took a question on another topic.

It was not clear what led to Monday's sudden question-and-answer session, which followed lunch between McConnell and Trump at the White House. Their meeting came at a critical time, with the Senate poised to vote this week on a budget that would set the stage for tax legislation that many Republicans view as make-or-break following the failure on health care. Both McConnell and Trump recommitted themselves to the goal of passing a tax bill by the end of this year.

The last time McConnell was at the White House was early last month. On that occasion, Trump bypassed him and Republican House Speaker Paul Ryan to cut a deal with the Senate's Democratic leader, Chuck Schumer, and House Minority Leader Nancy Pelosi on debt and spending.

That kicked off a brief period when bipartisanship was in the air in Washington, and it seemed possible that Trump would make common cause with Democrats at the expense of Republicans on other issues, too. But the suggestion of a deal on immigration appears to have fallen apart. Questioned Monday about Schumer and Pelosi, Trump replied: "Well, I hope to have a relationship. If we don't, we don't."

However, he claimed that his recent action to shut off certain payments to insurers under the Affordable Care Act, denounced by Democrats as sabotage, was forcing bipartisan talks. Indeed there may be a renewed focus on Senate bipartisan negotiations aimed at addressing the payments, which go to subsidize costs for low-income people.

"Because of that, people are talking now, Democrats are talking to the Republicans," Trump said, contending that a short-term fix would be followed next year by ultimate success in repealing "Obamacare," and asserting with no evidence, as he's done in the past, that the votes are there now to repeal the law.

Trump also denounced the investigation into his campaign's involvement with Russia, being conducted by a special counsel and GOP-led congressional committees.

"The whole Russia thing was an excuse for the Democrats losing the election," he said.

"There has been absolutely no collusion. It's been stated that they have no collusion. They ought to get to the end of it, because I think the American public is sick of it."

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Alex Brandon
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<![CDATA[Key Questions and Answers About Trump's Health Care Move]]>Sat, 14 Oct 2017 03:15:48 -0500https://media.nbcnewyork.com/images/213*120/AP_17285593800516.jpg

President Donald Trump's move to stop paying a major "Obamacare" subsidy will raise costs for many consumers who buy their own health insurance, and make an already complicated system more challenging for just about everybody.

Experts say the consequences will vary depending on how much money you earn, the state you live in, and other factors.

Overall, Trump's decision will make coverage under the Affordable Care Act less secure, because more insurers may head for the exits as their financial losses mount.

All of this is happening with the Nov. 1 start of sign-up season a couple of weeks away.

Here are some questions and answers as state regulators, insurance executives, consumer groups and number crunchers try to analyze the potential impacts:

Q: What exactly did Trump do, and why?
A: Trump said he'd immediately stop paying the Obama health law's cost-sharing subsidies, which reimburse insurers for reducing copays and deductibles for people with modest incomes.

The subsidies are under a legal cloud because of a partisan dispute over the wording of the health law.

The law requires insurers to reduce costs for low-income people, and specifies that the government must reimburse the companies. But Republicans and the Trump administration say the law failed to include a congressional appropriation, a specific instruction to pay that's required by the U.S. Constitution before federal money can be spent.

The dispute has been going on for years, and the government had continued to make monthly payments.

Trump had been threatening for months to stop the payments. Apparently he decided to bring things to a head, to force congressional Democrats to negotiate on a new health care law.

Q: How many people benefit from these subsidies?
A: About 60 percent of the estimated 9 million to 10 million people signed up for coverage through the health law's insurance markets qualify for reduced copays and deductibles, which are available to individuals making up to about $30,000.

Q: Does this mean they'll get no help?
A: No. Insurers are legally obligated to provide the discounts, and if the government doesn't reimburse them, the companies are expected to raise premiums.

In some states regulators have allowed insurers to increase premiums preemptively for 2018 because of the uncertainty over what Trump would do. Other states have contingency plans.

And there's another wrinkle: "Obamacare" also subsidizes monthly premiums, not just copays and deductibles.

So people getting premium subsidies will be shielded from those increases, for the most part.

Q: What about people who buy individual health insurance policies outside the "Obamacare" market and don't get help under the ACA?
A: This is where it could get tricky.

Many of these "off marketplace" customers are solid middle-class and don't qualify for financial assistance, so potentially they could face a big hit.

It depends on where they live, said Larry Levitt of the nonpartisan Kaiser Family Foundation.

In some states, regulators directed insurance companies to limit potential rate increases only to plans sold on the ACA markets. Unsubsidized customers would be protected in those states.

In other states, however, they might be in for a shock.

A crystal-clear picture of winners and losers will emerge in the weeks to come.

Q: Trump says this money is a bailout. What's the impact for insurance companies?
A: The National Association of Insurance Commissioners estimates that Trump's immediate cancellation of monthly payments will cost insurers about $1 billion they would have been owed for the remainder of the year. There's no way to raise premiums now for a few months to try to recoup any of that.

The nonpartisan organization representing state regulators says Trump's order will only add more disruptions to already shaky markets.

Elizabeth Carpenter of the consulting firm Avalere Health says more insurers may drop out if they can't figure out a way to recoup losses. About half of U.S. counties will only have one ACA insurer next year.

Q: Is there any way this can be fixed?
A: Congress could appropriate the money, quickly removing the legal doubt. Or a court may put a hold on Trump's order to consider objections being raised by state attorneys general.

Associated Press editor Kevin Vineys contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Evan Vucci]]>
<![CDATA[Paul Ryan Visits Puerto Rico as Trump Offers Support]]>Fri, 13 Oct 2017 14:48:37 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-861000150.jpg

House Speaker Paul Ryan is traveling to hurricane-ravaged Puerto Rico Friday as President Donald Trump assured residents that he "will always be with them."

Ryan and other members of a congressional delegation met at the airport briefly with officials from the Federal Emergency Management Agency on Friday.

He and other members of the delegation then boarded helicopters with Puerto Rico Gov. Ricardo Rossello to see some of the areas that the storm hit hardest Sept. 20.

More than three weeks later, only 9 percent of Puerto Rico has power and 63 percent has water, mainly in San Juan and the south and east. Thirty-six percent of cellphone towers are out of service and 18 bridges closed, making travel in some parts of the island difficult, Telemundo Puerto Rico reported. 

Ryan's visit is further demonstration of the federal government's commitment to helping Puerto Rico recover, coming a day after Trump lashed out at the island, insisting that the federal government can't keep sending help "forever." He'd also suggested the U.S. territory is to blame for its financial struggles.

After that comment, several federal officials, including White House chief of staff John Kelly committed to working on the recovery for the long haul.

The U.S. will "stand with those American citizens in Puerto Rico until the job is done," Kelly said.

Trump took a softer tone on Friday, saying in a tweet that "the wonderful people of Puerto Rico" have an "unmatched spirit." He added, "I will always be with them!"

But he also said again that residents "know how bad things were before" the hurricanes.

San Juan Mayor Carmen Yulin Cruz, an outspoken critic of the way Trump has handled the hurricane response, told NBC News late Thursday that "whomever deletes [Trump's Twitter] account should be nominated for the Nobel Peace Prize."

Ryan's visit came a day after Congress passed a $36.5 billion multistate disaster package that includes assistance for Puerto Rico. But officials warn more will be needed.

Copyright Associated Press / NBC New York



Photo Credit: Photo by Mario Tama/Getty Images]]>
<![CDATA[Trump's 'Obamacare' Move Shakes Up Health Care and Politics]]>Sat, 14 Oct 2017 01:57:27 -0500https://media.nbcnewyork.com/images/213*120/860674444-Trump-Health-Care.jpg

President Donald Trump's abrupt move to cut off federal payments to insurers jolted America's health care and political worlds alike, threatening to boost premiums for millions, disrupt insurance markets and shove Republicans into a renewed civil war over their efforts to shred "Obamacare."

Defiant Democrats, convinced they have important leverage, promised to press for a bipartisan deal to restore the money by year's end. That drive could split the GOP. On one side: pragmatists seeking to avoid political damage from hurting consumers. On the other: conservatives demanding a major weakening of the Affordable Care Act as the price for returning the money.

"The American people will know exactly where to place the blame," declared Senate Minority Leader Chuck Schumer, D-N.Y., all but daring Trump to aggravate what could be a major issue in the 2018 congressional elections.

The money goes to companies for lowering out-of-pocket costs like co-payments and deductibles for low- and middle-income customers. It will cost about $7 billion this year and help more than 6 million people.

Ending the payments would affect insurers because President Barack Obama's law requires them to reduce their poorer customers' costs. Carriers are likely to recoup the lost money by increasing 2018 premiums for people buying their own health insurance policies.

The National Association of Insurance Commissioners estimates that Trump's move would produce a 12 percent to 15 percent upsurge in premiums, while the nonpartisan Congressional Budget Office has put the figure at 20 percent. That's on top of premium increases from growing medical costs.

Experts say the political instability over Trump's effort to undermine Obama's health care law could also prompt more insurers to leave markets. As Trump frequently points out, next year about half of U.S. counties will have only one insurer on "Obamacare's" online marketplaces, up from the one-third of counties with one carrier in 2017.

Trump relished his latest blow against the law that he pledged to repeal during his presidential campaign, only to see the effort crash in the GOP-run Senate this summer. He's long derided the subsidies as bailouts to insurers, even though the payments and the cost reductions for consumers are required by law.

The scrapping of subsidies would affect millions more consumers in states won by Trump last year, including Florida, Alabama and Mississippi, than in states won by Democrat Hillary Clinton. Nearly 70 percent of the 6 million who benefit from the cost-sharing subsidies are in states that voted for the Republican.

"Congress, they forgot what their pledges were," Trump told conservative activists at the Values Voter Summit on Friday, recalling GOP candidates' repeated vows to repeal Obama's law. "So we're going a little different route. But you know what? In the end, it's going to be just as effective, and maybe it will even be better."

He later reiterated his belief that his move would pressure Democrats to bargain over major changes in the law and said, "There's going to be time to negotiate health care that's going to be good for everybody."

Trump's move was hailed by conservative groups including Heritage Action for America and Freedom Partners, backed by the Koch brothers.

But rallying against it were medical and consumer groups including the American Heart Association, the American College of Physicians and insurance industry behemoths America's Health Insurance Plans and Blue Cross Blue Shield Association.

Nineteen Democratic state attorneys general are suing Trump over the stoppage. Attorneys generals from California, Kentucky, Massachusetts and New York were among those who filed the lawsuit in federal court in California to stop Trump's attempt "to gut the health and well-being of our country."

A federal judge has found that Congress never properly approved the payments. The subsidies have continued under Obama and Trump until now, despite prior Trump threats to block them.

Schumer told reporters that Trump's "threats and bullying are not going to work." He said he saw a good chance of forcing money for the cost-sharing reductions into a massive spending bill Congress is expected to approve late this year.

Democrats think Trump would have little clout to block a bipartisan deal, citing support for the payments by some Republicans and polls showing the public would fault the GOP for any failure. Some Republicans privately agree.

"Now, President Trump has his fingerprints all over the knife," said Maryland Sen. Chris Van Hollen, who heads Senate Democrats' campaign committee.

In a survey released Friday by the nonpartisan Kaiser Family Foundation, 7 in 10 said the administration should help Obama's law work, not undermine it, including nearly half of Republicans. The same group conducted an August poll showing 6 in 10 people would blame Trump and the GOP for future health care woes.

Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., have been seeking a deal that Alexander said in a recent interview would reinstate the payments for two years. He said in exchange, Republicans want "meaningful flexibility for states" to offer lower-cost insurance policies with less coverage than Obama's law mandates.

Republicans are divided over that effort.

Rep. Mark Meadows, R-N.C., who leads the conservative House Freedom Caucus, said in an interview that he's willing to back the payments if they're "part of a transition from Obamacare to something else" with greater state flexibility than Alexander and Murray are discussing. Another conservative leader, Rep. Mark Walker, R-N.C., said "under no circumstance" should the payments be revived.

Some GOP leaders have expressed openness to continuing the payments, including Senate Majority Leader Mitch McConnell, R-Ky., who's said he wants them accompanied by significant changes. House Ways and Means Committee Chairman Kevin Brady, R-Texas, said this summer that the payments should be continued, citing their impact on premiums.

Moderates like Sen. Susan Collins, R-Maine, said Friday that halting the payments would make insurance costs "unaffordable for some people." Rep. Ileana Ros-Lehtinen, R-Fla., tweeted that the cuts "will mean more uninsured in my district."

AP reporters Ken Thomas and Jill Colvin contributed.

Copyright Associated Press / NBC New York



Photo Credit: Alex Wong/Getty Images
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<![CDATA[America's Obesity Epidemic Reaches Record High: Report]]>Fri, 13 Oct 2017 00:23:56 -0500https://media.nbcnewyork.com/images/213*120/AP_668885564479.jpg

Almost 40 percent of American adults are obese, the highest rate ever recorded for the United States, according to a report released Friday by the Centers for Disease Control and Prevention.

Nearly 20 percent of adolescents are obese, also a record high, NBC News reported. That comes out to one in five adolescents aged 12-19. Meanwhile, one in five kids aged 6-11 and one in 10 preschoolers aged 2-5 are obese.

"It's difficult to be optimistic at this point," said Dr. Frank Hu, chair of the Department of Nutrition at the Harvard School of Public Health. "The trend of obesity has been steadily increasing in both children and adults."

Obesity is medically defined as having a body-mass index of more than 30. Overweight and obese children have a higher risk to stay obese and childhood obesity is linked to a higher chance of early death in adulthood.



Photo Credit: AP Photo/Rogelio V. Solis, File]]>
<![CDATA[Millions Die Suffering Amid Global Opioid Gap: Report]]>Thu, 19 Oct 2017 14:31:05 -0500https://media.nbcnewyork.com/images/213*120/oxycodoneGetty_1200x675.jpg

Nearly 26 million people around the world die each year with serious suffering in part because of a huge gap in pain relief: The U.S. may be awash in opioid painkillers, but they're rare or unavailable in dozens of poor countries, says a new report.

The challenge is to improve palliative care in low-income countries while avoiding mistakes that led to the U.S. addiction crisis.

The report to be published Friday in The Lancet says one key is using off-patent morphine that costs pennies a dose — not profitable for drug companies that push pricier, more powerful opioids in rich countries, but critical to easing a health emergency.

In some places, even children dying of cancer or children in treatment for cancer can't get pain relief, said University of Miami professor Felicia Knaul. She co-chaired a Lancet-appointed international commission that spent three years studying the disparity and what she calls "the moral obligation" to help.

"This report finally gives voice to the suffering and a roadmap to governments," Knaul said.

Of the few hundred tons of morphine and equivalent opioids distributed worldwide, less than 4 percent goes to low- and middle-income countries, the researchers reported.

How much is needed? The Lancet Commission provided the first global estimates of the need for palliative care, defined as "serious health-related suffering" from certain life-threatening conditions, including cancer, HIV and trauma.

Some 2.5 million children are among the annual count of nearly 26 million who die without adequate relief, the team calculated.

Another 35.5 million people a year have serious pain and suffering from those conditions but aren't dying, and most live in low- or middle- income countries.

The world's poorest countries have access to enough morphine to meet less than 2 percent of their palliative care needs, the report found. India fares little better, at 4 percent; China meets 16 percent of its need, and Mexico 36 percent.

The 2010 earthquake in Haiti highlighted the scarcity, as doctors lacked opioids for people who were severely injured or needed surgery, the commission noted.

Beyond painkillers, the panel urged health systems to make available an "essential package" of palliative care services that also includes medications to ease breathing problems, muscle spasms, complications of heart or liver failure, and depression and psychological suffering. The list also includes practical equipment like pressure sore-reducing mattresses, adult diapers — and a lock box for any needed morphine.

The Lancet panel looked to lessons from the U.S. opioid crisis, and from Western Europe, which has avoided similar abuse thanks to strict opioid monitoring and to universal health coverage for non-opioid treatments for chronic pain, said report co-author Dr. Lukas Radbruch, a palliative care specialist at Germany's University of Bonn.

Among the recommendations:

-Countries should use cheap, immediate-release oral and injectable morphine for severe pain. Closing the pain gap would cost $145 million.

—Don't allow drug company marketing to patients, physicians or other health care providers. In the U.S., prescriptions soared after marketing of newer opioids for less severe types of pain.

—Closely monitor morphine supply, and train health workers in proper pain treatment.

The $1.5 million study was funded by the University of Miami and Harvard University and with grants including from the U.S. National Cancer Institute, American Cancer Society and drug maker Pfizer. Another drug company, Roche, provided a grant to help the University of Miami disseminate the findings.

One specialist who has long warned that the U.S. addiction crisis could spread internationally said the proposal for poor countries to avoid patented opioids was a "sensible" approach.

Still, "I wish they had included a stronger warning regarding the risks of a pain management agenda being co-opted by profit-seeking pharmaceutical companies as it was in the United States," said Stanford University psychiatry professor Keith Humpreys, who wasn't involved in the Lancet report.

Copyright Associated Press / NBC New York



Photo Credit: Photo by John Moore/Getty Images, File]]>
<![CDATA[Experts Say Trump Order Could Upend Health Care System]]>Thu, 12 Oct 2017 15:02:10 -0500https://media.nbcnewyork.com/images/213*120/AP_17285593800516.jpg

With Republican efforts to repeal Obamacare stalled, President Donald Trump issued a new executive order on Thursday that could undermine the law without Congress.

Experts say it has the potential to upend the current health care system for small businesses and individuals by opening up cheaper options for some customers, while spiking costs for others and encouraging more insurers to flee Obamacare’s exchanges.

Healthier customers, especially those making too much to qualify for subsidies, could abandon the exchanges for skimpier association plans, prompting insurers to hike premiums for the remaining sicker pool of customers.

Insurers and their customers won’t know the full effect of the executive order any time soon. It will likely take months, perhaps even a year or more, for agencies to examine the issues, propose new rules and then finalize them.



Photo Credit: AP Photo/Evan Vucci]]>
<![CDATA[As Puerto Rico Suffers, Trump Warns Help Won't Last Forever]]>Thu, 12 Oct 2017 19:49:01 -0500https://media.nbcnewyork.com/images/213*120/857023618-Trump-Travels-to-Puerto-Rico.jpg

President Donald Trump lashed out at hurricane-devastated Puerto Rico on Thursday, insisting in tweets that the federal government can't keep sending help "forever" and suggesting the U.S. territory was to blame for its financial struggles.

His broadsides triggered an outcry from Democrats in Washington and officials on the island, which has been reeling since Hurricane Maria struck three weeks ago, leaving death and destruction in an unparalleled humanitarian crisis.

San Juan Mayor Carmen Yulin Cruz, with whom Trump has had a running war of words, tweeted that the president's comments were "unbecoming" to a commander in chief and "seem more to come from a 'Hater in Chief.'"

"Mr. President, you seem to want to disregard the moral imperative that your administration has been unable to fulfill," the mayor said in a statement.

The debate played out as the House passed, on a sweeping 353-69 vote, a $36.5 billion disaster aid package that includes assistance for Puerto Rico's financially-strapped government. House Speaker Paul Ryan, R-Wis., said the government needs to ensure that Puerto Rico can "begin to stand on its own two feet" and said the U.S. has "got to do more to help Puerto Rico rebuild its own economy."

White House Press Secretary Sarah Huckabee Sanders praised the House action Thursday night and promised the administration "will continue to work with Congress to provide the resources necessary to recover and rebuild from the hurricanes" and the wildfires in California.

Forty-five deaths in Puerto Rico have been blamed on Maria, about 85 percent of Puerto Rico residents still lack electricity and the government says it hopes to have electricity restored completely by March.

Both Trump and Vice President Mike Pence visited the island last week to reaffirm the U.S. commitment to the island's recovery. But Trump's tweets Thursday raised questions about whether the U.S. would remain there for the long haul. He tweeted, "We cannot keep FEMA, the Military & the First Responders, who have been amazing (under the most difficult circumstances) in P.R. forever!"

In a series of tweets, the president added, "electric and all infrastructure was disaster before hurricanes." He blamed Puerto Rico for its looming financial crisis and "a total lack of accountability."

The tweets conflicted with Trump's past statements on Puerto Rico. During an event last week honoring the heritage of Hispanics, for example, the president said, "We will be there all the time to help Puerto Rico recover, restore, rebuild."

White House chief of staff John Kelly, speaking to reporters, said the military and other emergency responders were trying very hard to "work themselves out of a job." Reassuring the island, Kelly said the U.S. will "stand with those American citizens in Puerto Rico until the job is done."

At the Pentagon, Lt. Gen. Kenneth F. McKenzie Jr. told reporters "there's still plenty of work to be done" by the military troops in Puerto Rico. He said there was no current plan to withdraw troops who are supporting FEMA's recovery efforts. McKenzie, director of the military's Joint Staff, said it will be up to FEMA and other civilian agencies to decide when the military is no longer needed there.

Democrats said Trump's tweets were deplorable, given that the 3 million-plus U.S. citizens on Puerto Rico are confronting the kind of hardships that would draw howls of outrage if they affected a state. One-third of the island lacks clean running water and just 8 percent of its roads are passable, according to government statistics.

"It is shameful that President Trump is threatening to abandon these Americans when they most need the federal government's help," said Maryland Rep. Steny Hoyer, the second-ranking House Democrat.

After years of economic challenges, Puerto Rico was already in the process of restructuring much of its $74 billion in debt before the hurricane struck. The financial situation is more complicated than Trump's tweets suggest.

Puerto Rico lost population and jobs after Congress eliminated special tax breaks in 2006, making it more difficult to repay its debts. Yet lenders continued to extend credit to Puerto Rico despite its economic struggles, while pension costs strained Puerto Rico's government and its infrastructure deteriorated.

The legislative aid package totals $36.5 billion and sticks close to a White House request. For now, it ignores huge demands from the powerful Florida and Texas delegations, which together pressed for some $40 billion more.

A steady series of disasters could put 2017 on track to rival Hurricane Katrina and other 2005 storms as the most costly set of disasters ever. Katrina required about $110 billion in emergency appropriations.

The bill combines $18.7 billion for the Federal Emergency Management Agency with $16 billion to permit the financially troubled federal flood insurance program pay an influx of Harvey-related claims. An additional $577 million would pay for western firefighting efforts.

Up to $5 billion of the FEMA money could be used to help local governments remain functional as they endure unsustainable cash shortfalls in the aftermath of Maria, which has choked off revenues and strained resources.

Ryan, the House speaker, planned to visit Puerto Rico on Friday. He has promised that the island will get what it needs.

"It's not easy when you're used to living in an American way of life, and then somebody tells you that you're going to be without power for six or eight months," said Resident Commissioner Jenniffer Gonzalez-Colon, who represents Puerto Rico as a nonvoting member of Congress. "It's not easy when you are continue to suffer — see the suffering of the people without food, without water, and actually living in a humanitarian crisis."

Copyright Associated Press / NBC New York



Photo Credit: Mark Wilson/Getty Images]]>
<![CDATA[Calling It a Beginning, Trump Signs Health Care Order]]>Fri, 13 Oct 2017 05:34:07 -0500https://media.nbcnewyork.com/images/213*120/860565072-Trump-Signs-Health-Care-Order.jpg

President Donald Trump directed his administration Thursday to rewrite federal rules so consumers can have wider access to health insurance plans featuring lower premiums. He called his new executive order a "beginning" and promised more actions to come.

Frustrated by failures in Congress, Trump is moving to put his own stamp on health care. But even the limited steps the president outlined Thursday will take months for the federal bureaucracy to finalize in regulations. Experts said consumers should not expect immediate changes.

"This will cost the United States government virtually nothing, and people will have great, great health care, and when I say people, I mean by the millions," Trump said in announcing the order in the Roosevelt Room of the White House.

But the changes Trump hopes to bring about may not be finalized in time to affect coverage for 2019, let alone next year.

Trump said he will continue to pressure Congress to repeal and replace former President Barack Obama's Affordable Care Act, better known as "Obamacare."

One of the main ideas from the administration involves easing the way for groups and associations of employers to sponsor coverage that can be marketed across the land. That reflects Trump's longstanding belief that interstate competition will lead to lower premiums for consumers who buy their own health insurance policies, as well as for small businesses.

Those "association health plans" could be shielded from some state and federal insurance requirements. But responding to concerns, the White House said participating employers could not exclude any workers from the plan, or charge more to those in poor health.

Other elements of the White House plan include:

—Easing current restrictions on short-term policies that last less than a year, an option for people making a life transition, from recent college graduates to early retirees. Those policies are not subject to current federal and state rules that require standard benefits and other consumer protections.

—Allowing employers to set aside pre-tax dollars so workers can use the money to buy an individual health policy.

"This executive order is the start of a long process as the gears of the federal bureaucracy churn, not the final word," said Larry Levitt of the nonpartisan Kaiser Family Foundation.

It's also unlikely to reverse the trend of insurers exiting state markets. About half of U.S. counties will have only one "Obamacare" insurer next year, although it appears that no counties will be left without a carrier as was initially feared. White House officials said over time, the policies flowing from the president's order will give consumers more options.

Democrats are bracing for another effort by Trump to dismantle "Obamacare," this time with the rule-making powers of the executive branch. Staffers at the departments of Health and Human Services, Labor and Treasury have been working on the options since shortly after the president took office.

The president's move is also likely to encounter opposition from medical associations, consumer groups and perhaps even some insurers — the same coalition that so far has blocked congressional Republicans from repealing Obama's Affordable Care Act.

State attorneys general and state insurance regulators may try to block the administration in court, seeing the plan as a challenge to their traditional oversight authority.

As Trump himself once said, health care is complicated and working his will won't be as easy as signing a presidential order.

Experts say the executive order probably won't have much impact on premiums for 2018, which are expected to be sharply higher in many states for people buying their own policies.

Sponsors would have to be found to offer and market the new style association plans, and insurers would have to step up to design and administer them. For insurers, this would come at a time when much of the industry seems to have embraced the consumer protections required by the Obama health law.

Depending on the scope of regulations that flow from Trump's order, some experts say the alternatives the White House is promoting could draw healthy people away from "Obamacare" insurance markets, making them less viable for consumers and insurers alike

But conservatives such as Sen. Rand Paul, R-Ky., believe the federal government has overstepped its bounds in regulating the private health insurance market. They argue that loosening federal rules would allow insurers to design plans that — although they may not cover as much — work perfectly well for many people.

About 17 million people buying individual health insurance policies are the main focus of Trump's order. Nearly 9 million of those consumers receive tax credits under the Obama law and are protected from higher premiums.

But those who get no subsidies are exposed to the full brunt of cost increases that could reach well into the double digits in many states next year. Many in this latter group are solid middle-class, including self-employed business people and early retirees. Cutting their premiums has been a longstanding political promise for Republicans.

Copyright Associated Press / NBC New York



Photo Credit: Alex Wong/Getty Images]]>
<![CDATA[Trump Birth Control Rule Ignores Science, Critics Say]]>Wed, 11 Oct 2017 13:43:51 -0500https://media.nbcnewyork.com/images/213*120/AP_16239685238277.jpg

The Trump administration's new birth control rule is raising questions among some doctors and researchers, who say it overlooks known benefits of contraception while selectively citing data that raise doubts about effectiveness and safety.

"This rule is listing things that are not scientifically validated, and in some cases things that are wrong, to try to justify a decision that is not in the best interests of women and society," said Dr. Hal Lawrence, CEO of the American Congress of Obstetricians and Gynecologists, a professional society representing women's health specialists.

Two recently issued rules — one addressing religious objections and the other, moral objections — allow more employers to opt out of covering birth control as a preventive benefit for women under the Obama health care law. Although the regulations ultimately address matters of individual conscience and religious teaching, they also dive into medical research and scholarly studies on birth control.

It's on the science that researchers are questioning the Trump administration. They say officials ignored some recent research and stretched other studies.

"The interpretation is very selective in terms of the science that they use," said Alina Salganicoff, director of women's health policy at the nonpartisan Kaiser Family Foundation. "It's always possible to find one study that validates your claim, but you have to look at the quality of the study and the totality of the research. You can make an argument that you don't agree because of your religious or moral objections, but that is a different discussion."

In a statement, Health and Human Services Department spokeswoman Caitlin Oakley responded to critics, saying: "The rules are focused on guaranteeing religious freedom and conscience protections for those Americans who have a religious or moral objection to providing certain services based on their sincerely held beliefs."

The administration also says some parts of the rules are meant to illustrate the sorts of concerns that religious objectors may have, and don't necessarily reflect government policy.

Here's a look at examples from the Trump administration's birth control rules that are raising questions:

THE MORNING-AFTER PILL
Emergency contraception is birth control for use after unprotected sex, often called the "morning-after pill."

Referring to the morning-after pill as well as intrauterine devices or IUDs, the regulations state that the Food and Drug Administration "includes in the category of 'contraceptives' certain drugs and devices that may not only prevent conception (fertilization), but also may prevent implantation of an embryo."

Because of that, "many persons and organizations" believe emergency contraception methods cause "early abortion," the regulations add.

But Princeton researcher James Trussell said that while studies years ago suggested the morning-after pill might affect the lining of a woman's uterus and interfere with the implantation of a fertilized egg, more recent studies have not found such an effect.

"The preponderance of the evidence, and certainly the most recent evidence, is that there is no post-fertilization effect," said Trussell.

That's not included in the administration's rule.

"The actual medical evidence is that it blocks ovulation," or the release of an egg from the ovaries, explained Lawrence, the ob-gyn. "If you don't ovulate, there is no egg to get fertilized. It's not blocking implantation."

EFFECTIVENESS OF BIRTH CONTROL
The Trump administration's rule takes issue with the science behind the Obama-era decision to require most employers to cover birth control as preventive care.

It suggests that some studies cited in a key 2011 report did not show a direct cause-and-effect link between increased birth control use by women and a decline in unintended pregnancy.

But Adam Sonfield of the Guttmacher Institute said solid research does in fact exist. The organization does studies on reproductive health that are cited by opposing sides in the political debate.

For example, Sonfield cited a Guttmacher report which found that women who used birth control consistently year-round accounted for only 5 percent of unintended pregnancies in 2008.

"The vast majority of women use birth control at some point in their lives," said Sonfield. "As a medical service, it's far more universal than almost anything covered by insurance."

George Washington University public health professor Susan Wood, a former women's health chief for the FDA, said there's very clear clinical data that contraception prevents pregnancy. Why else would the FDA approve birth control pills?

"They are just using this as a smoke screen," Wood said of the administration. "They are picking out things that they like, and leaving out (studies) that support access to contraception."

THE SEXUAL REVOLUTION
The Trump administration's rule suggests there may be a link between birth control and promiscuity.

It cites a study finding that between 1960 and 1990, "as contraceptive use increased, teen sexual activity outside of marriage likewise increased." (The administration added a caveat that the study did not prove a cause-and-effect link.)

Lawrence, the ob-gyn, said he thinks that's a stretch.

"There were a whole lot of other things going on in the '60s," he said, such as changing social mores about sex before marriage. Also, many people relied on condoms, diaphragms and spermicides.

"The world of birth control in 2018 is about as similar to the world of birth control in 1960 as a Ralph Nader Chevy Corvair is to a space shuttle," he said.

Copyright Associated Press / NBC New York



Photo Credit: Rich Pedroncelli/AP]]>
<![CDATA[Teen Detained After Crossing Border Fights to Have Abortion]]>Tue, 10 Oct 2017 20:52:06 -0500https://media.nbcnewyork.com/images/213*120/womens-clinic-tx-EM.jpg

Advocates for a pregnant 17-year-old girl held in a Texas facility for immigrant children who have crossed the border alone are asking a federal judge to allow her to get an abortion, over the opposition of U.S. and state officials.

A federal magistrate judge in San Francisco has scheduled a hearing Wednesday on a request filed by the American Civil Liberties Union of Northern California, which accuses the U.S. Department of Health and Human Services of refusing to let the girl be taken for the procedure.

Rochelle Garza, a lawyer appointed to represent the girl's legal interests, told The Associated Press on Tuesday that she may be up to 14 weeks' pregnant. Texas state law prohibits most abortions after 20 weeks.

Garza says the teen is from Central America, like most people caught crossing the U.S.-Mexico border without legal permission. She declined to give the girl's name or identify the specific country where she was from, citing the girl's privacy as a minor, but said that the girl wanted an abortion in part because she had seen her parents abuse another sibling who was pregnant.

With Garza's help, the girl obtained a judicial waiver under a Texas law requiring a minor seeking an abortion to get consent from a parent. But staff at the facility where she's being held refused to take her to her appointments with a doctor to seek an abortion, or let the attorney take her, even though private groups that support abortion rights have raised money for the procedure, Garza said.

Instead, she was taken to a crisis pregnancy center. Such centers encourage pregnant women not to have an abortion.

"I feel like they are trying to coerce me to carry my pregnancy to term," the girl said in a declaration filed in federal court last week.

The ACLU of Northern California sued HHS last year over what it said was the denial of abortion and contraception to girls in its custody.

Unaccompanied Central American children apprehended at the U.S.-Mexico border are generally turned over to facilities run by private operators on behalf of HHS. Many facilities are affiliated with religious organizations that oppose abortion like the U.S. Conference of Catholic Bishops. Nearly 3,000 unaccompanied children were caught by Border Patrol agents at the border in August, the most recent month for which data is available.

U.S. lawyers representing HHS argued that the ACLU's request for a temporary restraining order allowing an abortion to go forward was wrong on technical grounds, since the original lawsuit argued HHS was violating the First Amendment by allowing religious groups to allegedly refuse access to abortion. In this case, the 17-year-old is not being held in a facility with a religious affiliation, government lawyers said.

It was not immediately known how long the girl would be held at the facility, or whether she would be eventually be transferred.

Texas Attorney General Ken Paxton went further in a separate filing Tuesday. Paxton, who is a strident opponent of abortion rights like most leaders in the nation's largest conservative state, argued that people in the United States illegally without some type of established ties to the country did not have a "constitutional right to an abortion on demand."

If the court rules in the girl's favor, "the ruling will create a right to abortion for anyone on earth who enters the U.S. illegally," Paxton said in a statement. "And with that right, countless others undoubtedly would follow. Texas must not become a sanctuary state for abortions."

Paxton was joined in filing the brief by the attorneys general of Louisiana, Missouri, Nebraska, Ohio, Oklahoma, and South Carolina.

Garza argued the girl's case "really has nothing to do with her immigration status," and that she had complied with the state's abortion laws.

"As far as I'm aware, abortion is legal in this country," Garza said. "Nobody has the right to force her to have a child against her will."

Copyright Associated Press / NBC New York



Photo Credit: Eric Gay/AP, File]]>
<![CDATA[Whole Foods Recalls Its Raisin Bran for Undeclared Peanuts]]>Mon, 09 Oct 2017 12:32:05 -0500https://media.nbcnewyork.com/images/213*120/whole-foods-recall.jpg

Whole Foods Market has recalled some of its 365 Everyday Value Organic Raisin Bran across the country because the cereal contains undeclared peanuts, the Food and Drug Administration and grocery chain said. 

Boxes of the cereal contained Peanut Butter Cocoa Balls, the recall announcement said. Peanuts can cause a serious and sometimes life-threatening reaction for people who are allergic to the nuts. 

Whole Foods' voluntary recall is for 15 oz. boxes labeled "365 Everyday Value Organic Raisin Bran" with UPC code 9948243903 and a best-by date of June 4, 2018. The items were sold across the United States and online through Amazon.com. No reactions have been reported, Whole Foods and the FDA said on Friday. 

Customers can receive a full refund at stores with a valid receipt. Those with questions may call 1-844-936-8255 from 7 a.m. and 10 p.m. CST on weekdays, or between 8 a.m. and 6 p.m. on weekends.

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<![CDATA[14 Desperate Days: Anatomy of an Opioid Overdose Outbreak]]>Mon, 09 Oct 2017 09:34:00 -0500https://media.nbcnewyork.com/images/213*120/fentanyl+10-09.PNG

An alert Georgia emergency room doctor who saw three strange overdose cases apparently related to the drug Percocet sounded the alarm to the Georgia Poison Center this June, NBC News reported, likely saving lives in an epidemic that began when a man arrived in Macon with a batch of little yellow pills.

Over two weeks, health officials dealt with 40 more cases like the first woman's, who took four hours to be revived after Narcan was administered. Six resulted in deaths.

When that first patient came to, she ripped a breathing tube out of her throat. "In the slightest of a whisper, she said she took a Percocet," Dr. Gregory Whatley said.

But after Whatley scrambled the poison center, which alerted local and federal investigators, toxicology tests determined that the pills weren't the opioid Percocet, but a new type of fentanyl, a synthetic opioid that can be 50 times stronger than heroin.



Photo Credit: NBC 7, File]]>
<![CDATA[White House Plans Order to Expand Health Care Options]]>Mon, 09 Oct 2017 14:15:46 -0500https://media.nbcnewyork.com/images/213*120/Trump-healthcare-face.jpg

The White House is finalizing an executive order that would expand health plans offered by associations to allow individuals to pool together and buy insurance outside their states, a unilateral move that follows failed efforts by Congress to overhaul the health care system.

President Donald Trump has long asserted that selling insurance across state lines would trigger competition that brings down premiums for people buying their own policies. Experts say that's not guaranteed, partly because health insurance reflects local medical costs, which vary widely around the country.

Moreover, White House actions may come too late to have much impact on premiums for 2018.

Trump was expected to sign the executive order this week, likely on Thursday, a senior administration official said Sunday.

Under the president's executive action, membership groups could sponsor insurance plans that cost less because — for example — they wouldn't have to offer the full menu of benefits required under the Affordable Care Act, also called "Obamacare." It's unclear how the White House plans to overcome opposition from state insurance regulators, who see that as an end-run to avoid standards.

"There are likely to be legal challenges that could slow this effort down," said Larry Levitt of the nonpartisan Kaiser Family Foundation.

Similar alternatives have been promoted by Kentucky Sen. Rand Paul, a Republican holdout during the health care debate. Senate leaders didn't bring the latest GOP health care bill to a vote because they lacked the votes to pass it.

Association plans "kind of went away with the ACA, and now the idea seems to be to re-create them," said Jeff Smedsrud, a health insurance marketing entrepreneur. "It's not clear what they would really look like."

Smedsrud said a different option also under consideration by the White House, to loosen restrictions on "short term" insurance plans, could be a safety valve for some consumers.

Those plans generally have limited benefits and remain in force for less than a year. During the Obama administration, the availability of short-term coverage was restricted. One of Smedsrud's companies sells short-term plans.

Others warned that over time the White House order could undermine state insurance markets created under Obama's law, by siphoning off healthy people to plans with lower premiums and skinnier benefits.

The order was being drafted as Trump expressed his willingness to work with Democrats on health care after Republicans were unable to approve legislation that would have repealed and replaced "Obamacare."

The president said Saturday that he had spoken to Senate Democratic leader Chuck Schumer of New York to see if Democrats would want to collaborate with him on improving health care. He told reporters before departing for a North Carolina fundraiser that he was willing to consider a "temporary deal" and referred to a popular Republican proposal that would have the federal government turn over money for health care directly to states in the form of block grants.

Schumer said through a spokesman Saturday that Trump "wanted to make another run at 'repeal and replace' and I told the president that's off the table." Schumer said if Trump "wants to work together to improve the existing health care system, we Democrats are open to his suggestions."

It was unclear if the expected White House order could lead to changes sweeping enough and quick enough to help several million consumers exposed to higher premiums next year for their individual health insurance plans.

It typically takes government agencies several months to carry out presidential directives, since they generally must follow a notice-and-comment process. Sign-up season for individual health insurance starts Nov. 1 and ends Dec. 15.

"Whether this executive order could impact the 2018 market is yet to be seen, since the health plans have created and priced their 2018 products already, and open enrollment begins in just three weeks," said health industry consultant Robert Laszewski.

While nearly 9 million consumers who receive tax credits under the Obama-era law are protected from higher premiums, about 6.7 million other customers with individual coverage get no subsidies and will bear the full brunt of cost increases that reach well into the double digits in many states.

Many in this group are solid middle-class, including self-employed business people and early retirees. Cutting premiums for them has been a longstanding Republican political promise.

"If the question is, is the president interested in working with Democrats to repeal and replace — that would be our language — the answer is yes," White House budget director Mick Mulvaney said during an interview with NBC's "Meet the Press." ''The Democrats would use a different word for that, but the president wants to get something done."

Copyright Associated Press / NBC New York



Photo Credit: Chris Kleponis/Getty Images (Pool), File]]>
<![CDATA[FDA: Drug Shortages Possible Due to Puerto Rico Power Outage]]>Fri, 06 Oct 2017 18:45:08 -0500https://media.nbcnewyork.com/images/213*120/PRmedicine_1200x675.jpg

The Food and Drug Administration on Friday warned that U.S. drug shortages are possible because power outages in Puerto Rico have stopped or limited production at many medicine factories there.

Nearly 10 percent of the medicines used by Americans, plus numerous medical devices, are made in Puerto Rico, which lost most electricity when it was hit hard by Hurricane Maria about two weeks ago.

FDA Commissioner Dr. Scott Gottlieb said in a statement that the agency is working to prevent shortages of about 40 crucial medicines. He has declined to identify those medicines but said Friday that the FDA would disclose any shortages if they occur; drug shortages are routinely listed on the FDA's website.

"We're keeping a close watch on the most critical medical products," Gottlieb said.

The FDA is working with drugmakers and device manufacturers, who are trying to restore partial operations with backup generators, according to the statement. In the most urgent cases, the FDA is helping companies get fuel to keep their generators running and ship finished products.

At a news conference Thursday, Puerto Rican Gov. Ricardo Rossello said power has been restored to 9 percent of customers. The government hopes to have the power back on for a quarter of the island within a month, and for the entire territory of 3.4 million people by March.

Gottlieb said the power disruptions could cause new medicine shortages and exacerbate shortages that existed before Hurricane Maria, and Irma before that, slammed the island.

At least for now, drugmakers say they should be able to prevent shortages by moving around inventory and, in some cases, increasing production at factories in other locations already making those products.

Medicines made in Puerto Rico include AstraZeneca's cholesterol drug Crestor, antibiotics and drugs for inflammation from Pfizer and Roche's Accu-Chek blood sugar test strips for diabetics. Eli Lilly makes the active ingredient for its diabetes medicines on the island. And Amgen, a huge biotech drugmaker, produces most of its medicines there, including widely used rheumatoid drug Enbrel, a number of cancer drugs, heart failure drug Corlanor and osteoporosis drugs Prolia and Xgeva.

Hurricane Maria didn't cause major damage to the roughly 80 medicine and device factories but many have needed cleanup and some repairs, according to several companies contacted by The Associated Press. The companies said operations were also hampered because workers couldn't get to factories and they were dealing with damage to their homes.

The medical products industry, which set up a large base in Puerto Rico decades ago to take advantage of since-expired tax advantages, is key to the financial health of the debt-laden territory. The FDA said medicines and medical devices account for about 30 percent of Puerto Rico's gross domestic product, and about 80 percent of those products are used by residents of Puerto Rico and the 50 states.




Photo Credit: AP/Ramon Espinosa, File]]>
<![CDATA[Trump's One-Two Punch Hits Birth Control, LGBT Rights]]>Fri, 06 Oct 2017 15:31:50 -0500https://media.nbcnewyork.com/images/213*120/AP_16239685238277.jpg

In a one-two punch elating religious conservatives, President Donald Trump's administration is allowing more employers to opt out of no-cost birth control for workers and issuing sweeping religious-freedom directions that could override many anti-discrimination protections for LGBT people and others.

At a time when Trump finds himself embattled on many fronts, the two directives — issued almost simultaneously on Friday — demonstrated the president's eagerness to retain the loyalty of social conservatives who make up a key part of his base. Leaders of that constituency were exultant.

"President Trump is demonstrating his commitment to undoing the anti-faith policies of the previous administration and restoring true religious freedom," said Tony Perkins, president of the Family Research Council.

Liberal advocacy groups, including those supporting LGBT and reproductive rights, were outraged.

"The Trump administration is saying to employers, 'If you want to discriminate, we have your back,'" said Fatima Goss Graves, president of National Women's Law Center.

Her organization is among several that are planning to challenge the birth-control rollback in court. The American Civil Liberties Union filed such a lawsuit less than three hours after the rules were issued.

"The Trump administration is forcing women to pay for their boss' religious beliefs," said ACLU senior staff attorney Brigitte Amiri. "We're filing this lawsuit because the federal government cannot authorize discrimination against women in the name of religion or otherwise."

Xavier Becerra, the Democratic attorney general of California, said he planned to file a similar lawsuit as soon as feasible. Other Democratic attorneys general said they were mulling the same step.

Both directives had been in the works for months, with activists on both sides of a culture war on edge about the timing and the details.

The religious-liberty directive, issued by Attorney General Jeff Sessions, instructs federal agencies to do as much as possible to accommodate those who claim their religious freedoms are being violated. The guidance effectively lifts a burden from religious objectors to prove that their beliefs about marriage or other topics that affect various actions are sincerely held.

"Except in the narrowest circumstances, no one should be forced to choose between living out his or her faith and complying with the law," Sessions wrote.

In what is likely to be one of the more contested aspects of the document, the Justice Department states that religious organizations can hire workers based on religious beliefs and an employee's willingness "to adhere to a code of conduct." Many conservative Christian schools and faith-based agencies require employees to adhere to moral codes that ban sex outside marriage and same-sex relationships, among other behavior.

The Alliance Defending Freedom, a conservative Christian law firm, called it "a great day for religious freedom." But JoDee Winterhof of the Human Rights Campaign, a national LGBT-rights group, depicted the two directives as "an all-out assault, on women, LGBT people and others" as the administration fulfilled a "wish list" of the religious right.

The new policy on contraception, issued by the Department of Health and Human Services, allows more categories of employers, including publicly traded companies, to opt out of providing no-cost birth control to women by claiming religious or moral objections — another step in rolling back President Barack Obama's health care law that required most companies to cover birth control at no additional cost.

Employers with religious or moral qualms will also be able to cover some birth control methods, and not others. Experts said that could interfere with efforts to promote modern long-acting implantable contraceptives, such as IUDs, which are more expensive.

The new policy took effect on Friday, but its impact won't be known immediately and may not be dramatic.

"I can't imagine that many employers are going to be willing to certify that they have a moral objection to standard birth control methods," said Dan Mendelson, president of the consulting firm Avalere Health.

Nonetheless, he worried that the new rules would set a precedent for undermining basic health benefits required under federal law. The administration has estimated that some 200 employers who have already voiced objections to the Obama-era policy would qualify for the expanded opt-out, and that 120,000 women would be affected.

Since contraception became a covered preventive benefit, the share of female employees paying with their own money for birth control pills has plunged to 3 percent, according to the Kaiser Family Foundation.

Many Catholic hospitals now rely on an Obama-era workaround under which the government pays for the cost of birth control coverage. That workaround can continue under the new rules.

Despite that workaround, there have been extensive legal battles waged by religious institutions and other parties challenging the birth-control mandate. The U.S. Conference of Catholic Bishops hailed the new policy as a "return to common sense" that would enhance "peaceful coexistence" between church and state.

Doctors' groups that were instrumental in derailing Republican plans to repeal Obama's health law outright expressed their dismay.

The American Congress of Obstetricians and Gynecologists said the new policy could reverse the recent progress in lowering the nation's rate of unintended pregnancies.

"Instead of fulfilling its mission 'to enhance and protect the health and well-being of all Americans,' HHS leaders under the current administration are focused on turning back the clock on women's health," said the organization's president, Dr. Haywood Brown.

___

Crary reported from New York. Associated Press writers Sadie Gurman and Eric Tucker in Washington and Religion Writer Rachel Zoll in New York contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: Rich Pedroncelli/AP]]>
<![CDATA[Obama Admin. Vets Launch Health Insurance Sign-Up Drive]]>Wed, 04 Oct 2017 14:53:30 -0500https://media.nbcnewyork.com/images/213*120/AP_937719406365.jpg

Former Obama administration officials are undertaking a private campaign to encourage people to sign up for coverage next year under the Affordable Care Act. 

With the start of open enrollment on Nov. 1, the Trump administration has slashed the Obama health law's ad budget, as well as grants to outside organizations that are supposed to help people sign up. Although Republican attempts to repeal the law have proven futile so far, President Donald Trump hasn't changed his view that the program is a "disaster." 

The former Obama officials said their campaign, set to begin Wednesday, will focus on young adults and try to encourage people to sign up for government-backed private health insurance because of subsidies available to cushion the impact of rising premiums. 

The effort is headed by Lori Lodes and Joshua Peck, who directed outreach and sign-up efforts during much of former President Barack Obama's second term. Joining them are Andy Slavitt, who ran federal health insurance programs for Obama, activist-actors Alyssa Milano and Bradley Whitford, social commentator Van Jones and insurance industry veteran Mario Molina. 

Lodes said the campaign has a modest budget for now, meaning that targeted internet advertising is probably all it can manage, at least initially. 

About 10 million people are signed up for subsidized private insurance plans through HealthCare.gov and state-run insurance markets. That figure is well below projections when the law was passed in 2010. An additional 11 million or so have signed up for Medicaid in states that took advantage of the law's expansion of the program to serve more low-income adults. 

Under Trump, the open enrollment period for 2018 has been shortened by about half. It now runs through Dec. 15. That's the last day when people can sign up to get coverage that will be effective on Jan. 1. 

Some Democrats say that's another indication that Trump is trying to "sabotage" insurance markets. But health insurers, with a vested interest in enrolling people, say a shorter, focused sign-up season period may actually be more manageable. 

Returning customers will be automatically re-enrolled unless they shop around and pick another plan. 

Health care consultant Dan Mendelson, president of data-tracker Avalere Health, said in an interview that he expects enrollment will remain relatively stable. 

"If you think about it, most of the people who are enrolled need the insurance," he said. "They are heavily subsidized and they are going to show up because they need insurance for themselves and their families. I think there will be a base stability to enrollment, but I wouldn't be looking for any major expansion." 

Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., are trying to negotiate a limited bipartisan deal to stabilize state-level markets for individual health insurance policies. People covered under the health law represent about half of those who purchase individual policies.

Copyright Associated Press / NBC New York



Photo Credit: Andrew Harnik/AP, File]]>
<![CDATA[How to Deal With Tragedy And Talk About It With Family]]>Tue, 03 Oct 2017 11:13:36 -0500https://media.nbcnewyork.com/images/213*120/20171002+Hug.JPG

Feeling overwhelmed, powerless or angry as you watch news of another mass shooting, this one in Las Vegas? Those feelings are normal, even for people who don't have ties to Nevada or anyone there, according to counselors. 

There are tools that can help in handling those emotional reactions. NBC10 Philadelphia's Tracy Davidson spoke to a counselor in the area Monday about what you and those you love can do.

Q: I feel overwhelmed by the news. How do I process this?
A: Each person's reaction to a tragedy is unique to that individual and that's OK, said Dana Careless, a counselor from the Philadelphia Department of Behavioral Health and Intellectual disAbility Services.

Some people disconnect and shut off communication while others are active on social media, looking for answers and trying to stay informed. No matter how you deal with tragedy, it is important to take care of yourself. If you start to feel overwhelmed, "take a step back, take a deep breath, and disconnect if you need to," Careless said.

Q: What things can I do to take care of myself?
A: Self-care is doubly important while we try to cope with trauma. Do what makes you happy or calms you down. Careless runs; some people choose yoga or swimming. Others need quiet time meditating, praying or listening to music. Careless said journaling can help some people.

Q: What should I do if I start to feel overwhelmed?
A: "It can be really, really easy to get caught up in all the information, to keep clicking and clicking," Careless said. She suggested people focus on staying grounded. Using your five senses can help you settle into the moment, she said; wherever you are, find five things you see, four things you hear, three things you touch, two things you smell and one thing you taste. Remember to take your time and breathe — in through your nose, out through your mouth, she said. 

Q: What if my children ask me about the event?
A: Careless suggested parents be open with children, if children want to talk. Don't shut down conversation or tell them to "get over it," she said. Try to normalize the discussion and reiterate to them that it is okay to be upset or confused by the tragedy. On the other hand, if they don't want to talk, give them some space until they feel like engaging. If your children seem to be struggling more than usual, consider reaching out for help or following up on their condition.


Q: How long will it take to heal and move on?
A: Every person’s process is different. The way you begin to heal is individual, so do what is necessary to help start the process. If you or a loved one start to have irregular habits, such as lack of sleep or oversleeping, that continue past two weeks, consider talking to someone who can help.

The federal government's mental health agency, the Substance Abuse and Mental Health Services Administration, has a 24-hour Disaster Relief Helpline. If you would like free support or counseling, contact them at 1-800-985-5990 or text “TalkWithUs’ to 66746. 



Photo Credit: Getty Images
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<![CDATA[Illinois Governor Signs Bill Allowing Medicaid for Abortions]]>Thu, 28 Sep 2017 22:51:03 -0500https://media.nbcnewyork.com/images/213*120/abortionbillsigned_290947981.jpg

Illinois Gov. Bruce Rauner signed legislation Thursday allowing state health insurance and Medicaid coverage for abortions, ending months of speculation after the Republican reversed his stance on the issue last spring.

The General Assembly controlled by Democrats approved the measure in May but delayed sending it to Rauner until Monday, in part because he has changed his mind about support of the plan.

As a candidate in 2014, Rauner said he would support expanding coverage for abortions. But last April he said he opposed the idea and said the state should focus on improving the economy.

The proposal would allow abortions funded by state employee health insurance and Medicaid. Democrats argue all women should have the same access to abortion services. Republicans argued taxpayers should not be forced to fund a morally objectionable procedure, particularly during a state budget crisis.

The Department of Healthcare and Family Services estimates the annual taxpayer cost of abortions under the measure would be $1.8 million.

The decision has been politically difficult for Rauner, who's considered one of the most vulnerable governors nationwide in his 2018 bid for a second term.

The former venture capitalist first won elected office in 2014, in part by getting support from independent voters in the suburbs, especially women, with his pledge to have "no social agenda." He often campaigned with his wife, Diana Rauner, who calls herself a "lifelong Democrat."

Rejecting the measure would turn off those voters while signing it would risk enraging social conservatives and could mean a primary challenger for him.

The law takes effect immediately.

The measure also removes language in Illinois law that states a desire to criminalize abortion if a 1973 U.S. Supreme Court ruling legalizing the procedure is overturned. Democrats initially sold the bill as a means of keeping abortion legal if Roe v. Wade were dumped.

President Donald Trump, who took office in January, has promised to nominate Supreme Court justices bent on revisiting Roe.

Copyright Associated Press / NBC New York

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<![CDATA[First Lady Listens and Learns at WH Opioid Crisis Discussion]]>Thu, 28 Sep 2017 13:27:46 -0500https://media.nbcnewyork.com/images/213*120/855179250-Melania-Trump-opioid-rountable.jpg

Melania Trump is listening and learning about the nation's opioid epidemic.

The first lady heard Thursday from experts and people affected by addiction to drugs whom she invited to the White House for a discussion.

Mrs. Trump said she is concerned about the well-being of children and wants to help as many as possible with the issues they face growing up.

"I am here today to listen and learn from all of your stories, and hope you will feel free to give me your thoughts and opinions on how best I can help," the first lady said as she opened the meeting. Mrs. Trump was joined by Kellyanne Conway, a senior adviser to President Donald Trump; Health and Human Services Secretary Tom Price and New Jersey Gov. Chris Christie, who chairs a presidential commission on drug abuse and opioids.

Other participants included a recovered addict and a husband and wife whose son recently died of a drug overdose.

The first lady has shown particular interest in the opioid issue. She joined the president for a briefing on the crisis last month. She also met regularly during the presidential campaign with families who had been affected by drug abuse and addiction, said her spokeswoman, Stephanie Grisham.

Grisham said Mrs. Trump wants to work with the presidential panel on youth and prevention initiatives.

President Trump said last month that he will officially declare the opioid crisis a "national emergency," but he has yet to issue a formal declaration. The commission chaired by Christie has called on Trump to take such a step.

An initial report from the President's Commission on Combating Drug Abuse and the Opioid Crisis noted that the approximately 142 deaths each day from drug overdoses mean the death toll from the epidemic is "equal to September 11th every three weeks."

Christie led a meeting of the commission Wednesday in an office building on the White House grounds. The first lady was in New York and did not attend.

The panel expects to issue its final report by Nov. 1, a month later than originally scheduled.

Copyright Associated Press / NBC New York



Photo Credit: Drew Angerer/Getty Images]]>
<![CDATA[FDA Approves 1st Blood Sugar Monitor Without Finger Pricks]]>Thu, 28 Sep 2017 12:38:38 -0500https://media.nbcnewyork.com/images/213*120/noprickbloodsugardevice_1200x675.jpg

Federal regulators have approved the first continuous blood sugar monitor for diabetics that doesn't need backup finger prick tests.

Current models require users to test a drop of blood twice daily to calibrate, or adjust, the monitor.

The discomfort of finger sticks and the cost of testing supplies can discourage people from keeping close tabs on their blood sugar.

Abbott's Labor new FreeStyle Libre Flash Glucose Monitoring System uses a small sensor attached to the upper arm. Patients wave a reader device over it to see the current blood sugar level and changes over the past eight hours.

The Food and Drug Administration approved the device Wednesday. Abbott isn't disclosing the price for the reader or the sensors, which should be available in pharmacies within months.


Copyright Associated Press / NBC New York



Photo Credit: Abbott Media ]]>
<![CDATA[US Health Officials Brace for Potentially Bad Flu Season]]>Thu, 28 Sep 2017 14:24:11 -0500https://media.nbcnewyork.com/images/213*120/GENERICFLUSHOT_1200x675.jpg

It's flu shot time, and health officials are bracing for a potentially miserable fall and winter.

The clues: The Southern Hemisphere, especially Australia, was hit hard over the past few months with a flu strain that's notorious for causing severe illness, especially in seniors.

And in the U.S., small clusters of that so-called H3N2 flu already are popping up.

"We don't know what's going to happen but there's a chance we could have a season similar to Australia," Dr. Daniel Jernigan, influenza chief at the U.S. Centers for Disease Control and Prevention, told The Associated Press.

The worrisome news came as the government urged Americans Thursday to make sure they get a flu shot before influenza starts spreading widely. Health and Human Services Secretary Tom Price got his own jab to publicize the importance, saying, "There's no reason not to get protected."

Last year, only about 47 percent of the population was vaccinated.

CDC's Jernigan cautions there's no good way to predict how bad the upcoming flu season will be. That H3N2 strain caused infections here last year, too. And although strains that circulate in the Southern Hemisphere often spread to North America and Europe, there's no guarantee it will make a repeat performance.

Still, H3N2 is "the bad actor," said Dr. William Schaffner of Vanderbilt University and the National Foundation for Infectious Diseases. "If you needed another reason to get vaccinated, there it is. Best get that protection."

Also Thursday, World Health Organization flu advisers meeting in Australia recommended updating future vaccines for the Southern Hemisphere to strengthen H3N2 protection.

Flu does constantly evolve, forcing new vaccine to be brewed each year to match the strains specialists expect to cause most illness. In the U.S., CDC's Jernigan said this year's shots aren't perfect — but that the H3N2 strain traveling around the globe hasn't significantly changed, so the vaccine remains a pretty good match.

"It's the best tool we have right now for preventing disease," he said in an interview.

Some things to know about the once-a-year rite of flu vaccination:

WHO NEEDS A SHOT?
Everybody, starting at 6 months of age, according to the CDC.

Flu is most dangerous for people over age 65, young children, pregnant women and people with certain health conditions such as asthma or heart disease.

But it can kill even the young and otherwise healthy. On average, the CDC says flu kills about 24,000 Americans each year, and last year, the toll included 105 children.

Last year, three-fourths of babies and toddlers — tots ages 6 months to 2 years — were vaccinated. So were two-thirds of adults 65 and older.

HOW WELL DOES THE VACCINE PROTECT?
The CDC says people who get flu shots have a 40 percent to 60 percent lower chance of getting seriously ill than the unvaccinated. If someone is infected despite vaccination, generally they have a milder illness than if they'd skipped the shot, Schaffner said.

"I like to tell my patients, 'You're here complaining, that's wonderful — you didn't die,'" he said.

DON'T DELAY
It takes about two weeks for good protection to kick in. Flu season tends to peak around January, but there's no way to know when it will start spreading widely.

Manufacturers say between 151 million and 166 million doses will be available this year. It's already widely available in doctors' offices and drugstores.

WILL THE SHOT MAKE ME SICK?
You can't get influenza from flu shots, specialists stress. But flu vaccine doesn't protect against colds or other respiratory viruses that people can confuse with influenza.

LOTS OF OPTIONS
The regular flu shot comes in versions that protect against either three or four strains of influenza — including that problematic H3N2 strain, another Type A strain known as H1N1, and one or two strains of Type B flu.

Ask your doctor or pharmacist about other options which are available for certain age groups.

For needle-phobes, there's a skin-deep vaccine that uses tiny needles, and a needle-free jet injector that shoots another vaccine through the skin.

Two vaccine brands target the 65-and-older crowd. They're especially vulnerable to flu's dangerous complications because they tend to have more underlying health problems than younger people — and because standard flu shots don't work as well with age-weakened immune systems. One high-dose version contains four times the usual anti-flu ingredient, while a competitor contains an extra immune-boosting compound.

And for those worried about allergies from eggs used in the production process, two more vaccines are egg-free.

SORRY KIDS, NO NASAL SPRAY OPTION
FluMist, a less ouchy nasal spray vaccine, once was popular with children. But last year, a baffled CDC said it was no longer protecting against certain influenza strains as well as regular flu shots — and told doctors not to use it. That's the same advice this year: Youngsters will need a shot, just like their parents.

And for kids between the ages of 6 months and 8 years who are getting a first-ever flu vaccination, they'll need two doses a month apart.

THE COST
Insurance covers most flu vaccinations, often without a copayment. For those paying out of pocket, prices can range between $32 and $40.

Copyright Associated Press / NBC New York



Photo Credit: Joe Raedle/Getty Images]]>
<![CDATA[Trump Says GOP Has Health Care Votes ... But It Doesn't]]>Wed, 27 Sep 2017 15:50:21 -0500https://media.nbcnewyork.com/images/213*120/Trump-healthcare-face.jpg

Guess what? Turns out Republicans have the votes to push health care legislation through the Senate, but they've been flummoxed because one supportive senator is in the hospital.

That was President Donald Trump's view of where things stand Wednesday on Capitol Hill. And it's not true.

Trump made the remarks a day after Senate GOP leaders discarded their drive to repeal President Barack Obama's health care overhaul. They lacked the votes to succeed, a not-so-minor snag that hadn't changed.

The three GOP senators whose opposition sunk the Republican measure all remained against it, aides confirmed. That was Arizona's John McCain, Kentucky's Rand Paul and Maine's Susan Collins.

On Twitter, Trump cited "very positive signs" from GOP Alaska Sen. Lisa Murkowski and "two others." He added: "we have the HCare Vote, but not for Friday!"

Murkowski never took a position on the bill, which was written quickly with little perusal by senators. She criticized the "lousy process" and said "substance matters."

No top Republicans were talking about returning to the matter until they get the 50 votes they'd need to succeed, a tie Vice President Mike Pence would break.

South Dakota Sen. John Thune, the chamber's No. 3 GOP leader, said if the bill's sponsors "get to where they can get 50 votes or something, my guess is we'll be coming back to it. That's a big if."

"That's probably a question for a little bit down the road," said Sen. Bill Cassidy, R-La., a sponsor of the last failed bill, when asked when the push would be revisited. "We have to reassess and regroup."

Trump saw things differently.

"We have the votes for health care. We have one senator that's in the hospital. He can't vote because he's in the hospital," he told reporters.

White House aides later said the hospitalized lawmaker Trump was talking about was Sen. Thad Cochran, R-Miss., who turns 80 in December.

That came as news to Cochran.

"Thanks for the well-wishes," he tweeted. "I'm not hospitalized, but am recuperating at home in Mississippi and look forward to returning to work soon."

Cochran's aides said he was being treated for a urological issue and could return to Washington if a vote was planned.

Trump later said the senator was "home recovering."

The withdrawn bill, which Cassidy sponsored with Sen. Lindsey Graham, R-S.C., would collapse much of Obama's law into block grants states would receive to shape their own programs.

Trump offered two pathways to success that seem far-fetched and mutually exclusive.

First, he said Republicans would have the votes to succeed early next year. But starting this Sunday, Republicans controlling the Senate 52-48 and will no longer be able to win with just 50 votes. They'd need 60 votes, an impossibility thanks to unbroken Democratic opposition to repealing one of their party's proudest achievements.

"They could try it again and again because they're going to fail again and again," Senate Minority Leader Chuck Schumer, D-N.Y., said in a brief interview.

Congress could theoretically vote to renew the health care bill's 50-vote protection next year. But GOP leaders are talking about first using that protection for their current top priority, tax cuts, not health care. And it's unclear Republicans are eager to revisit the issue in an election year.

Trump also said he'd talk to Democrats "and I will see if I can get a health care plan that is even better."

But there is no clear compromise between a GOP that's made scrapping Obama's law a guiding light for seven years and Democrats steadfast on protecting it.

The No. 2 Senate Democratic leader, Richard Durbin of Illinois, said the White House has yet to approach Democrats with a health care compromise and said he didn't see what one might look like.

"Block grants to the states with inadequate funding?" Durbin said of the abandoned bill. "Cutbacks in Medicaid? Reductions in health insurance? Those are not good starting points for a bipartisan discussion."

Trump said he was working on executive orders letting people buy health insurance across state lines and making it easier for them to join association health plans. Such plans let groups of people purchase insurance together for lower prices than individuals.

Democrats are wary of such ideas, worried they might expose customers with lesser coverage.

"I have to see it, but it could be a race to the bottom. Did he say anything about consumer protection, because that's the question," said Sen. Ron Wyden, D-Ore.

Associated Press writer Catherine Lucey contributed.

Copyright Associated Press / NBC New York



Photo Credit: Chris Kleponis/Getty Images (Pool)]]>
<![CDATA[Congress at Crossroads After GOP Health Care Fails: Analysis]]>Wed, 27 Sep 2017 12:36:57 -0500https://media.nbcnewyork.com/images/213*120/AP_17269693427697.jpg

Congress is at a crossroads after Republicans' stinging failure to repeal Barack Obama's health care law. But what's next — more partisan conflict or a pragmatic shift toward cooperation?

Unless Republicans and Democrats in Congress can work together, and bring along an often unpredictable President Donald Trump, political conflict over health care may spread. Bipartisan talks on legislation to stabilize shaky insurance markets are on again, but time is short and there's no guarantee of success.

Congress also has yet to renew funding for programs that traditionally enjoy broad support, such as children's health insurance and community health centers, despite approaching deadlines.

Feelings were raw Tuesday after Senate GOP leaders announced they would not take their latest "repeal and replace" bill to the floor for lack of support. Some lawmakers said it's still possible to bridge the partisan gap on a limited set of priority issues.

Sen. Lamar Alexander, R-Tenn., said he would resume efforts to reach a bipartisan deal with Sen. Patty Murray, D-Wash., to stabilize markets for individual insurance policies that 18 million people rely on. More than half of those consumers are covered under the health law.

Alexander is chairman of the Senate Health, Education, Labor and Pensions Committee; Murray is the top Democratic on the committee. Alexander runs the risk of being accused by some fellow Republicans of trying to "bail out Obamacare."

Murray is under pressure from fellow Democrats not to make concessions to Alexander, who is seeking changes that would make it easier for states to get waivers from some of the law's requirements, potentially leading to plans with lower premiums.

"I'm still concerned about the next two years, and Congress has an opportunity to slow down premium increases in 2018, begin to lower them in 2019, and do our best to make sure there are no counties where people have zero options to buy health insurance," Alexander said in a statement.

Neither Trump, nor House Speaker Paul Ryan nor Senate Majority Leader Mitch Connell has given clear approval for a bipartisan approach, though Trump said Wednesday that he will meet with Democrats and "see if I can get a health plan that is even better."

The president also said he's looking at taking executive action to make health care changes, including a "major executive order" that would allow people to buy insurance across state lines.

Trump insisted Republicans "have the votes" to pass legislation to repeal and replace former President Barack Obama's signature health care law, but it may not come until next year.

Sen. Ron Wyden, D-Ore., who has worked with Republicans on a range of health care issues, said cooperation is the only way to avoid creating needless problems for constituents.

"You recognize the opportunities that are in front of you," said Wyden, the top Democrat on the Senate Finance Committee, which oversees health care funding. "My hope is we can come together."

Wyden's list includes renewing the Children's Health Insurance Program for 9 million kids, whose funding expires this week, as well as short-term action to stabilize the Affordable Care Act's insurance markets, by guaranteeing subsidies for copayments and deductibles. Experts say that could cut expected double-digit premium increases in many states by about half.

The missing ingredient seems to be leadership, say outside observers.

Some governors have called for a health care reset that would involve both parties working together on a limited agenda, but their suggestion hasn't been embraced in Washington.

"The question is whether you can you forge a coalition that doesn't include either the hard right or the hard left," said GOP health economist Gail Wilensky. "I have not been able to answer who would provide the leadership for such an effort. Neither the leadership in the House or the Senate has embraced the notion of trying to forge a bipartisan coalition, and it is very hard to move legislation without that."

Rep. Richard Neal, D-Mass., said Trump at a meeting with lawmakers raised the possibility of seeking a deal with Democrats. There's no hint what that might entail.

If anything, Democrats have been moving to the left after Sen. Bernie Sanders, I-Vt., relaunched his "Medicare for all" plan recently. Under Sanders' plan, government would pay for medical services, replacing employers and insurers. Some liberal activists argue that support for "single-payer" should be a qualifying test for Democratic candidates in 2018 and beyond.

Other Democrats say single-payer would lead to political defeat, because of the massive tax increases required.

"It's not going to happen," said former Rep. Henry Waxman, D-Calif., one of the main authors of the Obama law. "You can talk about it, and plant a flag, and say that's where you'd like to go, but in the meantime people need their insurance coverage."

Wednesday is the deadline for insurers to sign contracts to offer policies for 2018 on the health law's markets. Sign-up season starts Nov. 1. About half the 18 million Americans with individual policies get no subsidies under the health law. Without congressional action some are facing premiums that rival a mortgage payment.

Saturday is the deadline for Congress to act on children's health insurance and community health center funding. Brief delays are not expected to cause disruptions, but a protracted holdup would.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/J. Scott Applewhite]]>
<![CDATA[US Sexually Transmitted Diseases Hit Another High ]]>Tue, 26 Sep 2017 13:21:24 -0500https://media.nbcnewyork.com/images/213*120/bowlofcondoms_1200x675.jpg

Health officials are reporting another record increase in infections from three sexually transmitted diseases.

More than 2 million new cases of chlamydia, gonorrhea and syphilis were reported in the United States last year — the most ever.

The diseases are treatable with antibiotics.

Rates for all three have been rising for several years. Health officials have said better testing and diagnosis have helped increased detection of cases, but also that treatment and prevention programs have been hurt by budget cuts.

Chlamydia is the most common, with nearly 1.6 million cases reported last year. About 470,000 gonorrhea cases were reported, and 28,000 cases of the most contagious forms of syphilis.

The Centers for Disease Control and Prevention released the numbers Tuesday.


Copyright Associated Press / NBC New York



Photo Credit: AP/Kathy Willens]]>
<![CDATA[Coffee Sold in California Could Come With Cancer Label]]>Tue, 26 Sep 2017 12:41:18 -0500https://media.nbcnewyork.com/images/180*120/coffeetasting.jpg

A future cup of coffee in California could give you jitters before you even take a sip.

A nonprofit group wants coffee manufacturers, distributors and retailers to post ominous warnings about a cancer-causing chemical stewing in every brew and has been presenting evidence in a Los Angeles courtroom to make its case.

The long-running lawsuit that resumed Monday claims Starbucks and about 90 other companies, including grocery stores and retail shops, failed to follow a state law requiring warning signs about hazardous chemicals found everywhere from household products to workplaces to the environment.

At the center of the dispute is acrylamide, a carcinogen found in cooked foods such as French fries that is also a natural byproduct of the coffee roasting process. The coffee industry has acknowledged the presence of the chemical but asserts it is at harmless levels and is outweighed by benefits from drinking coffee.

Although the case has been percolating in the courts since 2010, it has gotten little attention.

A verdict in favor of the little-known Council for Education and Research on Toxics could send a jolt through the industry with astronomical penalties possible and it could wake up a lot of consumers, though it's unclear what effect it would have on coffee-drinking habits.

The lawyer taking on Big Coffee said the larger goal is to motivate the industry to remove the chemical from coffee, which would also benefit his own three-cup-a-day fix.

"I'm addicted -- like two-thirds of the population," attorney Raphael Metzger said. "I would like the industry to get acrylamide out of the coffee so my addiction doesn't force me to ingest it."

Under the Safe Drinking Water and Toxic Enforcement Act, passed by voters as Proposition 65 in 1986, private citizens, advocacy groups and attorneys can sue on behalf of the state and collect a portion of civil penalties.

Metzger represented the council in a case later taken up by the state attorney general that resulted in potato-chip makers agreeing in 2008 to pay $3 million and remove acrylamide from their product.

The law has been roundly criticized for abuses by lawyers shaking down businesses for quick settlements but is also credited with reducing chemicals known to cause cancer and birth defects, such as lead in hair dyes, mercury in nasal sprays and arsenic in bottled water.

But warnings, which can be startling on first encounter, have been less effective due to sometimes inconspicuous placement or vague language. Drivers everywhere appear to prioritize parking in a garage over warnings such as, "This area contains chemicals known to the state of California to cause cancer, birth defects and other reproductive harm."

The state Office of Environmental Health Hazard Assessment adopted new regulations last year that will require more specific warnings that list the chemical consumers may be exposed to and list a website with more information. Parking garages, for example, will have to post that breathing air there exposes drivers to carbon monoxide and gas and diesel exhaust and warns people not to linger longer than necessary.

"The intent is not to scare people," said Allan Hirsch, chief deputy of the office. "The intention is to help people make more informed decisions. If you continue to buy a product that will expose you to a chemical, that's OK as long as you're informed."

Many of the coffee defendants have already posted warnings that specifically say California has determined acrylamide is among chemicals that cause cancer and attorneys have stated others, from mega-chains to mom-and-pop operations, will follow suit if the judge rules against them.

Metzger said many of those warnings often appear after the point of sale or where cream and sugar is provided, which offers no warning to someone drinking black coffee.

Coffee companies lost a first round in the case two years ago and are now presenting their last defense.

Defense lawyers declined to comment on the case but asserted in court that they should prevail under an exemption for chemicals that result naturally from cooking necessary for palatability or to avoid microbiological contamination.

"It is hard to imagine a product that could satisfy this exemption if coffee does not," defense attorney James Schurz said in court papers. "The answer to the question of whether Proposition 65 requires coffee to carry a cancer warning must be an emphatic 'No.'"

In the first phase, Superior Court Judge Elihu Berle said the defense failed to present enough credible evidence to show there was no significant risk posed by acrylamide in coffee. The law puts the burden on the defense to show that the level of the chemical won't result in one excess case of cancer for every 100,000 people exposed. Berle said the epidemiology studies they presented were inadequate to evaluate that risk.

Civil penalties could come to $2,500 per person exposed each day. With penalties reaching back eight years that could ring up an astronomical bill in a state with close to 40 million residents, though such a massive figure is very unlikely.

Starbucks Corp., the lead defendant, would not comment on the case. Its latest quarterly report said it's not "party to any legal proceeding that management believes could have a material adverse effect on our consolidated financial position, results of operations or cash flows."

Two of the defendants have settled in the past month and agreed to post warnings. BP West Coast Products, which operates gas station convenience stores, agreed to pay $675,000. Yum Yum Donuts Inc. agreed to pay nearly $250,000.

Copyright Associated Press / NBC New York



Photo Credit: Tristan Fewings/Getty Images, File]]>
<![CDATA[Long-Term Care for the Aging and Ailing Is Surging: Survey]]>Tue, 26 Sep 2017 11:23:19 -0500https://media.nbcnewyork.com/images/213*120/AP_285504724809.jpg

Long-term care costs are surging again and the most expensive option — a private nursing home room — may soon top $100,000 per year.

Growing labor expenses and sicker patients helped push the median cost of care that includes adult day care and assisted living communities up an average of 4.5 percent this year, according to a survey released Tuesday by Genworth Financial. That's the second-highest increase since Genworth started its survey in 2004.

The cost of home health aide services climbed the most, rising 6 percent, to $21.50 an hour. Private nursing home care now costs more than $97,000 annually.

Many Americans don't plan for expenses like these or understand them until they face them, said Joe Caldwell of the National Council on Aging, which is not tied to Genworth's study.

"People don't like to think about it and talk about it ahead of time, so they kind of put off planning and saving for it financially because they don't think it's going to happen to them," he said.

Long-term care costs can impose a crushing financial burden on individuals or families in part because private health insurance and Medicare, the federal program for people over age 65, offer only limited help. That can force people who don't have private coverage to spend down their assets until they qualify for the government's health insurance program for the poor, Medicaid.

Genworth Financial Inc. sells long-term care coverage and didn't address that cost in its national study, which was based on information from 15,000 long-term care providers.

Coverage costs are rising as well, Caldwell said, noting that few employers offer help with that expense like they do with retirement planning or more common forms of coverage such as health insurance.

Initial premiums for long-term care coverage can cost well over $2,000 annually, depending on the customer's age, according to the Bipartisan Policy Center, which researches health care issues.

A third of Americans 40 and older have done no planning for their long-term care needs, according to a 2016 Associated Press-NORC Center for Public Affairs Research survey.

Caldwell said many people don't realize the limits of Medicare coverage, and he expects the need for long-term care to soar.

"There is this aging baby-boom population that's going to be really hit hard in the coming decade," he said. "We need to figure it out."

For 2017, long-term care prices climbed in part because the cost of labor rose, according to Genworth. Care providers had to raise pay to compete for workers in a tight job market or comply with state requirements for minimum wages. Many also have started providing health insurance to their workers to comply with the Affordable Care Act. The federal law requires all companies with 50 or more full-time employees to offer coverage.

Genworth researchers say costs also are rising because care providers are working with patients that have more complex medical needs and live longer than they did a decade ago. Plus Medicaid offers reimbursement that can fall below the cost of care, which forces long-term care providers to make that up in their prices.

Genworth sees no sign that long-term care expenses are starting to slow, said David O'Leary, CEO of the company's U.S. life division.

"We only see cost of care increasing," he said.

Copyright Associated Press / NBC New York



Photo Credit: Darron Cummings/AP, File]]>
<![CDATA[Medicaid Recipients Watch Nervously as Health Bill Teeters]]>Tue, 26 Sep 2017 03:21:30 -0500https://media.nbcnewyork.com/images/213*120/AP_17268601164641.jpg

With the latest Republican health care overhaul teetering near collapse, one group in particular is watching with heightened anxiety.

The debate in Congress is personal for many of those who gained coverage through Medicaid in the 31 states that expanded the program under former President Barack Obama's Affordable Care Act.

Alan Purser, who lives in eastern Arkansas, credits expanded Medicaid with saving his life, after a routine doctor's visit ended with him being hospitalized and treated for multiple blood clots in both lungs. The 60-year-old diabetic said he would not be able to afford his insulin medication because he does not qualify for traditional Medicaid.

"I am going to be up a creek if it goes through," he said.

The Medicaid expansion brought health insurance to some 11 million lower-income Americans, helping drive the nation's uninsured rate to just 9 percent. That program would have ended in three years under the initial version of the Republican's latest health care bill, triggering widespread uncertainty for both recipients and states facing the prospect of winding down their coverage.

The latest GOP effort appeared to be doomed late Monday when Republican Sen. Susan Collins of Maine announced her opposition, citing in part the proposed cuts to Medicaid that she described as "devastating." With Democrats united in opposition, the only way Republicans can revive the bill is to alter it in ways they hope will change opposing senators' minds.

States signed up for the Medicaid expansion under the promise that the federal government would pick up the vast majority of the costs. Experts and officials in several of the states that opted for it said that under the GOP plan they would not have the ability to cover the costs of all those who benefited.

"I don't want to have to look those people in the eye and say you are losing your health insurance," said Nevada state Assemblyman Michael Sprinkle, a Democrat.

In his state, more than 300,000 people gained health insurance through the expansion, which extended coverage to more lower-income Americans by raising the income limit. Most were adults with no children at home.

Kentucky was another state seeing big gains under Obama's health care law, its uninsured rate dropping from 14.3 percent before it took effect to 5.1 percent last year. The 64 percent decline was the largest of any state, according to data from the U.S. Census Bureau.

Nearly all that gain was because Kentucky's former Democratic governor opted to expand Medicaid, which provided coverage to 461,000 Kentuckians. The state also is home to Senate Majority Leader Mitch McConnell, who is among those leading the Republican effort to dismantle the law, and now has a Republican governor who also favors repeal.

John Holbrook, of Ashland, does not want to see the law repealed. He received substance abuse treatment under the Medicaid expansion, after being hospitalized with a dangerously high blood-alcohol level in December 2015.

"I would be dead or still homeless," said Holbrook, 36, who now works as a peer support specialist at a private treatment facility that accepts Medicaid. "Working in recovery, I see it changing lives every day."

The original version of the GOP bill would end funding for expansion enrollees in 2020, among other changes that would shift more of the financial responsibility of the $500 billion-plus overall Medicaid program to the states. States already spend, on average, about 25 percent of their budgets on Medicaid.

Republicans have long sought to rework the program in an effort to rein in federal spending. But cutting the program and shifting more responsibility away from the federal government creates tricky math for the states.

In California, 3.8 million residents gained health coverage under the expansion, and a third of the state's population is enrolled in Medicaid. Given that, there is little chance the state program would be able to exist in its current form under the GOP plan.

A state analysis of a similar GOP proposal found that California would be on the hook for an additional $30 billion a year starting a decade from now, and that didn't factor in the total elimination of federal funding for the expansion population.

"We can't come up with that kind of money," said Phil Ting, a Democrat who is chairman of the budget committee in the state Assembly. "It's like picking and choosing between your thumb and your pinky, what we could protect."

Under the Republican bill, all the federal money currently being spent in various states on expansion would be collected, beginning in 2020, into a single pool. It would include other funding that is being used for subsidies that have helped an additional 12 million people buy private health insurance through government-sponsored markets.

That money would then be shared among all states based partly on how many lower-income adults they have. Under the initial version of the bill, that additional money would stop entirely in 2027.

Stephanie McCoin of Baton Rouge, Louisiana, fears her 27-year-old daughter will be among those hurt by efforts to undo the Medicaid expansion. She has a chronic adrenal condition, and at one point before the Affordable Care Act went to emergency rooms eight times in a little over a month because she couldn't afford insurance.

"I'm afraid that if she loses this," McCoin said, "she will die."

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Susan Walsh]]>
<![CDATA[Protesters Removed From Senate Health Care Bill Hearing]]>Mon, 25 Sep 2017 18:10:08 -0500https://media.nbcnewyork.com/images/214*120/US-Health-Care-2-CR-150637884759400002.jpg

Protesters chanting "No cuts for Medicaid, save our liberty!" were forcibly removed from the Senate Finance Committee room Monday as lawmakers attempted to convene a hearing into the Republican Graham Cassidy health care bill.]]>
<![CDATA[1M-Person Study Seeks End to Cookie-Cutter Health Care]]>Mon, 25 Sep 2017 10:19:17 -0500https://media.nbcnewyork.com/images/213*120/AP_17236756008031-One-in-a-Million-Study.jpg

U.S. researchers are getting ready to recruit more than 1 million people for an unprecedented study to learn how our genes, environments, and lifestyles interact.

Today, health care is based on averages, what worked best in short studies of a few hundred or thousand patients. The massive "All of Us" project instead will push what's called precision medicine, using traits that make us unique to forecast health and treat disease.

The goal is to end cookie-cutter health care.

A pilot is underway now. If all goes well, the National Institutes of Health plans to open enrollment early next year.

Participants will get DNA tests, and report on their diet, sleep, exercise and numerous other health-affecting factors. It's a commitment: The study aims to run for at least 10 years.

The pilot testing now underway involves more than 2,500 people who already have enrolled and given blood samples. More than 50 sites around the country -- large medical centers, community health centers and other providers like the San Diego Blood Bank and, soon, select Walgreens pharmacies -- are enrolling patients or customers in this invitation-only pilot phase.

If the pilot goes well, NIH plans to open the study next spring to just about any U.S. adult who's interested, with sign-up as easy as going online.

The goal is to enroll a highly diverse population, people from all walks of life -- specifically recruiting minorities who have been under-represented in scientific research.

And unusual for observational research, volunteers will receive results of their genetic and other tests, information they can share with their own doctors.

"Anything to get more information I can pass on to my children, I'm all for it," said Erricka Hager, 29, as she signed up last month at the University of Pittsburgh, the project's first pilot site. A usually healthy mother of two, she hopes the study can reveal why she experienced high blood pressure and gestational diabetes during pregnancy.

Heading the giant All Of Us project is a former Intel Corp. executive who brings a special passion: How to widen access to the precision medicine that saved his life.

In college, Eric Dishman developed a form of kidney cancer so rare that doctors had no idea how to treat him, and predicted he had months to live. Only two studies of that particular cancer had ever been done, on people in their 70s and 80s.

"They didn't know anything about me because they'd never seen a 19-year-old with this disease," said Dishman.

Yet he survived for two decades, trying one treatment after another. Then, as he was running out of options, a chance encounter with a genetics researcher led to mapping Dishman's DNA -- and the stunning discovery that his kidney cancer was genetically more like pancreatic cancer. A pancreatic cancer drug attacked his tumors so he could get a kidney transplant.

"I'm healthier now at 49 than I was at 19," said Dishman. "I was lucky twice over really," to be offered an uncommon kind of testing and that it found something treatable.

Precision medicine is used most widely in cancer, as more drugs are developed that target tumors with specific molecular characteristics. Beyond cancer, one of the University of Pittsburgh's hospitals tests every patient receiving a heart stent -- looking for a genetic variant that tells if they'll respond well to a particular blood thinner or will need an alternative.

The aim is to expand precision medicine.

"Why me?" is the question cancer patients always ask -- why they got sick and not someone else with similar health risks, said Dr. Mounzer Agha, an oncologist at the University of Pittsburgh Medical Center.

"Unfortunately I don't have answers for them today," said Agha, who says it will take the million-person study to finally get some answers. "It's going to help them understand what are the factors that led to their disease, and it's going to help us understand how to treat it better."

And NIH Director Francis S. Collins expects surprises. Maybe, he speculates, Type 2 diabetes will turn out to be a collection of genetic subtypes that require varied treatments.

"This looks at individual responses to treatment in a way we couldn't do previously with smaller studies," he said.

The study starts simply: Volunteers get some standard health checks -- weight, blood pressure and heart rate. They then answer periodic questionnaires about their health, background and habits, and turn over electronic health records. They give a blood sample that, if they agree, will undergo DNA testing sometime next year.

Eventually, researchers will ask some participants to wear sensors that may go beyond today's Fitbit-style health trackers, such as devices that measure blood pressure while people move around all day, or measure environmental exposures, Collins said.

In Pittsburgh, the Rev. Paul Abernathy made a health change after signing up for the pilot study: Surprised to learn his BMI was too high despite regular weightlifting, he began running.

"I'm praying I have the discipline to continue that, certainly in midst of a busy schedule," said Abernathy, who directs the nonprofit Focus Pittsburgh that aids the poor and trauma victims.

"We have a chance really to influence history, to influence the future of our children and our children's children," added Abernathy, who hopes the study will help explain racial disparities such as lower life expectancies between African-Americans and whites who live in the same areas.

At NIH, Collins plans to enroll, too. He's had his DNA mapped before but can't pass up what he's calling a one-in-a-million experience to be part of a monumental study rather than the scientist on the other side.

"I'm curious about what this might teach me about myself. I'm pretty healthy right now. I'd like to stay that way." 

Copyright Associated Press / NBC New York



Photo Credit: Dake Kang/AP]]>
<![CDATA[Sen. Collins' Opposition Likely Kills GOP Health Care Drive ]]>Mon, 25 Sep 2017 22:32:18 -0500https://media.nbcnewyork.com/images/211*120/AP_17136032403447.jpg

The last-gasp Republican drive to tear down President Barack Obama's health care law essentially died Monday as Maine Sen. Susan Collins joined a small but decisive cluster of GOP senators in opposing the push.

The Maine moderate said in a statement that the legislation would make "devastating" cuts in the Medicaid program for poor and disabled people, drive up premiums for millions and weaken protections Obama's law gives people with pre-existing medical conditions. She said the legislation is "deeply flawed," despite eleventh-hour changes its sponsors have made in search of support.

The only way Republicans could resuscitate their push would be to change opposing senators' minds, which they've tried unsuccessfully to do for months. Collins told reporters that she made her decision despite a phone call from President Donald Trump, who's been futilely trying to press unhappy GOP senators to back the measure.

"They're still working it and a lot of conversations are going on," No. 3 Senate GOP leader John Thune of South Dakota told reporters. But he conceded that a revival would be "a heavy lift" and the prospects were "bleak."

The collapse marks a replay of the embarrassing loss Trump and party leaders suffered in July, when the Senate rejected three attempts to pass legislation erasing Obama's 2010 statute. The GOP has made promises to scrap the law a high-profile vow for years, and its failure to deliver despite controlling the White House and Congress has infuriated conservatives whose votes Republican candidates need.

Republicans had pinned their last hopes on a measure by GOP Sens. Bill Cassidy of Louisiana and South Carolina's Lindsey Graham. It would end Obama's Medicaid expansion and subsidies for consumers and ship the money — $1.2 trillion through 2026 — to states to use on health services with few constraints.

With their narrow 52-48 majority and solid Democratic opposition, three GOP "no" votes would doom the bill. GOP Sens. John McCain of Arizona, Rand Paul of Kentucky and Texas' Ted Cruz have said they oppose the measure, though Cruz aides said he was seeking changes that would let him vote yes.

Sen. Lisa Murkowski, R-Alaska, remains undecided. Murkowski, who voted against the failed GOP bills in July, has said she's analyzing the measure's impact on her state, where medical costs are high.

The Senate must vote this week for Republicans to have any chance of prevailing with their narrow margin. Next Sunday, protections expire against a Democratic filibuster, bill-killing delays that Republicans lack the votes to overcome.

It was unclear if Senate Majority Leader Mitch McConnell, R-Ky., would hold a roll call. Thune said he believed McConnell would have a vote if Republicans "have at least some hope that we would pass it."

Collins announced her decision shortly after the nonpartisan Congressional Budget Office said "millions" of Americans would lose coverage under the bill and projected it would impose $1 trillion in Medicaid cuts through 2026.

Desperate to win over reluctant senators, GOP leaders revised the measure several times, adding money late Sunday for Alaska, Arizona, Maine, Kentucky and Texas in a clear pitch for Republican holdouts. They also gave states the ability — without federal permission — to permit insurers to charge people with serious illnesses higher premiums and to sell low-premium policies with big coverage gaps and high deductibles.

Collins said the eleventh-hour revision "epitomizes the problems" with the GOP-only process.

Collins decision drew a shout-out from late night talk-show host Jimmy Kimmel, who tweeted, "Thank you @SenatorCollins for putting people ahead of party. We are all in your debt." Kimmel had been an outspoken critic of the bill.

Kentucky's Paul said the bill spent too much and said Republicans were motivated by fear of punishment by conservative voters if they failed.

"It's like a kidney stone. Pass it, pass it, pass it," Paul told reporters.

Loud protesters forced the Senate Finance Committee to briefly delay the chamber's first and only hearing on the charged issue. Police lugged some demonstrators out of the hearing room and trundled out others in wheelchairs as scores chanted, "No cuts to Medicaid, save our liberty."

On Monday, Trump took on McCain, who'd returned to the Senate after a brain cancer diagnosis in July to cast the key vote that wrecked this summer's effort. Trump called that "a tremendous slap in the face of the Republican Party" in a call to the "Rick & Bubba Show," an Alabama-based talk radio program.

Cassidy and Graham defended their bill before the Finance committee.

"I don't need a lecture from anybody about health care," Graham told the panel's Democrats. Referring to Obama's overhaul, he added, "What you have created isn't working."

Also appearing was Sen. Mazie Hirono, D-Hawaii, who learned earlier this year that she has kidney cancer.

She said colleagues and others have helped her battle the disease with compassion, saying, "Sadly, this is not in this bill."

Copyright Associated Press / NBC New York



Photo Credit: AP
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<![CDATA['About Time': BYU's 6-Decade Caffeinated Soda Ban Fizzles]]>Fri, 22 Sep 2017 05:38:29 -0500https://media.nbcnewyork.com/images/213*120/94967797-Brigham-Young-University.jpg

Mormon church-owned Brigham Young University ended a six-decade ban Thursday on the sale of caffeinated soft drinks on campus, surprising students by posting a picture of a can of Coca-Cola on Twitter and just two words: "It's happening."

The move sparked social media celebrations from current and former students, with many recalling how they had hauled their own 2-liter bottles of caffeinated sodas in their backpacks to keep awake for long study sessions.

The university never banned having caffeinated drinks on campus, but held firm to the ban on sales even when The Church of Jesus Christ of Latter-Day Saints in 2012 clarified that church health practices do not prevent members from drinking caffeinated soft drinks.

The ban has been in place since the mid-1950s. But officials with the school of 33,000 students in Provo, Utah, said Thursday that increasing demand prompted the change.

Students were abuzz about a change that meant they'll no longer have to make off-campus runs to load up on their favorite caffeinated sodas to jolt their sleep-deprived brains.

"It's about time," said Sara McLaws, a junior advertising and graphic design major from Park City, Utah. "BYU is a great school but it's behind in some ways. Just the small change of allowing caffeinated beverages — because it's not against our religion — it's high time."

As cafeteria workers stocked refrigerators in the student center food court with caffeinated Diet Coke, Coca-Cola and Mr. Pibb, students joked about it being the "best day ever.

"I absolutely love it. It's been a big game changer, even just day one," said Mckay Murphy, a junior statistics major from Springville, Utah. "I'm a really big fan of caffeine and just soda in general so it's nice to have it on campus with easy access."

Caffeinated soft drinks will also be sold at sporting events that draw tens of thousands of fans. Sales of highly caffeinated energy drinks are still banned.

The Utah-based Mormon religion directs its nearly 16 million worldwide members to avoid alcohol and hot beverages such as coffee and tea as part of an 1833 revelation from Mormon founder Joseph Smith.

Alumni applauded a change many said was long overdue.

"I drank a lot of caffeinated beverages while I was here but none of them was purchased on campus," said Christopher Jones, 34, a visiting BYU history professor and former student. "I never thought I would see the day so it's exciting."

Jones said he didn't know whether to believe it when he saw the announcement on his phone so he walked to a student center and saw the first bottles being stocked in vending machines and refrigerators. He was one of the first people to buy one.

"Did I just buy the first-ever caffeinated Coke Zero Sugar sold in #BYU's Wilkinson Student Center?" he tweeted. 'Yes, yes I did."

BYU alum Karl Jepsen, 48, was visiting his daughter who is now a student and basked in being able to drink "real Diet Coke" from the fountain machine.

"It's a big day because we can finally drink on campus what we're allowed to drink in real life," said Jepsen, a 1994 graduate. "It's been ridiculous that we couldn't have caffeinated soda on campus."

Amber Whiteley said she used to get nasty looks when she brought Mountain Dew to campus when she was a BYU student nearly a decade ago.

"You youths will never understand the struggle we went through," Whiteley wrote jokingly in a Facebook post.

In a telephone interview, Whiteley said the change could impact views among Mormons about caffeine. She said some older Mormons in her Salt Lake City congregation still believe all caffeine is prohibited.

"Maybe this will be one more way to get the word out that it's OK to have caffeine," said Whiteley, a mother who is pursuing her doctorate in counselling psychology.

AP writer Michelle L. Price contributed to this story.



Photo Credit: George Frey/Bloomberg via Getty Images, File]]>
<![CDATA[CVS to Limit Opioid Prescriptions to 7-Day Supply]]>Thu, 21 Sep 2017 18:27:25 -0500https://media.nbcnewyork.com/images/213*120/cvsgeneric_1200x675.jpg

CVS Pharmacy will limit opioid prescriptions to a seven-day supply for certain conditions, becoming the first national retail chain to restrict how many pain pills doctors can give patients, NBC News reported.

When filling prescriptions for opioid pills, pharmacists will also be required to talk to patients about the risks of addiction, secure storage of medications in the home and proper disposal, the retail pharmacy chain said Thursday.

The move by CVS to limit prescription opioids like OxyContin or Vicodin to a seven-day supply is a significant restriction for patients — the average pill supply given by doctors in the U.S. increased from 13 days in 2006 to 18 days in 2015, according to a recent report from the Centers for Disease Control and Prevention.



Photo Credit: Getty Images, File ]]>
<![CDATA[GOP Health Bill Provisions Help 2 States: Analysts]]>Thu, 21 Sep 2017 20:39:15 -0500https://media.nbcnewyork.com/images/213*120/lindseygraham_1200x675.jpg

Provisions shoehorned into the Republican health care bill dangle extra money for Alaska and Wisconsin, home states of one GOP senator whose vote party leaders desperately need and another who co-sponsored the legislation, according to analysts who've studied the legislation.

The 140-page measure, which top Republicans hope to push through the Senate next week, is stuffed with language making some states winners and others losers. Aides say the legislation is still changing as leaders hunt the 50 GOP "yes" votes they'll need to turn this summer's jarring Senate rejection of the party's crusade to erase President Barack Obama's law into an eleventh-hour triumph.

Alaska is home to GOP Sen. Lisa Murkowski, who's among a handful of Republicans who've not said how they'll vote. Sen. Ron Johnson, R-Wis., is one of the bill's co-sponsors and his support is not in question, but the episode suggests the value of helping craft of legislation.

The bill was chiefly written by GOP Sens. Bill Cassidy of Louisiana and South Carolina's Lindsey Graham. It would end Obama's Medicaid expansion and subsidies for people buying private insurance and combine the money into new block grants for states.

With all Democrats opposed, Republicans controlling the Senate 52-48 can lose only two votes if they are to succeed, leaving the bill's fate uncertain. Generally, it would shift money from states that expanded their Medicaid programs for the poor under Obama's statute, which tend to be run by Democrats, to the largely Republican-run states that shunned that expansion.

The measure would shield Alaska from some cuts it imposes on Medicaid, according to analysts, including from the nonpartisan Kaiser Family Foundation, by limiting spending to a maximum amount per beneficiary starting in 2020. The federal-state program for low earners has always automatically provided whatever money is needed for eligible recipients. Montana would also qualify for the exemption.

It would also increase federal Medicaid funds for states with high American Indian populations, including Alaska, according to health care consultant April Grady.

Analysts offered no figures about how much money the provisions would mean for Alaska.

The provisions hardly ensure support from Murkowski, who's said she's studying how the measure would affect her state. The administration was pushing for her support, with Vice President Mike Pence calling into an Anchorage talk-radio show Thursday and urging listeners to contact Murkowski and ask her to "stand with President Trump" and support the bill.

According to studies released this week by Kaiser and the consulting firm Avalere Health, Alaska is among many states that would lose money overall under the bill. Alaska has unusually high health care costs because of the remoteness of many communities.

The provisions do not mention Alaska or Wisconsin by name.

But the bill allows a state that turned down extra federal funds to expand Medicaid under Obama's statute to count the rejected money in determining how large its block grant will be, analysts say.

Grady, Avalere analyst Chris Sloan and others said they were unaware of states other than Wisconsin that would benefit from the provision. This language could mean "potentially hundreds of millions" of extra dollars for Wisconsin, said Grady.

In a written statement provided by aides, Johnson said funding formulas to correct "the grossly unfair" distribution of money under Obama's law needed to be changed "to reflect the unique circumstances of many states, including recognizing the innovative reforms of Wisconsin."

Wisconsin is among 19 states that declined to fully expand Medicaid under Obama's law, which also provided generous federal reimbursements. Under Gov. Scott Walker, a GOP 2016 presidential contender, Wisconsin just partially expanded Medicaid and agreed to accept smaller federal subsidies.

The provision in the health care bill applies to states that expanded Medicaid only up to 100 percent of the federal poverty level and had that expansion in effect this past Sept. 1.

Since the bill's details emerged, health industry and other groups have been lining up against it.

The National Association of Medicaid Directors, representing state officials who administer Medicaid, said it is concerned the measure would have damaging consequences on state budgets. Also announcing opposition recently was America's Health Insurance Plans, a huge health insurers' trade group, the American Hospital Association and the American Medical Association.

Copyright Associated Press / NBC New York



Photo Credit: Drew Angerer/Getty Images, File]]>
<![CDATA[Aaron Hernandez's Family Suing NFL, Pats After CTE Diagnosis]]>Thu, 21 Sep 2017 22:32:56 -0500https://media.nbcnewyork.com/images/213*120/Despiden-a-Aaron-Hernandez-en-discreto-funeral-privado.jpg

Lawyers for Aaron Hernandez are suing the NFL and the New England Patriots over his death after a brain study showed the former football star suffered from a "severe case" of the degenerative brain disease chronic traumatic encephalopathy.

"Not only were the results positive, but we're told it was the most severe case they had ever seen for someone of Aaron's age," Hernandez's lawyer Jose Baez said in a news conference Thursday at his office.

The lawsuit was filed in federal court in Boston on behalf of Hernandez's 4-year-old daughter. It claims the team and the league deprived Avielle Hernandez of the companionship of her father. 

Baez said Hernandez had Stage 3 out of 4 CTE, usually found in a 67-year-old man. Boston University officials who examined Hernandez's brain said he also had early brain atrophy and perforations in a central membrane. CTE can only be diagnosed in an autopsy.

Avielle Hernandez's mother, Shayanna Jenkins-Hernandez, attended Thursday's news conference but did not speak.

"We are deeply troubled, deeply saddened," Baez said. "And I know for a fact his entire family - especially Shayanna - is deeply troubled by this whole thing."

The Patriots did not immediately respond to requests for comment. The NFL said it has not seen a copy of the lawsuit and "cannot comment at this time."

CTE can be caused by repeated head trauma and leads to symptoms like violent mood swings, depression and other cognitive difficulties. Hernandez killed himself in April in the jail cell where he was serving a life-without-parole sentence for a 2013 murder. His death came just hours before the Patriots visited the White House to celebrate their latest Super Bowl victory.

Soon after his prison suicide in April, Hernandez's family decided they wanted his brain to be studied by the Boston University Chronic Traumatic Encephalopathy Center.

State officials originally refused to release the brain because it was part of the ongoing investigation into Hernandez's death, but later agreed to release it after the ex-NFL star's lawyer accused them of holding the brain illegally.


Baez said at the time that the family hoped Hernandez's brain could be examined to help future athletes and to shed any more light on his client's death. A recent study conducted by Boston University found CTE in the brains of 110 of the 111 brains of former NFL players that were tested.


Hernandez, 27, was serving a life sentence for murder and was acquitted in two other killings just days before he hanged himself with a bed sheet attached to his cell window at the Souza-Baranowski Correctional Center in Shirley, Massachusetts, in the early morning hours of April 19.

Hernandez blocked access to his cell from the inside by jamming cardboard into the door tracks, investigators said. They also said there were no signs of a struggle and Hernandez was alone at the time of the hanging.


His Bible was found marked with blood at John 3:16, a verse that describes eternal life for those who believe in God. The verse name was also written in blood on the wall and in pen on his forehead.

A star for the University of Florida when it won the 2008 title, Hernandez dropped to the fourth round of the NFL draft because of trouble in college that included a failed drug test and a bar fight. His name had also come up in an investigation into a shooting.

In three seasons with the Patriots, Hernandez joined Rob Gronkowski to form one of the most potent tight end duos in NFL history. In 2011, his second season, Hernandez caught 79 passes for 910 yards and seven touchdowns to help the team reach the Super Bowl, and he was rewarded with a $40 million contract.

But the Patriots released him in 2013, shortly after he was arrested in the killing of semi-pro football player Odin Lloyd, who was dating the sister of Hernandez's fiancee. Hernandez was convicted and sentenced to life in prison; the conviction was voided because he died before his appeals were exhausted, though that decision is itself being appealed.

SUICIDE PREVENTION HELP: The National Suicide Prevention Hotline (1-800-273-8255) is open 24 hours a day, 7 days a week.

Copyright Associated Press / NBC New York



Photo Credit: Jared Wickerham/Getty Images, File]]>
<![CDATA[Kimmel Ramps Up Battle Against GOP Health Care Bill]]>Thu, 21 Sep 2017 07:51:24 -0500https://media.nbcnewyork.com/images/213*120/849709530-Jimmy-Kimmel.jpg

Jimmy Kimmel used his late-night platform to continue his assault on the GOP health care bill, firing back at critics including U.S. Sen. Bill Cassidy and "Fox & Friends" co-host Brian Kilmeade.

The ABC star on Wednesday was following up on his monologue from Tuesday, when he said the bill Cassidy is co-sponsoring in failed the "Jimmy Kimmel test," a phrase Cassidy coined in May after Kimmel announced his newborn son underwent heart surgery for a birth defect.

The Louisiana Republican said Wednesday that Kimmel doesn't understand the bill. He told NBC News that the bill does indeed pass the "Kimmel test," and that he couldn't help the comedian's personal attacks.

"If you're in Texas or if you're in Maine and Virginia, Missouri, there'll be resources in your state that you've not had to provide you coverage," Cassidy said when asked about Kimmel's criticism.

Sen. Lindsey Graham, R-S.C., the bill's other co-sponsor, said it was inappopriate for Kimmel to attack the bill without discussing it with the senators who proposed it.

And President Donald Trump weighed in as well, saying in a tweet late Wednesday night that Cassidy is "a class act who really cares about people" who "doesn't lie."

But Kimmel mocked Cassidy's claim that he doesn't understand the bill, calling it "the worst health care bill yet." He named more than a dozen medical associations and groups who oppose it.

"When Sen. Cassidy was on my show in May, he told me that he believes every American family, regardless of income, should be able to get quality healthcare," Kimmel said. "Sadly, the bill he unveiled last week ... indicates that he was not sincere."

After Kilmeade labeled Kimmel as a "Hollywood elite" pushing politics, Kimmel called Kilmeade "a phony little creep" who Kimmel says previously asked him to write a blurb for his book.

Copyright Associated Press / NBC New York



Photo Credit: Randy Holmes/ABC via Getty Images, File
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<![CDATA[Why Do College Kids Think Backpacks Can Save a Drunk Friend?]]>Thu, 21 Sep 2017 20:37:57 -0500https://media.nbcnewyork.com/images/213*120/drunk_pack_stock_image.jpg

In the final hours of his life, Tim Piazza lay on a couch in a Penn State frat house barely conscious and occasionally vomiting from alcohol poisoning and serious internal injuries.

Twice on a night of heavy drinking in early February, frat brothers, apparently oblivious to his injuries, strapped a backpack on the very ill young man. Piazza died a day later, February 4, at Hershey Medical Center.

In another, more recent death on a Pennsylvania college campus, dorm mates of Lafayette College freshman McCrae Williams put a backpack on the young lacrosse player as he lay in his bed this September. He had thrown up and fallen to the floor in his room after what has been described as a "day drink" party and possibly another party the night before.

The college kids in both instances put backpacks on their dying friends in the hope of preventing the young men from turning unconsciously onto their backs and asphyxiating on their vomit, according to authorities.

There is even a term for it now in college circles: "JanSporting," named after the popular brand of backpack used by high school and college students. Another term for it is "the drunk pack." Pillows often are placed in the backpack to prevent a person from turning from his or her side.

One article on the lifestyle website Total Frat Move claims "JanSporting" "just might save" a drunken friend's life, though it also emphasizes that overly intoxicated people shouldn't be left alone, regardless of what position they are put in.

"JanSporting" may be popular on campus, but it is not a prescription likely to gain support in the medical community anytime soon.

"Sadly, 'JanSporting' is another one of those internet-fueled misconceptions that people, especially college students, use to prevent bad outcomes from excessive alcohol consumption," said Dr. Ralph Riviello, vice chair of clinical operations at Drexel University's Department of Emergency Medicine. While "the backpack theoretically can prevent someone from rolling onto their back, aspiration can occur in other positions, and the degree of intoxication and responsiveness are the biggest determinants of aspiration."

He said if a friend is so drunk that unconscious vomiting is a concern, calling 911 is the right and immediate thing to do.

"If someone is that drunk that you are considering putting a backpack on them, you need to call 911. They need to be transported to ED for evaluation," Riviello said.

He said a common misconception among young people, particularly underage college students, is that going to an emergency room for intoxication will lead to ramifications with their college administrators.

But details of their hospital trip are protected by privacy rights and the Health Insurance Portability and Accountability Act known as HIPAA.

"We see a lot of college kids on Friday or Saturday. We never would report them to the Dean’s office or campus officials," Riviello said. "We would encourage kids to seek help or visit their student health center and that sort of thing, but we don’t call the school."

The one call doctors and nurses might make? "We may call your parents if you’re underage and they are close enough to pick you up," he said.

Still, as recent college tragedies should teach other young people, Riviello said it’s better to get to a doctor quickly and live than worry about the embarrassment and fallout from being dangerously intoxicated.

"If you're that sick or you're that out of it, you need medical attention," Riviello said. "Your drunk friends aren’t going to provide the amount of attention that you need."



Photo Credit: NBC10]]>
<![CDATA['Scam': Kimmel Slams 'Kimmel Test' Senator's Bill]]>Wed, 20 Sep 2017 08:02:18 -0500https://media.nbcnewyork.com/images/213*120/Kimmel-Cassidy.jpg

Late-night host Jimmy Kimmel sounded off on Tuesday to blast Republican Sen. Bill Cassidy for his part in crafting the latest GOP health care proposal that, Kimmel said, goes against the promises the senator had made to him on his show. 

Kimmel had discussed health care with Cassidy after the late-night host revealed in early May that his newborn son had open-heart surgery to fix birth defects. This led Kimmel to deliver an emotional message to Congress, pleading for affordable health care for Americans, especially those in similar situations.

Cassidy then famously coined the "Jimmy Kimmel test" phrase, saying families like Kimmel's should not have to deal with high premiums, lifetime caps and rate hikes when it comes to coverage. A week after Kimmel's plea, the Louisiana senator appeared on "Jimmy Kimmel Live" to expand on his idea of affordable health care.

Kimmel is now claiming Cassidy "lied right to my face" in that conversation.


Cassidy delivered his replacement for the Affordable Health Care Act last week. In a proposed bill written with Sen. Lindsey Graham, states would receive block grants and cuts would be made to Medicaid, among other things.

"This new bill (passes) a different 'Jimmy Kimmel test,'" Kimmel said on his show. "In this one, your child with a pre-existing condition will get the care he needs if, and only if, his father is Jimmy Kimmel. Otherwise, you might be screwed." 

He claimed the Graham-Cassidy bill would kick 30 million Americans off their insurance and give states certain control over lifetime caps and coverage for people with pre-existing conditions. The Congressional Budget Office said it plans to deliver an initial analysis on the bill early next week, but can't do a full analysis by the end of the month. That's when a crucial deadline hits for Senate Republicans to act under special budget rules. 

In the meantime, groups including the American Medical Association and AARP have come out against the proposal. 

Kimmel went on to argue this latest bill is "actually worse" than the GOP's previous attempt to replace the ACA. That "skinny repeal" came to a halt when Republican Sen. John McCain delivered the deciding vote against it in the early hours of July 28.

Before McCain went thumbs down, GOP Sens. Susan Collins and Lisa Murkowski also voted "no."

"I hope they have the courage and good sense to do that again with this one," Kimmel said of the Graham-Cassidy proposal, calling it a "scam of a bill." 


"Health care is complicated. It's boring. I don't want to talk about it… And that's what these guys are relying on," Kimmel continued. "Most of the congresspeople who vote on this bill probably won't even read it, and they want us to do the same thing. They want us to treat it like an iTunes service agreement." 

Cassidy responded to Kimmel's heated monologue with a statement late Tuesday. 

"We have a September 30th deadline on our promise," the senator wrote. "Let's finish the job. We must because there is a mother and father whose child will have insurance because of Graham Cassidy Heller Johnson. There is someone whose pre-existing condition will be addressed because of GCHJ. I dedicated my medical career to care for such as these; this is why GCHJ must pass." 

Speaking on CNN Wednesday morning, Cassidy also argued that "more people will have coverage and we'll protect people with pre-existing conditions."

"I'm sorry he does not understand," Cassidy said of Kimmel.

Independent analysts have said the proposal allows states to take action that could raise the cost of coverage for people with pre-existing conditions. Cassidy said that if a state applied for a waiver it must provide affordable coverage.  

As Kimmel urged viewers to call their representatives with opposition to the bill, he offered one final reason why he renewed his health care debate.

"Before you post a nasty Facebook message saying I'm politicizing my son's health problems, I want you to know, I am politicizing my son's health problems because I have to," Kimmel said. "My family has health insurance. We don't have to worry about this, but other people do."




Photo Credit: Files
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<![CDATA[One Last Chance: GOP Strains for Obamacare Repeal Votes]]>Tue, 19 Sep 2017 17:16:50 -0500https://media.nbcnewyork.com/images/213*120/Last-Chance-Senate-Health-Care-EM.jpg

Time growing short, President Donald Trump and Republican Senate leaders dove into a frantic hunt for votes Tuesday in a last-ditch effort to repeal and replace "Obamacare." The pressure was intense, the outcome uncertain in a Capitol newly engulfed in drama over health care.

Senate Majority Leader Mitch McConnell, whose failure to pass an Obamacare repeal bill in July opened a bitter public rift with Trump, pressed hard for the newly revived effort, which had been left for dead as recently as a week or two ago. But in a sign he remained short of votes, McConnell refused to commit to bringing the legislation to the floor.

As in July, much of the focus was on Arizona Sen. John McCain. Would he step back in line with fellow Republicans now that there was a bill co-written by Lindsey Graham of South Carolina, his best friend in the Senate? McCain wasn't saying. Lisa Murkowski of Alaska, another crucial vote, wasn't talking either.

Republicans must act by Sept. 30 in the Senate, or face the prospect of a Democratic filibuster. That blocking action is currently staved off by budget rules that will expire at the end of the fiscal year. The new legislation, by Graham and Sen. Bill Cassidy of Louisiana, would undo the central pillars of former President Barack Obama's health care law, and replace them with block grants to the states so they could make their own health care coverage rules.

"Governors and state legislators of both parties would have both the opportunity and the responsibility to help make quality and affordable health care available to their citizens in a way that works for their own particular states," McConnell said on the Senate floor. "It's an intriguing idea and one that has a great deal of support."

Democrats are unanimously opposed, arguing that the legislation would result in millions of Americans losing their health insurance, decrease access to affordable care and damage the Medicaid health program for the poor.

So McConnell must win the votes of 50 of the 52 Senate Republicans. That would amount to victory in the 100-member Senate, because GOP Vice President Mike Pence would then break a tie.

Pence appeared at the Capitol Tuesday and declared the Trump administration was "all-in" on the effort. The president himself was closely in touch with Graham and others.

If the bill does pass, Speaker Paul Ryan has committed to pushing it through the House as-is, and straight to the president's desk, according to Graham. After seven years of promises to get rid of "Obamacare," Republicans would have finally succeeded. It would be a promise kept to the GOP base, yet one with uncertain and potentially devastating political consequences for the Republican Party given that millions of people would be likely to lose their health coverage and others might have skimpier care.

The bill would let states set their own coverage requirements, allow insurers to boost prices on people with serious medical conditions, end Obama's mandates that most Americans buy insurance and that companies offer coverage to workers, and cut and reshape Medicaid.

The bill's full impacts are difficult to predict since the Congressional Budget Office has not had time to assess it. But senators plan to move forward without a complete CBO "score," heightening outrage from Democrats who denounced the legislation as cruel and draconian.

By Tuesday evening the legislation remained at least one or two votes short.

The situation is nearly identical to where Republicans found themselves back in July when McConnell made one last attempt to pass a stripped-down repeal bill. It failed in a tense late-night session, with McCain, newly diagnosed with brain cancer, casting the decisive "no" vote.

McCain finds himself once again at the center of the drama this time around. But now there's a twist: His best friend in the Senate, Graham, is an author of the bill.

McCain has been more more than willing to buck his party's leadership over the years, and to defy Trump. Undercutting Graham might be a different issue, and McCain brusquely refused to tip his hand Tuesday.

"I don't have anything to say," McCain said repeatedly and snapped at a reporter who pressed for more. "I have nothing to say, do you hear me?"

Graham made clear he was arguing the case forcefully to his longtime friend, with whom he's partnered on any number of policy initiatives over the years and rarely parted ways. A hearing on the legislation was scheduled for next week after McCain had complained there weren't any.

"I'm not speaking for Sen McCain. I know he likes federalism, I know he wants bipartisanship, but I just don't personally see a bipartisan proposal that's got a snowball's chance in hell of doing anything other than propping up Obamacare," Graham said. "It's either this or a march toward Bernie-care," a reference to Sen. Bernie Sanders' Medicare-for-all bill.

GOP Sen. Rand Paul of Kentucky has announced his opposition to the legislation, saying it doesn't go far enough in repealing "Obamacare," while moderate GOP Sen. Susan Collins of Maine, who opposed earlier repeal bills, also sounded like a "no" Tuesday. She said the Graham-Cassidy bill could be worse than earlier versions because of potential harm to people with pre-existing conditions.

In addition to McCain, the focus was on moderate Murkowski, who was the third "no" vote on the earlier bill along with Collins and McCain.

Murkowski kept a low profile Tuesday but in what could be a significant factor for her, Alaska's independent governor, Bill Walker, joined a bipartisan letter with other governors in opposition to the bill, asking senators to instead focus on bipartisan approaches.

And a pair of potent interest groups, the American Medical Association and AARP, also declared their opposition.

Associated Press writers Alan Fram, Kevin Freking, Andrew Taylor and Richard Lardner in Washington and Julie Carr Smyth in Columbus, Ohio contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: J. Scott Applewhite/AP]]>
<![CDATA[States Ask Insurers to Prioritize Non-Opioid Pain Treatment]]>Mon, 18 Sep 2017 18:21:12 -0500https://media.nbcnewyork.com/images/213*120/oxycodoneGetty_1200x675.jpg

Attorneys general representing the majority of states asked health insurers Monday to encourage pain treatment through means other than prescriptions for opioid painkillers, which are responsible for tens of thousands of deaths a year in the U.S.

The top government lawyers in 35 states signed a letter to the trade group America's Health Insurance Plans. The group, which also includes attorneys general for Puerto Rico and the District of Columbia, asked insurers to make coverage of non-opioid treatments such as physical therapy and massage a priority.

"The status quo, in which there may be financial incentives to prescribe opioids for pain which they are ill-suited to treat, is unacceptable," the attorneys general wrote.

The letter targets prescribing powerful drugs for chronic pain, a practice several studies have found is not effective.

The insurers group did not immediately respond to requests for comment.

Opioid-related overdoses have hit especially hard in the Appalachian states. On Monday, the attorney generals from two of them, Kentucky and West Virginia, held a joint news conference to highlight the pressure on the health insurance industry.

"If we can get the best practices changed with insurance companies and the payment incentives are just a bit different than what they are today, I think that's going to continue to see the number of pills prescribed and dispensed drop dramatically," said West Virginia Attorney General Patrick Morrisey, a Republican. "This is an important new front to open up."

Kentucky's Andy Beshear, a Democrat, said the number of overdoses might not fall quickly if companies follow the requests, but said it could help prevent more people from becoming addicted in the future.

The nation is in the thick of an opioid epidemic. In 2015, more than 52,000 people across the country died from drug overdoses — more than from car crashes or shootings.

Nearly two-thirds of those overdoses were from opioids, including prescription drugs such as OxyContin and Vicodin and illicit drugs including heroin and fentanyl. Often, abusers switch between prescription and illegal drugs.

A few years ago, governments were reacting mostly through measures such as creating databases of prescriptions to identify abusers or by increasing the availability of a drug that counteracts overdoses.

Lately, they've been getting more aggressive.

More than 60 local and state governments have filed, announced or publicly considered lawsuits against drug makers or distributors. In June, several attorneys general announced a multi-state investigation of the industry.

Since last year, states have been adopting laws limiting initial prescriptions to opioids in the hopes of cutting down on misuse.

Copyright Associated Press / NBC New York



Photo Credit: John Moore/Getty Images, File]]>
<![CDATA[Medicare Cards Being Remade to Protect Seniors ]]>Thu, 14 Sep 2017 10:50:39 -0500https://media.nbcnewyork.com/images/213*120/medicarenewcardforseniorss_1200x675.jpg

Medicare cards are getting a makeover to fight identity theft.

No more Social Security numbers plastered on the card. Next April, Medicare will begin mailing every beneficiary a new card with a unique new number to identify them.

"Criminals are increasingly targeting people age 65 and older for medical identity theft," Medicare chief Seema Verma told The Associated Press. "We are committed to preventing fraud."

Medicare is revealing the cards' new design on Thursday as the government gears up for a massive transition that will involve coordination with 58 million beneficiaries and their family members, plus hospitals, doctors, insurance companies, pharmacies and state governments.

While the first mailings of new cards begin next April, Congress has set an April 2019 deadline for all beneficiaries to have received one.

One goal is to make sure seniors know what's coming so they're not confused by the change — and in the meantime, are reminded to guard their old cards that, if lost or stolen, can leave them vulnerable to financial and legal consequences. The government recorded 2.6 million cases of identity fraud involving seniors in 2014, up from 2.1 million in 2012.

Verma said one woman reported her Medicare card was stolen, got a replacement and thought no more about it until two years later when she learned she might be arrested: The thief had impersonated her to get opioid painkillers.

Medicare has set up a website — www.cms.gov/newcard — and is beginning ads to tell beneficiaries what to expect starting next spring. Medicare will automatically mail beneficiaries their new card. They'll be instructed to destroy their old cards after they get a new one. New cards may be used right away.

Private insurers already have stopped using Social Security numbers on ID cards.

While the Medicare change is crucial for seniors, the transition period also is a time when crooks may pounce, warned AARP's Amy Nofziger, a fraud prevention expert.

"If anyone calls you to say you need to pay for your new Medicare card, it is a scam," she said. "If anybody is calling you and asking you to verify your Social Security number in order to issue your new Medicare card, it is a scam."

Copyright Associated Press / NBC New York



Photo Credit: Centers for Medicare & Medicaid Services via AP]]>
<![CDATA[Selena Gomez Undergoes Kidney Transplant Due to Lupus]]>Fri, 15 Sep 2017 05:53:15 -0500https://media.nbcnewyork.com/images/213*120/selenagomeztransplantfeuerherd.jpg

Selena Gomez recently received a kidney transplant from television actress Francia Raisa due to her struggle with lupus, the actress-singer revealed Thursday.

Gomez disclosed in an Instagram post confirmed by her publicist that she has been somewhat out of the spotlight this summer because she was recovering from the procedure. The 25-year-old calls the transplant "what I needed to do for my overall health."

The post didn't reveal Gomez's current condition or say where or when the procedure took place. Gomez's publicist declined to release more information.

Gomez wrote "there aren't words to describe" how she can thank Raisa, who she says gave "the ultimate gift and sacrifice by donating her kidney."

"I am incredibly blessed," she added.


The Instagram post includes a picture of Gomez and Raisa holding hands while lying side-by-side in hospital beds and another photo of a scar on Gomez's abdomen. The 29-year-old Raisa is best known for her role on the ABC Family series "The Secret Life of the American Teenager." Raisa's publicist didn't immediately return a request for comment Thursday.

Gomez revealed her lupus diagnosis in 2015 and took a break from her career last year to deal with anxiety, panic attacks and depression stemming from her battle with the disease.

Lupus is an autoimmune disease, where the body mistakenly attacks its own tissues, sometimes including the kidneys. One healthy kidney is all the body needs, so a single kidney transplant can resolve the problem, said Dr. David Klassen, chief medical officer for the United Network for Organ Sharing, which runs the nation's transplant system.

"Lupus tends to be a disease of younger women, and younger people tend to do better with transplants than older patients, so the expectation is she would do quite well," he said of Gomez.

Lupus also tends not to come back after the operation — "the drugs that prevent kidney rejection are also very good for treating lupus, the underlying disease," Klassen said.

The causes of lupus are unknown. Symptoms can include bloody or foamy urine, unexplained weight gain, high blood pressure or swelling in the legs, ankles or around the eyes.

Only about 3 percent of kidney transplants are for lupus — most are due to diabetes or chronic damage from high blood pressure.

There were about 19,000 kidney transplants in the U.S. last year.

Gomez, whose hits include "Good for You," ''Same Old Love" and "Come & Get It," has been in the spotlight since she was a child. She appeared on "Barney and Friends" before breaking through as a teen star on the Disney Channel's "Wizards of Waverly Place." She has a massive following on social media. Her 126 million followers on Instagram are the most on the platform.

She is set to star in an upcoming Woody Allen movie due out next year.

Gomez, who has been dating the singer The Weeknd for several months, also has had success behind the scenes as the executive producer of Netflix's "13 Reasons Why," the controversial young adult series that became a summer sensation this year.

Copyright Associated Press / NBC New York



Photo Credit: SelenaGomez/Instagram
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<![CDATA[Study Prompts Call to Examine Flu Vaccine and Miscarriages]]>Wed, 13 Sep 2017 12:19:37 -0500https://media.nbcnewyork.com/images/213*120/flushottechnician_1200x675.jpg

A puzzling study of U.S. pregnancies found that women who had miscarriages between 2010 and 2012 were more likely to have had back-to-back annual flu shots that included protection against swine flu.

Vaccine experts think the results may reflect the older age and other miscarriage risks for the women, and not the flu shots. Health officials say there is no reason to change the government recommendation that all pregnant women be vaccinated against the flu. They say the flu itself is a much greater danger to women and their fetuses.

The Centers for Disease Control and Prevention has reached out to a doctor's group, the American Congress of Obstetricians and Gynecologists, to warn them the study is coming out and help them prepare for a potential wave of worry from expectant moms, CDC officials said.

"I want the CDC and researchers to continue to investigate this," said Dr. Laura Riley, a Boston-based obstetrician who leads a committee on maternal immunization. "But as an advocate for pregnant women, what I hope doesn't happen is that people panic and stop getting vaccinated."

Past studies have found flu vaccines are safe during pregnancy, though there's been little research on impact of flu vaccinations given in the first three months of pregnancy.

Flu and its complications kill thousands of Americans every year. The elderly, young children and pregnant women are especially at risk. When a new "swine flu" strain emerged in 2009, it killed 56 U.S. pregnant women that year, according to the CDC.

The study's authors, two of whom are CDC researchers, saw a big difference when they looked at women who had miscarried within 28 days of getting a shot that included protection against swine flu, but it was only when the women also had had a flu shot the previous season.

They found 17 of 485 miscarriages they studied involved women whose vaccinations followed that pattern. Just four of a comparable 485 healthy pregnancies involved women who were vaccinated that way.

The first group also had more women who were at higher risk for miscarriage, like older moms and smokers and those with diabetes. The researchers tried to make statistical adjustments to level out some of those differences but some researchers don't think they completely succeeded.

Other experts said they don't believe a shot made from killed flu virus could trigger an immune system response severe enough to prompt a miscarriage. And the authors said they couldn't rule out the possibility that exposure to swine flu itself was a factor in some miscarriages.

Two other medical journals rejected the article before a third, Vaccine, accepted it. Dr. Gregory Poland, Vaccine's editor-in-chief, said it was a well-designed study that raised a question that shouldn't be ignored. But he doesn't believe flu shots caused the miscarriages. "Not at all," said Poland, who also is director of vaccine research at the Mayo Clinic.

Though this study may cause worry and confusion, it is evidence "of just how rigorous and principled our vaccine safety monitoring system is," said Jason Schwartz, a Yale University vaccine policy expert.

Some of the same researchers are working on a larger study looking at more recent data to see if a possible link between swine flu vaccine and miscarriage holds up, said James Donahue, a study author from the Wisconsin-based Marshfield Clinic Research Institute. The results aren't expected until next year at the earliest, he said.

Copyright Associated Press / NBC New York



Photo Credit: Tim Boyle/Getty Images, File]]>
<![CDATA[Sanders Would Make Government Health Care Role Even Bigger]]>Wed, 13 Sep 2017 17:43:25 -0500https://media.nbcnewyork.com/images/213*120/health-care-overhaul-plans.jpg

In an animated, campaign-style rally, Sen. Bernie Sanders unwrapped his plan to remake the nation's convoluted health care system into federally run health insurance Wednesday — a costly proposal embraced by liberal activists hoping to steer the Democratic Party in upcoming elections.

The Vermont independent's plan would hand government a dominant role in insuring Americans, a crucial step, he said, in guaranteeing health care for all. Census Bureau data this week showed the proportion of people lacking policies falling to 8.8 percent last year under "Obamacare," the lowest level ever recorded, but he called it an "international disgrace" that not all Americans have coverage.

Though Sanders' plan is going nowhere in the current GOP-controlled Congress, he drew a big crowd to a packed and electrified Senate hearing room.

Hours earlier, Republican senators unveiled their own last-ditch, long-shot plan to scuttle President Barack Obama's 2010 statute and practically begged the White House to help.

"Pick up the phone" and ask governors to support the repeal effort, said Sen. Lindsey Graham, R-S.C., aiming his remarks at President Donald Trump. "Tell them this matters to you, that you weren't kidding about repealing and replacing Obamacare, that you actually meant it."

Shortly afterward, Trump issued a statement saying "I sincerely hope" the effort by Graham and three other GOP senators will succeed.

The waning desire of GOP lawmakers to revive their failed effort to scrap Obama's law contrasted with growing, though wary, Democratic support for Sanders' bill. It has attracted 16 co-sponsors, one-third of all Senate Democrats, though most are from safely Democratic states.

"Today we begin the long and difficult struggle to end the international disgrace of the United States, our great nation, being the only major country on Earth not to guarantee health care to all," Sanders declared.

Though his bill has no chance in the current Congress, the issue is enthusiastically backed by large segments of a Democratic Party hoping to capture House control in the 2018 elections. Sanders caucuses with Democrats and unexpectedly gave Hillary Clinton a tough run for the party's presidential nomination last year.

The room where Sanders spoke held more than 200 people, including members of unions and progressive groups. Many waved posters and chanted "Medicare for all," the name he has given his 96-page bill, which would gradually expand the health insurance program for the elderly to cover all Americans.

Nine other senators attended and most also spoke, including at least four potential 2020 presidential aspirants who almost seemed to be auditioning. Sen. Cory Booker, D-N.J., called the health care battle "a fight for our nation to live up to our ideals."

Cries for universal coverage and government-provided, single-payer health care have simmered among Democrats for decades.

The notion was submerged as Obama enacted his overhaul, which boosted federal spending and set coverage requirements but left much of the existing private system in place. About 156 million people get policies at work, about half of all those insured, with most of the rest getting coverage through Medicare or Medicaid or by buying individual plans.

But support among Democrats for Sanders' bill and similar measures by other Democrats, plus polling showing growing public backing, suggests the push for a single-payer system will be a major theme inside the party.

"We will defend it at every turn," Sen. Elizabeth Warren, D-Mass., another possible presidential hopeful, told the crowd about Obama's law. "But we will go further." Potential candidates Kirsten Gillibrand of New York and Kamala Harris of California also attended the event.

Sanders provided no details about the price tag of his measure or how it would be financed. Aides have said it would likely rely largely on income-adjusted premiums people would pay the government, ranging from zero for the poorest Americans to high levies on the rich and corporations.

People would no longer owe monthly premiums and other out-of-pocket costs like copayments, and companies would not have to offer coverage to workers. Sanders says most people and employers would save money.

The version he introduced during his 2016 presidential run was supposed to cost an enormous $1.4 trillion annually.

His plan would surpass Obama's law in covering a long list of services, including dental, vision, hospital, doctors and mental health costs. Copayments would be allowed for prescription drugs.

Many Democrats from politically competitive states have shied away from Sanders' plan, aware that Republicans are ready to cast it as a huge tax hike and government-run health care.

"The president as well as the majority of the country knows that the single-payer system that the Democrats are proposing is a horrible idea," said White House spokeswoman Sarah Huckabee Sanders. "I can't think of anything worse than having government being more involved in your health care instead of less involved."

Meanwhile, Graham and three other GOP senators released details of their proposal to erase many of the subsidies and coverage requirements of Obama's law and instead give block grants to states to help individuals pay for coverage.

"If you believe repealing and replacing Obamacare is a good idea, this is your best and only chance to make it happen because everything else has failed," Graham said.

Republicans lost the votes of three of their 52 senators in July on legislation aimed at Obamacare repeal. A special budget procedure that's allowed them to approve the legislation with just 51 votes, instead of the usual 60, expires Sept. 30.

With Democrats all opposed, that gives Republicans barely two weeks to succeed.

Copyright Associated Press / NBC New York



Photo Credit: AP Photos/Andrew Harnik]]>
<![CDATA[Age Matters When It Comes to Screening for Cervical Cancer]]>Tue, 12 Sep 2017 11:55:32 -0500https://media.nbcnewyork.com/images/213*120/cervicalcancer_1200x675.jpg

Getting checked for cervical cancer isn't one-size-fits-all: Millions of women may soon have to decide between a routine Pap or a newer test that detects if they have a cancer-causing virus.

Draft national guidelines released Tuesday for the first time say either option is reasonable for certain women — those ages 30 to 65.

Paps, a mainstay for women's health for decades, can spot pre-cancerous abnormalities in time to prevent cancer. Newer HPV tests detect the virus that causes nearly all of that cancer, and while they're widely used to confirm Pap results, most U.S. medical groups haven't yet pushed them as a stand-alone alternative for screening.

Tuesday's proposal doesn't signal an imminent end to the Pap era. Paps, not HPV tests, still are recommended for screening women in their 20s, stressed the guidelines from the U.S. Preventive Services Task Force.

And don't let the which-test debate blur the main message: "Screening for cervical cancer saves lives," said Task Force member Dr. Carol Mangione of the University of California, Los Angeles.

Today, too many women still miss out. Here are some things to know:

CERVICAL CANCER STILL A THREAT

Cervical cancer has dropped dramatically over the past half-century thanks to Pap testing. Still, this year an estimated 12,820 U.S. women will be diagnosed with cervical cancer, and about 4,200 will die. Most haven't been screened, or have gone too long between checks.

Paps examine cells scraped from the cervix. HPV testing looks for high-risk strains of the human papillomavirus, the nation's most common sexually transmitted infection. According to the Centers for Disease Control and Prevention, just about everyone will get at least one strain at some point in their lives. But only certain strains cause cervical cancer — and only if they linger long enough in the body.

AGE MATTERS FOR SCREENING

Otherwise healthy women need a Pap every three years from age 21 to 29, agree most U.S. physician groups and the draft Task Force guidelines. Cervical cancer grows so slowly that regular Paps can find a problem early enough to treat.

While the Food and Drug Administration has approved an HPV test for women as young as 25, national guidelines have long recommended Pap screening for 20-somethings. That age group is most likely to get HPV — and the vast majority of the time their bodies clear the infection before it harms.

WHAT CHANGES AT AGE 30?

The older you get, the greater the chance that an HPV infection is the yearslong, harmful kind. To better catch those cases, today what's called co-testing is increasingly common for women 30 and over — a Pap-plus-HPV test combination. If the results of both tests are negative, women can wait five years to test again.

But both Paps and HPV testing can trigger false alarms, prompting unneeded, and sometimes harmful, additional care to rule out cancer. New studies show co-testing leads to more false alarms than either test alone, without adding benefit.

That spurred Tuesday's Task Force proposal to let women 30 and over choose an HPV test by itself every five years — or a Pap every three years instead. The proposal is open for public comment through Oct. 9, before it will be finalized.

Some countries already are moving to make HPV testing the chief screening tool, including the Netherlands and Australia.

"Most experts in this area are in agreement that HPV testing alone is the future of cervical screening," said Debbie Saslow of the American Cancer Society, who wasn't involved with Tuesday's draft guidelines.

WEIGH PROS AND CONS

Women in their 30s and older need to discuss screening options with their health providers, said Dr. Jason Wright, gynecologic oncology chief at New York-Presbyterian/Columbia University Medical Center, who also wasn't involved with the new guidelines.

An HPV test can cost twice as much as a $40 Pap, but doesn't require screening as often. Some data suggest HPV testing leads to more diagnosis of risky pre-cancer — but even by itself, an HPV test can spark more false alarms than a Pap, Wright said.

Also, some follow-up tests can alter the cervix in ways that may affect future pregnancies, a consideration for women still interested in childbearing, added the Task Force's Mangione.

WHO CAN SKIP CERVICAL CANCER SCREENING?

It's not recommended for women younger than 21, or those who had a cervix-removing hysterectomy.

Women can stop screening after age 65 if proper checks until then show they're healthy, current guidelines agree.

WHAT IF WOMEN RECEIVED THE HPV VACCINE AS AN ADOLESCENT?

Keep getting screened, following recommendations for your age. The first HPV vaccine hit the market about 10 years ago, too soon to know if it's safe for the now-grown first recipients to be screened less often, and newer vaccine versions protect against more strains, said Saslow, the cancer society's senior director of HPV-related and women's cancers.

Eventually, if enough young women grow up fully vaccinated, screening recommendations may change, she said.


Copyright Associated Press / NBC New York



Photo Credit: American Cancer Society/Getty Images]]>
<![CDATA[Infected Puppies Put 9 in Hospital, Sicken 30 More]]>Mon, 11 Sep 2017 17:22:19 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-55656729.jpg

Puppies carrying a common germ have infected 39 people, putting nine of them into the hospital, federal health officials told NBC News.

The cases are all linked to puppies sold in seven states by the pet store chain Petland, the Centers for Disease Control and Prevention said. The infection, called Campylobacter, is common in dogs and it can pass to people easily.

“The ill people are from seven states (Florida, Kansas, Missouri, Ohio, Pennsylvania, Tennessee, and Wisconsin),” the CDC said. The illnesses go back nearly a year, to September of 2016.

Dogs infected with Campylobacter might look perfectly well, but they can also have diarrhea, vomiting, or a fever. In people, symptoms include diarrhea, sometimes bloody; fever; stomach cramps; nausea and vomiting.



Photo Credit: Chris Graythen/Getty Images, File]]>
<![CDATA[FDA Recalls Pacemakers Over Fear of Hackers]]>Fri, 01 Sep 2017 13:32:41 -0500https://media.nbcnewyork.com/images/213*120/drvisit_1200x675.jpg

The Food and Drug Administration is recalling 465,000 pacemakers over fears that they could be hacked.

The pacemakers are to be uploaded with new secure software after the FDA discovered cybersecurity vulnerabilities that would allow a hacker to take over the medical device that controls the heart.

Pacemaker brands from Abbott -- the Accent, Anthem, Accent MRI, Accent ST, Assurity, and Allure -- are included in the recall.

Patients do not need another surgery. The FDA said the recall requires an in-person patient visit with a health-care provider. An update of the firmware, the device's permanent software, will take approximately 3 minutes to complete.

According to the FDA, while the pacemaker is being updated, it will operate in backup mode, pacing at 67 beats per minute, and essential, life-sustaining features will remain available. At the completion, the device will return to its pre-update settings.

"To further protect our patients, Abbott has developed new firmware with additional security measures that can be installed on our pacemakers," said Robert Ford, an Abbot executive vice president for medical devices, in a statement about the update. 

The FDA approved the firmware update last week.

Cybersecurity concerning patients' medical devices and their associated computers, networks, programs, and data focuses on protecting them from unintended or unauthorized access, change, or destruction.

The FDA said there have been no reports of unauthorized access to any patient's implanted device, and according to an advisory issued by the U.S. Department of Homeland Security, compromising the security of the devices would require a highly complex set of circumstances.



Photo Credit: Justin Sullivan/Getty Images]]>
<![CDATA[High Levels of Lead Found in Some Homes: Newark Mayor]]>Fri, 01 Sep 2017 16:30:23 -0500https://media.nbcnewyork.com/images/213*120/newark+water+facet.jpg

Officials in Newark have announced a program that allows city residents to replace their lead pipes after recent tests of drinking water found some homes and buildings with elevated levels of lead.

The city is also conducting an inventory of lead service lines in the city following the tests, officials said in a press release Friday.

Of 116 homes tested between January and June of this year, 13 of them had elevated levels of lead, according to the city's Office of Water and Sewer Utilities. That's about 12 percent of the homes. 

“Recent tests have shown elevated lead levels, so we are now going to act swiftly, competently, and professionally to eliminate this menace from our city, by providing property owners with services and technology to do so,” Mayor Ras Baraka said in the release.

Baraka urged property owners to test their water for lead or have it inspected, and if high lead levels are discovered, to use the new program provided by the city.

Officials said lead service lines can be replaced for a nominal fee.

City spokesperson Marjorie Harris said no one has suffered ill effects from the water. 

"The water is not dangerous," Harris said in an email to News 4. "We are simply advising residents of the results of our findings, as required by State law." 

This isn’t the first time lead has come up as a health concern in Newark. Over the past two years, elevated lead levels were found in drinking water at half of the city's schools. Lead above the federally recommended threshold was found in facilities used by city and charter schools, data released by the city showed. The city began testing students for lead and installing filtration systems after the discovery.

Lead is a metal that was previously used in soldering joints for plumbing systems. It’s now prohibited, but many houses still have lead in their systems. Lead can have negative effects on the brain, kidneys and nervous system and is of particular risk to pregnant women and children.

Residents who suspect their water contains lead are advised to contact the Department of Water and Sewer Utilities at (973) 733-6303 or by e-mail at waterandswer@ci.newark.nj.us. They can arrange to have their water tested for lead and/or get a service line inspection for free, the city says.

For more information on how to protect yourself from lead poisoning, head to NewarkNJ.gov.



Photo Credit: NBC 4]]>
<![CDATA[Former Monk Sues Cosmetics Giant Over Anti-Aging Formula]]>Wed, 30 Aug 2017 12:24:58 -0500https://media.nbcnewyork.com/images/213*120/monkloreallawsuit_1200x675.jpg

A former Roman Catholic monk has filed a federal lawsuit against cosmetics giant L'Oreal, accusing the company of stealing patented technology in an anti-aging wrinkle cream that his charity was selling to raise money for the poor.

Dennis Wyrzykowski and his company, Carmel Laboratories LLC, have been joined in the lawsuit by the University of Massachusetts Medical School, which developed the technology and licensed it to Carmel in 2009.

According to the lawsuit, the cream, called Easeamine, is made using technology inspired by a discovery by two UMass scientists that adenosine, a chemical compound found in the heart, can promote skin elasticity.

The lawsuit, filed in June and amended this month, alleges L'Oreal was aware UMass held the patent for the science. It alleges L'Oreal had been denied patents because of their similarity to those granted to UMass, but the cosmetic company went ahead with a line of products based on the adenosine technology.

Wyrzykowski, who leads a religious charity known as the Teresian Carmelites in Millbury, Massachusetts, said in an interview Tuesday that he was selling the cream online for $65 per tube to support the Carmelites work with prisoners, drug addicts, and school children.

He said the availability of the L'Oreal products decimated the Carmelites business.

"For me, L'Oreal pillaged the poor, that's what they did," Wyrzykowski said.

L'Oreal, which is based in Paris and has U.S. operations in New York, has asked a U.S. District Court judge in Delaware to dismiss the lawsuit. The company's attorneys argue in court documents that L'Oreal believes its use of adenosine falls outside the University of Massachusetts patents.

"While we admire the purpose of the work these two organizations are doing together, we find no merit in these allegations," L'Oreal said in an email Wednesday to The Associated Press. "We expressed this point of view in many conversations we had with the Teresian Carmelites and their outside legal advisers over the past two years."

Mark Shelton, a spokesman for the UMass Medical School, said they were not involved in drafting or filing the lawsuit, but became plaintiffs because they are obligated to protect the licensing agreement with Carmel.

James Dobson Jr., a now-retired cardiovascular physiologist who was one of two UMass scientists to make the discovery, said the technology is potentially worth millions of dollars.

"If you know a patent is out there and you willingly infringe on it, that really upsets me," he said. "What also upsets me is that the Teresian Carmelites were going to use the proceeds for the poor and disadvantaged in central Massachusetts and that was a noble thing to do."

Wyrzkowski said the loss of profits from the cream forced him to sell property that was going to be used for a spiritual center and curtailed other charitable works.

The Catholic Church withdrew recognition for the Teresian Carmelites in 2008, saying they no longer met the criteria to be a Catholic organization. But the group continued as a nondenominational, nonprofit with about 15 current members, Wyrzykowski said.

"We've basically turned it into a foundation because we were no longer able to sustain what we were doing because of what L'Oreal did," he said.

The lawsuit seeks unspecified damages.

Copyright Associated Press / NBC New York



Photo Credit: AP/Steven Senne]]>
<![CDATA[US Clears Breakthrough Gene Therapy for Childhood Leukemia]]>Wed, 30 Aug 2017 19:00:04 -0500https://media.nbcnewyork.com/images/213*120/clearedforleukemia_1200x675.jpg

Opening a new era in cancer care, U.S. health officials on Wednesday approved a breakthrough treatment that genetically engineers patients' own blood cells into an army of assassins to seek and destroy childhood leukemia.

The Food and Drug Administration called the approval historic, the first gene therapy to hit the U.S. market. Made from scratch for every patient, it's one of a wave of "living drugs" under development to fight additional blood cancers and other tumors, too.

Novartis Pharmaceuticals set the price for its one-time infusion of so-called "CAR-T cells" at $475,000, but said there would be no charge for patients who didn't show a response within a month.

"This is a brand new way of treating cancer," said Dr. Stephan Grupp of Children's Hospital of Philadelphia, who treated the first child with CAR-T cell therapy — a girl who'd been near death but now is cancer-free for five years and counting. "That's enormously exciting."

CAR-T treatment uses gene therapy techniques not to fix disease-causing genes but to turbocharge T cells, immune system soldiers that cancer too often can evade. Researchers filter those cells from a patient's blood, reprogram them to harbor a "chimeric antigen receptor" or CAR that zeroes in on cancer, and grow hundreds of millions of copies. Returned to the patient, the revved-up cells can continue multiplying to fight disease for months or years.

It's a completely different way to harness the immune system than popular immunotherapy drugs called "checkpoint inhibitors" that treat a variety of cancers by helping the body's natural T cells better spot tumors. CAR-T cell therapy gives patients stronger T cells to do that job.

"We're entering a new frontier in medical innovation with the ability to reprogram a patient's own cells to attack a deadly cancer," said FDA Commissioner Scott Gottlieb.

The first CAR-T version, developed by Novartis and the University of Pennsylvania, is approved for use by several hundred patients a year who are desperately ill with acute lymphoblastic leukemia, or ALL. It strikes more than 3,000 children and young adults in the U.S. each year and while most survive, about 15 percent relapse despite today's best treatments.

In a key study of 63 advanced patients, 83 percent went into remission soon after receiving the CAR-T cells. Importantly, it's not clear how long that benefit lasts: Some patients did relapse months later. The others still are being tracked to see how they fare long-term.

Still, "a far higher percentage of patients go into remission with this therapy than anything else we've seen to date with relapsed leukemia," said Dr. Ted Laetsch of the University of Texas Southwestern Medical Center, one of the study sites. "I wouldn't say we know for sure how many will be cured yet by this therapy. There certainly is a hope" that some will be.

Most patients suffered side effects that can be grueling, even life-threatening. An immune overreaction called "cytokine release syndrome" can trigger high fevers, plummeting blood pressure and in severe cases organ damage, side effects that require sophisticated care to help patients without blocking the cancer attack. The FDA designated a treatment for those side effects Wednesday.

"This is remarkable technology," said Dr. Mikkael Sekeres of the American Society of Hematology. But, he cautioned that CAR-T "isn't a panacea."

Among concerns, sometimes leukemia can develop resistance, and sometimes patients worsen while waiting for their new cells, said Sekeres, who directs the Cleveland Clinic's leukemia program and wasn't involved with CAR-T testing.

"Unfortunately leukemia grows so rapidly that it can evade even the smartest of our technologies," he added.

To better ensure patient safety, the FDA is requiring Novartis to offer CAR-T therapy only through medical centers specially trained and certified to handle the complicated treatment. Novartis expects to have 32 centers around the country, mostly in large cities, running by year's end, with the first 20 offering care within the next month.

Patients' collected immune cells will be frozen and shipped to a Novartis factory in New Jersey that creates each dose, a process the company says should take about three weeks. The $475,000 price tag doesn't include the cost of needed hospitalizations, travel to a certified hospital and other expenses.

On a conference call Wednesday, Novartis executives said the company is working with the Medicaid program and private insurers and expects broad coverage, and will offer some financial assistance with such things as copay and travel costs. But they didn't promise all patients would be able to get the therapy.

For some patients, the new CAR-T therapy might replace bone marrow transplants that cost more than half a million dollars, noted Grupp, who led the Novartis study.

"I don't want to be an apologist for high drug prices in the U.S.," Grupp stressed. But if it's the last treatment they need, "that's a really significant one-time investment in their wellness, especially in kids who have a whole lifetime ahead of them."

"This is a turning point in the fight" against ALL, said Penn's Dr. Carl June, who pioneered the therapy.

But he and other researchers say thousands more patients eventually may benefit. Kite Pharma's similar CAR-T brand, developed by the National Cancer Institute, is expected to win approval later this year to treat aggressive lymphoma, and Juno Therapeutics and other companies are studying their own versions against blood cancers including multiple myeloma.

Scientists around the country also are trying to make CAR-T therapies that could fight more common solid tumors such as brain, breast or pancreatic cancers — a harder next step.

"Although narrow in scope, today's FDA ruling is a milestone," said Dr. David Maloney of the Fred Hutchinson Cancer Research Center in Seattle, whose team has worked with Juno and is researching CAR-T in a variety of cancers. "Approvals are an important step, but they're just the beginning."

AP Medical Writer Linda A. Johnson in Trenton, New Jersey, contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: Children’s Hospital of Philadelphia/AP]]>
<![CDATA[Public Health Dangers Loom in Harvey-Hit Areas]]>Mon, 28 Aug 2017 19:34:24 -0500https://media.nbcnewyork.com/images/213*120/Harvey-houston-victims.jpg

The muddy floodwaters now soaking through drywall, carpeting, mattresses and furniture in Houston will pose a massive cleanup challenge with potential public health consequences.

It's not known yet what kinds or how much sewage, chemicals and waterborne germs are mixed in the water. For now, health officials are more concerned about drownings, carbon monoxide poisoning from generators and hygiene at shelters. In the months and years to come, their worries will turn to the effects of trauma from Hurricane Harvey on mental health.

At a shelter set up inside Houston's George R. Brown Convention Center, Dr. David Persse is building a clinic of doctors and nurses and trying to prevent the spread of viruses or having to send people to hospitals already stretched thin.

"This is rapidly evolving," said Persse, Houston Director of Emergency Medical Services. "I always worry in these large congregations of people about viral outbreaks that cause nausea, vomiting and diarrhea. And we are just getting started."

Medics have been at the convention center since it started taking in evacuees, along with police and other first responders. Over the last 24 hours, doctors and nurses arrived at the convention center to volunteer.

Fewer than 20 people have been hospitalized so far from the convention center.

"One of our goals is to appropriately treat people here with minor things so we don't send everybody off to the hospital," Persse.

Many of the around 3,000 people who fled from Harvey's flooding waited hours in water mixed with sewage, oil and gasoline. Some weren't able to grab their medications or medical devices. Police officers on Monday afternoon were looking for more wheelchairs.

Donors have brought diapers, baby formula and other basic necessities to the convention center. Officials are working with local pharmacies to replace lost medicines and dialysis clinics to serve patients in need of treatment. The Red Cross is arranging to bring in portable showers. A shipment of 50 wheelchairs was on the way Monday afternoon.

The U.S. Environmental Protection Agency will begin sampling the floodwaters as soon as possible, said EPA spokeswoman Liz Bowman in an email Monday. EPA teams will also be visiting water and sewage plants to offer help, she said.

EPA helped secure Superfund pollution cleanup sites last week ahead of the storm and is continuing to check with site operators.

Floodwater can be dangerous for people with open wounds, particularly if they have other health conditions. After Hurricane Katrina, five people with infected wounds died and health officials believe that exposure to brackish floodwater contributed to the deaths.

Katrina taught other lessons.

"In Katrina, a lot of people were concerned about illnesses from contact with the floodwater, but more infectious disease was associated with poor hygiene in overcrowded shelter facilities," said Karen Levy, associate professor of environmental health at Emory University in Atlanta.

At Houston-area shelters, access to clean water or hand sanitizer and proper disposal of human waste should be stressed, she said.

Any health problems will be more dangerous for the most vulnerable — people with immune disorders, the elderly and the poor, Levy said.

Katrina left a wake of post-traumatic stress disorder and depression, said Dr. Pierre Buekens, dean of Tulane University's School of Public Health and Tropical Medicine. He said their surveys showed roughly 10 percent had PTSD, but also that people were resilient.

"I'm sure this will happen in Houston," he said.

The most common flood-related deaths occur when people try to drive through flooded areas, according to the Centers for Disease Control and Prevention. Carbon monoxide may kill more as people return to homes without electricity and hook up generators, said the CDC's Renee Funk.

"Any sort of roof over a generator is actually a problem," Funk said. "When people go in and out to refill the generator they can be overcome. If a structure is attached to the house, the house can fill with fumes.

Best advice: Use a battery-operated carbon monoxide detector in the house if you're using a generator for power, she said.

Mold is also a health hazard. The CDC recommends removing and disposing of drywall and insulation that was tainted by floodwater or sewage. Mattresses, pillows, carpeting — even stuffed toys — should be tossed out. Hard surfaces can be disinfected with a solution of one cup of bleach to five gallons of water.

"That little spot of mold can grow in the home especially in the heat of the South," said Dr. Parham Jaberi of the Louisiana Department of Health.

If mold covers more than 100 square feet, a trained mold remover is recommended, he said.

Johnson reported from Chicago.

Copyright Associated Press / NBC New York



Photo Credit: Gerald Herbert/AP]]>
<![CDATA[2 NJ Cities Among Least Cancer-Prone in the US: Reports]]>Fri, 25 Aug 2017 14:24:24 -0500https://media.nbcnewyork.com/images/213*120/jersey+city+1.jpg

Two New Jersey cities are among the top cities where residents are least likely to get cancer, reports say.

Jersey City and Newark are both in the top 10 least cancer-prone cities of 100 cities ranked, according to Men’s Health.

Between the two cities, Jersey City came out on top, ranking as the fourth healthiest city when it comes to the risk of getting cancer.

Jersey City has the fourth lowest smoking rate on the list. It also ranked second for the least number of residents diagnosed with cancer and second for the least number of inflammatory diseases, which can cause tumors to grow and cancer to spread, according to the scientific journal Cell, according to Men’s Health.

The report also credits New Jersey’s health initiative program, the Partnership for a Healthier New Jersey, as lowering the risk of cancer in Jersey City and the state. The program has increased the number of primary health care providers and promoted healthy recreational activities like walking and biking.

Meanwhile, Newark was the ninth least cancer-prone city on the list. Despite its large, international airport and history of industry, the city is chock-full of young people, with its affordable housing in close proximity to New York. More than half of the city’s population is under 35 years old, and most cancers are diagnosed in older adults, according to Men’s Health.

Newark’s residents also report eating their fruits and veggies and not binge drinking too much, which pushed it up on the list, the report said. However, of all the cities ranked, Newark had the greatest percentage of residents at an unhealthy weight, which is a factor in a significant number of cancers.

Two other tri-state cities made the list: Bridgeport, Connecticut, was the 22nd least cancer-prone city and New York City was the 34th least cancer-prone.



Photo Credit: File photo]]>
<![CDATA[Aetna Envelope Window Reveals Patients' HIV Status: Lawyers]]>Fri, 25 Aug 2017 12:33:38 -0500https://media.nbcnewyork.com/images/213*120/aetna-HIV-letter.jpg

Two legal organizations say health insurer Aetna revealed the HIV status of patients in several states by mailing envelopes with a large, clear window that showed information on purchasing HIV prescriptions.

The Legal Action Center and the AIDS Law Project of Pennsylvania claim some patients' relatives and neighbors learned of their HIV status as a result.

Aetna said that "this type of mistake is unacceptable" and that the company is reviewing processes to ensure it never happens again.

The Hartford, Connecticut-based Aetna started notifying customers of the breach in letters sent this week.

The legal organizations sent a cease-and-desist letter to Aetna. They want the insurer to show what corrective measures are being taken.

Patients were in Arizona, California, Georgia, Illinois, New Jersey, New York, Ohio, Pennsylvania and Washington, D.C.


Copyright Associated Press / NBC New York



Photo Credit: Legal Action Center]]>
<![CDATA[Trump Administration Cuts Funding to Teen Pregnancy Programs]]>Fri, 25 Aug 2017 05:24:58 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-3155076.jpg

The U.S. has experienced a drastic drop in teen pregnancies, which many hail as proof of the effectiveness of an Obama-era federal grant program, NBC News reported.

Started in 2010, the Teen Pregnancy Prevention Program gives $89 million a year to 81 organizations around the country. It was renewed in 2015 for another five years.

But a letter from the Department of Health and Human Services dated July 3 shows that the Trump administration is slashing more than $200 million from the program without warning — meaning funding is now slated to end in June 2018, not in 2020.

The abrupt funding cut to teen pregnancy prevention, at a time when teenage births are at historic lows, has been called "highly unusual" by Senate Health Committee Democrats, especially since Congress has yet to vote on the 2018 appropriations bill.



Photo Credit: David Paul Morris/Getty Images, File]]>
<![CDATA[Lone Uncovered US County Gets Insurer for Health Exchange]]>Thu, 24 Aug 2017 13:49:44 -0500https://media.nbcnewyork.com/images/200*120/dremergencyroom_1200x675.jpg

The lone county currently at risk of going uncovered on the federal health law's insurance exchanges has landed an insurer.

Ohio-based insurer CareSource will step up to provide health insurance coverage in Paulding County, Ohio, in 2018, the company and the state Department of Insurance announced Thursday.

The most recent national analysis by the Kaiser Family Foundation identified Paulding, just south of Toledo, as the final county still at risk of lacking a provider when 2018 signups begin Nov. 1. About 10 million people, including 11,000 Ohio residents, currently are served through HealthCare.gov and its state counterparts, a system created under the Affordable Care Act.

Earlier this year, well over 40 mostly rural counties faced the prospect of having no options for their exchanges, but insurers have gradually come forward to fill the gaps.

Insurers began pulling back from the exchanges after getting stung by heavy losses and struggling to attract enough young, healthy customers to balance all the claims they get from people who use their coverage. Many also cited uncertainty over the future of President Barack Obama's health care law, which Congress is revisiting — though, so far, without success.

Rural counties have been particularly uninviting for insurance companies because they usually have a smaller, older customer base and a care provider like a hospital system with a dominant market position. That can make it difficult to negotiate payment rates.

Health care consultant Robert Laszewski, a former insurance executive, said exchange coverage is a small, difficult slice of business for most insurers. Still, companies are expanding to fill the holes that develop in these markets, often after nudging from state regulators.

"Good, long-term relationships with the insurance commissioner are very important to an insurance company," Laszewski said.

Some insurers also have figured out they can make money on exchanges by targeting low-income customers, who receive big tax credits to help cover their insurance bills that can both insulate consumers and provide steady revenue to insurers.

In Ohio, 20 of 88 counties were threatened with a lack of coverage as insurers withdrew. State officials had previously announced coverage was restored to the other 19.

Republican Gov. John Kasich has been part of a bipartisan governors' group calling for action in Washington to strike a compromise on the embattled health care law, which many Republicans revile as "Obamacare," in order to stabilize insurance markets.

While insurers now have made preliminary plans to sell coverage on the exchanges in every U.S. county next year, they still have about a month to back out.

They are worried about the fate of billions of dollars in payments from the government to cover cost-sharing reductions for customers with modest incomes.

These payments reimburse insurers for lowering deductibles and other out-of-pocket expenses for customers. They are separate from the income-based tax credits that help people buy coverage.

The federal government announced last week that it will make these payments for this month, but their future is unclear. President Donald Trump has repeatedly threatened to end them, and insurers say premiums will soar for some of their plans if this happens.

California-based insurer Molina Healthcare has said it will increase premiums 55 percent next year for its exchange business, under the assumption that the cost-sharing reduction subsidies will not return. That premium increase would have been 30 percent if the insurer assumed that the subsidies would return.

CareSource President and CEO Pamela Morris expressed her company's commitment to the exchange, also called the Marketplace. The company had been one of the insurers to cover some other counties that lost their exchange options.

"The Marketplace provides vital health care coverage to more than 10.3 million Americans and we want to be a resource for consumers left without options," she said in a statement. "Our decision to offer coverage in the bare counties speaks to our mission and commitment to the Marketplace and serving those who are in need of health care coverage."

Ohio State Insurance Director Jillian Froment said working through the challenge of covering affected counties has been a priority of her staff in recent weeks.

"There is a lot of uncertainty facing consumers when it comes to health insurance and these announcements will provide important relief," she said.

AP Health Writer Tom Murphy reported from Indianapolis. Data editor Meghan Hoyer contributed from Washington, D.C.

 

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Parents Add Drug Tests to Back-to-School Routines]]>Thu, 24 Aug 2017 10:30:23 -0500https://media.nbcnewyork.com/images/213*120/NC_drugtests0823_1500x845.jpg

Parents, worried about drug abuse and the country's rising opioid epidemic, are adding drug tests to their child's back-to-school routines this fall in places like Cincinnati, Ohio. Drug testing companies say parents test for amphetamines, barbiturates, cocaine and marijuana use, among others. ]]>
<![CDATA[Personal Tragedy Sets NJ Parents on a Mission]]>Wed, 23 Aug 2017 17:03:26 -0500https://media.nbcnewyork.com/images/213*120/Personal_Tragedy_Sets_NJ_Parents_on_a_Mission.jpg

A mother and father who lost their son to heart problems have set up an organization in their boy's name to help save other children. Pat Battle reports.]]>
<![CDATA[Backyard Chickens, Ducks Linked to Salmonella Cases: CDC]]>Tue, 22 Aug 2017 23:36:14 -0500https://media.nbcnewyork.com/images/213*120/CHICKENS6.jpg

Recent salmonella outbreaks may be linked to backyard poultry, according to the Centers for Disease Control and Prevention.

In an outbreak advisory released Monday, the CDC said there have been 961 cases in 48 states and Washington, D.C., so far this year. Of the nearly 1,000 cases, 215 resulted in hospitalization and one in death.  

In tracking the illnesses, the CDC said 74 percent of those who got sick reported that they'd had contact with live poultry in the week before the illness started.

The federal agency and multiple states are investigating 10 separate multistate outbreaks of salmonella infections in people who had contact with backyard flocks. The CDC said chickens, ducks and their young can be carrying the salmonella bacteria but appear healthy and clean with no signs of illness.

The agency recommends always washing hands thoroughly with soap and water right after touching live poultry. They said children younger than 5 years old should not handle or touch live poultry without adult supervision.

There have been 56 reported cases of salmonella in Virginia — the highest number reported in the United States — seven in Maryland, and one in D.C. 



Photo Credit: Getty Images (File)]]>
<![CDATA[Signs of Potential Eye Damage After Watching Eclipse: Expert]]>Tue, 22 Aug 2017 23:20:01 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-835902046.jpg

Experts have long warned that watching a solar eclipse without proper eyewear can lead to potential damage in your eyes. 

But what might that damage look like? 

Dr. Linda Chous, chief eye care officer for UnitedHealthcare, helps answer that question. 

If you’ve looked at the eclipse without glasses, do you feel the adverse effects immediately or over time?
It is unsafe for anyone to look directly at the sun for any length of time or during an eclipse, as damage can occur within seconds of exposure. The sun is incredibly bright – some 400,000 times brighter than a full moon. Any amount of exposure can cause short-term and long-term damage.

If immediately, what are the signs?
Short-term issues can include solar keratitis, which is similar to sunburn of the cornea (the front part of the eye). This can cause eye pain and light sensitivity, with symptoms often occurring within 24 hours after exposure.

If over time, what are the things you should look for?
Long-term issues can include solar retinopathy, which is when the sun burns a hole in the retinal tissues, usually occurring at the fovea. This can cause loss of central vision, with symptoms occurring immediately to two weeks after exposure. Depending on the severity of the retinopathy, vision problems can last for months or be permanent.

How do you know if you might have damaged your retina/vision?
There are often no immediate signs of eye damage after viewing an eclipse without proper eye protection. Symptoms can occur immediately, within several hours or even weeks after exposure. Potential signs of damage include sensitivity to light, eye pain and loss of vision in one or both eyes.

Is there anything you can do immediately following viewing without the glasses?
Visit a local eye care professional for a comprehensive exam if you or a family member experience discomfort or vision problems following the eclipse. It is important to note there can be a delayed response to any damage incurred during an eclipse, with symptoms showing up hours later.



Photo Credit: Getty Images]]>
<![CDATA[Docs Criticize Move by Top Drug Middleman to Limit Opioids ]]>Thu, 17 Aug 2017 10:54:02 -0500https://media.nbcnewyork.com/images/213*120/Opioid-Pills1.jpg

The nation's largest pharmacy benefit manager will soon limit the number and strength of opioid drugs prescribed to first-time users as part of a wide-ranging effort to curb an epidemic affecting millions of Americans.

But the new program from Express Scripts is drawing criticism from the American Medical Association, the largest association of physicians and medical students in the U.S., which believes treatment plans should be left to doctors and their patients.

About 12.5 million Americans misused prescription opioids in 2015, according to the U.S. Department of Health and Human Services. More than 33,000 deaths that year were blamed on opioid overdoses.

Express Scripts launched a yearlong pilot program in 2016 aimed at reducing patients' dependency on opioids and the risk of addiction, said Snezana Mahon, the Missouri-based company's vice president of clinical product development.

Mahon said analysis of 106,000 patients in the pilot program showed a 38 percent reduction in hospitalizations and a 40 percent reduction in emergency room visits, compared to a control group. The program is scheduled to take effect nationwide on Sept. 1 for Express Scripts members whose employer or health insurer has enrolled to participate.

Under the program, new opioid users are limited to seven-day prescriptions, even if the doctor orders scripts for much longer. Mahon said the average prescription is for 22 days.

The program also requires short-acting drugs for first-time opioid prescriptions, even though many doctors prescribe long-acting opioids. Dosage is also limited, and the company will monitor and try to prevent for patterns of potential "pill shopping," where a patient goes from doctor to doctor to collect prescriptions.

The program does not apply to patients in hospice or palliative care, or to cancer patients.

A competitor, CVS Caremark, has a similar program.

"A lot of times physicians are prescribing these drugs blindly," Mahon said. "They don't know that a patient may be going to see multiple prescribers."

She said some physicians "are actually appreciative and saying, 'Thank you, I didn't know this was happening.'"

But Dr. Patrice Harris, an Atlanta psychiatrist who chairs the American Medical Association's Opioids Task Force, said doctors are already working toward addressing the opioid epidemic.

Harris said doctors have reduced such prescriptions by 17 percent over the past couple of years and are directing patients to other forms of pain management, including physical therapy and cognitive behavioral therapy.

"We want to be pro-active in making sure the alternatives are available, versus a sort of blunt, one-size-fits-all-all approach regarding the number of prescriptions," Harris said. "The AMA's take has always been that the decision about a specific treatment alternative is best left to the physician and their patient."

Express Scripts said that if a doctor wants a patient to have more than a seven-day supply of medication, he or she can request it. Harris said those additional steps create an administrative burden for the doctor, "but more importantly they delay care for the patient."

Harris said the AMA has not contacted Express Scripts to raise concerns about the program or taken any action to stop it.

The U.S. Food and Drug Administration already requires label warnings about misuse on all prescription medications, but Express Scripts will take the additional step of sending a letter to new opioid patients warning about the dangers of misuse and addiction.

CVS Caremark already has a 10-day limit on opioids and limits the dosage, the company said. Patients must start on short-acting drugs, and physicians are required to regularly assess patients using opioid prescriptions.

CVS Caremark also has a monitoring process to identify pill shopping and other forms of misuse or fraud, and works with its retail pharmacies to review "prescribing trends and irregular behavior and with physicians to ensure appropriate therapy for patients with chronic pain," spokeswoman Christine Cramer said in an email.

Express Scripts also is providing data analytics as part of Missouri's new prescription drug-monitoring program. Republican Gov. Eric Greitens announced details last month at the Express Scripts corporate headquarters in suburban St. Louis. Missouri was the last state without a program to track prescription drugs.

Copyright Associated Press / NBC New York



Photo Credit: John Moore / Getty Images ]]>
<![CDATA[Teen Overdose Death Rate Doubles]]>Thu, 17 Aug 2017 10:21:35 -0500https://media.nbcnewyork.com/images/213*120/NC_teenoverdoses0816_1500x845.jpg

A new report from the Centers for Disease Control and Prevention show a steep increase in fatal drug overdoses involving teenagers ages 15 - 19 since 2015 after years of decline. Deaths from fatal drug overdoses doubled, with most cases stemming from opioid use. ]]>
<![CDATA[Overdoses on the Road: Drugged Driving Rises as a Menace]]>Thu, 17 Aug 2017 10:13:24 -0500https://media.nbcnewyork.com/images/180*120/GettyImages-517238888.jpg

An SUV crashed after all four occupants overdosed on heroin in North Carolina. The same day, a man in Williamsport, Pennsylvania, grabbed the steering wheel after his grandson lost consciousness while driving. Police in the city of 30,000 responded to 11 other overdose reports that day, including a woman who crashed her car just before a highway entrance.

The next day in Cleveland, a rescue squad found an unconscious 43-year-old man who had driven off the road and hit a pole. An overdose antidote brought him back around, police say. He was seriously hurt from the crash and was cited for driving under the influence.

Car crashes caused by overdosing drivers are becoming so commonplace, authorities say, that some rescue crews immediately administer the antidote, naloxone, to any unresponsive driver they find at an accident scene.

People who use heroin and related drugs are sometimes so eager to get high, or so sick from withdrawal, that they'll shoot up in the car as soon as they get their hands on more, police say. Often they're back on the road before the overdose takes hold, and they lose consciousness, a recipe for traffic accidents.

"There's no waiting period like we used to see with other drugs where you go buy it, then go home and get high, or go to a party and get high," said Scott Houston, a major with the sheriff's office in Pamlico County, North Carolina, where the SUV crashed June 29. "We don't see that anymore."

Police in New Hampshire charged a man with driving under the influence June 7 after he allegedly shot up heroin before crashing into a parked tractor-trailer in Manchester.

A man who shot up in a Kmart parking lot in Iowa City, Iowa, in March crashed his car and was revived with naloxone. Last month, according to police, he led them to the dealer who sold him heroin laced with the potent opioid acrylfentanyl.

In June 2016 in Kalamazoo, Michigan, a man named Charles Pickett Jr. allegedly took a handful of pain pills and muscle relaxers and plowed his pickup truck into a group of bicyclists , killing five of them. Police at the scene said he was "completely out of it."

Pickett's attorney said he intends to use an insanity defense against charges that include second-degree murder. Pickett's trial is set for Sept. 18. If convicted, he could face life in prison.

Two years ago, Koriann Evans had just picked up her 2-year-old son and 5-year-old daughter from her mother's when her dealer reached out to her. She shot up in a parking lot in Fremont, Ohio, and then headed down the road.

Within a few minutes, she couldn't breathe. With her children in the back, Evans managed to stop in the middle of the road with her foot on the brake before passing out. Nearby residents pulled her and her children from the car and called authorities. Rescuers told her she would have died quickly without the naloxone she was given.

Now more than two years sober, the 36-year-old Evans works in a vinyl siding factory while trying to become a substance abuse counselor. She lost custody of her children but sees them regularly.

"I knew from that point on that something had to change within me, because the reality is that my addiction, my use almost killed me, my two kids and possibly somebody else," Evans said.

Drunken-driving deaths are on the decline, dropping 24 percent since 2006, according to the National Highway Traffic Safety Administration. Meanwhile, deaths in crashes involving drugs are soaring.

Ohio saw 4,615 drug-related crashes last year, an increase of more than 21 percent since 2013, according to the state Department of Transportation. The data aren't broken down by type of drug. Pennsylvania saw a similar spike, with drugged-driving crashes jumping from 3,019 in 2011 to 4,078 last year.

Nationally, fatalities in crashes where drugs were involved soared from 2,003 in 1993 to 7,438 in 2015, according to the most recent data from the National Highway Traffic Safety Administration. The data reflect only the presence of drugs in a driver, not whether the drugs caused the crash.

In Columbus, the number of emergency runs by the fire department involving naloxone administered to someone in a vehicle has jumped each of the past three years and is headed for another record this year, according to fire department statistics.

Many of the runs involve people overdosed in parked cars, whether in parking lots, near their homes or sitting in the middle of an intersection after they nodded off.

Some people using drugs are known to purposely shoot up in running cars with their foot on the brake, figuring that if they pass out, the car will move and alert someone to their condition, said James Davis, assistant fire chief.

Fire-rescue personnel are "carting naloxone and giving it blindly up the nose in a nasal-spray type of delivery system," said Kennard Skaggs, a national representative for the labor union International Association of EMTs and Paramedics. "They don't know exactly whether or not the person is taking (opioids), but it can't hurt."

Copyright Associated Press / NBC New York



Photo Credit: John Moore/Getty Images, File]]>
<![CDATA[Arkansas Can Block Planned Parenthood Money: Federal Court]]>Wed, 16 Aug 2017 15:26:19 -0500https://media.nbcnewyork.com/images/213*120/arkansasabortion_1200x675.jpg

A federal appeals court panel ruled Wednesday that Arkansas can block Medicaid funding to Planned Parenthood, two years after the state ended its contract with the group over videos secretly recorded by an anti-abortion group.

In a 2-1 ruling, an 8th U.S. Circuit Court of Appeals panel vacated preliminary injunctions a federal judge issued preventing the state from suspending any Medicaid payments for services rendered to patients from Planned Parenthood. Republican Gov. Asa Hutchinson ended the state's Medicaid contract with the organization in 2015.

The court ruled the unnamed patients suing the state did not have the right to challenge the defunding decision. The panel did not directly address Arkansas' reason for terminating the contract.

The decision could potentially lead to a showdown before the U.S. Supreme Court over efforts by Arkansas and several other states to defund Planned Parenthood that have been blocked by other courts. In a dissenting opinion to Wednesday's ruling, Judge Michael Melloy noted that several other federal courts have ruled the opposite way on defunding and said the patients have a right to challenge the end of Planned Parenthood's contract.

U.S. District Judge Kristine Baker initially ordered the state to continue the payments to three patients who had sued over the move and later expanded that order to anyone who seeks or wants to obtain services from the organization's health centers in Arkansas.

Planned Parenthood said it's evaluating options for challenging the appeals court's decision. The ruling does not take effect until the court issues its mandate in about one to two weeks, and Planned Parenthood said it's still serving Medicaid patients in Arkansas.

"We will do everything in our power to protect our patients' access to birth control, cancer screenings, and other lifesaving care," Dr. Raegan McDonald-Mosley, chief medical officer for Planned Parenthood Federation of America, said in a statement. "Extreme politicians are trying to defund and shut down Planned Parenthood — and this is not what Americans want. Every person deserves the opportunity to lead a healthy life and access care at a provider they know and trust, no matter who you are or where you live."

Attorney General Leslie Rutledge praised the court's ruling.

"The Court found that Planned Parenthood and the three patients it recruited could not contest in federal court Arkansas's determination that a medical provider has engaged in misconduct that merits disqualification from the Medicaid program," Rutledge, a Republican, said in a statement. "All patients should have access to ethical, quality and responsible health care, and should never be beholden to a company that is only seeking to protect its profits."

The state has said Planned Parenthood received $51,000 in Medicaid funds in the fiscal year before Hutchinson's decision to terminate the contract. None of the money paid for abortions. Planned Parenthood operates health centers in Fayetteville and Little Rock.

Republican lawmakers and governors around the country targeted the organization after several videos were released by the anti-abortion Center for Medical Progress. The center said the videos showed that Planned Parenthood illegally sells fetal tissue for profit. Planned Parenthood said the videos were heavily edited and denied seeking any payments beyond legally permitted reimbursement of costs. A Texas grand jury that looked into the videos cleared Planned Parenthood of misusing fetal tissue

The decision is the latest in a series of federal court fights over efforts in solidly Republican Arkansas to limit abortion.

Baker last month blocked Arkansas from enforcing four new abortion restrictions, including a ban on a common second-trimester procedure. Another federal judge is weighing whether to halt another new law that would allow Arkansas to suspend or revoke an abortion clinic's license for any violation. In a separate case, the 8th Circuit last month vacated another preliminary injunction Baker issued preventing Arkansas from enforcing new limits on how the abortion pill is administered.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Danny Johnston]]>
<![CDATA[If Trump Cuts Obamacare Subsidies, Premiums Will Spike: CBO]]>Tue, 15 Aug 2017 13:45:28 -0500https://media.nbcnewyork.com/images/213*120/AP_17206719818863.jpg

The Congressional Budget Office says Obamacare premiums will increase by 20 percent next year and by 25 percent in 2020 — if President Donald Trump ends key federal subsidies to the program.

The CBO report released Tuesday also found that if the administration moves to cut the billions in subsidies to insurers, that would leave about 5 percent of Americans living in areas with no access to individual health care plans.

As CNBC reports, Trump has repeatedly threatened to end the billions of dollars in payments to insurance companies that sell individual health plans under the Affordable Care Act.

Insurers have warned they will be forced to raise premiums sharply to make up for the loss of cost-sharing reductions payments, or CSRs, if Trump cuts them off.



Photo Credit: Alex Brandon/AP (File)]]>
<![CDATA[Apple, Aetna Meeting to Bring Apple Watch to Aetna: Sources]]>Mon, 14 Aug 2017 13:25:56 -0500https://media.nbcnewyork.com/images/213*120/applewatchcolorful-1200x675.jpg

Apple and Aetna held secret meetings last week to bring Apple's health- and fitness-tracking device, Apple Watch, to Aetna customers, according to three sources who spoke with CNBC. 

Aetna, which covers an estimated 23 million people, is negotiating a deal with Apple to either provide the smartwatch for free or at a discounted rate to its members. 

Recently, Apple has focused on developing new health sensors for people with chronic disease, according to a CNBC report in April.

Apple Watch recently surpassed Fitbit as the top-selling health-tracking device, after shipments reached an estimated 22 million in early 2017. 



Photo Credit: Justin Sullivan/Getty Images, File]]>
<![CDATA[A Stronger Medicaid Emerges From GOP Health Overhaul Debate]]>Mon, 14 Aug 2017 07:32:35 -0500https://media.nbcnewyork.com/images/213*120/809452094-Medicaid-protests.jpg

Medicaid, a 1960s Great Society pillar long reviled by conservatives, seems to have emerged even stronger after the Republican failure to pass health overhaul legislation.

The federal-state health insurance program for low-income Americans hasn't achieved the status of Social Security and Medicare, considered practically untouchable by politicians, like an electrified "third rail." But it has grown to cover about 1 in 5 U.S. residents, ranging from newborns to Alzheimer's patients in nursing homes, and even young adults trying to shake addiction. Middle-class working people are now more likely to personally know someone who's covered.

Increased participation — and acceptance — means any new GOP attempt to address problems with the Affordable Care Act would be unlikely to achieve deep Medicaid cuts.

"This was an important moment to show that people do understand and appreciate what Medicaid does," said Matt Salo, executive director of the National Association of Medicaid Directors, a nonpartisan group that represents state officials. "The more people understand what Medicaid is and what it does for them, the less interested they are in seeing it undermined."

With Republicans in control of the White House, both chambers of Congress, and 34 out of 50 governorships, it would have been hard to imagine a more politically advantageous alignment for a conservative overhaul of Medicaid.

President Barack Obama's Affordable Care Act expanded Medicaid to cover more low-income adults, many of them working jobs without health insurance. Thirty-one states have accepted the ACA's expansion, covering about 11 million people.

The GOP bills would have phased out funding for the Obama expansion, but they also placed a limit on future federal spending for the entire program — a step now seen as overreach.

The per-beneficiary spending caps in the House and Senate bills translated to deep cuts that divided Republicans.

Also, GOP governors who had expanded the program couldn't swallow the idea of denying coverage to hundreds of thousands of constituents. Some Republican governors went public with their opposition, while others quietly warned their congressional delegations about dire consequences.

"I think there is a recognition among many that Medicaid is not just a welfare program but an underpinning of our social system," said Diane Rowland of the Kaiser Family Foundation.

An AP-NORC poll taken last month found the public overwhelmingly opposed to GOP Medicaid cuts, by 62-22.

"You just can't do this to people who are in situations that they didn't put themselves in," said Sara Hayden of Half Moon Bay, California. Unable to work as a data journalist due to complications of rheumatoid arthritis, she was able to get health insurance when her state expanded Medicaid.

Hayden estimates that one of the medications she takes for the disease would cost about $16,000 a month if she were uninsured. She pays nothing with Medi-Cal, as the Medicaid program is known in California.

"If they are going to repeal and replace, then I am dead in the water," she said.

Brian Kline of Quakertown, Pennsylvania, works as a customer service representative, and got coverage after his state expanded Medicaid in 2015. Early last year he was diagnosed with colon cancer following a colonoscopy. After treatment that Medicaid paid for, his last CT scan was clear.

"You just wonder if the Republican bill had passed...what would have happened to me?" said Kline. "Would I have had access to my doctors and the tests to make sure my cancer didn't come back? I'm not sure what the answer to that question would have been."

Many Republicans view Obama's Medicaid expansion as promoting wasteful spending, because the federal government pays no less than 90 percent of the cost of care, a higher matching rate than Washington provides for the rest of the program.

"That is not a good recipe for encouraging states to implement better, lower-cost models of care," said Mark McClellan, who oversaw Medicare and Medicaid under former President George W. Bush.

Nonetheless, the debate showed Congress can't just elbow its way to a Medicaid overhaul.

'You are going to have to be gentle and thoughtful, working in a bipartisan way to see what ideas will reach across the aisle," said Republican economist Gail Wilensky, also a former Medicare and Medicaid administrator.

The push for Medicaid changes will now shift to the states. Some on the political right are seeking federal approval for work requirements and drug testing. But activists in the 19 states that have not yet expanded their programs are contemplating revived campaigns.

An area that could find bipartisan support is health promotion, since Medicaid beneficiaries tend to have higher rates of smoking and other harmful lifestyle factors.

Katherine Hempstead, who directs health insurance research for the nonpartisan Robert Wood Johnson Foundation says Medicaid has come out a "winner" in the debate.

"Medicaid has shown itself to be very much appreciated by a broader constituency than we might have originally thought," she said. "And that is an important takeaway."

Copyright Associated Press / NBC New York



Photo Credit: Drew Angerer/Getty Images]]>
<![CDATA[Student Seeking Paramedic Internship Saves Choking Man]]>Fri, 11 Aug 2017 12:50:16 -0500https://media.nbcnewyork.com/images/213*120/ambulance+GettyImages-478895016.jpg

A man who started choking in a coffeehouse was saved by a California State University, Sacramento student who was waiting to interview for a paramedic internship.

Coastal Peaks Coffee owner Mike Knight tells The Tribune he was leaving his office Wednesday to go into the San Luis Obispo establishment's cafe area when he heard someone choking and saw a young man quickly come to the man's aid.

The student, Will Stewart, was waiting with other candidates for internships with San Luis Ambulance.

He tells the newspaper he saw the man choking and performed the Heimlich maneuver.

Fred Motlo, a San Luis Ambulance field supervisor, says Stewart didn't mention the incident during the internship interview and they did not find out about it until later.

Stewart got the internship.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images, File]]>
<![CDATA[Looking into the Future: Online Eye Exams]]>Fri, 11 Aug 2017 10:12:35 -0500https://media.nbcnewyork.com/images/213*120/MD02F_1200x675_1022508099586.jpg

An online eye exam that you can take on a computer, in the comfort of your home. Seems like the perfect solution for busy people who may not have time to see the eye doctor. Yet, the increasingly popular tests have left many in the medical community skeptical.]]>
<![CDATA[5 Die After Being Fitted With Obesity Devices, FDA Says]]>Fri, 11 Aug 2017 10:16:20 -0500https://media.nbcnewyork.com/images/213*120/cms794.jpg

At least five people have died after receiving gastric balloons to help them lose weight, the Food and Drug Administration said Thursday. 

It’s unclear whether the balloons or the surgery to implant them could have caused the deaths, but the FDA issued an alert to doctors to monitor patients who have the devices, according to NBC News. The balloons are intended to treat severe obesity by reducing how much a person can eat by filling the stomach, closing off part of the stomach or surgically reducing stomach volume.

Two different balloon devices have been involved in reports of the deaths, which came as quickly as a day after surgery: one made by Apollo Endo-Surgery, the other by ReShape.

Apollo said the company has sold 180,000 of Orbera balloon devices worldwide.



Photo Credit: AP Photo/Andrew Harnik, File]]>
<![CDATA[1 in 3 Cancer Patients Face Unexpected Costs: Study]]>Thu, 10 Aug 2017 13:34:05 -0500https://media.nbcnewyork.com/images/214*120/Screen+Shot+2017-08-10+at+11.30.52+AM.png

A Duke University study found more than a third of cancer patients with health insurance faced out-of-pocket costs that were more than they expected. Researchers say patients with unexpected costs are less willing to pay for care and may skip or opt out of necessary treatments.]]>
<![CDATA[The Freshman 15 Is a Myth]]>Thu, 10 Aug 2017 09:19:39 -0500https://media.nbcnewyork.com/images/213*120/freshman15.jpg

Incoming college students have long feared the freshman 15, the alleged 15 pound weight gain common among first year students. But studies suggest this concept is nothing more than a myth, NBC News reported.

Only 10 percent of students end up gaining 15 pounds or more. Fluctuation in weight is still common for freshmen, but students typically gain an average of 7.5 pounds.

For some students, stress and other factors can actually trigger weight loss. It’s worth noting that the peak age for eating disorders is 18 to 21, right around the time students first enter college.

There are many measures students can take to maintain a healthy weight as they leave home for the first time. Establishing a routine meal schedule and limiting snacking will help make the adjustment easier. Getting a good night’s sleep and working to keep stress levels low will also help.



Photo Credit: Justin Sullivan / Getty Images ]]>
<![CDATA[Trump Actions Trigger Health Premium Hikes for 2018: Study]]>Thu, 10 Aug 2017 06:35:54 -0500https://media.nbcnewyork.com/images/213*120/821754746-Trump-Victims-of-Obamacare.jpg

The Trump administration's own actions are triggering double-digit premium increases on individual health insurance policies purchased by many consumers, a nonpartisan study has found.

The analysis released Thursday by the Kaiser Family Foundation found that mixed signals from President Donald Trump have created uncertainty "far outside the norm," leading insurers to seek higher premium increases for 2018 than would otherwise have been the case.

The report comes with Republicans in Congress unable to deliver on their promise to repeal and replace the Obama-era Affordable Care Act. Trump, meanwhile, insists lawmakers try again. The president says "Obamacare" is collapsing, but he's also threatened to give it a shove by stopping billions of dollars in payments to insurers. Some leading Republicans are considering fallback measures to stabilize markets.

Researchers from the Kaiser foundation looked at proposed premiums for a benchmark silver plan across major metropolitan areas in 20 states and Washington, D.C. Overall, they found that 15 of those cities will see increases of 10 percent or more next year.

The highest: a 49 percent jump in Wilmington, Delaware. The only decline: a 5 percent reduction in Providence, Rhode Island.

About 10 million people who buy policies through HealthCare.gov and state-run markets are potentially affected, as well as another 5 million to 7 million who purchase individual policies on their own.

Consumers in the government-sponsored markets can dodge the hit with the help of tax credits that most of them qualify for to help pay premiums. But off-marketplace customers pay full freight, and they face a second consecutive year of steep increases. Many are self-employed business owners.

The report also found that insurer participation in the ACA markets will be lower than at any time since "Obamacare" opened for business in 2014. The average: 4.6 insurers in the states studied, down from 5.7 insurers this year. In many cases insurers do not sell plans in every community in a state.

The researchers analyzed publicly available filings through which insurers justify their proposed premiums to state regulators. To be sure, insurers continue to struggle with sicker-than-expected customers and disappointing enrollment. And an ACA tax on the industry is expected to add 2 to 3 percentage points to premiums next year.

But on top of that, the researchers found the mixed signals from the administration account for some of the higher charges. Those could increase before enrollment starts Nov. 1.

"The vast majority of companies in states with detailed rate filings have included some language around the uncertainty, so it is likely that more companies will revise their premiums to reflect uncertainty in the absence of clear answers from Congress or the administration," the report said. Once premiums are set, they're generally in place for a whole year.

Insurers who assumed that Trump will make good on his threat to stop billions in payments to subsidize copays and deductibles requested additional premium increases ranging from 2 percent to 23 percent, the report found.

Insurers who assumed the IRS under Trump will not enforce unpopular fines on people who remain uninsured requested additional premium increases ranging from 1.2 percent to 20 percent.

"In many cases that means insurers are adding double-digit premium increases on top of what they otherwise would have requested," said Cynthia Cox, a co-author of the Kaiser report. "In many cases, what we are seeing is an additional increase due to the political uncertainty."

That doesn't sound like what Trump promised when he assumed the presidency.

In a Washington Post interview ahead of his inauguration, Trump said, "We're going to have insurance for everybody."

"There was a philosophy in some circles that if you can't pay for it, you don't get it," he added. "That's not going to happen with us."

People covered under Obama's law "can expect to have great health care," Trump said at the time. "It will be in a much simplified form. Much less expensive and much better."

But the White House never produced the health care proposal Trump promised. And the GOP bills in Congress would have left millions more uninsured, a sobering side-effect that contributed to their political undoing.

The Trump administration sidestepped questions about its own role raised by the Kaiser study.

Spokeswoman Alleigh Marre said rising premiums and dwindling choices predate Trump.

"The Trump administration is committed to repealing and replacing Obamacare and will always be focused on putting patients, families, and doctors, not Washington, in charge of health care," Marre said in a statement.

The ongoing political turmoil for people who buy individual health insurance stands in sharp contrast to relative calm and stability for the majority of Americans insured through workplace plans. The cost of employer-sponsored coverage is expected to rise around 5 or 6 percent next year, benefits consultants say.

Associated Press Health Writer Tom Murphy contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: Chris Kleponis - Pool/Getty Images, File]]>
<![CDATA[Lawsuit: CVS Charges More for Drugs Paid for With Insurance]]>Thu, 10 Aug 2017 05:16:34 -0500https://media.nbcnewyork.com/images/213*120/cvsgeneric_1200x675.jpg

A California woman sued CVS Health Corporation Monday, accusing the company of charging customers more when they use insurance to pay for certain generic prescriptions, NBC News reported.

Megan Schultz claims in the lawsuit that she paid $165.68 for a prescription at CVS, America's largest pharmacy chain. Had she bought the same drug without using insurance, she said it would have only cost $92.

"CVS never told her that paying in cash would allow her to pay 45% less for the drug," the complaint says, claiming that the higher costs come from the pharmacy overcharging and remitting the excess payments to its pharmacy benefit manager, which negotiates between the insurance company and pharmacy.

CVS denied the allegations, responding in a statement that they "are built on a false premise and are completely without merit."



Photo Credit: Scott Olson/Getty Images, File]]>
<![CDATA[Americans’ Use of Alcohol Is on the Rise: Study]]>Thu, 10 Aug 2017 08:36:21 -0500https://media.nbcnewyork.com/images/213*120/DIT_NAT_ALCOHOL_INCREASE_080917-150230034019500001.jpg

A new study has found an 11 percent increase in alcohol use among Americans between 2002 and 2012. There was an even bigger jump in high-risk drinking and alcohol-use disorders. Women, older adults and racial minorities were found to have increased their alcohol use and abuse the most.]]>
<![CDATA[Infant Mortality Rates Up in Appalachia vs Rest of US: Study]]>Tue, 08 Aug 2017 12:37:33 -0500https://media.nbcnewyork.com/images/213*120/appalachia-infant-mortality.jpg

Placing much of the blame on smoking, a study chronicling the ongoing health crisis in Appalachia has concluded that the 13-state region suffers from a growing disparity in infant mortality and life expectancy, two key indicators of "a nation's health and well-being."

The study, published in the August issue of Health Affairs, compared infant mortality and life expectancy rates in Appalachia with the rest of the United States between 1990 and 2013. It found while the rates were similar in the 1990s, by 2013 infant mortality across Appalachia was 16 percent higher than the rest of the country while life expectancy for adults was 2.4 years shorter.

While the region has been the focus of the opioid epidemic in recent years, the study found one of the biggest culprits was likely the prevalence of smoking and the region's tendency to be "more accepting of tobacco use as a social norm."

Gopal K. Singh, a co-author of the study and a senior health equity adviser with the Health Resources and Services Administration, noted nearly 20 percent of Appalachian women report they smoked during pregnancy. In the rest of the country, it's 8 percent.

"Smoking takes a tremendous toll on the health of Appalachians," the authors wrote.

The study used the federal Appalachian Regional Commission to define the region, which covers 428 counties across 13 states. It includes all of the counties in West Virginia along with some counties in Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee and Virginia.

Heart disease, cancer and other respiratory illnesses were among the leading causes of death throughout the study period, all of which can be caused by using tobacco. Kentucky and West Virginia have some of the highest smoking rates in the nation coupled with some of the lowest cigarette taxes.

In Kentucky, state lawmakers passed a law requiring health insurance companies to cover tobacco cessation medications that have been approved by federal regulators. But they failed to pass a bill that would have banned tobacco products from public school campuses. Just 36 percent of Kentucky's 173 public school districts ban all tobacco products on campus and at school-sponsored events.

"What this report shows is the extreme damage tobacco is causing our people and how we are getting hammered by it worse than any other place in this country," said Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky.

The study found that drug overdoses accounted for 6.3 percent of the life expectancy gap between 2009 and 2013, and it was a likely explanation for why the life expectancy of white women declined between 1990 and 2004 while increasing among white women among the rest of the country.

Singh noted the study only includes date through 2013. Since then, drug overdose deaths in Kentucky and elsewhere have soared because of the availability of heroin and fentanyl, a synthetic opioid that is much more powerful than heroin.

"The contribution of drug overdoses could be higher for the most recent time period," he said.

Other causes included accidental deaths, such as car wrecks. The study noted 30 percent of "unintentional injury deaths" in Appalachia are from car wrecks, which "contributes substantially to the life expectancy gap."

Copyright Associated Press / NBC New York



Photo Credit: Spencer Platt/Getty Images]]>
<![CDATA[Researchers Detail Heroin, Drug Use at Underground US Haven]]>Tue, 08 Aug 2017 14:09:18 -0500https://media.nbcnewyork.com/images/213*120/AP_110511068014-heroin-injection-site-Vancouver.jpg

A safe haven where drug users inject themselves with heroin and other drugs has been quietly operating in the United States for the past three years, a report reveals.

None were known to exist in the U.S. until the disclosure in a medical journal, although several states and cities are pushing to establish these so-called supervised injection sites where users can shoot up under the care of trained staff who can treat an overdose if necessary.

In the report released Tuesday, two researchers said they've been evaluating an underground safe place that opened in 2014. As a condition of their research, they didn't disclose the location of the facility — which is unsanctioned and potentially illegal — or the social service agency running it.

The researchers offered little data, and their main finding was that no one died while injecting at the safe place. There were two overdoses on site, which were reversed by staff members using the overdose medication naloxone.

Advocates and some politicians in recent years have called for government-sanctioned injection sites as the U.S. grapples with the opioid epidemic. More than 52,000 Americans died from drug overdoses in 2015 — the most ever — fueled by soaring abuse of heroin and prescription painkillers. Government statistics for the first nine months of last year, also released Tuesday, show overdose death rates continuing to spiral.

Some say the new report could have an impact on efforts to establish safe injection sites around the U.S. Such sites have been backed by lawmakers in New York, California and other states, along with officials in cities like Seattle, San Francisco and Ithaca, New York.

"It shows people that it's possible" to operate one of these in the U.S., said Lindsay LaSalle, an attorney with Drug Policy Alliance who has helped draft safe haven legislative proposals in six states.

Injection sites are legal in countries including Australia, Canada, Denmark, France, Germany, Luxembourg, the Netherlands, Norway, Spain and Switzerland where medical professionals monitor drug users. They also provide clean needles to prevent the spread of infectious diseases like HIV or hepatitis C. Ideally, they also steer users into treatment and other services.

Some experts say new approaches are needed to fight the opioid epidemic, including safe havens. But they've faced legal and political hurdles. Critics have argued these places may undermine prevention and treatment, and seem to fly in the face of laws aimed at stopping use of deadly illicit drugs.

Safe injection sites are different from syringe exchange programs, which were once controversial but now exist in 33 states.

The underground safe haven is open between four and six hours a day, five days a week, according to Alex Kral, a San Francisco-based researcher with RTI International, and Peter Davidson of the University of California, San Diego. Their report was published online in the American Journal of Preventive Medicine.

The space consists of two rooms — an "injection room" with five stainless steel stations with mirrors and stools and a room next door where users are monitored afterward. There are trained staff on hand, but no one who is medically licensed, according to the researchers. Smoking is not allowed there, but drugs like heroin, pain pills, cocaine and methamphetamine are.

Use of the space was by invitation only. Most visitors are white, homeless men. It was used 2,500 times over two years by over 100 people, although researchers say the exact number of participants isn't known because the facility relies on anonymous surveys.

There's no data on deaths or drug use by clients who injected when the site was closed and it's not known whether any went into treatment, Kral said.

The study also didn't look at issues opponents worry about, like whether creation of a safe place is associated with an increase in people beginning to try drugs, said Jonathan Caulkins, a drug policy expert at Carnegie Mellon University who nonetheless applauded the organization's effort to try to stop overdose deaths.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/The Canadian Press, Darryl Dyck, File]]>
<![CDATA[Opioid Overdoses Have Been Higher Than Thought: Study]]>Tue, 08 Aug 2017 05:40:56 -0500https://media.nbcnewyork.com/images/213*120/AP_17171822298733-hypodermic-needles-syringes-everywhere-.jpg

Deaths from heroin and opioid overdoses may have been underreported by more than 20 percent, according to a new study from the University of Virginia.

Researchers looking into the nation's deadly drug overdose epidemic revisited thousands of death certificates between 2008 and 2014 and found that mortality rates for opioids were 24 percent higher than previously reported, while the mortality rate for heroin was 22 percent higher than previously reported, according to NBC News.

"Opioid mortality rate changes were considerably understated in Pennsylvania, Indiana, New Jersey and Arizona," according to the study, published this week in the American Journal of Preventative Medicine. "Increases in heroin death rates were understated in most states, and by large amounts in Pennsylvania, Indiana, New Jersey, Louisiana and Alabama."

The presidential opioid commission, chaired by New Jersey Gov. Chris Christie, has urged President Donald Trump to "declare a national emergency" to deal with the crisis that, according to the National Institute on Drug Abuse, killed nearly 35,000 across the United States since 2015.



Photo Credit: AP Photo/Charles Krupa, File]]>
<![CDATA[Transgender Medical Center Opens For Kids]]>Thu, 03 Aug 2017 07:53:34 -0500https://media.nbcnewyork.com/images/213*120/NC_transgenderclinic0802_1500x845.jpg

Transgender kids in the St. Louis, Missouri, area now have somewhere to go for medical care and counseling. A transgender medical center opened Tuesday, and it's the first of its kind in the region. The medical facility is expected to help hundreds of children and their families throughout the region with comprehensive health care.]]>
<![CDATA[Public Lactation 'Pods' Open for Nursing Moms in 5 Boroughs]]>Thu, 03 Aug 2017 07:53:32 -0500https://media.nbcnewyork.com/images/213*120/lactation+pod.jpg

The city's Health Department has officially opened five public "lactation pods" -- one in each borough -- for nursing moms. 

Each pod is 4 by 8 feet and a self-contained mobile unit equipped with comfortable benches, a table, an electrical outlet for plugging in breast pumps and a door that can be locked for privacy. 

The lactation pods are now available to the public at Health + Hospitals’ Queens Hospital Center and Harlem Hospital Center; the Bronx Zoo; the Staten Island Children’s Museum; and the Brooklyn Children’s Museum. 

The new pods are part of the city's ongoing efforts to promote and support breastfeeding in communities with the lowest rates of nursing, and to ensure that mothers feel comfortable pumping and breastfeeding in whichever setting they choose. 

In August 2016, Mayor de Blasio signed legislation requiring the Administration for Children’s Services, New York City Human Resources Administration/Department of Social Services and the Department of Health and Mental Hygiene to establish lactation rooms in select locations where social services are offered to the public. There are now more than two dozen locations open, and authorities say they plan to open additional ones as well. Here's a complete list of the public lactation room and pod locations in the city. 

Exclusive breastfeeding is recommended for the first six months of life until one year of age or longer. Breastfed babies are less likely to have ear infections, diarrhea and respiratory problems, health officials say. When done in partnership with safe sleep practices, breastfed babies are also at lower risk for Sudden Infant Death Syndrome (SIDS). While the exact cause of SIDS is unknown, breast milk may help build a baby’s immune system to fight SIDS-related infections. Mothers who breastfeed for 12 months or more have a lower risk of developing breast or ovarian cancer and cardiovascular disease. 

“Breastfeeding is the most complete and natural form of nutrition for babies, and it also provides health benefits for new mothers,” Health Commissioner Dr. Mary T. Bassett said in a statement. “We are fortunate to live in a city that protects a mother’s right to breastfeed anywhere, anytime. We’re happy to provide a comfortable option for women who prefer to breastfeed or pump in a private space.”



Photo Credit: Handout]]>
<![CDATA[Amrita Protein Bars Recalled for Listeria Risk]]>Thu, 03 Aug 2017 05:43:15 -0500https://media.nbcnewyork.com/images/213*120/necn+recall+generic.jpg

A brand of protein bars has been recalled by its manufacturer because it may be contaminated with listeria.

Amrita Health Foods, which is based in Pleasantville, New York, voluntarily recalled a limited number of Amrita Bars after a supplier reported that sunflower seeds and sunflowers seed butter sold to the company could be contaminated.

The recalled Amrita Bar were distributed to retail stores across the country. The following products have been recalled:

  • Amrita Chocolate Maca Bar, 60g (UPC 853009004056) : Best Buy date between 04/24/2018 to 05/31/2018
  • Amrita Dark Chocolate Quinoa, 60g (UPC 853009004438) : Best Buy date between 04/24/2018 to 05/31/2018
  • Amrita Sunflower Seed Butter, 60g (UPC 853009004414) : Best Buy date between 04/24/2018 to 05/31/2018
  • Amrita Chocolate Chip Coconut, 50g (UPC 853009004391) : Best Buy date between 04/24/2018 to 05/31/2018
  • Amrita Mango Coconut, 50g (UPC 853009004018) : Best Buy date between 04/24/2018 to 05/31/2018
  • Amrita Apricot Strawberry, 50g (UPC 853009004056) : Best Buy date between 04/24/2018 to 05/31/2018
  • Amrita Pineapple Chia, 50g (UPC 853009004025) : Best Buy date between 04/24/2018 to 05/31/2018
  • Amrita Apple Cinnamon, 50g (UPC 853009004049) : Best Buy date between 04/24/2018 to 05/31/2018
  • Amrita Cranberry Raisin, 50g (UPC 853009004032): Best Buy date between 04/24/2018 to 05/31/2018


Listeria monocytogenes can cause serious infections in young children, the elderly, and anyone with weakened immune systems. Symptoms include fever, nausea and diarrhea.

Anyone with questions about the recall can call Amrita Health Foods Monday through Friday from 9 a.m. until 4p.m. at 1-888-728-7779. Or click here for more information.  



Photo Credit: necn]]>
<![CDATA[Scientists Repair Gene in Human Embryos for First Time]]>Wed, 02 Aug 2017 12:33:30 -0500https://media.nbcnewyork.com/images/213*120/embryosfeuerherd.jpg

Altering human heredity? In a first, researchers safely repaired a disease-causing gene in human embryos, targeting a heart defect best known for killing young athletes — a big step toward one day preventing a list of inherited diseases.

In a surprising discovery, a research team led by Oregon Health and & Science University reported Wednesday that embryos can help fix themselves if scientists jump-start the process early enough.

It's laboratory research only, nowhere near ready to be tried in a pregnancy. But it suggests that scientists might alter DNA in a way that protects not just one baby from a disease that runs in the family, but his or her offspring as well. And that raises ethical questions.

"I for one believe, and this paper supports the view, that ultimately gene editing of human embryos can be made safe. Then the question truly becomes, if we can do it, should we do it?" said Dr. George Daley, a stem cell scientist and dean of Harvard Medical School. He wasn't involved in the new research and praised it as "quite remarkable."

"This is definitely a leap forward," agreed developmental geneticist Robin Lovell-Badge of Britain's Francis Crick Institute.

Today, couples seeking to avoid passing on a bad gene sometimes have embryos created in fertility clinics so they can discard those that inherit the disease and attempt pregnancy only with healthy ones, if there are any.

Gene editing in theory could rescue diseased embryos. But so-called "germline" changes — altering sperm, eggs or embryos — are controversial because they would be permanent, passed down to future generations. Critics worry about attempts at "designer babies" instead of just preventing disease, and a few previous attempts at learning to edit embryos, in China, didn't work well and, more importantly, raised safety concerns.

In a series of laboratory experiments reported in the journal Nature, the Oregon researchers tried a different approach.

They targeted a gene mutation that causes a heart-weakening disease, hypertrophic cardiomyopathy, that affects about 1 in 500 people. Inheriting just one copy of the bad gene can cause it.

The team programmed a gene-editing tool, named CRISPR-Cas9, that acts like a pair of molecular scissors to find that mutation — a missing piece of genetic material.

Then came the test. Researchers injected sperm from a patient with the heart condition along with those molecular scissors into healthy donated eggs at the same time. The scissors cut the defective DNA in the sperm.

Normally cells will repair a CRISPR-induced cut in DNA by essentially gluing the ends back together. Or scientists can try delivering the missing DNA in a repair package, like a computer's cut-and-paste program.

Instead, the newly forming embryos made their own perfect fix without that outside help, reported Oregon Health & Science University senior researcher Shoukhrat Mitalipov.

We all inherit two copies of each gene, one from dad and one from mom — and those embryos just copied the healthy one from the donated egg.

"The embryos are really looking for the blueprint," Mitalipov, who directs OHSU's Center for Embryonic Cell and Gene Therapy, said in an interview. "We're finding embryos will repair themselves if you have another healthy copy."

It worked 72 percent of the time, in 42 out of 58 embryos. Normally a sick parent has a 50-50 chance of passing on the mutation.

Previous embryo-editing attempts in China found not every cell was repaired, a safety concern called mosaicism. Beginning the process before fertilization avoided that problem: Until now, "everybody was injecting too late," Mitalipov said.

Nor did intense testing uncover any "off-target" errors, cuts to DNA in the wrong places, reported the team, which also included researchers from the Salk Institute for Biological Studies in California and South Korea's Institute for Basic Science. None of the embryos was allowed to develop beyond eight cells, a standard for laboratory research.

Genetics and ethics experts not involved in the work say it's a critical first step — but just one step — toward eventually testing the process in pregnancy, something currently prohibited by U.S. policy.

"This is very elegant lab work," but it's moving so fast that society needs to catch up and debate how far it should go, said Johns Hopkins University bioethicist Jeffrey Kahn.

And lots more research is needed to tell if it's really safe, added Britain's Lovell-Badge.

"What we do not want is for rogue clinicians to start offering treatments" that are unproven like has happened with some other experimental technologies, he stressed.

Among key questions: Would the technique work if mom, not dad, harbored the mutation? Is repair even possible if both parents pass on a bad gene?

Mitalipov is "pushing a frontier," but it's responsible basic research that's critical for understanding embryos and disease inheritance, noted University of Pittsburgh professor Kyle Orwig.

In fact, Mitalipov said the research should offer critics some reassurance: If embryos prefer self-repair, it would be extremely hard to add traits for "designer babies" rather than just eliminate disease.

"All we did is un-modify the already mutated gene."

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Paul Sancya]]>
<![CDATA[2 From Queens Apt Building Hospitalized With Legionnaires']]>Wed, 02 Aug 2017 05:33:57 -0500https://media.nbcnewyork.com/images/213*120/LEGIONNAIRES2.jpg

Two residents of an apartment building in Flushing were hospitalized after they contracted Legionnaires' disease, and one of them is still being treated as the city tests the building’s water supply, health officials said.

The residents with Legionnaires’ disease were diagnosed 10 months apart over the past year, according to officials, who said one of them has been discharged and the other is recovering at a hospital. 

“The Health Department is currently investigating two cases of Legionnaires’ disease at Latimer Gardens that occurred within the same building over a year period,” the New York City Health Department said in a statement Tuesday.

Until results of the building's water tests are available, and out of an abundance of caution, NYCHA is installing a copper silver ionization system to disinfect the water, officials said.

The building — 34-20 137th St. — does not have a cooling tower, a common breeding ground for the Legionella bacteria, according to officials.

Last week, members of the Health Department went door to door to notify residents. Health officials also held meetings with tenants and senior center attendees on Thursday and Friday, respectively.

Residents of the apartment building told News 4 that they're fearing the worst after building staff put notices on every door saying they will be randomly testing the water. 

Officials said residents can still use and drink the water at Latimer Gardens, but tenants with compromised immune systems should take a number of precautions, including minimizing the amount of water vapor in the air by not taking showers and slowly filling tubs and sinks, starting with cool water. It's also recommended that residents use cold water when possible. 

Barbara Tyce-Butler has lived in the building for 13 years. She says she has been taking baths and not using the shower. 

"Some people are still taking showers. I wouldn't do it," she said.

Another resident said she's been taking showers at a friend's house. 

Legionnaires' disease is a type of pneumonia and is treatable and not contagious. Symptoms include fever, cough and difficulty breathing. 

There are 200 to 400 cases of the disease in New York City every year, according to a 2016 report by the health department.

Clusters of Legionnaires’ have cropped up around the city in recent years. This case is not a cluster, as more than three people have not been infected.

Last month, the Health Department concluded its investigation into a Legionnaires’ disease cluster in Manhattan, ordering dozens of cooling towers to be disinfected after one person died and six others were hospitalized in June.

Days before that, a Harlem police officer contracted the disease, apparently at his or her precinct in Harlem.

In the summer of 2015, the largest Legionnaires’ disease outbreak in New York City history sickened more than 120 people, killing 12 of them, in the Morris Park neighborhood of the Bronx. Another person died after a separate cluster emerged in the neighborhood in the following weeks; more than a dozen were sickened in the second cluster.

]]>
<![CDATA[Glitter iPhone Cases Recalled for Burn Risk]]>Thu, 03 Aug 2017 14:05:49 -0500https://media.nbcnewyork.com/images/213*120/iphone-cases.jpg

Decorative iPhone cases sold at Victoria's Secret, Nordstrom Rack and other stores have been recalled by their manufacturer because a liquid glitter inside the cases can cause skin irritation and chemical burns.

MixBin Electronics recalled 24 styles of cases for iPhone 6, 6S, and 7. Over 260,000 affected cases were sold at websites and stores for Victoria's Secret, Nordstrom Rack, Amazon, Tory Burch, Henri Bendel and MixBin.

Worldwide, 24 cases have been reported of the liquid inside the cases causing skin irriation or chemical burns, including 19 cases in the U.S., according to the U.S. Consumer Product Safety Commission.

One consumer reported permanent scarring from a chemical burn, and another reported chemical burns and swelling to her leg, face, neck, chest, upper body and hands.

Only fluid released from a cracked or broken case may cause skin irritation. If you come into contact with the liquid glitter, immediately wash affected areas with warm soapy water and seek medical attention if irritation continues.

Consumers should immediately stop using the recalled cases and contact MixBin Electronics for a full refund at 855-215-4935 or online here.



Photo Credit: US Consumer Product Safety Commission]]>
<![CDATA[1 in 3 Americans Took Prescription Opioids in 2015: Survey]]>Tue, 01 Aug 2017 12:31:21 -0500https://media.nbcnewyork.com/images/213*120/lucha+opioides.jpeg

About one in three Americans used prescription opioid painkillers like OxyContin or Vicodin in 2015, according to a survey released by the National Institute on Drug Abuse, NBC News reported.

The NIDA study calculated 91.8 million Americans used prescription opioids, with nearly five percent of adults surveyed saying they took them without their doctor’s permission.

“The most commonly reported sources were friends and relatives for free,” the study reported. “Or a physician.”

Also Monday, a presidential opioid commission chaired by New Jersey Gov. Chris Christie released an interim report that said the U.S. "is enduring a death toll equal to September 11th every three weeks." The report urged President Donald Trump to "declare a national emergency."

The commission suggested expanding treatment facilities across the country, educating doctors about the proper way to prescribe pain medication, equipping all police officers with the anti-overdose remedy naloxone, developing new fentanyl detection sensors, and improving data-sharing among law enforcement agencies.



Photo Credit: Getty Images]]>
<![CDATA[Xtreme Eating Awards: 2017's Calorie-Filled Recipients]]>Mon, 31 Jul 2017 16:18:43 -0500https://media.nbcnewyork.com/images/213*120/Chillis+Ultimate+Smokehouse+Combo.jpg

Most people won't consider eating five bacon double cheeseburgers from Burger King, but that's the calorie equivalent of one Buffalo Wild Wings Cheese Curd Bacon Burger with fries.

That's just one of the "nutritional nightmares" the nonprofit Center for Science in the Public Interest has called out in its latest Xtreme Eating Awards.

The annual awards "dishonors" chain restaurant meals that exceed the recommended daily allowances of calories (2,000), sodium (2,300 mg), saturated fats (20 g) and added sugar (50 g).

"These meals are extreme, but even the typical dishes served at restaurants are a threat to Americans' health because they increase the risk of obesity, diabetes, heart disease, and more," CSPI Senior Nutritionist Lindsay Moyer said in a statement.

The 2010 Affordable Care Act included provisions requiring calorie counts on the menus and menu boards of chains with 20 or more outlets. The Food and Drug Administration had scheduled the rules to go into effect on May 5 of this year. But less than a week before that deadline, lobbyists for pizza chains, supermarkets, and convenience stores convinced the Trump administration to delay the implementation date.

The decision prompted the CSPI to confer its first-ever Xtreme Putting Profits Before Public Health Award to Domino’s Pizza — the loudest industry voice opposing calorie labeling.

"Who cares about the obesity and diabetes epidemics, as long as the cash keeps rolling in to one of the nation’s premier purveyors of white flour and cheese?" the group said in a news release.

From the belt-busting Carnivore Pizzadilla to the caloric Flying Gorilla cocktail milkshake, here are some of the worst offenders of 2017.

Worst Cheese in a Leading Role: Buffalo Wild Wings' Cheese Curd Bacon Burger

A regular burger with deep fried cheese curds, bacon, American cheese, and something called “cool heat sauce,” Buffalo Wild Wings’ cheese curd bacon burger comes with a side of fries and contains 53 g of saturated fat and 1,950 calories, according to CSPI.

Worst Visceral Effects: Chili’s Ultimate Smokehouse Combo

A sort of create-your-own-adventure meal, Chili’s Ultimate Smokehouse Combo contains a little bit of everything. Diners choose three meat from a list that includes BBQ chicken breast, jalapeño-cheddar smoked sausage, battered Chicken Crispers, or a half rack of baby back ribs, plus four sides.  That's 2,440 calories, 41 g of saturated fat and a ridiculous 7,610 mg of sodium. While CSPI notes that this meal contains enough sodium for nearly four days, it is also possible that the sheer quantity of this meal could last for the same amount of time. 

Least Original Breakfast: IHOP Cheeseburger Omelette With Pankcakes

IHOP’s cheeseburger omelette is loaded with chunks of ground beef, hash browns, tomatoes, onions, American cheese, and topped with ketchup, mustard and pickles and comes with a stack of buttermilk pancakes on the side. The meal contains just about an entire day's worth of calories (1,900) and added sugar (44 g), plus double the amount of saturated fat (45 g) and sodium (4,580 mg), and a whopping three-days worth of cholesterol (1,005 mg). As CSPI notes, “it’s the equivalent of eating four McDonald’s Sausage Egg McMuffins drizzled with two tablespoons of syrup.”

In a statement, an IHOP spokesperson said that while it applauds the CSPI's efforts, "it's misleading to single out the highest meal combinations without informing people of the wide range of choices offered at our restaurants that meet a variety of dietary needs. Our commitment is to offer guests flavorful, inventive all-day breakfast dishes that can be enjoyed as they see fit - whether it's every day or occasionally depending on how they choose to live a balanced lifestyle."

Worst Adapted Pasta: The Cheesecake Factory Pasta Napoletana

The Cheesecake Factory, which has appeared on the list every year since it began in 2007, is on the list this time twice: for worst cocktail for its Flying Gorilla, and worst pasta dish for the Pasta Napoletana.

How do you turn a meat lover’s pizza into a pasta? Start with a mountain of spaghetti, then heap it with Italian sausage, pepperoni, meatballs, bacon, butter and cream, of course. The Cheesecake Factory's Pasta Napoletana is like eating a Pizza Hut Meat Lover's Personal Pan Pizza, but with an additional cup of pasta and a cup of heavy cream,  the CSPI says.

"With more than 250 menu items, The Cheesecake Factory has always been about choices," said spokeswoman Aletha Rowe, in a statement to NBC. "Many of our guests come in and want to celebrate and not be concerned with calories. Others want to share their dish - and we love it when guests share - that's a great sign that our portions are generous - and a large percentage of our guests take home leftovers for lunch the next day."

"For our calorie conscious guests we have our award-winning SkinnyLicious menu featuring nearly 50 delicious choices with 590 calories or less - which is actually larger than many restaurants entire menus," Rowe added.

Worst Original Appetizer: Dave & Buster’s Carnivore Pizzadilla

What’s the most calorie-dense portmanteau of a food item imaginable? The award goes to Dave & Buster’s Carnivore Pizzadilla. The 12-inch pizza quesadilla hybrid with cheese, pepperoni, and Italian sausage. The dish packs 67 grams of saturated fat and 4,700 mg of sodium, the equivalent of 100 slices of pepperoni layered atop two Taco Bell Cheese Quesadillas or half a stick of butter melted over three McDonald’s Quarter Pounders with Cheese, the CSPI said.

Most Damage From Supporting Vegetable: Texas Roadhouse Prime Rib, Loaded Sweet Potato, Ceasar Salad

The Texas Roadhouse’s Loaded Sweet Potato was voted worst side at (770) and comes covered in marshmallows and caramel sauce. It's one of two sides diners can get with the 16 oz prime rib (1,570). Add a Caesar salad as your second side, and it’s like eating two of the chain’s 12 oz. New York strip steak dinners, according to the CSPI.

"We are proud of our made-from-scratch food and the vast menu options that we offer our guests," a Texas Roadhouse spokesperson said in a statement to NBC. "We also list calories on our menu and online, which allows our guests to choose what they feel is best for them."

Most Ridiculous Ending: Uno Pizzeria & Grill Ridiculously Awesome, Insanely Large Chocolate Cake

Truly both awesome in the literal sense of the word and insane in the colloquial one, a slice of Uno Pizzeria’s “Ridiculously Awesome, Insanely Large Chocolate Cake” weighs over a pound and contains an estimated 168g of sugar and 1,740 calories, according to CSPI. And while it may be appealing to hard core chocolate lovers, this confection is not for the faint of heart, literally.

NBC's Danielle Abreu contributed to this story.



Photo Credit: Courtesy Chilli's]]>
<![CDATA[US Hospitals Treating Heart Attacks at Record Speed]]>Mon, 31 Jul 2017 14:37:27 -0500https://media.nbcnewyork.com/images/213*120/heart-attack-care.jpg

There's never been a better time to be treated for a heart attack. U.S. hospitals have set a record for how quickly they open blocked arteries, averaging under one hour for the first time since these results have been tracked.

More than 93 percent of patients now have their arteries opened within the recommended 90 minutes of arrival.

"Things have definitely improved" from a decade ago, when less than half of heart attack patients were treated that fast, said Dr. Fred Masoudi, a University of Colorado cardiologist who led a recent report examining response times.

It's based on records from about 85 percent of U.S. hospitals that do the artery procedure, angioplasty . Through a blood vessel in the groin or an arm, doctors guide a tube to the blockage causing the heart attack. They inflate a tiny balloon to flatten the clog, and leave behind a mesh tube called a stent to prop the artery open.

The sooner blood flow is restored, the less chance of permanent damage.

"It's one of the few things in medicine where time, literally seconds, is of the essence. It's where the phrase 'time is muscle' comes from," said Dr. Ajay Kirtane, director of the lab that performs angioplasties at New York-Presbyterian/Columbia University Medical Center.

The risk of dying goes up 42 percent if care is delayed even half an hour beyond the 90 minutes that U.S. guidelines say patients should be treated after arrival.

In 2005, this "door-to-balloon" time averaged a dismal 96 minutes, and the American College of Cardiology led a drive to get hospitals to improve. The report shows it plunged to 59 minutes in 2014.

It was only 24 minutes for George Smith at UConn John Dempsey Hospital in Farmington, Connecticut. The 82-year-old woke up on March 31 with intense jaw pain, the same kind he had during a heart attack two years ago. His wife called 911. An ambulance whisked him to the emergency room, and "they were all waiting for me" at the door, he said.

An hour later he was sitting up in bed with a new stent. "I was amazed," he said. "Such a blessing."

One reason UConn is so fast — its median door-to-balloon time was 56 minutes last year, and only 39 minutes during one recent quarter — is the work it has done to make its emergency responders part of the cardiac care team, said the hospital's EMS coordinator, Peter Canning.

"We used our paramedics to extend our hospital into the patient's home," where they do an extensive electrocardiogram of the heartbeat and call results ahead to the hospital to get the angioplasty room ready, he said. "Calling from 25 minutes out instead of 5 minutes out can be a savings of 20 minutes of heart muscle."

But all that speed by the hospital won't do much good unless patients act fast, too, and call 911 if they think they might be having a heart attack.

The warning signs:

—Discomfort in the center of the chest lasting more than a few minutes, or that goes away and comes back. It can feel like pressure, squeezing, fullness or pain.

—Pain or discomfort in one or both arms, the back, neck, jaw or stomach.

—Shortness of breath, which might include breaking out in a cold sweat, or feelings of nausea or lightheadedness.

"For women, the symptoms may not be the same. It may not be the typical chest pain" but rather abdominal pain, nausea or unusual tiredness, said Dr. Annapoorna Kini, a cardiologist at Mount Sinai Hospital in New York City.

What to do? "Get medical help," she said. "It's better to worry after" about whether it was really a stomach problem rather than a heart attack.

Angioplasty also is done for non-emergency conditions, to treat chronic chest pain caused by arteries that are clogged but not severely blocked, and its use in that setting is more questionable. Often medicines and other things can be tried first, and angioplasty can be avoided or delayed.

The report shows that fewer people are getting these procedures inappropriately. In 2014, about one third of angioplasties were elective, for non-emergency situations. Just over half were deemed to be done for clearly appropriate reasons and another one third were classified "may be appropriate" under guidelines from the cardiology college and others. About 14 percent were deemed "rarely appropriate" — less than other research has found in the past.

Copyright Associated Press / NBC New York



Photo Credit: Mark Lennihan/AP Photo]]>
<![CDATA[2017 Xtreme Eating Awards Announced by The Center for Science in the Public Interest]]>Mon, 31 Jul 2017 08:14:23 -0500https://media.nbcnewyork.com/images/213*120/NC_extremeeating0728_1500x845.jpg

The Center for Science in the Public Interest has released its 2017 Xtreme Eating awards. Most people wouldn't dream of eating five bacon double cheeseburgers from Burger King all at once, but at Buffalo Wild Wings you'd consume even more calories by eating just one Cheese Curd Bacon Burger and fries.]]>
<![CDATA[Higher Prices, Fewer Options Likely After Health Bill Fail]]>Fri, 28 Jul 2017 15:49:31 -0500https://media.nbcnewyork.com/images/213*120/health-protest.jpg

The health care law of the land has survived for now, but it needs help — and it needs it soon.

Soaring prices and fewer choices may greet customers when they return to the Affordable Care Act's insurance marketplaces this fall, in part because insurers are facing deep uncertainty about whether the Trump administration will continue to make key subsidy payments and enforce other parts of the existing law that help control prices.

Assurances don't look to be coming anytime soon. "As I said from the beginning, let ObamaCare implode, then deal. Watch!" President Donald Trump tweeted early Friday, soon after the Senate narrowly rejected the latest push to dismantle the Obama-era health care law.

Health and Human Services Secretary Tom Price said in a statement after the Senate vote that the Trump administration would pursue its health care goals through regulation.

That kind of uncertainty rattles insurers, many of whom have already stopped selling policies through public insurance markets established by the health law because they were losing money.

Their main concern now is that the Trump administration will stop paying crucial subsides called for in the law that help reduce costs like deductibles for people with low incomes. The subsidies, estimated at $7 billion a year, have been challenged by Republicans in court, and Trump has only guaranteed them through this month.

If they stop, insurers will have to raise prices for coverage, known as premiums, because by law they must still offer the same reduced deductibles for their low-income customers.

Leerink analyst Ana Gupte surveyed several states and has said that insurers are asking for price hikes of around 36 percent when they assume the subsidies go away, compared with about 18 percent if they stay.

People with low incomes might be shielded from these hikes in part because the law provides tax credits that cover much of the premium.

But those who make too much to qualify for that help — and tend to vote Republican — could get hit hard, noted health care consultant Robert Laszewski, a former insurance executive.

"(Trump's) hurting his own people," Laszewski said.

Of course, all shoppers will be hurt if insurers leave markets, noted Urban Institute health economist Linda Blumberg.

"Then there's nowhere to use your subsidy," she said.

The Blue Cross-Blue Shield insurer Anthem has already withdrawn from markets in Ohio, Wisconsin and Indiana. CEO Joseph Swedish said Wednesday the company may cut back further if it doesn't get certainty on the subsidies "quickly."

Insurers have until the middle of next month to finalize their 2018 prices, industry officials say. They must leave enough time for the rates to be submitted to the marketplaces, and then for the on-line exchanges that sell the coverage to be tested before enrollment for next year's plans begins on Nov. 1.

If insurers want to back out of a market, they have until about late September to do so.

Options already have grown thin. About a third of the U.S.'s approximately 3,000 counties have only one insurer selling coverage on their exchange, which is the only place where shoppers can get tax credits based on their income to help buy coverage. Those credits are separate from the subsidies for low-income customers.

Nearly 40 counties currently have no choices for next year on their exchanges.

Dan Mendelson, president of the consulting firm Avalere, says there is some hope that the Trump administration could yet shore up the system. He thinks the administration could recognize that it will be held accountable by voters for the condition of the law's marketplaces. Further deterioration "would be very negative for them," he said.

"I think in the end they're going to have to stabilize these markets," he said.

Copyright Associated Press / NBC New York



Photo Credit: Joe Raedle/Getty Images]]>
<![CDATA[FDA to Target Addictive Levels of Nicotine in Cigarettes]]>Fri, 28 Jul 2017 16:56:14 -0500https://media.nbcnewyork.com/images/213*120/050517+cigarettes+generic.jpg

For the first time, the federal government is proposing cutting the nicotine level in cigarettes so they aren't so addictive.

U.S. Food and Drug Administration chief Scott Gottlieb on Friday directed the agency's staff to develop new regulations on nicotine. The FDA has had the power since 2009 to regulate nicotine levels but hasn't done so. Stocks of cigarette makers plunged after the announcement.

As part of the new strategy, the FDA is giving e-cigarette makers four more years to comply with a review of products already on the market, Gottlieb said. The agency intends to write rules that balance safety with e-cigarettes' role in helping smokers quit, he said.

"A renewed focus on nicotine can help us to achieve a world where cigarettes no longer addict future generations of our kids," Gottlieb said in a speech to staff in Silver Spring, Maryland.

Tar and other substances inhaled through smoking make cigarettes deadly, but the nicotine in tobacco is what makes them addictive.

Tobacco use is the leading cause of preventable heart disease, cancer and death in the United States, causing more than 480,000 deaths annually. Smoking rates, though, have been falling for decades and are at about 15 percent.

Gottlieb said he has asked the FDA's Center for Tobacco Products to explore whether lowering nicotine could create a black market for higher nicotine products and what role e-cigarettes and other products play in reducing harm from smoking. Battery-powered e-cigarettes turn liquid nicotine into an inhalable vapor. He also wants new rules to address flavored tobacco products and kids.

The FDA announcement is great news, said Eric Donny, a University of Pittsburgh researcher who has studied what happens when smokers puff on cigarettes with lower levels of nicotine. Donny and other researchers found that reducing nicotine substantially — by around 90 percent — leads to smokers being less dependent on cigarettes and smoking fewer of them.

There have been concerns that smokers might react to lower nicotine levels by smoking more. But the research shows that's not what happens — not if enough nicotine is taken out, Donny said.

"Most of the harm associated with smoking is related not to the nicotine but everything else in the smoke. Reducing nicotine doesn't make a cigarette safe, it just makes it less addictive," said Donny, director of Pitt's Center for the Evaluation of Nicotine in Cigarettes.

There's additional research underway to see how often people who smoke lower-nicotine cigarettes switch to e-cigarettes or other, less harmful tobacco products, he said.

Kenneth Warner, a retired University of Michigan public health professor who is a leading authority on smoking and health, said he was pleasantly surprised to learn of the FDA announcement.

"If you can separate the nicotine people are craving from the smoke that's killing them, then you may be doing something very important," Warner said.

Campaign for Tobacco-Free Kids president Matthew Myers praised the overall approach as "a bold and comprehensive vision" but called the e-cigarettes delay "a serious error."

"This long delay will allow egregious, kid-friendly e-cigarettes and cigars, in flavors like gummy bear, cherry crush and banana smash, to stay on the market with little public health oversight," Myers said in a statement.

Altria Group, which sells Marlboro, other brands and e-cigarettes in the U.S., said it would be "fully engaged" in FDA's rule-making process.

"It's important to understand that any proposed rule such as a nicotine product standard must be based on science and evidence, must not lead to unintended consequences and must be technically achievable," the company said in a statement.

Gottlieb touched on premium cigars in his announcement, saying the agency wants to hear from the industry about their patterns of use and public health impacts. He said the FDA will "seriously consider" new data relevant to how premium cigars should be regulated.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[CTE Reports, Concussions Deter Parents From Youth Football]]>Mon, 31 Jul 2017 07:24:20 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-499666996.jpg

Lori Anderson grew up with a big, traditional, football-loving family in Austin, Texas, and moved her own family to midwest Michigan. There, she did what was once unthinkable: She did not let her 13-year-old son play football.

"I feel it is my job as a parent to make those hard decisions and this was one of them," she said. "I told him that there were studies that showed that some hits injured the brain, and that I didn’t want him to possibly have problems later in life."

Most of the brains of deceased football players analyzed in a study of professional and non-professional athletes released this month found the existence of Chronic Traumatic Encephalopathy, or CTE. The disease was even found in some high school players.

While the National Football League is the professional authority on the sport, the future of American football relies on the engagement of young children. It seems revelations from CTE studies are deterring some parents from starting their children in the sport. Some, though not all, leagues say they have had declining participation rates in football. And youth organizations like Pop Warner have responded to the fears by making more concerted efforts to protect their young players with rule changes and more training for coaches.

Anderson said she sat her son down when he was 9 or 10 years old and explained to him that it wasn't going to be safe for him to play football. When he was 12, his friend was badly injured and ended up in a neck brace. That "hit home for him," Anderson said. After that, her son began looking up CTE for himself on the internet and made peace with not being allowed to play. 

Over 1 million high school students played football in the 2015-16 season, according to an annual participation survey by the National Federation of State High School Associations (NFHS). But participation has steadily decreased since the 2008-09 season. The most recent report shows a 2.5 percent drop, or about 28,000 fewer players than nine years ago.

The report published July 25 by the Journal of the American Medical Association (JAMA), found that 177 of the 202 deceased football players had CTE. The disease was found in 110 of 111 brains from former NFL players; 48 of 53 college players; nine of 14 semi-professional players; seven of eight Canadian Football league players; and three of 14 high school players.

"Essentially this says it's a problem for football, it's a problem at all levels at high school and above," said the study's lead author Dr. Ann McKee, a Boston University neuroscientist. "We need to now look for ways to detect it in living people, and most importantly, to treat it in living people."

CTE is linked to repeated blows to the head, resulting in irreversible changes to the brain, including memory loss, depression and dementia. As of now, the disease has no known treatment.

Anderson's 13-year-old son is on the track team and runs for the cross country team. She said he also swims and wants to play golf next year.

"He still has the teamwork aspect, which I do feel is important to experience at his age," she said. "He is still learning about hard work and time management."

Dr. Barry Kosofsky is the chief of child neurology at Weill Cornell in New York City and director of the pediatric concussion clinic. His general rule about receiving concussions while playing sports is "three strikes, you're out." But that should not apply to children under 14, who, in his opinion, should not play tackle football in any capacity.

"Football is not safe for children to play, no," he said. "Football is bad for your brain."

While the JAMA study represents a skewed sample, Kosofsky said it still managed to make breakthroughs on CTE. 

"They've shown, which no one else has shown, that you can get it at earlier ages with less football exposure," he said. 

USA Football, the national governing body for amateur football, uses numbers provided in the Sports and Fitness Industry Association's Topline Participation Report for tackle and flag football, for players ages 6-17. The report’s trend since 2012 has shown a drop in enrollment by 1.7 percent, a smaller percentage decline than shown by the NFHS survey.

"The youth game is taught and played differently today than it was a few short years ago," a USA Football representative said in response to questions about the latest CTE report.

Carrie Bembry is a mother of three in Centerville, Ohio. Her youngest is 10 years old and he is passionate about football. He has played since kindergarten, she said, and she does not intend to keep her son from the sport, unless he receives another concussion.

Bembry's oldest child is 17 years old and he stopped playing football after his freshman year of high school. He was sidelined by a series of concussions that lead to noticeable cognitive difficulties. Bembry said her once-honor roll, popular son is now withdrawn, depressed and struggles in school. He has difficulty completing multi-step tasks. Doctors have correlated the recent issues to concussions.

"Of course I worry about concussions with my youngest playing football, but even with my oldest son's post-concussion problems, it is a risk that we are willing to take because he loves the game so much," Bembry said. "[But] yes, it for sure weighs heavily on my mind."

Rep. Jan Schakowsky, D-Ill., is fighting against CTE in Congress, calling for legislation to protect players. Last year, as a member of the House Committee on Energy and Commerce, she pressed a NFL spokesman to note the link between CTE and football. In a statement following Tuesday's report, she said, "The time for denying facts and looking the other way is over."

"We must now actively seek out ways to protect the health and well-being of players, from Pop Warner to the NFL and every league in between," Schakowsky said. "It is also imperative to ensure that the American people are informed about the dangers associated with playing football."

Pop Warner, a youth football program with players across the country, is one of the oldest and largest of its kind. According to spokesman Brian Heffron, enrollment has remained steady over the past five years. Their last significant drop in enrollment was from 2010-12, when "certainly the concussion issue played a role."

Heffron attributes their since-steady participation to Pop Warner's aggressive campaign for player safety, including banning kickoffs and head-on blocking, and mandating a coaching education.

"As an organization driven by player safety, we're grateful for the scientific community's focus on the issue," Heffron said. "We think there are valuable learnings in this study, but even the researchers point out that this was a narrow study."

The JAMA report is a continuation of research that began eight years ago and serves as the largest update on the study. The subjects of the study were not randomly chosen; they were submitted by players themselves or their families because of repeated concussions and/or troubling symptoms before death.

Dr. Greg Landry is a member of the American Academy of Pediatrics’ sports council, and co-authored the guidelines on concussions and return to play. The son of a football coach, Landry played from ages 11 to 22, and was a team doctor for the University of Wisconsin for 25 years.

The JAMA study, he said, leaves many questions from the "biased sample" and he believes "youth football is low risk." But "coaches and officials need to do more to help football players protect their heads," he said. 

NFL spokesman Brian McCarthy said the JAMA study was "important to further advancing the science and progress related to trauma."

"As noted by the authors, there are still many unanswered questions relating to the cause, incidence and prevalence of long-term effects of head trauma such as CTE," McCarthy said. "The NFL is committed to supporting scientific research into CTE and advancing progress in the prevention and treatment of head injuries."

The NFL pledged $100 million to research on neuroscience-related topics last year, after settling a $1 billion concussion lawsuit brought forth by former players.

Christina Barrett, of Macomb, Michigan, said all the reports on CTE and the movie "Concussion" were enough to convince her that her 10-year-old son should not play football.

"No sport is worth endangering a child’s health," she said. "While sports are important, they aren’t more important than my child’s health or academics. His future successes will be dependent upon his brain, not his athletic skills."



Photo Credit: John Greim/LightRocket via Getty Images]]>
<![CDATA[Mexico Responds to US Salmonella Outbreak Linked to Papayas]]>Fri, 28 Jul 2017 00:31:30 -0500https://media.nbcnewyork.com/images/213*120/Untitled-1261.jpg

Mexico's food safety agency says it is "premature" to point to Mexican papayas as the source of a salmonella outbreak in the U.S.

One person in New York has died of the disease and 46 have fallen ill in 12 other states.

A Thursday statement by Mexico's Agriculture Department says agency technicians have begun collecting samples from across Mexico. The agency say it will not be possible to pinpoint the origin of the outbreak until a laboratory analysis is completed.

On Wednesday, the U.S. Food and Drug Administration said the illness had been tracked to the Caribena brand Maradol papayas. The FDA has categorically advised consumers to avoid these.

Salmonella can cause diarrhea, vomiting, stomach pain and fever, especially in older adults or those with weakened immune systems.

Copyright Associated Press / NBC New York

]]>
<![CDATA[Oregon Scientists Do First Human Gene Embryo Editing in US]]>Thu, 27 Jul 2017 16:05:46 -0500https://media.nbcnewyork.com/images/213*120/embryosfeuerherd.jpg

For the first time in the United States, scientists have edited the genes of human embryos, a controversial step toward someday helping babies avoid inherited diseases.

The experiment was just an exercise in science — the embryos were not allowed to develop for more than a few days and were never intended to be implanted into a womb, according to MIT Technology Review, which first reported the news.

Officials at Oregon Health & Science University confirmed Thursday that the work took place there and said results would be published in a journal soon. It is thought to be the first such work in the U.S.; previous experiments like this have been reported from China. How many embryos were created and edited in the experiments has not been revealed.

The Oregon scientists reportedly used a technique called CRISPR, which allows specific sections of DNA to be altered or replaced. It's like using a molecular scissors to cut and paste DNA, and is much more precise than some types of gene therapy that cannot ensure that desired changes will take place exactly where and as intended. With gene editing, these so-called "germline" changes are permanent and would be passed down to any offspring.

The approach holds great potential to avoid many genetic diseases, but has raised fears of "designer babies" if done for less lofty reasons, such as producing desirable traits.

Last year, Britain said some of its scientists could edit embryo genes to better understand human development.

And earlier this year in the U.S., the National Academy of Sciences and National Academy of Medicine said in a report that altering the genes of embryos might be OK if done under strict criteria and aimed at preventing serious disease.

"This is the kind of research that the report discussed," University of Wisconsin-Madison bioethicist R. Alta Charo said of the news of Oregon's work. She co-led the National Academies panel but was not commenting on its behalf Thursday.

"This was purely laboratory-based work that is incredibly valuable for helping us understand how one might make these germline changes in a way that is precise and safe. But it's only a first step," she said.

"We still have regulatory barriers in the United States to ever trying this to achieve a pregnancy. The public has plenty of time" to weigh in on whether that should occur, she said. "Any such experiment aimed at a pregnancy would need FDA approval, and the agency is currently not allowed to even consider such a request" because of limits set by Congress.

One prominent genetics expert, Dr. Eric Topol, director of the Scripps Translational Science Institute in La Jolla, California, said gene editing of embryos is "an unstoppable, inevitable science, and this is more proof it can be done."

Experiments are in the works now in the U.S. using gene-edited cells to try to treat people with various diseases, but "in order to really have a cure, you want to get this at the embryo stage," he said. "If it isn't done in this country, it will be done elsewhere."

There are other ways that some parents who know they carry a problem gene can avoid passing it to their children, he added. They can create embryos through in vitro fertilization, screen them in the lab and implant only ones free of the defect.

Dr. Robert C. Green, a medical geneticist at Harvard Medical School, said the prospect of editing embryos to avoid disease "is inevitable and exciting," and that "with proper controls in place, it's going to lead to huge advances in human health."

The need for it is clear, he added: "Our research has suggested that there are far more disease-associated mutations in the general public than was previously suspected."

Hank Greely, director of Stanford University's Center for Law and the Biosciences, called CRISPR "the most exciting thing I've seen in biology in the 25 years I've been watching it," with tremendous possibilities to aid human health.

"Everybody should calm down" because this is just one of many steps advancing the science, and there are regulatory safeguards already in place. "We've got time to do it carefully," he said.

Michael Watson, executive director of the American College of Medical Genetics and Genomics, said the college thinks that any work aimed at pregnancy is premature, but the lab work is a necessary first step.

"That's the only way we're going to learn" if it's safe or feasible, he said.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Paul Sancya]]>
<![CDATA[What’s Next: Health Care ‘Vote-a-Rama’ and the End Game]]>Wed, 26 Jul 2017 21:07:35 -0500https://media.nbcnewyork.com/images/213*120/AP_17207774939980.jpg

What can be expected from the health care bill? More debating. Senate leaders are expected to have 20 hours debate before a final vote.

When the debate is done, the Senate moves on to what is unofficially called the "Vote-a-Rama," possibly as early as Thursday. During this period, senators from both parties can offer an unlimited number of amendments which are voted on without debate.

But there are limits: Their amendments have to be relevant to the bill and they can’t increase the deficit. They also can’t use the process to filibuster a bill by speaking indefinitely.

What's the end game? It’s not certain, but the most prominent idea being floated right now is a "skinny repeal" bill that would eliminate Obamacare’s requirements that individuals buy insurance and employers provide it, along with the law’s medical device tax.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/J. Scott Applewhite]]>
<![CDATA[Plunging Sperm Counts Called a 'Major Public Health' Crisis]]>Wed, 26 Jul 2017 09:27:03 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-674416385-sperm.jpg

A recent meta-analysis found a 40-year decline in sperm count in a large sample of men across North America, Europe, Australia and New Zealand, NBC News reported.

Researchers from the Hebrew University in Jerusalem and Icahn School of Medicine in New York reviewed 185 studies from 1973 to 2011, and observed a 52 percent decline in sperm concentration and a 59 percent decline in total sperm count.

"For couples who are trying to conceive, this is a very severe problem and it's difficult psychologically, but in the big scheme of things, this is also a major public health issue," said Dr. Shanna Swan, an author of the study and professor of environmental medicine at the Icahn School of Medicine.

The paper doesn’t give reasons for the decline and cause-and-effect is unclear. But Dr. Joseph Alukal, a urologist and director of male reproductive health at NYU Langone Health, recommends that men can increase their count with a healthy diet, exercise, by not smoking and getting sleep.



Photo Credit: Getty Images/Science Photo Libraray]]>
<![CDATA[Scientists Build DNA From Scratch to Alter Life's Blueprint]]>Wed, 26 Jul 2017 08:52:33 -0500https://media.nbcnewyork.com/images/213*120/dna9.jpg

At Jef Boeke's lab, you can whiff an odor that seems out of place, as if they were baking bread here.

But he and his colleagues are cooking up something else altogether: yeast that works with chunks of man-made DNA.

Scientists have long been able to make specific changes in the DNA code. Now, they're taking the more radical step of starting over, and building redesigned life forms from scratch. Boeke, a researcher at New York University, directs an international team of 11 labs on four continents working to "rewrite" the yeast genome, following a detailed plan they published in March.

Their work is part of a bold and controversial pursuit aimed at creating custom-made DNA codes to be inserted into living cells to change how they function, or even provide a treatment for diseases. It could also someday help give scientists the profound and unsettling ability to create entirely new organisms.

The genome is the entire genetic code of a living thing. Learning how to make one from scratch, Boeke said, means "you really can construct something that's completely new."

The research may reveal basic, hidden rules that govern the structure and functioning of genomes. But it also opens the door to life with new and useful characteristics, like microbes or mammal cells that are better than current ones at pumping out medications in pharmaceutical factories, or new vaccines. The right modifications might make yeast efficiently produce new biofuels, Boeke says.

Some scientists look further into the future and see things like trees that purify water supplies and plants that detect explosives at airports and shopping malls.

Also on the horizon is redesigning human DNA. That's not to make genetically altered people, scientists stress. Instead, the synthetic DNA would be put into cells, to make them better at pumping out pharmaceutical proteins, for example, or perhaps to engineer stem cells as a safer source of lab-grown tissue and organs for transplanting into patients.

Some have found the idea of remaking human DNA disconcerting, and scientists plan to get guidance from ethicists and the public before they try it.

Still, redesigning DNA is alarming to some. Laurie Zoloth of Northwestern University, a bioethicist who's been following the effort, is concerned about making organisms with "properties we cannot fully know." And the work would disturb people who believe creating life from scratch would give humans unwarranted power, she said.

"It is not only a science project," Zoloth said in an email. "It is an ethical and moral and theological proposal of significant proportions."

Rewritten DNA has already been put to work in viruses and bacteria. Australian scientists recently announced that they'd built the genome of the Zika virus in a lab, for example, to better understand it and get clues for new treatments.

At Harvard University, Jeffrey Way and Pamela Silver are working toward developing a harmless strain of salmonella to use as a vaccine against food poisoning from salmonella and E. coli, as well as the diarrhea-causing disease called shigella.

A key goal is to prevent the strain from turning harmful as a result of picking up DNA from other bacteria. That requires changing its genome in 30,000 places.

"The only practical way to do that," Way says, "is to synthesize it from scratch."

The cutting edge for redesigning a genome, though, is yeast. Its genome is bigger and more complex than the viral and bacterial codes altered so far. But it's well-understood and yeast will readily swap man-made DNA for its own.

Still, rewriting the yeast genome is a huge job.

It's like a chain with 12 million chemical links, known by the letters, A, C, G and T. That's less than one-hundredth the size of the human genome, which has 3.2 billion links. But it's still such a big job that Boeke's lab and scientists in the United States, Australia, China, Singapore, and the United Kingdom are splitting up the work. By the time the new yeast genome is completed, researchers will have added, deleted or altered about a million DNA letters.

Boeke compares a genome to a book with many chapters, and researchers are coming out with a new edition, with chapters that allow the book to do something it couldn't do before.

To redesign a particular stretch of yeast DNA, scientists begin with its sequence of code letters — nature's own recipe. They load that sequence into a computer, then tell the computer to make specific kinds of changes. For example one change might let them rearrange the order of genes, which might reveal strategies to make yeast grow better, says NYU researcher Leslie Mitchell.

Once the changes are made, the new sequence used as a blueprint. It is sent to a company that builds chunks of DNA containing the new sequence. Then these short chunks are joined together in the lab to build ever longer strands.

The project has so far reported building about one-third of the yeast genome. Boeke hopes the rest of the construction will be done by the end of the year. But he says it will take longer to test the new DNA and fix problems, and to finally combine the various chunks into a complete synthetic genome.

Last year, Boeke and others announced a separate effort, what is now called Genome Project-write or GP-write . It is chiefly focused on cutting the cost of building and testing large genomes, including human ones, by more than 1,000-fold within 10 years. The project is still seeking funding.

In the meantime, leaders of GP-write have started discussions of ethical, legal and social issues. And they realize the idea of making a human genome is a sensitive one.

"The notion that we could actually write a human genome is simultaneously thrilling to some and not so thrilling to others," Boeke said. "So we recognize this is going to take a lot of discussion."

___

This Associated Press series was produced in partnership with the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Mary Altaffer]]>
<![CDATA[Chipotle's Norovirus Outbreak the Result of Lax Sick-Policy]]>Wed, 26 Jul 2017 18:00:49 -0500https://media.nbcnewyork.com/images/213*120/cms872.jpg

Chipotle Mexican Grill's recent norovirus outbreak in Virginia was the result of lax sick policy enforcement by store managers, the company confirmed on Tuesday.

The company said in their earnings conference call that they believe an employee was the cause of the outbreak.

"We conducted a thorough investigation, and it revealed that our leadership there didn't strictly adhere to our company protocols. And we believe someone was working while sick. And we took swift action and made it clear to the entire company that we have a 0 policy -- or a 0-tolerance policy for not following these protocols," CEO Steve Ells said during the conference call.

It has been about two years since an E. coli outbreak rattled the food chain. In Oct. and Dec. 2015, at least 60 people were infected with the illness after eating at locations across the country. At least 22 people were hospitalized.

CLARIFICATION (July 26, 2017, 6:58 p.m. EST): An earlier version of this story implied that a direct quote was made from a Chipotle executive about the cause of the outbreak.



Photo Credit: AFP/Getty Images, File]]>
<![CDATA[6 Health Benefits of Owning a Pet]]>Tue, 25 Jul 2017 11:45:39 -0500https://media.nbcnewyork.com/images/180*120/GettyImages-639191848.jpgCute puppies and furry cats make great additions to the family, and they can even help boost their owners' health. Studies show that animals can help people make healthy choices and lead positive lifestyles. Here are six ways your pet can boost your health.

Photo Credit: fizkes/Getty Images]]>
<![CDATA[Nearly All NFL Players in Brain Study Had CTE]]>Tue, 25 Jul 2017 17:47:15 -0500https://media.nbcnewyork.com/images/213*120/Brain-Generic.jpg

Research on 202 former football players found evidence of a brain disease linked to repeated head blows in nearly all of them, from athletes in the National Football League, college and even high school.

It's the largest update on chronic traumatic encephalopathy, or CTE, a debilitating brain disease that can cause a range of symptoms including memory loss.

The report doesn't confirm that the condition is common in all football players; it reflects high occurrence in samples at a Boston brain bank that studies CTE. Many donors or their families contributed because of the players' repeated concussions and troubling symptoms before they died.

"There are many questions that remain unanswered," said lead author Dr. Ann McKee, a Boston University neuroscientist. "How common is this" in the general population and all football players?

"How many years of football is too many?" and "What is the genetic risk? Some players do not have evidence of this disease despite long playing years," she noted.

It's also uncertain if some players' lifestyle habits - alcohol, drugs, steroids, diet - might somehow contribute, McKee said.

Dr. Munro Cullum, a neuropsychologist at UT Southwestern Medical Center in Dallas, emphasized that the report is based on a selective sample of men who were not necessarily representative of all football players. He said problems other than CTE might explain some of their most common symptoms before death - depression, impulsivity and behavior changes. He was not involved in the report.

McKee said research from the brain bank may lead to answers and an understanding of how to detect the disease in life, "while there's still a chance to do something about it." Currently, there's no known treatment.

The strongest scientific evidence says CTE can only be diagnosed by examining brains after death, although some researchers are experimenting with tests performed on the living. Many scientists believe that repeated blows to the head increase risks for developing CTE, leading to progressive loss of normal brain matter and an abnormal buildup of a protein called tau. Combat veterans and athletes in rough contact sports like football and boxing are among those thought to be most at risk.

The new report was published Tuesday in the Journal of the American Medical Association.

CTE was diagnosed in 177 former players or nearly 90 percent of brains studied. That includes 110 of 111 brains from former NFL players; 48 of 53 college players; nine of 14 semi-professional players, seven of eight Canadian Football league players and three of 14 high school players. The disease was not found in brains from two younger players.

A panel of neuropathologists made the diagnosis by examining brain tissue, using recent criteria from the National Institute of Neurological Disorders and Stroke, McKee said.

The NFL issued a statement saying these reports are important for advancing science related to head trauma and said the league "will continue to work with a wide range of experts to improve the health of current and former NFL athletes."

After years of denials, the NFL acknowledged a link between head blows and brain disease and agreed in a $1 billion settlement to compensate former players who had accused the league of hiding the risks.

The journal update includes many previously reported cases, including former NFL players Bubba Smith, Ken Stabler, Dave Duerson and Ralph Wenzel.

New ones include retired tight end Frank Wainright, whose 10-year NFL career included stints with the Miami Dolphins, New Orleans Saints and Baltimore Ravens. Wainright died in April 2016 at age 48 from a heart attack triggered by bleeding in the brain, said his wife, Stacie. She said he had struggled almost eight years with frightening symptoms including confusion, memory loss and behavior changes.

Wainright played before the league adopted stricter safety rules and had many concussions, she said. He feared CTE and was adamant about donating his brain, she said.

"A lot of families are really tragically affected by it - not even mentioning what these men are going through and they're really not sure what is happening to them. It's like a storm that you can't quite get out of," his wife said.

Frank Wycheck, another former NFL tight end, said he worries that concussions during his nine-year career - the last seven with the Tennessee Titans - have left him with CTE and he plans to donate his brain to research.

"Some people have heads made of concrete, and it doesn't really affect some of those guys," he said. "But CTE is real."

"I know I'm suffering through it, and it's been a struggle and I feel for all the guys out there that are going through this," said Wycheck, 45.

In the new report, McKee and colleagues found the most severe disease in former professional players; mild disease was found in all three former high school players diagnosed with the disease. Brain bank researchers previously reported that the earliest known evidence of CTE was found in a high school athlete who played football and other sports who died at age 18. He was not included in the current report.

The average age of death among all players studied was 66. There were 18 suicides among the 177 diagnosed.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Medicaid is a Matter of Life or Death for a 2-Year-Old in Pennsylvania]]>Tue, 25 Jul 2017 09:46:38 -0500https://media.nbcnewyork.com/images/213*120/Claire+Concilio.jpg

The health care debate played out closer to home Monday as Senate Republicans continued to weigh which version of their bill will be brought to a vote Tuesday.

Pennsylvania Sen. Pat Toomey, a Republican who supports replacing and repealing former President Barack Obama’s Affordable Care Act (ACA), told NBC10 it was not clear if his party has enough votes to push through legislation.

“If we do nothing, if we keep the design as it is now, if we keep the Obamacare expansion in exactly the form it is, if we do nothing else, then someday ... this is going to blow up,” he said. “The federal government cannot continue to run the kinds of deficit, rack up the kind of debt, it has.”

One way or another, it won’t be the end of the fight, he said.

But to one Mount Airy family, the federal deficit is not the problem. Instead, they wonder if their 2-year-old daughter will ever walk or run.

Claire Concilio's parents use Medicaid coverage to access treatment at the Children’s Hospital of Philadelphia for spinal muscular atrophy, a rare neuromuscular disorder that can lead to death.

The disorder didn’t surface in the young girl until six months after her birth. That’s when Concilio’s parents noticed their daughter moving slowly and unable to lift her head. Her pediatrician thought weight gain was to blame until several more months passed and Concilio became increasingly incapacitated.

At her one year check-up, doctors found the problem.

"If Claire were to lose Medicaid, we'd lose more than the hope of her ever having a normal life,” Amy Concilio, Claire’s mother, said. “We would lose her."

Without treatment, the 2-year-old cannot hold herself in a sitting position. She would likely never walk, let alone run or skip with her friends.

Sen. Mitch McConnell's health care legislation would uproot much of Obama's health care law, eliminating its tax penalties on people not buying policies, cutting the Medicaid health care program for the poor and providing less generous health care subsidies for consumers, according to the Congressional Budget Office.

The burden, some say, is too great for some families to bear. 

“We’re going to fight and we’re going to hope she can walk with a walker or crutches someday,” Concilio said.

“Thank you, CHOP, and thank you, Medicaid, for saving my daughter. Thank you for giving her a chance, and thank you, Pennsylvania, for not taking that chance away.” 

More than 80 percent of patients at CHOP's Karabot Center receive health insurance through Medicaid, a program that could be substantially reduced under a new health care bill.

“If you’re surprised by that number, you’re not alone,” Madeline Bell, president of CHOP, said. “Medicaid is the largest children’s health program in the United States. Many of these children have no other options for health insurance.”

Throughout the state, more than 1.1 million people receive coverage through the Affordable Care Act’s health insurance exchange and Medicaid expansion, Gov. Tom Wolf said while touring CHOP Monday afternoon.

Roughly 32,000 patients at CHOP and its West Philadelphia Karabots Pediatric Care Center are on Medicaid, the hospital’s largest insurance payer, according to Bell. Nationally, more than 33 million kids depend on Medicaid.

“Everything we have seen proposed up to this time significantly cuts Medicaid and benefits for those children,” Bell said.

“When you start thinking about the fact that we support buildings and jobs, not to mention very vulnerable children, it would have a very devastating impact on CHOP, the local economy in Philadelphia. It’s those talking points that sometimes get missed.”

A spokesperson from Toomey's office said the Senate bills being considered would not impact children with disabilities. 



Photo Credit: NBC10]]>
<![CDATA[Twins Born Conjoined at the Heart]]>Tue, 25 Jul 2017 09:55:49 -0500https://media.nbcnewyork.com/images/213*120/Joined_at_the_heart-150093339088500001.jpg

Twin baby girls Paisleigh and Paislyn Martinez were born conjoined at the chest, with their hearts fused together. Doctors from University of Minnesota Masonic Children's Hospital used groundbreaking technology to separate them.]]>
<![CDATA[Burr-Hamilton? Angry Lawmaker Singles Out 'Female Senators']]>Mon, 24 Jul 2017 18:06:01 -0500https://media.nbcnewyork.com/images/213*120/TXrepBlakeFarenthold_1200x675.jpg

Passions are running high on Capitol Hill — but pistols at 10 paces over health care?

GOP Rep. Blake Farenthold of Texas is angry with some fellow Republicans in the Senate who are balking at parts of legislation to overturn "Obamacare." After GOP promises to repeal the law, that "is just repugnant to me," he says.

Who's to blame?

"Some of the people that are opposed to this, there are some female senators from the Northeast," Farenthold said.

And it's a good thing they're women, according to the congressman from Corpus Christi.

"If it was a guy from south Texas, I might ask them to step outside and settle this Aaron Burr-style," he said. That was a reference to the 1804 firearms duel in which Vice President Aaron Burr killed former Treasury Secretary Alexander Hamilton.

Who are those female senators from the Northeast?

Farenthold named no names. But Susan Collins of Maine has been consistent in opposing the GOP replacement for Obamacare. She remains concerned about deep cuts in Medicaid and has criticized the bill-writing process, with about a dozen men crafting the measure behind closed doors. Under the latest iteration of the bill, 22 million more people would become uninsured by 2026, many of them Medicaid recipients, according to the nonpartisan Congressional Budget Office.

Asked about Farenthold's comments, Collins said: "In the 20 years that I've been in the Senate, I've heard a lot of suggestions for how to resolve disagreements. But this is the first time that anyone has suggested a duel. And as far as I know, dueling is illegal in every state. He'll be disappointed, I guess."

Other female senators who have expressed reservations are Shelley Moore Capito of West Virginia and Lisa Murkowski of Alaska, some distance from the Northeast.

Farenthold made his comments in a radio interview Friday with Bob Jones of Corpus Christi radio "1440 Keys."

In a statement late Monday, the Texas lawmaker said: "This was clearly tongue in cheek. That being said, I'm extremely frustrated with Senate Republicans who are breaking their promise to the American people to repeal and replace Obamacare."

For weeks, Senate Republicans have struggled to agree on a bill to repeal and replace much of the 2010 law. Lacking support, Majority Leader Mitch McConnell, R-Ky., has postponed votes twice but hopes to bring the latest measure up again on Tuesday.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Jacquelyn Martin, File]]>
<![CDATA[Girl's HIV Infection Seems Under Control Without AIDS Drugs]]>Mon, 24 Jul 2017 21:34:48 -0500https://media.nbcnewyork.com/images/213*120/HIVvirsucell_1200x675.jpg

A South African girl born with the AIDS virus has kept her infection suppressed for more than eight years after stopping anti-HIV medicines — more evidence that early treatment can occasionally cause a long remission that, if it lasts, would be a form of cure.

Her case was revealed Monday at an AIDS conference in Paris, where researchers also gave encouraging results from tests of shots every month or two instead of daily pills to treat HIV.

"That's very promising" to help people stay on treatment, the U.S.'s top AIDS scientist, Dr. Anthony Fauci, said of the prospects for long-acting drugs.

Current treatments keep HIV under control but must be taken lifelong. Only one person is thought to be cured — the so-called Berlin patient, a man who had a bone marrow transplant in 2007 from a donor with natural resistance to HIV.

But transplants are risky and impractical to try to cure the millions already infected. So some researchers have been aiming for the next best thing — long-term remission, when the immune system can control HIV without drugs even if signs of the virus remain.

Aggressive treatment soon after infection might enable that in some cases, and the South African girl is the third child who achieved a long remission after that approach.

She was in a study sponsored by the agency Fauci heads, the National Institute of Allergy and Infectious Diseases, that previously found that early versus delayed treatment helped babies survive.

The girl, who researchers did not identify, started on HIV drugs when she was 2 months old and stopped 40 weeks later. Tests when she was 9 1/2 years old found signs of virus in a small number of immune system cells, but none capable of reproducing. The girl does not have a gene mutation that gives natural resistance to HIV infection, Fauci said, so her remission seems likely due to the early treatment.

The previous cases:

—A French teen who was born with HIV and is now around 20 has had her infection under control despite no HIV medicines since she was roughly 6 years old.

—A Mississippi baby born with HIV in 2010 suppressed her infection for 27 months after stopping treatment before it reappeared in her blood. She was able to get the virus under control again after treatment resumed.

At least a dozen adults also have had remissions lasting for years after stopping HIV medicines.

A study underway now is testing whether treating HIV-infected newborns within two days of birth can control the virus later after treatment stops. It started in 2014 in South America, Haiti, Africa and the United States, and some of the earliest participants might be able to try stopping treatment later this year.

Treatment might get easier if two large studies underway now confirm results reported Monday from a study testing a long-acting combo of two HIV drugs — Janssen's rilpivirine and ViiV Healthcare's cabotegravir.

Cabotegravir is experimental; rilpivirine is sold now as Edurant and used in combination with other drugs for treating certain types of HIV patients.

After initial treatment to get their virus under control, about 300 study participants were given either daily combination therapy pills or a shot every four or eight weeks of the long-acting drug duo to maintain control.

After nearly two years, 94 percent on eight-week shots, 87 percent on four-week shots and 84 percent on daily pills had their infections suppressed, with similar rates of side effects.

"The results were good regardless of whether people came monthly or every two months for their treatment. This has important policy implications," said Dr. Linda-Gail Bekker, deputy director of the Desmond Tutu HIV Centre at the University of Cape Town in South Africa, and a co-leader of the conference.

The study was sponsored by the drugmakers. Results were published in the British medical journal Lancet.

Two large studies aimed at winning approval to sell the treatment are testing the monthly shots. Janssen said in a statement that good results from eight-week shots warrant reconsidering the longer approach.

If it works, "this will have a huge impact on how we manage that very important group of people who are not able to access and take drugs on a day-to-day basis," such as those with mental health or drug abuse problems, said Dr. Steven Deeks, an AIDS specialist at the University of California, San Francisco.


Copyright Associated Press / NBC New York



Photo Credit: Centers for Disease Control and Prevention via AP]]>
<![CDATA[Tractor-Trailer Deaths in Texas Highlight Danger of Heat]]>Sun, 23 Jul 2017 20:22:42 -0500https://media.nbcnewyork.com/images/213*120/KevinSmith.gif

Experts say the temperature inside of the tractor-trailer where smuggled immigrants died and many others were left in dire health would have quickly become unbearable in the Texas heat.

Authorities said they found more than three dozen people, including eight who were dead, in the truck's trailer after an employee at the San Antonio Walmart where it was parked overnight called the police. One later died at a hospital. San Antonio Fire Chief Charles Hood said Saturday that the trailer didn't have a working air conditioning system and the victims "were very hot to the touch."

Thomas Homan, acting director of U.S. Immigration and Customs Enforcement, told The Associated Press that based on initial interviews with survivors, there may have been more than 100 people in the truck at one point, including some who were picked up by other vehicles or who fled.

This and other tragic instances of human smuggling, including a 2003 case in Victoria, Texas, in which 19 immigrants died, highlight the dangers that extreme heat poses to would-be immigrants.

TREACHEROUS TRAILER
With a high of 101 degrees (38 Celsius) in San Antonio on Saturday, the temperature inside a parked car would have reached 120 degrees (49 Celsius) in 10 minutes, said Jan Null, a meteorology professor at San Jose State University who tracks U.S. child deaths in vehicles on his website, www.NoHeatStroke.org. Within 20 minutes, the temperature would have risen to 130 degrees (54 Celsius).

The lack of windows on the trailer in San Antonio may have reduced the temperature inside by a couple degrees because of the lack of direct sunlight, but the heat and moisture from the bodies of everyone inside would have added heat and humidity.

Enduring those temperatures for any length of time is dangerous, said Dr. Eric Ernest, assistant professor of emergency medicine at University of Nebraska Medical Center in Omaha.

"Those are very brutal conditions that the human body wasn't meant for," he said.

HEAT HAZARDS
When heatstroke sets in after a person's body heat rises above 104 degrees (40 Celsius), perspiration shuts down, eliminating the body's primary method of cooling itself through the evaporation of sweat.

At this point, a person's skin begins to feel hot and appear red, and a person suffering heatstroke may appear confused, according to the Centers for Disease Control and Prevention.

Around 107 degrees (42 Celsius), cells start to die and organs can begin to fail. Once that happens, a person's health can deteriorate quickly.

"The body loses its ability to deal with heat," Ernest said.

Higher humidity makes things worse because perspiration won't evaporate as quickly.

One of the best ways to avoid heat-related illnesses is by drinking plenty of fluids, which authorities say weren't available to those on the truck.

"In 100 degree temperatures, you almost can't drink water fast enough," Null said.

DANGEROUS HEAT
Children, the elderly and people who are ill are most susceptible to heat-related problems because their bodies can't cool themselves as effectively as a healthy adult's can.

The CDC says about 618 people die in the U.S. each year from heat-related illnesses. Roughly 37, on average, are children who die in vehicles, according to Null's count.

Copyright Associated Press / NBC New York



Photo Credit: AP, File]]>
<![CDATA[GOP Health Care Bill Still a Mystery Before Planned Vote]]>Mon, 24 Jul 2017 05:46:22 -0500https://media.nbcnewyork.com/images/213*120/818430998-Mitch-McConnell-Health-Care-Bill.jpg

The Senate will move forward with a key vote this week on a Republican health bill but it's not yet known whether the legislation will seek to replace President Barack Obama's health care law or simply repeal it.

Sen. John Thune of South Dakota, the third-ranking Republican, said Senate Majority Leader Mitch McConnell will make a decision soon on which bill to bring up for a vote, depending on ongoing discussions with GOP senators. Thune sought to cast this week's initial vote as important but mostly procedural, allowing senators to begin debate and propose amendments. But he acknowledged that senators should be able to know beforehand what bill they will be considering.

"That's a judgment that Senator McConnell will make at some point this week before the vote," Thune said, expressing his own hope it will be a repeal-and-replace measure. "But no matter which camp you're in, you can't have a debate about either unless we get on the bill. So we need a 'yes' vote."

He said the procedural vote will be held "sometime this week."

President Donald Trump has said he wants Congress to repeal and replace Obamacare, but would accept a straight-repeal of the law if senators couldn't reach agreement. In a sign of the high stakes involved, Trump exhorted senators anew Sunday night to pass health legislation. "If Republicans don't Repeal and Replace the disastrous ObamaCare, the repercussions will be far greater than any of them understand!" Trump tweeted.

The Republican-controlled House in May narrowly passed its version of a bill to repeal and replace the Affordable Care Act, or "Obamacare."

Senate Republicans are now considering two versions of similar legislation, one that would repeal and replace, and another that would simply repeal "Obamacare" with a two-year delay for implementation to give the Senate more time to agree on a replacement.

Both versions encountered opposition from enough GOP senators to doom the effort, but McConnell, R-Ky., is making a last-gasp attempt this week after Trump insisted that senators not leave town for the August recess without sending him some kind of health overhaul bill to sign.

In the Senate, Republicans hold a 52-48 majority. They can only afford to have one of their senators defect and still prevail on a health bill. That's because Republican Sen. John McCain is in Arizona dealing with brain cancer, while Democrats are standing united in opposition. Vice President Mike Pence would cast a tie-breaking vote.

Thune said no matter the outcome of the upcoming vote, senators would continue working to pass health legislation no matter how long it took, having promised voters they would do so.

"We are going to vote to repeal and replace Obamacare," he said, arguing that it was better if done sooner rather than later. "It's not a question of if, it's a question of when."

Still, at least two Republican senators Sunday appeared to reaffirm their intention to vote against the procedural motion if it involved the latest version of the GOP's repeal-and-replace bill.

Moderate Sen. Susan Collins of Maine said she continued to have concerns about reductions to Medicaid and criticized the Republican process, saying lawmakers were being unfairly kept in the dark. Under McConnell's plan, 22 million more people would become uninsured by 2026, many of them Medicaid recipients. She wants to hold public hearings and work with Democrats.

"We don't know whether we're going to be voting on the House bill, the first version of the Senate bill, the second version of the Senate bill, a new version of the Senate bill, or a 2015 bill that would have repealed the Affordable Care Act," Collins said. "I don't think that's a good approach to replacing legislation that affects millions of people."

Conservative Sen. Rand Paul of Kentucky said he would only support a repeal-only bill. That version would reduce government costs but lead to 32 million additional uninsured people over a decade. At least three senators including Collins have previously expressed opposition to that plan.

"The real question is what are we moving to? What are we opening debate to? Last week, Senate leadership said it would be a clean repeal ... and I think that's a good idea," Paul said. "The other alternative is the Senate leadership bill that doesn't repeal Obamacare, is Obamacare light and is loaded with pork. ... I'm not for that."

Thune appeared on "Fox News Sunday," Collins was on CBS' "Face the Nation," and Paul spoke on CNN's "State of the Union."

Copyright Associated Press / NBC New York



Photo Credit: Chip Somodevilla/Getty Images, File]]>
<![CDATA[5 Reasons the Health Care Bill May Fail, 3 Why It May Not]]>Sun, 23 Jul 2017 16:39:23 -0500https://media.nbcnewyork.com/images/214*120/GettyImages-495314721-doctor.jpg

There are many reasons why the Senate will probably reject Republicans' crowning bill razing much of former President Barack Obama's health care law. There are fewer why Senate Majority Leader Mitch McConnell might revive it and avert a GOP humiliation.

Leaders say the Senate will vote Tuesday on their health care legislation. They've postponed votes twice because too many Republicans were poised to vote no. That could happen again.

The latest bill by McConnell, R-Ky. — and it could change anew — would end penalties Democrat Obama's health care law slapped on people without insurance, and on larger companies not offering coverage to workers. It would erase requirements that insurers cover specified medical services, cut the Medicaid health insurance program for the poor and shrink subsidies for many consumers.

IT FAILS:

AWFUL POLL NUMBERS
In an Associated Press-NORC Center for Public Affairs Research poll this month, 51 percent supported Obama's statute while just 22 percent backed GOP legislation.

Perhaps more ominously for Republicans, the AP-NORC poll found that by a 25-percentage-point margin, most think it's the federal government's responsibility to ensure all Americans have coverage. That's a growing view — there was just a 5-percentage-point gap in March. It underscores a harsh reality for the GOP: It's hard to strip benefits from voters.

AWFUL CBO NUMBERS
The nonpartisan Congressional Budget Office says under McConnell's plan, 22 million more people would be uninsured by 2026, mostly Medicaid recipients and people buying private policies. For single people, the typical deductible — out-of-pocket expenses before insurance defrays costs — would balloon that year to $13,000, up from $5,000 under Obama's law.

Note to the entire House and one-third of the Senate, which face re-election in 2018: 15 million would become uninsured next year. And though CBO says average premiums should fall in 2020, they'll head up in 2018 and 2019.

Oh, yes. The bill would let insurers charge people approaching retirement age higher prices than they can now, boosting premiums "for most older people," CBO says.

Older people like to vote.

AWFUL SENATE NUMBERS
With a 52-48 GOP majority, the bill would survive if no more than two Republicans oppose it. With the indefinite absence of the cancer-stricken Sen. John McCain, R-Ariz., McConnell's margin of error shrinks to one.

At least a dozen senators have expressed opposition to the legislation or been noncommittal. Lawmakers and aides say others haven't publicly surfaced.

Moderate senators from states with vast Medicaid populations want to protect those voters. Conservatives consider it their mission to eliminate the law they've campaigned on abolishing for years. These aren't easily resolved disputes.

PRESIDENTIAL DRAG
President Donald Trump wants "Obamacare" repealed.

He also has public approval ratings below 40 percent — Bad! — and a propensity for turning on people.

Just ask House Speaker Paul Ryan, R-Wis., and Attorney General Jeff Sessions.

After Ryan labored for months before the House approved its health care bill and earned a Rose Garden celebration, Trump called the measure "mean." Trump said he wouldn't have picked Sessions for his job had he known he'd recuse himself from investigations into Russian meddling in last year's campaign.

Some lawmakers might not be blamed for declining to carry Trump's water.

Trump expressed frustration with Republicans Sunday on Twitter. He said: "It's very sad that Republicans, even some that were carried over the line on my back, do very little to protect their President."

While he didn't directly say why he was upset with GOP lawmakers, Trump's tweet came as lawmakers are struggling to reach agreement on health care.

LEMONS INTO LEMONADE

The bill's rejection would still let lawmakers cast votes showing their positions. Supporters could say they honored their repeal "Obamacare" pledges, foes could say they protected their states or adhered to conservative principles.

Defeat would let the Senate refocus on tax cuts or other initiatives, though it's unclear what major issues don't divide Republicans.

A loss means there won't be a GOP law voters might blame for health care problems they encounter. Though Republicans may already own the issue in the public's eye, since they run the government.

IT PASSES:

THE UNTHINKABLE
This isn't happening, right? Republicans have run on repealing "Obamacare" for years.

The administration won't let the effort fail without a fight.

Trump lunched with senators at the White House last week and tweeted that Republicans "MUST keep their promise to America!"

On Friday, Vice President Mike Pence urged leaders of conservative, anti-abortion and business groups to pressure senators. Medicaid administrator Seema Verma has tried luring senators unhappy with Medicaid cuts, including Ohio's Rob Portman and West Virginia's Shelley Moore Capito, with more flexibility for governors to use Medicaid funds to help pay expenses for beneficiaries shifting to private insurance.

MCCONNELL
The health bill's floundering has tarnished McConnell's reputation as a legislative mastermind. Many Republicans privately say if the votes were gettable, he'd have gotten them already.

But the 33-year Senate veteran is wily and doesn't want his record stained with this failure. He understands what GOP senators need and has time, and if anyone can rescue the legislation, it's him.

TRUMP FACTOR
GOP senators cross Trump at their own peril. Eight in 10 Republicans still rate him favorably. In the 2018 midterm elections, when turnout is traditionally down, those loyal voters could make a difference.

Copyright Associated Press / NBC New York



Photo Credit: Joe Raedle/Getty Images, File]]>
<![CDATA[New Yorker Dead Amid Papaya Salmonella Outbreak]]>Mon, 24 Jul 2017 13:11:24 -0500https://media.nbcnewyork.com/images/213*120/Untitled-1261.jpg

A New Yorker has died from Salmonella they contracted from eating papayas, federal health officials say, and at least 25 people in New Jersey and New York have been infected.

The Centers for Disease Control and Prevention has declared a multi-state Salmonella outbreak from yellow Maradol papayas, a fruit with green skin that turns yellow when ripe.

Twelve people in New Jersey and 13 people in New York have been infected, officials say — more than any other states affected by the outbreak, which has also hit 10 other states, including Pennsylvania, Massachusetts and Maryland.

So far, the CDC has reported 47 people of all ages with Salmonella from the 12 states. Twelve of the people who were infected reported being hospitalized, but the only fatality is the person from New York City, officials say. It’s unclear if they are a man or a woman, or from what borough they hailed.

Public health officials identified the first Salmonella cluster in Maryland. Lab evidence suggested that the yellow Maradol papaya from a common grocery store was the root of the bacteria outbreak.

Reports of Salmonella in the fruit first cropped up in mid-May. Cases have continued into the summer, officials say.

The symptoms of Salmonella include diarrhea, fever, and abdominal cramps, which can appear up to three days after eating the fruit, according to the CDC. However, it takes an average of two to four days for people to report the illness.

For now, the CDC recommends that consumers stop eating yellow Maradol papayas, and restaurants and retailers stop selling it until further notice.

An investigation into the Salmonella outbreak is ongoing. For more on the outbreak, head to CDC.gov.

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<![CDATA[Cancer Patients' Gray Hair Turned Dark in New Drug Trials]]>Fri, 21 Jul 2017 13:08:05 -0500https://media.nbcnewyork.com/images/213*120/cancer-hair-color.jpg

Cancer patients' gray hair unexpectedly turned youthfully dark while taking novel drugs, and it has doctors scratching their heads.

Chemotherapy is notorious for making hair fall out, but the 14 patients involved were all being treated with new immunotherapy drugs that work differently and have different side effects. A Spanish study suggests that may include restoring hair pigment, at least in patients with lung cancer.

With the first patient, "we thought it could be an isolated case," said Dr. Noelia Rivera, a dermatologist at Autonomous University of Barcelona.

But she said the research team found the same thing when they asked other patients for photos from before treatment.

The 14 cases were among 52 lung cancer patients being followed to see whether they developed bad side effects from the drugs — Keytruda, Opdivo and Tecentriq.

While most patients did not have a color change, the 14 cases suggest it's not an isolated finding. In 13 patients, hair turned darkish brown or black. In one patient, it turned black in patches.

In another odd twist, the same drugs have been linked previously with hair losing color in patients with another cancer, melanoma.

All but one of the 14 patients in the Spanish study had at least stable disease and responded better to treatment than other patients, suggesting that hair darkening might be an indication that the drugs are working, the researchers said.

Rivera said they are continuing the study to search for an explanation and to see if the cases are just a fluke.

"It's a fascinating report — one of those things that comes out of the blue," said Dr. June Robinson, a Northwestern University research professor in dermatology. Robinson is also editor of the medical journal JAMA Dermatology, which published the study online this month.

She said the results deserve a deeper look but cautioned that it's way too soon to suggest that they might lead to new treatments for gray hair.

Rivera noted that the study drugs have serious side effects that make them unsafe for healthy people. But if it's confirmed that they do change hair color, a different drug could be developed to treat gray hair, she said.

The pharmaceutical industry has previously capitalized on unexpected drug side effects; examples include the male pattern baldness drug Propecia, the eyelash growing drug Latisse, and Botox anti-wrinkle injections. Active ingredients in these drugs were initially approved to treat enlarged prostates, eye pressure problems, and eye muscle spasms.

Copyright Associated Press / NBC New York



Photo Credit: JAMA via AP Photo]]>
<![CDATA[Abortion Fight Rages in Kentucky, Which Has Just 1 Clinic]]>Fri, 21 Jul 2017 15:40:14 -0500https://media.nbcnewyork.com/images/213*120/antiabortionkentuckycourts_1200x675.jpg

Both sides in the abortion fight raging in Kentucky agree on one thing: The stakes are as high as ever in a state that could become the first in the nation without an abortion clinic.

Political pressure has intensified since the Kentucky GOP took control of state government and moved quickly to pass new restrictions on abortions. And Republican Gov. Matt Bevin makes no apologies for waging a licensing fight against a Louisville clinic that is the last remaining facility performing abortions in the state.

Another battle-tested participant joins the fight this weekend. Operation Save America, a Christian fundamentalist group, plans to mobilize hundreds of activists to protest against EMW Women's Surgical Center.

The group's leaders state their purpose unequivocally: to rid Kentucky of its last abortion clinic. Some of the group's followers were arrested during a protest outside EMW in the spring. The group has said it won't use those same tactics in the coming days, but a federal judge on Friday ordered the creation of a "buffer zone" to keep protesters out of an area in front of the clinic. The pre-emptive move was requested by federal prosecutors to prevent protesters from blocking access to the surgical center.

"We have never been under siege like this," Dr. Ernest Marshall, a co-founder of the clinic open since the early 1980s, recently told The Associated Press. "We have never had any question as to whether we would exist."

For years, protesters have been a fixture outside Marshall's clinic, a plain brick building in Louisville's bustling downtown. Blinds are drawn to keep people from peeking inside.

Volunteers in bright orange vests stand watch near the clinic, walking patients past sign-waving activists. On a recent morning, as a demonstrator held a sign that said: "Abortion an American Holocaust," a child walking nearby asked a woman what holocaust means.

As a volunteer whisked another woman past a handful of protesters, a demonstrator clutching a rosary told the patient's male companion: "Men don't kill their babies. Man up." The man turned and glared but said nothing.

The demonstrator, Chuck Jones, defended his harsh words.

"This is the last chance we'll get to talk to them before they go in," the retired sheet-metal worker from Indiana said. "I just wanted him to think about what he's doing. If anybody believes in God, they can't be for abortion, in my opinion."

The 66-year-old Marshall — the father of three grown children and grandfather of eight — said he attends church every Sunday and is a former Sunday school teacher. He said abortion protesters don't have a "monopoly on morals." He condemned their tactics as "very harassing, very judgmental," taking a toll on patients and staff.

"Some of the things I see out in front of our clinic, to me, by the pro-life people, don't represent good Christianity," Marshall said. "I just don't think Jesus would harass people or name-call people or call doctors murderers."

The number of protesters is expected to surge this weekend when Texas-based Operation Save America converges on Louisville for a weeklong vigil, with the long-term goal of making Kentucky a national model in its push to end abortion. The group urges state officials to ignore the Supreme Court's Roe v. Wade decision in 1973 that legalized abortion.

Its activists plan to demonstrate outside the clinic, elsewhere downtown and in the neighborhoods where the clinic's doctors live, organizers said.

The buffer zone in front of the clinic won't deter those vigils, said Rusty Thomas, the group's national director.

Brigitte Amiri, an attorney for the ACLU Reproductive Freedom Project, said the buffer zone gives patients a "small measure of relief," ensuring they can enter.

The clinic has been on the defensive since Bevin's election in 2015 put a social conservative and ardent abortion foe in the governor's office. Last year, the GOP finished its takeover of Kentucky's legislature by winning control of the House of Representatives. They have been in charge of the state Senate for years.

Early this year, abortion opponents pushed through two bills signed by Bevin. One measure banned abortions in Kentucky after 20 weeks of pregnancy unless the mother's life is in danger. The other requires the abortion doctor or a "qualified technician" to perform an ultrasound and then try to show fetal images to the pregnant woman before she provides consent to an abortion. Women are allowed to avert their eyes. The procedure also seeks to detect the fetal heartbeat.

The ultrasound law is being challenged in federal court.

It's one of two pending legal fights in Kentucky over abortion.

The other was sparked when abortion rights supporters say Bevin's administration tried to shut down EMW earlier this year. State officials said the clinic was out of compliance with state requirements related to its agreements with a hospital and ambulance service. EMW sued in federal court, and Bevin's administration agreed to renew the clinic's license until after the lawsuit is resolved. A September trial is scheduled.

EMW's legal team points to a 2016 U.S. Supreme Court ruling that struck down Texas regulations that required doctors who perform abortions to have admitting privileges at nearby hospitals and forced clinics to meet hospital-like standards for outpatient surgery.

Though the types of regulations differ, the EMW case "falls squarely" within the Texas ruling because the Bevin administration's efforts would put an "undue burden" on women seeking abortions, said Heather Gatnarek, an attorney with the American Civil Liberties Union of Kentucky. The Kentucky case is even "more stark," she said, because a revocation of EMW's license would leave the state without an abortion facility.

The Supreme Court has found that access to an abortion must be guaranteed, but it remains to be seen whether eliminating every clinic in a single state would pass that test.

"I can't imagine being a female and being ... forced to have a baby that I didn't want," Marshall said.

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Texas Coffee Recalled for Viagra-Like Ingredient]]>Fri, 21 Jul 2017 05:56:15 -0500https://media.nbcnewyork.com/images/213*120/BESTHERBS-COFFEE-RECALL.JPG

Coffee from a North Texas company was recently recalled for containing an ingredient similar to the drug in Viagra, the U.S. Food and Drug Administration said.

Bestherbs Coffee LLC, in Grand Prairie, voluntarily recalled all of its "New of Kopi Jantan Tradisional Herbs Coffee" after an FDA lab analysis detected desmethyl carbodenafil, which is structurally similar to sildenafil, according to the FDA notice.

Sildenafil is the active ingredient in the FDA-approved prescription drug Viagra, which treats erectile dysfunction.

Desmethyl carbodenafil may react with nitrates found in some prescription drugs, lowering blood pressure to dangerous levels, the FDA said. The drug poses a risk to men with diabetes, high blood pressure, high cholesterol or heart disease.

The instant coffee packs also include milk, but the potential allergen is not included on the labels.

The coffee was sold nationwide online, with each box containing 25, 13-gram packs of coffee, and was officially recalled on July 13.

People who purchased the recalled coffee can return it to the Bestherbs office for a full refund. The address is listed below:

Bestherbs Coffee LLC
4250 Claremont Drive
Grand Prairie, TX 75052



Photo Credit: FDA]]>
<![CDATA[What Competing in the Tour de France Can Do to Your Legs ]]>Thu, 20 Jul 2017 16:42:34 -0500https://media.nbcnewyork.com/images/213*120/pawGettyImages-805284696.jpg

Polish cyclist Pawel Poljanski gave his Instagram followers a glimpse into the toll that riding 1,758 miles can take on one’s body.

On Tuesday, after riding in the 16th stage of the Tour de France, Poljanski posted a picture of his legs and added: “After sixteen stages, I think my legs look a little tired.”

Medical experts say Poljanski’s condition is caused by a massive amount of blood moving through the veins, Today reported.



Photo Credit: Getty Images
This story uses functionality that may not work in our app. Click here to open the story in your web browser.]]>
<![CDATA[GOP Health Bill Adds 22 Million Uninsured: Budget Office]]>Thu, 20 Jul 2017 14:25:57 -0500https://media.nbcnewyork.com/images/213*120/818430998-Mitch-McConnell-Health-Care-Bill.jpg

A revised Republican health care bill would drive up the number of uninsured Americans by 22 million by 2026, the Congressional Budget Office estimated Thursday in a report unlikely to help GOP leaders persuade their party's senators to back the reeling legislation in an upcoming showdown vote.

An earlier projection by Congress' nonpartisan budget analysts on the initial version of the GOP legislation projected the same number of people losing coverage. That figure has already proven to be enough to make some Republican senators unwilling to support the legislation.

In another blow to Republicans, the report estimates that single people buying a typical individual plan would face an annual deductible — out-of-pocket expenditures before benefits kick in — of $13,000 in 2026. That is far above the $5,000 deductible they'd be expected to pay under current law.

The $13,000 would engulf such a large amount of peoples' earnings that "many with low income would not purchase any plan even if it had very low premiums," the budget office wrote.

The reworked bill would increase average premiums over the next two years, but reduce them starting in 2020 by 30 percent, the report estimated. But the policies would typically offer less coverage.

And because the GOP measure would also eliminate federal subsidies that let insurers lower out-of-pocket costs for low-earners, there would be fewer lower-income people with coverage, the budget office said.

The report was released a day after President Donald Trump spurred GOP senators to resume trying to resuscitate their bill to erase and replace much of President Barack Obama's health care law.

White House officials and Senate leaders have been suggesting new changes aimed at winning over Republicans, but there's no evidence so far that those efforts have worked. Senate Majority Leader Mitch McConnell, R-Ky., has said he wants a vote on the legislation next week.

The budget office's new estimate does not include the impact of the most important change McConnell made in the legislation in an attempt to gain votes from conservatives. Language added by Sen. Ted Cruz, R-Texas, would let insurers sell low-premiums policies with minimal coverage, an option he and his supporters say would drive down premiums.

The coverage impact of Cruz's proposal is unclear. Many think it would increase the number of healthy people buying policies, but drive down the number of consumers with serious pre-existing conditions who could afford to purchase coverage.

McConnell's other changes included adding $45 billion to help states combat the abuse of drugs including opioids, extra money to help insurers curb cost increases and retention of tax increases Obama's law aimed at higher-income people.

GOP leaders' effort to win support for their bill may face even longer odds because of Sen. John McCain's jarring diagnosis of brain cancer.

Nursing a slender 52-48 majority, McConnell has been unable to muster the 50 votes he'd need to approve his party's health care overhaul. Vice President Mike Pence would cast the tiebreaking vote.

But with McCain, R-Ariz., receiving treatment back home for an uncertain period of time, McConnell's numerical advantage has dwindled. In McCain's absence, if just two Republicans defect it would sink Trump's and the GOP's banner legislative priority, and more than that have said they are ready to do so.

After a face-to-face lecture from Trump, around two dozen GOP senators staged a nearly three-hour bargaining session Wednesday night to resolve their disputes. When it was over, none offered specific examples of any progress.

Also attending Wednesday's private meeting were health secretary Tom Price and Seema Verma, the Medicaid and Medicare administrator. It was interrupted by prayer after the lawmakers learned that McCain, 80, had a cancerous brain tumor.

Earlier Wednesday at the White House, Trump told them they must not leave town for their August recess without sending him an "Obamacare" repeal bill to sign.

Earlier in the week, the latest Senate GOP health care plan collapsed, leading Trump to call for simply letting Obama's law fail.

McConnell indicated he was prepared to stick a fork in the Republican bill and move on to other issues including overhauling the tax code. But, plunging into the issue after a period of lackadaisical involvement, Trump pressured McConnell to delay the key vote until next week, and he invited Republican senators to the White House for lunch.

There, with cameras rolling in the State Dining Room, Trump spoke at length as he cajoled, scolded and issued veiled threats to his fellow Republicans, all aimed at wringing a health care bill out of a divided caucus that's been unable to produce one so far.

McConnell has failed repeatedly to come up with a bill that can satisfy both conservatives and moderates in his Republican conference. Two different versions of repeal-and-replace legislation fell short of votes before coming to the floor, pushing him to announce Monday night that he would retreat to a repeal-only bill that had passed Congress when Obama was in office.

But that bill, too, died a premature death as three GOP senators announced their opposition on Tuesday, one more than McConnell can lose in the closely divided Senate.

Copyright Associated Press / NBC New York



Photo Credit: Chip Somodevilla/Getty Images, File]]>
<![CDATA[Panel Finds Lifestyle Changes Could Stave Off Alzheimer's]]>Thu, 20 Jul 2017 09:32:32 -0500https://media.nbcnewyork.com/images/213*120/AP_03100701524-brain.jpg

There are no proven ways to stave off Alzheimer's, but a new report raises the prospect that avoiding nine key risks starting in childhood just might delay or even prevent about a third of dementia cases around the world.

How? It has to do with lifestyle factors that may make the brain more vulnerable to problems with memory and thinking as we get older. They're such risks as not getting enough education early in life, high blood pressure and obesity in middle age, and being sedentary and socially isolated in the senior years.

Thursday's report in the British journal Lancet is provocative — its authors acknowledge their estimate is theoretical, based on statistical modeling. A recent U.S. report was much more cautious, saying there are encouraging hints that a few lifestyle changes can bolster brain health but little if any proof.

Still, it's never too early to try, said Lancet lead author Gill Livingston, a psychiatry professor at University College London.

"Although dementia is diagnosed in later life, the brain changes usually begin to develop years before," she noted.

Early next year, a $20 million U.S. study will begin rigorously testing if some simple day-to-day activities truly help older adults stay sharp. In the meantime, Alzheimer's specialists say there's little down side to certain common-sense recommendations.

"Increased health of the body supports increased health of the brain," said cognitive neuroscientist Laura Baker of Wake Forest School of Medicine in North Carolina, who will lead the upcoming U.S. study.

Consider physical activity, crucial for heart health. "If in fact it should also improve the prospects for cognitive function and dementia, all the better," said Dr. Richard Hodes, director of the U.S. National Institute on Aging and an avid exerciser.

Here's the latest from this week's Alzheimer's Association International Conference on possible ways to guard your brain:

KEY RISKS
A Lancet-appointed panel created a model of dementia risks throughout life that estimates about 35 percent of all cases of dementia are attributable to nine risk factors — risks that people potentially could change.

Their resulting recommendations: Ensure good childhood education; avoid high blood pressure, obesity and smoking; manage diabetes, depression and age-related hearing loss; be physically active; stay socially engaged in old age.

The theory: These factors together play a role in whether your brain is resilient enough to withstand years of silent damage that eventually leads to Alzheimer's.

DOES CHANGING THESE OR OTHER LIFESTYLE FACTORS REALLY HELP?Last month, the U.S. National Academies of Sciences, Engineering and Medicine reported there's little rigorous proof. That report found some evidence that controlling blood pressure, exercise and some forms of brain training — keeping intellectually stimulated — might work and couldn't hurt.

Why? What's good for the heart is generally good for the brain. In fact, high blood pressure that can trigger heart attacks and strokes also increase risk for what's called "vascular dementia."

And exercising your gray matter may bulk up the brain, whether it's from childhood education or learning a new language as an adult. The more you learn, the more connections your brain forms, what scientists call cognitive reserve. Some U.S. studies have suggested that generations better educated than their grandparents have somewhat less risk of dementia.

Other factors have less scientific support. Studies show people with hearing loss are more likely to experience memory problems, and have speculated that it's because hearing loss leads to depression and social isolation — or even makes the brain work harder to deal with garbled sound, at the expense of other thinking skills. But so far there aren't studies proving hearing aids reverse that risk.

In fact, the strongest evidence that lifestyle changes help comes from Finland, where a large, randomized study found older adults at high risk of dementia scored better on brain tests after two years of exercise, diet, cognitive stimulation and social activities.

HUNTING PROOF
Would those strategies help Americans, who tend to be sicker, fatter and more sedentary than Scandinavians? The Alzheimer's Association is funding a study to find out, with enrollment of 2,500 cognitively healthy but high-risk older adults to begin next year.

Want to try on your own? They'll test:

  • Walking — supervised, so no cheating. Wake Forest's Baker puts seniors on treadmills at the local YMCA to avoid bumpy sidewalks. She starts exercise-newbies at 10 minutes a day for two days a week and works up to longer walks on more days.
  • A diet that includes more leafy greens, vegetables, whole grains, fish and poultry than the typical American menu.
  • Certain brain games and what Baker called an "intellectual stimulation barrage," outings and other steps that keep people social, not sitting home on a computer, while they exercise their brains.
  • Improving control of medical conditions like high blood pressure and diabetes that are toxic to the brain.


Copyright Associated Press / NBC New York



Photo Credit: AP Photo/David Duprey, File]]>
<![CDATA[For 1st Time, Over Half of People With HIV Taking AIDS Drugs]]>Thu, 20 Jul 2017 06:36:33 -0500https://media.nbcnewyork.com/images/213*120/aidsribbonfeuerherd.jpg

For the first time in the global AIDS epidemic that has spanned four decades and killed 35 million people, more than half of all those infected with HIV are on drugs to treat the virus, the United Nations said in a report released Thursday.

AIDS deaths are also now close to half of what they were in 2005, according to the U.N. AIDS agency, although those figures are based on estimates and not actual counts from countries.

Experts applauded the progress, but questioned if the billions spent in the past two decades should have brought more impressive results. The U.N. report was released in Paris where an AIDS meeting begins this weekend.

"When you think about the money that's been spent on AIDS, it could have been better," said Sophie Harman, a senior lecturer in global health politics at Queen Mary University in London.

She said more resources might have gone to strengthening health systems in poor countries.

"The real test will come in five to 10 years once the funding goes down," Harman said, warning that some countries might not be able to sustain the U.N.-funded AIDS programs on their own.

The Trump administration has proposed a 31 percent cut in contributions to the U.N. starting in October.

According to the report , about 19.5 million people with HIV were taking AIDS drugs in 2016, compared to 17.1 million the previous year.

UNAIDS also said there were about 36.7 million people with HIV in 2016, up slightly from 36.1 million the year before.

In the report's introduction, Michel Sidibe, UNAIDS' executive director, said more and more countries are starting treatment as early as possible, in line with scientific findings that the approach keeps people healthy and helps prevent new infections. Studies show that people whose virus is under control are far less likely to pass it on to an uninfected sex partner.

"Our quest to end AIDS has only just begun," he wrote.

The report notes that about three-quarters of pregnant women with HIV, the virus that causes AIDS, now have access to medicines to prevent them from passing it to their babies. It also said five hard-hit African countries now provide lifelong AIDS drugs to 95 percent of pregnant and breast-feeding women with the virus.

"For more than 35 years, the world has grappled with an AIDS epidemic that has claimed an estimated 35 million lives," the report said. "Today, the United Nations General Assembly has a shared vision to consign AIDS to the history books."

The death toll from AIDS has dropped dramatically in recent years as the wide availability of affordable, life-saving drugs has made the illness a manageable disease. But Harman said that "Ending AIDS" — the report's title — was unrealistic.

"I can see why they do it, because it's bold and no one would ever disagree with the idea of ending AIDS, but I think we should be pragmatic," she said. "I don't think we will ever eliminate AIDS, so it's possible this will give people the wrong idea."

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Aaron Favila]]>
<![CDATA[Health Plan's Fall Brings Dread for 'Obamacare' Recipients]]>Wed, 19 Jul 2017 15:07:20 -0500https://media.nbcnewyork.com/images/213*120/AP_17198746409580.jpg

One American was able to afford her toddler's latest heart operation. Another had the means to go back to college to pursue her dreams.

They and thousands of others were able to do so as beneficiaries of President Barack Obama's Affordable Care Act. And while Republicans in Congress failed this week to craft a new health care plan, they did succeed in shaking the confidence of those who rely on the act the most. President Donald Trump's "Let Obamacare fail" remark did nothing to assuage their fears.

Here's a snapshot of their concerns from around the country:

'THE WIND KNOCKED OUT OF ME'
Alison Chandra sobbed with relief Monday night when she heard that the Republican health care plan appeared doomed.

It meant she could still afford medical bills for her 3-year-old son, Ethan, who suffers from heterotaxy syndrome — a rare genetic disorder that causes organs to form incorrectly or in the wrong place.

But Chandra's anxiety swept back when she heard about the GOP effort to repeal the health plan with no replacement.

"That felt like getting the wind knocked out of me," said Chandra, a resident of Middlesex, New Jersey.

Chandra's story drew attention in June when she shared a photo of one of Ethan's hospital bills on Twitter. It showed a list of charges topping $230,000 for her son's latest heart operation at Boston Children's Hospital. At the bottom, it listed what she owed after insurance payments: $500.

Chandra worries about losing the law's ban on lifetime limits. Before the law, many health plans capped what they would pay for an individual's medical care over a lifetime, typically at $1 million or $2 million.

Repeal, Chandra said, "just doesn't work for families with medically fragile children like ours."

'SAVED MY LIFE AND SANITY'
Dawn Erin went to her first round of physical therapy Tuesday to treat painful bladder infections she's suffered for two decades. Her copay was $20 and her health plan covers the rest.

Physical therapy might seem mundane for some, but the 46-year-old from Austin, Texas, was ecstatic.

As a self-employed massage therapist who had hepatitis C, her pre-existing condition made it impossible for her to afford insurance before the Affordable Care Act.

"This is care I have needed all my adult life, but insurance didn't cover it and I couldn't afford to pay out of pocket," said Erin, who voted for Hillary Clinton in November.

Erin relies on a government subsidy to help pay for her plan. She also was able to get expensive medication to cure her hepatitis C.

"I really wish some GOP senator would call me and explain to me how the (Affordable Care Act) is failing because this insurance reform has saved my life and sanity," she said.

'A REALLY HORRIFYING LOTTERY'
Alexandra Flores, 29, a library assistant at the University of South Florida in St. Petersburg, was astonished with Trump's "Let Obamacare fail" declaration and his further insistence that "I'm not going to own it."

"To say that he 'won't own it' now when his party owns the House, Senate and White House is preposterous," Flores said. "The president of the United States should not be treating health care this way."

Flores is pursuing a master's degree in library science. She credits the Affordable Care Act for her decision to go back to school rather than be locked into her previous office job. She pays $77 a month for her health plan. The government kicks in about $100.

"Trump is acting like those who currently benefit from the ACA are wrong and will be punished for the simple act of having health insurance," Flores said, adding that she feels he's using her health care coverage "as a bargaining chip."

"I'm not sure there is a way to plan" for the future, she said. "It's like we're playing a really horrifying lottery."

'IT'S NOT A GAME'
Matt Mason, 48, of Omaha, Nebraska, says the Affordable Care Act radically reduced the costs of treating his Type I diabetes. Before it, he had to rely on state-subsidized coverage and buy a separate policy for his wife and two children.

By the time Obama signed the law in 2010, rising costs had forced Mason to take a plan with a $10,000 deductible. His family now shares one plan that he purchased through the federal exchange. The small nonprofit that employs him does not offer health care benefits.

Mason knows the ACA has its problems: Every year it's more expensive, and every year he's had to change carriers and policies because fewer insurers participate in the exchanges.

"Just repealing and saying, 'We'll replace it in two years,' that's just playing like it's a game," Mason said. "For me, it's not a game."

'I'M MORE CAUTIOUS'
Deborah deMoulpied, 62, of Concord, New Hampshire, owned a small home goods store and struggled to afford insurance when she first purchased a plan through the Affordable Care Act. She has since sold the store and is "semi-retired," though her premiums have risen about 25 percent a year.

She worries that her age and pre-existing condition — thyroid cancer — would make it impossible to pay for a plan under what Republicans have proposed. So she's thinking about what health tests she might schedule in the next few months — and what she might do without — in case she loses coverage.

"I'm sort of watching my pennies more," deMoulpied said. "It has made me pull back on spending. I'm more cautious."

'A LOT MORE DAY-TO-DAY STRESS'
Jake Martinez, 32, of the Salt Lake City suburb of Murray, Utah, is a social work student who also works two part-time jobs. He takes medication for his epilepsy that can cost hundreds of dollars a month. The Affordable Care Act, he said, made it possible to get affordable coverage for himself, his wife and their three children. Without it, he may decide to drop out of college so he can afford insurance.

"If I can't treat my epilepsy, I can't drive, I can't go to work. Things that are day-to-day activities become health hazards," Martinez said.

He and his wife, who owns a home day care business, have been trying to create a bare-bones budget they could live under if they can no longer buy health care on exchanges with help from subsidies. It's not easy, he said.

"We live now a life of a lot more day-to-day stress," Martinez said.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Manuel Balce Ceneta]]>
<![CDATA['Repeal Now, Replace Later' Would Impact Consumers Quickly]]>Wed, 19 Jul 2017 08:08:54 -0500https://media.nbcnewyork.com/images/180*120/repeal-now-replace-later.jpg

Consumers would feel the impact immediately if Republicans repeal "Obamacare" with no replacement.

Problems could start this fall for customers buying individual health policies, say independent experts, with more insurers likely to exit state markets around the country, and those remaining seeking higher rates.

Low-income people who qualified for expanded Medicaid expansion under the Affordable Care Act, or ACA, might be shielded for a year or two. But then federal funding for their coverage would stop and states would have to decide whether to keep those able-bodied adults on the rolls.

Though the latest approach seems doomed to fail, Senate Majority Leader Mitch McConnell insists he'll move to a vote.

Meanwhile, President Donald Trump has floated another idea: to "just let Obamacare fail." But that could also backfire, since his administration is unlikely to escape at least some of the blame.

With no good options for Republicans, here's a look at the potential consequences for consumers:

'RECIPE FOR CHAOS'
The repeal bill that McConnell is contemplating would not fully repeal the 2010 law enacted under President Barack Obama, and that wrinkle immediately starts creating problems.

The ACA requirement that individuals carry insurance would disappear right away. That would be followed in two years by the tax credits that help individuals pay their insurance premiums, as well as the money to subsidize state coverage for adults eligible for expanded Medicaid.

But ACA rules that make insurance more costly would remain in place for the foreseeable future. Those include protections for people with pre-existing conditions, standard benefits, and a limit on how much insurers can charge older adults.

That head-scratching outcome would stem from Senate rules that limit the kinds of "Obamacare" provisions Republicans can repeal with just 51 votes.

"It's a recipe for chaos," said Larry Levitt of the nonpartisan Kaiser Family Foundation. "It's worse in terms of coverage and premiums."

Combine that with uncertainty about the Trump administration's intentions, and "there would be an increased number of insurers exiting the market, leaving more counties without any coverage," Levitt added.

Conservative policy expert Jim Capretta of the American Enterprise Institute doesn't see it as a good move either.

"The insurance markets would become quite a bit more unstable in the near term," said Capretta. "Even before the subsidy structure is fully withdrawn the uncertainty would probably unravel the thing."

'LET IT FAIL'
If Congress can't get it done, Trump is suggesting maybe the answer is to "just let Obamacare fail." That might get Democrats clamoring for action, he says, and a deal might finally be in sight.

But not all of "Obamacare" is teetering. Medicaid expansion in 31 states basically operates on autopilot. And private insurance markets are stable in most areas, albeit with less consumer choice. Finally, voters might not blame Obama for the problems and instead turn their ire on Trump and the Republicans.

Insurers say their major worry currently is the reluctance of the White House and Congress to guarantee billions of dollars in "cost sharing" subsidies that help cover deductibles and copayments for low-income consumers. In the past Trump has suggested withholding the money to force Democrats to negotiate, but his administration has continued to make subsidy payments to insurers from month to month.

Some insurers have cited the lack of a guarantee on the subsidies as a factor behind requested premium increases for next year.

BlueCross BlueShield of North Carolina blamed the problem for most of its nearly 23 percent premium increase for 2018. With a guarantee that Washington would continue honoring the subsidies, the insurer said it would have sought a hike of just under 9 percent.

Insurers make their final decisions for 2018 by the end of September.

"With open enrollment ... only three months away, our members and all Americans need the certainty and security of knowing coverage will be available and affordable for them," said Justine Handelman, top Washington lobbyist for the BlueCross BlueShield Association. "We have consistently urged that there be immediate, certain funding for the cost-sharing reduction program."

The subsidies are under a legal cloud because of a lawsuit filed by House Republicans when Obama was president.

AN 'IOU' FROM CONGRESS
In theory "repeal now, replace later," would create space for orderly health care negotiations while Congress attends to other pressing business, such as raising the federal borrowing limit. Funding for expanded health insurance coverage would be continued for another two years, thereby setting a deadline for lawmakers to act.

But in the current unsettled political climate, that could work in just the opposite way.

"You've got an IOU for health system change, and we don't really know what will happen," said Dan Mendelson, CEO of the consulting firm Avalere Health. "It would just create a situation of great uncertainty for consumers and health care providers."

And Congress does not have a good record of meeting deadlines.

With past similar schemes, "Washington has been incapable of acting," said GOP adviser Lanhee Chen, who served as policy director for 2012 Republican candidate Mitt Romney.

Even with another two years there's no guarantee Republicans will be able to resolve their internal differences. "You'll still have a group of Republicans who like the Medicaid expansion, and another group that wants a complete repeal," said Chen.

Copyright Associated Press / NBC New York



Photo Credit: Joe Raedle/Getty Images]]>
<![CDATA[Brain Scans May Change Care for Some People With Memory Loss]]>Wed, 19 Jul 2017 07:56:00 -0500https://media.nbcnewyork.com/images/213*120/brain-scan-photos.jpg

Does it really take an expensive brain scan to diagnose Alzheimer's? Not everybody needs one but new research suggests that for a surprising number of patients whose memory problems are hard to pin down, PET scans may lead to changes in treatment.

The findings, reported Wednesday, mark a first peek at a huge study under way to help determine if Medicare should start paying for specialized PET scans that find a hallmark of Alzheimer's — a sticky plaque called amyloid.

Alzheimer's is the most common form of dementia, and classic symptoms plus memory tests often are enough for a reliable diagnosis. But unusual symptoms could mark another form of dementia that, while there are no cures, could require different symptom care. And on the other end of the spectrum, it's hard to tell if mild memory loss might be an early Alzheimer's signal, a more treatable condition such as depression, or even age-related decline.

"We're not accurate enough," said Dr. Gil Rabinovici of the University of California, San Francisco, who is leading the new research.

"Patients know there's something wrong. Often they can sense in their gut that it's not normal aging," he added. Without a clear-cut test, "doctors are very reluctant to make the diagnosis in many cases."

Until a few years ago, amyloid build-up could only be seen during autopsies. Older types of PET scans show what region of the brain appears most affected, of limited help.

Yet it's not clear how best to use the new amyloid-detecting scans, which can cost up to $6,000. They can rule out Alzheimer's if there's little amyloid. But cognitively healthy seniors can harbor amyloid, too, and Medicare won't pay for the new scans outside of a few research studies.

One of those is the IDEAS study, which is testing the impact of amyloid-detecting PET scans in more than 18,000 Medicare beneficiaries. To enroll, patients either must have atypical dementia with an unclear cause — or have particularly puzzling "mild cognitive impairment," or MCI, early memory problems that raise the risk of later developing dementia. Researchers check if doctors' initially recorded treatment plans — medications, counseling or additional testing — were altered by patients' PET results.

That happened in about two-thirds of the cases, according to preliminary findings from nearly 4,000 patients who were the first to enroll.

Most changes involved medications that can temporarily ease Alzheimer's symptoms, said Rabinovici, who presented the findings at the Alzheimer's Association International Conference in London. The PET scans found 70 percent of the dementia patients indeed had amyloid build-up, pointing out those who might benefit from those drugs and those who won't.

More intriguing, just 54 percent of the MCI patients had amyloid build-up, putting them at higher risk for later Alzheimer's. For the rest, "Alzheimer's disease was effectively ruled out, so it's something else," Rabinovici said.

The early findings don't prove PETs affect health outcomes.

But the Centers for Medicare and Medicaid Services helped plan the research and insisted on this midpoint check to be sure the study should continue, said Maria Carrillo, the Alzheimer's Association's chief medical officer. Researchers also will compare the 18,000 study participants with Medicare records of similar patients who didn't get PET scans, seeking final evidence of benefit.

"To get that right diagnosis, that's really important," said Cynthia Guzman of Napa, California, whose initial Alzheimer's diagnosis was ruled out in an earlier PET scan study.

Guzman had unusual fluctuating memory problems. Some days she functioned normally. Others, she'd stop her car at a stop sign without knowing how she got there or where she was going. Eventually, tremors and hallucinations led specialists to conclude she has Lewy body dementia. Knowing, Guzman said, has allowed her to avoid a list of common medications that could worsen her symptoms.

While any treatment changes today may be modest, researchers are hunting drugs that eventually might at least slow Alzheimer's rather than just treat symptoms, more impetus for a precise diagnosis.

"We all hope for a day when this will be critically important," said Dr. Richard Hodes, director of the National Institute on Aging, who wasn't involved with the IDEAS study.

For now, in addition to people who qualify for the IDEAS study, the Alzheimer's Association and Society of Nuclear Medicine and Molecular Imaging say:

—Unusually young dementia patients, younger than 65, also might be candidates for a PET scan.

—The scans shouldn't be used as a screening tool for people without symptoms or who worry they're at risk.

—Nor are they for people who can be diagnosed by standard means, or to determine disease severity. 

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Eric Risberg]]>
<![CDATA[Boy, 10, Among Youngest Fla. Victims of Opioid Crisis: Officials]]>Tue, 18 Jul 2017 19:41:27 -0500https://media.nbcnewyork.com/images/213*120/071817+alton+banks.jpg

A 10-year-old boy from a drug-ridden Miami neighborhood apparently died of a fentanyl overdose last month, becoming one of Florida's littlest victims of the opioid crisis, authorities said Tuesday. But how he came in contact with the powerful drug is a mystery.

Fifth-grader Alton Banks died June 23 after a visit to the pool in the city's Overtown section. He began vomiting after coming home and was found unconscious that evening. Preliminary toxicology tests show he had fentanyl in his system, authorities said.

"We don't believe he got it at his home," Miami-Dade State Attorney Katherine Fernandez Rundle said. "It could be as simple as touching it. It could have been a towel at the pool."

She added: "We just don't know."

The case has underscored how frighteningly prevalent fentanyl has become — and how potent it is. Exposure to just tiny amounts can be devastating.

Investigators said Alton may been exposed to the drug on his walk home in Overtown, a poor, high-crime neighborhood where Assistant Miami Fire Chief Pete Gomez said he has seen a spike in overdoses in the past year and where needles sometimes litter the streets.

"There is an epidemic," Gomez said. "Overtown seems to have the highest percentage of where these incidents are occurring."

Detectives are still trying to piece together the boy's final day. Rundle appealed to the public for information.

"This is of such great importance. We need to solve this case," she said. "I believe this may be the youngest victim of this scourge in our community."

The boy's mother, Shantell Banks, was informed of the preliminary findings last week. A distraught Banks told The Miami Herald that her son was a "fun kid" who wanted to become an engineer and loved the NFL's Carolina Panthers, especially Cam Newton.

Jessie Davis, who lives in an apartment house next to the building where Alton lived, said her grandchildren, ages 8, 9 and 10, regularly make the same walk to the nearby park with a swimming pool. She said she initially thought the pool water made Alton sick and was shocked by news reports that he had been exposed to fentanyl.

"Where would a 10-year-old baby get something like that?" Davis said.

Thinking about her own grandchildren going to the pool, Davis said, "I'm going to tell them, 'Don't touch nothing.' I don't know whether they think it's candy, but somebody needs to tell these kids something. I don't know how you just by touching contract it or whatever. We need to know more."

Fentanyl is a synthetic painkiller that has been in use for decades to treat cancer patients and others with severe pain, through use of a patch. But recently it has been front-and-center in the U.S. opioid abuse crisis.

Perhaps best known as the drug that killed pop star Prince, it is many times stronger than heroin and is often mixed with heroin by dealers.

"It's heroin laced with fentanyl, that's what is killing people," Palm Beach State Attorney Dave Aronberg said in a recent interview.

Fentanyl is so powerful that some police departments have warned officers not to even touch the drug. Last year, three police dogs in Broward County got sick after sniffing the drug during a federal raid, officials said.

Gomez said his crews wear protective clothing, including long sleeves, coveralls, gloves and masks, while handling fentanyl.

"You never want to start reaching into people's pockets," he said, adding that crews often cut people's pockets open for fear of pricking themselves with needles.

The Florida Legislature addressed the epidemic, passing a law that imposes stiff minimum mandatory sentences on dealers caught with 4 grams (0.14 ounces) or more of fentanyl or its variants.

The law also makes it possible to charge dealers with murder if they provide a fatal dose of fentanyl or drugs mixed with fentanyl. The law goes into effect Oct. 1.

Nearly 300 overdose deaths in Miami-Dade County last year involved variants of fentanyl, according to the medical examiner's office. Statewide, fentanyl and its variants killed 853 people in the first half of 2016. Of those, only nine were under age 18.

Copyright Associated Press / NBC New York



Photo Credit: John Moore/Getty Images, Facebook
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<![CDATA[Chipotle in Va. Reopens After Closure, Reports of Illness]]>Wed, 19 Jul 2017 12:27:58 -0500https://media.nbcnewyork.com/images/213*120/Chipotle-GettyImages-509063322.jpg

A Chipotle restaurant in Sterling, Virginia, is back open after being closed for two days because people said they got sick after eating there. 

Chipotle said Tuesday that it temporarily closed the restaurant, marking a possible setback in the chain's efforts to recover from past food scares.

The company said it became aware of a "small number" of reported illnesses. The reported symptoms are consistent with norovirus, for which symptoms include vomiting, diarrhea and stomach pain. 

The restaurant was back open Wednesday morning. 

The specific cause of the outbreak has not been found, the Loudoun County Health Department said in a statement Wednesday. 

"We are encouraged that those affected are starting to feel better, and we are focused on preventing any new infections," the statement said.

The health department did not release information on how many people said they got sick. 

Other Chipotle locations in the D.C. area remained open. 

Beth Oteyza said she and her daughter got severely ill after they shared a salad with chicken from the Chipotle location in Sterling on Friday.

"We decided to call the ambulance because I couldn't even sit up," Oteyza said. "The ambulance took me to Leesburg hospital. My daughter came and my husband came, and as they were waiting for me in the ER, she started throwing up."

"They both diagnosed us with the same thing, which is gastroenteritis. And when we compared our notes, we determined that the one thing we had both eaten in common was the Chipotle carryout food," Oteyza continued.

On Tuesday afternoon, she said she still felt sick. 

Customer Chris Lee said he also got sick after he ate at the restaurant on Friday. He also ordered a salad with chicken.

"About 7 o'clock on Saturday, really bad stomach pains. I just got better today," he said Tuesday afternoon.

The Denver-based company said norovirus does not come from its food supply and it is safe to eat at its restaurants.

"We take every report of illness seriously. In accordance with our established protocols, our team is working to ensure the safety of our customers and employees, including voluntarily closing the restaurant yesterday to conduct a complete sanitization," Jim Marsden, executive director for food safety, said in a statement issued Tuesday. 

Norovirus is a highly contagious virus you can get from contaminated food, surfaces or people, according to the Centers for Disease Control and Prevention. Food workers can spread the virus through poor hygiene practices.

Chipotle said Tuesday morning that it planned to reopen the restaurant later that day after a "complete sanitization." A Loudoun County health inspector at the restaurant Tuesday afternoon said she believed the restaurant would not reopen Tuesday.

Chipotle has been working to bounce back from food scares that included an E. coli outbreak in the fall of 2015 and a norovirus case in Boston later that year. Among the changes the company has announced are tweaks to cooking methods and training for employees to prevent such cases.

In addition to reassuring customers of the safety measures it has taken, Chipotle had been giving away coupons for free burritos and stepping up marketing to win back customers. For the first three months of this year, sales were up 18 percent at established locations. That followed a 20 percent decline in 2016.

Norovirus is the leading cause of illness and outbreaks from contaminated food in the United States, according to the Centers for Disease Control and Prevention. Infected employees are frequently the source of the outbreaks, the CDC says, often by touching foods such as raw fruits and vegetables with their bare hands before serving them.

Anyone who at at the Sterling location and fell ill is encouraged to call the county health department at 703-771-5411. 

Chipotle Mexican Grill's shares fell more than 5 percent Tuesday, after Business Insider reported the closure in Virginia.

One Chipotle customer outside the restaurant on Tuesday said she'll return no matter what.

"I love Chipotle," she repeated and laughed.

Copyright Associated Press / NBC New York



Photo Credit: AFP/Getty Images, File]]>
<![CDATA['Let Obamacare Fail,' Trump Says After GOP Plan Collapses]]>Tue, 18 Jul 2017 20:45:07 -0500https://media.nbcnewyork.com/images/213*120/818159534-Trump-Let-Obamacare-Fail.jpg

President Donald Trump declared Tuesday it's time to "let Obamacare fail" after the latest GOP health care plan crashed and burned in the Senate, a stunning failure for the president, Republican leader Mitch McConnell and a party that has vowed for years to abolish the law.

In a head-spinning series of developments, rank-and-file Republican senators turned on McConnell and Trump for the third time in a row, denying the votes to move forward with a plan for a straight-up repeal of "Obamacare." This time, it was three GOP women — Susan Collins of Maine, Lisa Murkowski of Alaska, and Shelley Moore Capito of West Virginia — who delivered the death blow.

All had been shut out of McConnell's initial all-male working group on health care.

McConnell, who could afford to lose only two votes in the narrowly divided Senate, had turned to the repeal-only bill after his earlier repeal-and-replace measure was rejected on Monday. That had followed the failure of an earlier version of the bill last month.

The successive defeats made clear that despite seven years of promises to repeal former President Barack Obama's Affordable Care Act, Republicans apparently cannot deliver. Nonetheless, McConnell insisted he would move forward with a vote on his measure to repeal the law, effective in two years, with a promise to work — along with Democrats — to replace it in the meantime.

The vote to move ahead to the bill will take place early next week, McConnell announced late Tuesday. It appears doomed to fail, but GOP leaders want to put lawmakers on record on the issue and move on.

At the White House, Trump appeared to recognize defeat, at least for the moment, while insisting he bore none of the blame.

"I think we're probably in that position where we'll just let Obamacare fail," the president said. "We're not going to own it. I'm not going to own it. I can tell you that the Republicans are not going to own it. We'll let Obamacare fail and then the Democrats are going to come to us and they're going to say, 'How do we fix it?'"

White House press secretary Sean Spicer said Tuesday night that all GOP senators have been invited to the White House tomorrow for lunch to discuss the way forward on health care.

Despite the current law's problems, most health care experts do not believe it is at immediate risk of outright failure, and Democratic cooperation to adjust the law is far from assured.

Nor does it appear likely that Republicans can escape owning the problems with the law and the health care system overall, now that they control the House, Senate and White House, partly on the strength of campaigning against the law.

"They seem to have this notion that they can be a majority party, and have control of the White House, and not be responsible for bringing down the health care system," said Democratic Sen. Dick Durbin of Illinois. "It doesn't work that way."

Asked how he would justify the GOP's failure on health care to voters, McConnell responded: "Well, we have a new Supreme Court justice" — suggesting inaction on health care would be forgiven because of that success along with some regulatory roll-backs.

As the day began Tuesday, McConnell was hunting for votes to open debate on a revived version of legislation Congress sent to Obama's desk in 2015 that would have repealed major portions of Obamacare, with a two-year delay built in. He had turned to that approach after getting stunned Monday night by defections by Sens. Mike Lee of Utah and Jerry Moran of Kansas on a repeal-and-replace bill.

Many Republicans support the repeal-only approach, and they questioned how senators who voted for the legislation two years ago could oppose it now.

"We're going to find out if there's hypocrisy in the United States Senate in the next few days I'm afraid," said Sen. David Perdue, R-Georgia.

But for others, the implications were too severe now that the bill could actually become law with a Republican president in the White House ready to sign it. The Congressional Budget Office has estimated that more than 30 million people would lose insurance over a decade under the legislation.

Collins voted against the legislation in 2015 while Murkowski and Capito both supported it. Murkowski told reporters Tuesday that repealing the Affordable Care Act without the promise of a replacement would cause uncertainty and chaos.

"To just say repeal and 'Trust us, we're going to fix it in a couple of years,' that's not going to provide comfort to the anxiety that a lot of Alaskan families are feeling right now," she said.

Said Capito: "I did not come to Washington to hurt people."

What's next? Go back to the committee room and work on a bipartisan basis "in a way that the public feels that we are really working toward their best interests," Murkowski said. "It's where we should have started. ... And yes, this is hard."

Sure enough, later in the day health committee chairman Sen. Lamar Alexander of Tennessee announced he planned hearings on the issue in the next few weeks, a step Senate Republicans have not taken to date.

The GOP's struggles over the latest measures came down to differences between moderates who feared the implications of a full-blown repeal, and conservatives who wanted nothing less. Speaker Paul Ryan managed to bridge those divides in the House in May, barely passing a bill that would have eliminated the coverage mandates and tax hikes in the Affordable Care Act, while unwinding the Medicaid expansion and removing insurance coverage for millions.

But the GOP bills polled poorly, and Trump never tried to sell them to the country. Meanwhile, Obama's law grew steadily more popular in polls, and Republicans learned anew that a benefit, once given, is hard to take away.

Associated Press writers Stephen Ohlemacher, Richard Lardner and Mary Clare Jalonick contributed.

Copyright Associated Press / NBC New York



Photo Credit: Alex Wong/Getty Images]]>
<![CDATA['Raining Needles': Drug Crisis Creates Syringe Pollution]]>Mon, 17 Jul 2017 06:55:23 -0500https://media.nbcnewyork.com/images/213*120/AP_17171822298733-hypodermic-needles-syringes-everywhere-.jpg

They hide in weeds along hiking trails and in playground grass. They wash into rivers and float downstream to land on beaches. They pepper baseball dugouts, sidewalks and streets. Syringes left by drug users amid the heroin crisis are turning up everywhere.

In Portland, Maine, officials have collected more than 700 needles so far this year, putting them on track to handily exceed the nearly 900 gathered in all of 2016. In March alone, San Francisco collected more than 13,000 syringes, compared with only about 2,900 the same month in 2016.

People, often children, risk getting stuck by discarded needles, raising the prospect they could contract blood-borne diseases such as hepatitis or HIV or be exposed to remnants of heroin or other drugs.

It's unclear whether anyone has gotten sick, but the reports of children finding the needles can be sickening in their own right. One 6-year-old girl in California mistook a discarded syringe for a thermometer and put it in her mouth; she was unharmed.

"I just want more awareness that this is happening," said Nancy Holmes, whose 11-year-old daughter stepped on a needle in Santa Cruz, California, while swimming. "You would hear stories about finding needles at the beach or being poked at the beach. But you think that it wouldn't happen to you. Sure enough."

They are a growing problem in New Hampshire and Massachusetts — two states that have seen many overdose deaths in recent years.

"We would certainly characterize this as a health hazard," said Tim Soucy, health director in Manchester, New Hampshire's largest city, which collected 570 needles in 2016, the first year it began tracking the problem. It has found 247 needles so far this year.

Needles turn up in places like parks, baseball diamonds, trails and beaches — isolated spots where drug users can gather and attract little attention, and often the same spots used by the public for recreation. The needles are tossed out of carelessness or the fear of being prosecuted for possessing them.

One child was poked by a needle left on the grounds of a Utah elementary school. Another youngster stepped on one while playing on a beach in New Hampshire.

Even if adults or children don't get sick, they still must endure an unsettling battery of tests to make sure they didn't catch anything. The girl who put a syringe in her mouth was not poked but had to be tested for hepatitis B and C, her mother said.

Some community advocates are trying to sweep up the pollution.

Rocky Morrison leads a cleanup effort along the Merrimack River, which winds through the old milling city of Lowell, and has recovered hundreds of needles in abandoned homeless camps that dot the banks, as well as in piles of debris that collect in floating booms he recently started setting.

He has a collection of several hundred needles in a fishbowl, a prop he uses to illustrate that the problem is real and that towns must do more to combat it.

"We started seeing it last year here and there. But now, it's just raining needles everywhere we go," said Morrison, a burly, tattooed construction worker whose Clean River Project has six boats working parts of the 117-mile (188-kilometer) river.

Among the oldest tracking programs is in Santa Cruz, California, where the community group Take Back Santa Cruz has reported finding more than 14,500 needles in the county over the past 4 1/2 years. It says it has gotten reports of 12 people getting stuck, half of them children.

"It's become pretty commonplace to find them. We call it a rite of passage for a child to find their first needle," said Gabrielle Korte, a member of the group's needle team. "It's very depressing. It's infuriating. It's just gross."

Some experts say the problem will ease only when more users get treatment and more funding is directed to treatment programs.

Others are counting on needle exchange programs, now present in more than 30 states, or the creation of safe spaces to shoot up — already introduced in Canada and proposed by U.S. state and city officials from New York to Seattle.

Studies have found that needle exchange programs can reduce pollution, said Don Des Jarlais, a researcher at the Icahn School of Medicine at Mount Sinai hospital in New York.

But Morrison and Korte complain poor supervision at needle exchanges will simply put more syringes in the hands of people who may not dispose of them properly.

After complaints of discarded needles, Santa Cruz County took over its exchange from a nonprofit in 2013 and implemented changes. It did away with mobile exchanges and stopped allowing drug users to get needles without turning in an equal number of used ones, said Jason Hoppin, a spokesman for the Santa Cruz County.

Along the Merrimack, nearly three dozen riverfront towns are debating how to stem the flow of needles. Two regional planning commissions are drafting a request for proposals for a cleanup plan. They hope to have it ready by the end of July.

"We are all trying to get a grip on the problem," said Haverhill Mayor James Fiorentini. "The stuff comes from somewhere. If we can work together to stop it at the source, I am all for it."

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Charles Krupa]]>
<![CDATA[Preventive Care, Screenings Could Be Compromised by GOP Bill]]>Mon, 17 Jul 2017 06:29:59 -0500https://media.nbcnewyork.com/images/213*120/health-care-preventive.jpg

President Donald Trump has often said he doesn't want people "dying in the streets" for lack of health care.

But in the United States, where chronic conditions are the major diseases, people decline slowly. Preventive care and routine screening can make a big difference for those at risk for things such as heart problems and cancer, especially over time.

That edge is what doctors and patients fear will be compromised if Republican efforts to repeal the Obama-era health law lead to more uninsured people. The uninsured tend to postpone care until problems break through.

It's a message that lawmakers are hearing from doctors' groups and constituents, in letters and emails, and at town hall meetings.

About 10 years ago, Cathy Cooper of Ocala, Florida, was battling a blood cancer. Against doctor's advice, she continued to work full time as a paralegal, through chemotherapy and radiation, just to preserve her health insurance. Cooper said she would schedule chemo on Fridays, spend the weekend sick from side effects and report back to work Monday.

Now in her early 30s, Cooper is healthy. She has her own business as a photographer specializing in maternity, newborns, families and seniors, and a family of her own. Her health insurance is through HealthCare.gov. With her cancer history, Cooper is worried about changes under debate that may reduce options for people with medical conditions. She said she voted for Hillary Clinton in the presidential election.

"The 'dying in the streets' thing — it's an over-time process," said Cooper. "If I didn't have insurance, it (cancer) could just keep forming inside me and I wouldn't know. Then I'd go into the hospital, and there's nothing they could do. And then, yeah, I could die in the street. But that's because I wouldn't have had insurance to get things checked out prior to that point."

In Charlotte, North Carolina, Dr. Octavia Cannon said that's basically what happened to one of her patients several years ago. The patient, a working mother with three young children and more than one job, was uninsured after losing previous Medicaid coverage. She went to Cannon, an osteopathic ob-gyn, because of abnormal bleeding. Cannon said she knew something was horribly wrong on the basis of her initial physical examination. The pathology lab confirmed advanced cervical cancer.

"In six months, she was dead," Cannon recalled. "All I could think was 'Who is going to take care of these babies?' If she had only come in for a Pap smear."

Such stories are swirling around the Senate debate as Majority Leader Mitch McConnell, R-Ky., pushes toward a vote on legislation rolling back much of former President Barack Obama's Affordable Care Act. The GOP bill has been facing headwinds since the Congressional Budget Office estimated it would lead to 22 million more uninsured people by 2026.

Administration officials say the nonpartisan budget office has been wrong before about health coverage, and its analytical methods may give too much weight to the current requirement that most people carry health insurance or risk fines. (Republicans would repeal that immediately.) Health and Human Services Secretary Tom Price said Trump's goal is more people with health insurance, not fewer.

"Nobody is looking at it in its totality," Price said recently on NBC. "We will bring down premiums, we will increase coverage, we'll increase choices. And I believe we'll increase the quality of care provided in this nation."

There's not much debate about the negative consequences of being uninsured.

Studies by the National Academies have found that the uninsured are more likely to receive too little care, and too late; be sicker and die sooner; and receive poorer care in the hospital.

But surprisingly, there are questions about whether gaining coverage produces tangible health benefits.

Major government surveys have documented clear improvements to family finances associated with Obama's coverage expansion. On health itself, the evidence is mixed.

Medicaid expansions in New York, Maine and Arizona in the early 2000s were associated with a 6 percent decline in death rates in those states, compared with neighboring states that did not expand coverage for low-income people. A study of Massachusetts found a similar trend.

But in Oregon a Medicaid expansion study that found a marked reduction in depression failed to detect significant improvement in blood sugars, blood pressure and cholesterol levels — risk factors for heart disease and diabetes.

Dr. Cyrus Hamidi, a solo family medicine practitioner in Sparks, Maryland, said having insurance is a start, reducing barriers to access for patients.

"If you have to pay to go to the doctor, then you worry about payment instead of what you need to do to reduce the risk of dropping dead," he said.

Gaywin Day, a union electrician from Austin, Texas, said being able to get coverage under Obama's law in the aftermath of a medical crisis has been "a lifesaver."

Day, in his early 60s, was between jobs and uninsured when he had a stroke in March. A couple of months later, a "special enrollment period" enabled him to get subsidized coverage through HealthCare.gov, opening doors to physical therapy and follow-up medical care.

Now, Day no longer uses a walker or cane. He's thinking about returning to work.

"Nobody wants anybody dying in the streets, but if I hadn't got this. ... I could just be shriveling up in my bed," he said.

He didn't cast a ballot last year. "I don't vote," said Day. "I do a lot of praying."

___

Associated Press writer Sheila Burke in Nashville, Tennessee, contributed to this report.


Copyright Associated Press / NBC New York



Photo Credit: AP Photo/John Raoux]]>
<![CDATA[Health Plan Hinges on the Young, a Tough Sell: Analysis]]>Mon, 17 Jul 2017 18:27:10 -0500https://media.nbcnewyork.com/images/214*120/GettyImages-495314721-doctor.jpg

Julian Senn-Raemont isn't convinced he needs to buy health insurance when he loses coverage under his dad's plan in a couple of years — no matter what happens in the policy debate in Washington, or how cheap the plans are.

The 24-year-old musician hasn't known a world without a health care safety net. But he hates being forced by law to get coverage, and doesn't think he needs it.

"I'm playing the odds," said Senn-Raemont, who lives in Woodstock, Illinois. He will go without insurance, he said, until he starts a family or gets a job with benefits. "I feel comfortable I could get care if I needed it."

Senn-Raemont's outlook could pose a major problem for Republicans who await a delayed vote on a replacement for the Affordable Care Act. Insurers need young and healthy enrollees like him to buy insurance because they keep premiums down for everyone. The current law attempts to do that by mandating that everyone get coverage. The Republican plan replaces that mandate with penalties for those who let coverage lapse, and aims to entice young adults by allowing insurance companies to sell bare-bones coverage that could be cheaper.

But cheap isn't free, which turns off people like Senn-Raemont. And other young adults worry that opening the door to these bare-bones plans will make the more comprehensive coverage they know now too expensive or even unavailable.

In Houston, 29-year-old Jimmieka Mills pays $15 a month for a government-subsidized "Obamacare" health plan. She fears Congress will weaken the health law's guarantees of free preventive care, so she made an appointment to get a birth control implant that will last for years.

"I'm scared," Mills said. "I'm like a bear getting ready for hibernation. That's how I feel."

Language is still being nailed down in the retooled bill, but it includes a proposal from conservative Sen. Ted Cruz, R-Texas, which would let insurers sell plans with minimal coverage, as long as they also sell policies that meet strict coverage requirements set by the Obama-era health care law. Insurers could deny the slimmer coverage to people with pre-existing conditions or charge them more.

Georgetown University health policy researcher Sabrina Corlette said young adults may find the "Cruz plans" more affordable, but they should "read the fine print."

"You may end up with unexpected costs," Corlette said. "And if, God forbid, you do end up needing better coverage, you will be blocked from that coverage for six months." To encourage continuous coverage, the GOP plan installs a six-month waiting period for anyone with a two-month gap in coverage. The skimpy policies wouldn't qualify as continuous coverage.

The insurance industry also sharply questioned this approach. In a statement last week, the industry group America's Health Insurance Plans said the proposal would create an "un-level playing field" that would lead to "unstable health insurance markets."

Other features of the proposal aimed at young adults include allowing them to stay on their parents' insurance until they turn 26, as they can now, and shifting costs to older enrollees.

Current law restricts how much insurers can charge for insurance based on age. "Obamacare" limits the ratio to 3-to-1, meaning a 50-year-old can be charged only three times as much as a 20-year-old. The Republican plan shifts that ratio to 5-to-1.

More flexible pricing could attract young adults, the Congressional Budget Office said in a review of a previous draft of the Senate plan. But other provisions, including cuts to Medicaid, would result in 22 million people losing insurance over the next decade. All ages and income levels would have higher uninsured rates. For low-income young adults, CBO said, the uninsured rate would double.

A CBO analysis was expected Monday but has been postponed, according to the Senate Budget Committee. Senate Majority Leader Mitch McConnell announced late Saturday he was delaying the vote on the bill while Sen. John McCain recovers from surgery.

"On the whole, the bill is bad for young people," said Jen Mishory, executive director of the youth advocacy group Young Invincibles. "It is particularly concerning for the most vulnerable young people, those who are low-income and folks with pre-existing conditions."

Young Americans, ages 18-34, remain more likely to be uninsured than older age groups, but the rate of uninsured young Americans dropped under "Obamacare" to 16 percent from 29 percent.

Obama's health law also gives them job flexibility because good health insurance was no longer tied to employment, said Republican labor economist Craig Garthwaite of Northwestern University's Kellogg School of Management.

"That gives young adults the opportunity to find a first job that's right for their talents," Garthwaite said.

Alexandra Flores, 29, works as a library assistant at University of South Florida in St. Petersburg while pursuing a master's degree in library science. She credits the Obama health law for her decision to go back to school rather than be locked into her previous office job. She pays $77 a month for her "Obamacare" health plan. The government kicks in about $100.

"Without health care, I wouldn't feel comfortable growing my career the way I have," Flores said.

Republican proposals to ban federal funding of Planned Parenthood for a year would affect 34-year-old Renee Wsol of Chicago. A Medicaid beneficiary, she received a free IUD for long-acting birth control from the organization this year. Planned Parenthood is now her regular source of women's health care, including cancer screenings.

"I feel comfortable and safe at Planned Parenthood," she said. "It makes no sense to pluck that care away from people who already have limited choices."

Jackie Todd, 28, of Chicago, feels hemmed in by the health care debate because she would like to pursue a master's in filmmaking, but doesn't want to risk losing the insurance she has through her job. She has an implanted device for a heart rhythm problem, which will need to be replaced in two years, "and I cannot be uninsured when that happens."

"The GOP doesn't think I deserve a shot at an even playing field because being sick is somehow my fault," she said.

Copyright Associated Press / NBC New York



Photo Credit: Joe Raedle/Getty Images, File]]>
<![CDATA[More Hurdles as Senate Again Delays Vote on GOP Health Bill]]>Sun, 16 Jul 2017 17:46:41 -0500https://media.nbcnewyork.com/images/213*120/johnmccainefeuerherdII.jpg

The Senate delayed a highly anticipated vote this coming week to repeal and replace the nation's health care law after Sen. John McCain's announced absence due to surgery, an enormous setback as time dwindles for Republicans to pass the signature legislation after years of promises.

The decision by Senate Majority Leader Mitch McConnell late Saturday came not long after McCain's office disclosed that he had undergone surgery to remove a blood clot from above his left eye. He's expected to be out for the week, recovering in Arizona.

Adding to the uncertainty, the Congressional Budget Office also indicated on Sunday it no longer expected to release its analysis on Monday on the estimated cost and scope of insurance coverage under the latest GOP bill, which has the support of President Donald Trump.

The No. 2 Senate GOP leader, John Cornyn of Texas, said he still expected the Senate to move quickly, holding a vote as soon as McCain returns. But amid growing public unease over the bill, some Republicans suggested the delay will make McConnell's task of winning enough support even harder.

In a Senate divided 52-48 between Republicans and Democrats, McConnell can lose no more than two GOP votes and still prevail.

"There are about eight to 10 Republican senators who have serious concerns about this bill. And so at the end of the day, I don't know whether it will pass," said moderate Sen. Susan Collins, R-Maine. She has made clear she would vote against the bill, citing proposed cuts to the Medicaid health program for the poor and elderly.

Sen. Rand Paul, R-Ky., who is also opposed, said doubts also are increasing among Republicans who want to see a fuller repeal of the Affordable Care Act. "The longer the bill's out there, the more conservative Republicans are going to discover that it's not repeal," he said.

The White House said Sunday that Trump was "monitoring what's going on with health care" but did not otherwise weigh in on the growing uncertainty. "We wish Sen. McCain a speedy recovery," said Helen Aguirre Ferre, director of media affairs.

McConnell last week had refashioned the legislation to attract additional GOP votes. The new package added language letting insurers sell discount-priced policies with minimal coverage aimed at winning over conservatives, and revised funding formulas that would mean federal money for states including Louisiana and Alaska — home to four GOP senators who are uncommitted on the measure.

But the health care legislation was already hanging by a thread. McCain's absence meant it would become impossible for the majority leader to round up the votes needed this week to proceed on the bill.

It was the second time that McConnell was forced to call off a planned vote, even with heavy lobbying by Trump administration officials. A vote was postponed last month also due to limited support. Democrats are unanimously opposed to the bill, as are the nation's major medical groups and insurers.

"While John is recovering, the Senate will continue our work on legislative items and nominations, and will defer consideration of the Better Care Act," McConnell, R-Ky., said on Saturday. He has already said the Senate will work through the first two weeks of the August recess, citing a need to finish a slate of unfinished business.

McConnell did not indicate when he would aim to return to the health care bill, but Cornyn made clear Sunday that moving quickly is important.

"I believe as soon as we have a full contingent of senators, that we'll have that vote," he said.

Cornyn acknowledged that if the Senate is unable to attract enough GOP votes that it will "keep trying" but will eventually have to come up with a different plan. "We're willing to do what we can to shore up the system now, to stabilize it to make health care available to people now, but we want reforms to go along with it," he said.

The Senate bill, like legislation the House passed earlier, repeals mandates requiring individuals to carry insurance and businesses to offer it, and unravels an expansion of the Medicaid program enacted under President Barack Obama's law. Analyses of the earlier version of the Senate bill found it would result in more than 20 million additional uninsured Americans over a decade compared to current law.

The newest version attempts to attract conservative support by allowing insurers to offer skimpy coverage plans alongside more robust ones, but also reaches out to moderates by adding billions in help for the opioid crisis and to defray high costs for consumers.

In Phoenix, Mayo Clinic Hospital doctors said McCain underwent a "minimally invasive" procedure to remove the nearly 2-inch (5-centimeter) clot and that the surgery went "very well," a hospital statement said. McCain was reported to be resting comfortably at his home in Arizona.

Pathology reports on the clot were expected in the next several days.

McCain, 80, is a three-time survivor of melanoma. Records of his medical exams released in 2008 when he was the GOP candidate for president showed that he has had removed precancerous skin lesions, as well as an early stage squamous cell carcinoma, an easily cured skin cancer.

Cornyn appeared on NBC's "Meet the Press," Collins was on ABC's "This Week" and CNN's "State of the Union," and Paul was on "Fox News Sunday" and CBS' "Face the Nation."

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Jacquelyn Martin]]>
<![CDATA[White House Pitches Health Bill to Skeptical US Governors]]>Sat, 15 Jul 2017 14:57:49 -0500https://media.nbcnewyork.com/images/213*120/governorshealthbill.jpg

The Trump administration is struggling to get support from skeptical U.S. governors for a revised health care bill before the U.S. Senate.

U.S. Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services Administrator Seema Verma made their pitch Saturday morning during a closed-door meeting of the bipartisan National Governors Association. Vice President Mike Pence also met several of the governors privately after his public address at the Rhode Island conference on Friday.

Nevada Gov. Brian Sandoval, one of the bill's most prominent Republican skeptics, said Saturday it's unlikely they changed anyone's mind.

"I am struggling to validate the numbers that are being presented to me by the administration, versus what I'm hearing from independent (experts), what I'll likely hear from the (Congressional Budget Office), what I'm hearing from back home," Sandoval said after the governors-only meeting.

Sandoval has expressed concerns about the legislation's cuts to the Medicaid program for the poor and disabled. His position is important because of the pressure he could place on Nevada's Republican Sen. Dean Heller of Nevada, a possible swing vote.

With two GOP senators already opposed to the legislation, one more "no" vote would kill the bill outright in a Senate divided 52-48 between Republicans and Democrats. Sandoval said "Sen. Heller's his own man" but he's trying to give him the best information about how the legislation would affect their state.

"He's the United States senator. At the end of the day, he's the one who pushes the button," Sandoval said. "I'm going to inform him about how I feel about the bill."

Connecticut Gov. Dannel Malloy, chairman of the Democratic Governors Association, said the mood at the Saturday breakfast meeting was "tense" and "there are a lot of Republican governors who apparently have a neck problem, because they were all looking down."

Malloy added that a few Republican governors did ask questions. Others said they raised their concerns to the White House in one-on-one meetings.

Wisconsin Republican Gov. Scott Walker said he had an "extensive meeting" Friday with Pence and Price and "we're hopeful they're going to get to a point where they're going to have a repeal-and-replace that works." Walker declined to say if he supports the current version.

"I haven't read through it all yet so I've still got to look at it," Walker said. "It just came out yesterday."

Participants said the meeting with governors included an appeal from Democratic Delaware U.S. Sen. Tom Carper, who is a former governor, asking the Trump administration to put the debate on hold and look for a bipartisan solution.

The conference's host, Rhode Island Democratic Gov. Gina Raimondo, said she didn't think anyone's mind was changed.

"If the federal government is trying to save hundreds of billions of dollars, the money's got to come from somewhere, and it either means it's coming from taking health insurance away from people who are now insured under the Medicaid expansion, or it means shifting the financial burden to the states," she said. "Either way, that's bad for Rhode Island and bad for many of the states whose governors were represented at that meeting."

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Stephan Savoia]]>
<![CDATA[Trump, Administration Press Republicans to Back Health Bill]]>Fri, 14 Jul 2017 15:11:18 -0500https://media.nbcnewyork.com/images/213*120/mitchmcconnellfeuerherdIIIVVV.jpg

From both sides of the Atlantic, President Donald Trump and other administration officials lobbied Republicans Friday to support the Senate GOP's reworked health care bill, with the president saying wavering senators "must come through" to keep the measure from collapsing.

But the bill, repealing much of President Barack Obama's health care overhaul, hovered near failure as Senate Majority Leader Mitch McConnell strained to keep more Republicans from deserting. Complicating the effort, Ohio GOP Gov. John Kasich called the revised measure "still unacceptable," largely because of its cuts to Medicaid, the same concern that's been voiced by Ohio Republican Sen. Rob Portman, one of the holdouts.

McConnell, R-Ky., released the measure Thursday, a plan that caps seven years of his party's promises to obliterate Obama's 2010 law.

But two GOP senators immediately said they'd vote "no" on a crucial vote planned for next week. Facing uniform Democratic opposition, a third Republican defection would sink it — a reality not lost on Trump.

"After all of these years of suffering thru ObamaCare, Republican Senators must come through as they have promised!" the president tweeted from Paris, where he was attending Bastille Day ceremonies.

Also under pressure, indirectly, was Sen. Dean Heller, R-Nev., who opposed McConnell's initial bill last month, also citing its Medicaid reductions. Heller, who faces a tough re-election next year, has stood arm-in-arm with his state's popular GOP Gov. Brian Sandoval in opposing cuts to that program for the poor, disabled and nursing home patients.

In an interview Friday, Sandoval said his initial understanding of the new bill was that it "really doesn't change the dynamic" about the Medicaid cuts, and "that's a big concern for me."

Sandoval said he expected to meet privately with Vice President Mike Pence and Health Secretary Tom Price at governors' meetings he is attending in Providence, Rhode Island, and had already heard from both men. Republicans consider winning over Sandoval a key to gaining Heller's vote.

The nation's largest doctors' group dealt another blow Friday, saying the plan falls short on coverage and access, particularly for low-income people on Medicaid. The American Medical Association said Medicaid cuts and "inadequate subsidies" will lead to "millions of Americans losing health insurance coverage."

The AMA said GOP leaders took a "positive step" by adding $45 billion for treatment to help victims of the opioid epidemic. But it pointed out that people dealing with addiction also need regular health insurance, and that many would lose it if Republicans succeed in rolling back Medicaid financing.

McConnell's reworked bill aims to win conservatives' support by letting insurers sell low-cost, skimpy policies. At the same time, he seeks to placate hesitant moderates by adding billions to combat opioid abuse and help consumers with skyrocketing insurance costs.

Moderate Republican Sen. Susan Collins of Maine told reporters she had informed McConnell she would be voting against beginning debate on the bill, citing in part cuts in the Medicaid health program for the poor and disabled. Sen. Rand Paul of Kentucky, who has repeatedly complained that McConnell's efforts don't amount to a full-blown repeal of Obama's law, also announced he was a "no."

Texas Sen. John Cornyn, the No. 2 Senate GOP leader, said in an interview he is hoping for the climactic vote Tuesday or Wednesday. "I'm optimistic we'll get there," he said of prevailing.

McConnell could cancel next week's vote if he's short of support, something he did last month when his original legislation was headed toward defeat. He and other GOP leaders are urging senators to at least vote in favor of opening debate, which would open the measure up to amendments.

Like legislation earlier passed by the House after struggles of its own, the Senate bill would get rid of the law's mandates for individuals to buy insurance and for companies to offer it, repeal taxes and unwind the Medicaid expansion created by the Affordable Care Act. Analyses by the Congressional Budget Office have found the House bill and the earlier Senate version both would eliminate insurance coverage for more than 20 million people over the next decade.

The new bill contains language demanded by conservative Sen. Ted Cruz of Texas letting insurers sell plans with minimal coverage, as long as they also sell policies that meet strict coverage requirements set by Obama's 2010 statute.

The retooled measure retains McConnell's plan to phase out the extra money 31 states have used to expand Medicaid under Obama's statute, and to tightly limit the overall program's future growth.

The rewritten package would add $70 billion to the $112 billion McConnell originally sought that states could use to help insurers curb the growth of premiums and consumers' other out-of-pocket costs. And it has an added $45 billion for states to combat the misuse of drugs like opioids.

Associated Press writers Ricardo Alonso-Zaldivar, Mary Clare Jalonick, Julie Bykowicz, Matthew Daly and Kevin Freking in Washington, Jennifer McDermott in Providence, Rhode Island, and Julie Carr Smyth in Columbus, Ohio, contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/J. Scott Applewhite]]>
<![CDATA[Trump Will Take Health Care Credit or Cast Blame: Analysis]]>Fri, 14 Jul 2017 06:22:41 -0500https://media.nbcnewyork.com/images/213*120/AP_17124741528885.jpg

If congressional Republicans succeed in repealing and replacing "Obamacare," expect a big Rose Garden celebration with President Donald Trump taking credit.

If they fail? Trump has already indicated he will hold Senate Majority Leader Mitch McConnell responsible, setting up an intraparty blame game that could be devastating for the GOP.

Trump made it clear this week the onus for delivering a major Republican achievement and fulfilling seven years of GOP promises is on the six-term Kentucky senator, who is battle-hardened by legislative negotiating — not on the president and author of "The Art of the Deal."

"Mitch has to pull it off. He's working very hard. He's got to pull it off," Trump said in an interview for the Christian Broadcasting Network's "The 700 Club."

Trump has cast himself as a bystander in the monthslong process, saying he's sitting in the Oval Office waiting to sign a bill erasing much of the 2010 Obamacare law. He is reminding GOP lawmakers who promised so often to repeal and replace, and voted repeatedly but never finally to do it, that they better not blow this best shot.

And if they do, "I will be very angry about it, and a lot of people will be very upset," the president says.

After brokering deals with individual lawmakers before a health care bill barely made it through the House in May, Trump has largely stayed on the sidelines as the Senate has dealt with the issue.

That's partly because McConnell had made his preference clear that Trump keep out of Senate business, according to associates. Trump has mostly acceded to the request, partly because McConnell had earned his respect by shepherding conservative jurist Neil Gorsuch to Supreme Court confirmation in April. That still stands as Trump's most significant achievement since taking office.

But McConnell's stewardship of the health care issue has proved less adroit. He had to abruptly cancel a vote last month on a bill he drafted largely in secret after it became clear support was lacking. He's now struggling to nail down votes to pass the latest version next week.

The president has shown some patience with McConnell's predicament, telling reporters on Air Force One en route to France that "the only thing more difficult than peace between Israel and the Palestinians is health care." He then repeated his confidence in a successful outcome.

But he has delivered no major speech in six months on health care either before Congress or outside Washington, addressing it only in a few tweets and a couple of asides at rallies in Iowa and elsewhere.

Pressed on what the president is doing to secure the votes for the Senate bill, White House aide Sarah Huckabee Sanders said the administration has provided "technical assistance throughout the process."

In comparison, Obama aggressively used the bully pulpit of the presidency to secure passage of his Affordable Care Act, with at least five town halls in Wisconsin, Ohio, Colorado and Virginia, prime-time speeches to Congress, health care summits at the White House and elsewhere, and personal lobbying of lawmakers.

GOP lawmakers insist that Trump has been helpful, though sometimes they've struggled to depict exactly how. But his distance from the process could help him to avoid blame if failure is the outcome.

And now, Trump's words signal that if Congress fails, lawmakers can expect his wrath and that of his followers — a relative minority of the population but an important slice of the GOP base that has the ability to punish Republicans who cross the president. In last year's elections, the two major Republican Senate candidates who lost their races, then-Sen. Kelly Ayotte of New Hampshire and Rep. Joe Heck of Nevada, did so after withdrawing their support from Trump. Winning Republicans stuck with him.

For many GOP lawmakers, the greatest fear is not a Democratic opponent but a primary challenge from the right. Republican Sen. Jeff Flake of Arizona, who was one of Trump's most outspoken critics throughout last year's campaign, has grown much quieter about the president as he faces re-election next year and a primary opponent who has embraced Trump and taunted Flake for his stances.

Now Flake is looking like a likely "yes" vote on the health care bill. He said Thursday he was still considering it, but he applauded inclusion of an amendment by conservative Sen. Ted Cruz of Texas that would allow insurers to sell skimpy, low-cost health care.

"I like the consumer freedom amendment in it, you've got to get relief to Arizonans that just don't have insurance," Flake said.

Most Republicans say that even though the GOP's health care bills have polled poorly, and they will be forced to defend yanking insurance coverage from millions, a worse result would be failing to repeal. That would undermine the GOP's ability to present itself as a governing party, while breaking seven years of promises.

The Republican in the White House might be able to dodge the finger-pointing that would surely follow. But he might be the only one.

"I think the whole party is going to be responsible so everyone with that label is probably going to have to bear responsibility no matter what they go home and claim," said conservative former Sen. Jim DeMint.

Copyright Associated Press / NBC New York



Photo Credit: Evan Vucci/AP, File]]>
<![CDATA[This Is How the GOP Plan Would Change Health Care Coverage]]>Thu, 13 Jul 2017 19:57:32 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-813943998.jpg

Senate Republican leaders released a new version of their health care bill on Thursday and they hope to vote on it as soon as next week. Here’s what you need to know about how it would affect your health care:

Premiums and deductibles: Like Obamacare, the Senate bill provides subsidies to buy insurance on the individual market based on a person’s income. But they’re less generous overall and encourage people to buy plans that cover fewer out-of-pocket costs.

Pre-existing conditions: The Senate bill would weaken protections for people with pre-existing conditions and push sicker customers toward more expensive plans and healthier customers toward cheaper, less generous plans.

Medicaid: The Senate bill would reduce Medicaid spending dramatically compared to current law.



Photo Credit: Joe Raedle/Getty Images]]>
<![CDATA[Keep Your Cool This Summer: Safety Tips for the Heat]]>Thu, 13 Jul 2017 12:32:18 -0500https://media.nbcnewyork.com/images/213*120/AP_17186795988820.jpg

With temperatures in some parts of the country soaring as high as 120 degrees this summer, combating the heat is no easy task. Last year, 94 people suffered from heat related deaths, more than double the number from 2015, according to data from the National Weather Service.

Here are tips from the National Weather Service you can use to help keep cool and stay safe during this summer.


Track the Heat
If you’ve been outside for long enough it can be hard to tell how hot is too hot to be outdoors. The Occupational Safety and Health Administration and the National Institute for Occupational Safety and Health have created a mobile app that calculates the heat risk index of any given location.

What to Know About Fans
During times of extreme heat risk, limit the time you spend outside as much as possible. If you can’t get access to air conditioning, fans can help. But try not to point the fan directly at you because the dry air can make you become dehydrated faster, according to the National Weather Service.

Reapply Sunscreen
If you must go outside, stay in the shade and apply sunscreen at least every two hours. Reapply immediately after swimming. 

Warmer Water Is Better Than Icy
Make sure to drink plenty of water, even if you aren’t thirsty. Excessive sweating will cause you to lose fluids at a rapid pace. Although ice water may feel refreshing, opt for room temperature fluids. When water is especially cold your body will exert more energy trying to adjust to the temperature.

Watch Out for Seatbelts
The inside of a car can be one of the most deadly places during a heat wave. Before you buckle up, check the metal on the seatbelt to avoid burns. Never leave a child or animal unattended in a vehicle even if you have the window rolled down. To ensure your children don’t accidentally trap themselves inside, keep the doors and trunk locked at all times.

Know The Signs
It can be easy to confuse heat stroke and heat exhaustion, so knowing what to look for is crucial. Heat stroke is more serious and common symptoms include a throbbing headache, no sweating, red, hot, or dry skin, nausea and vomiting. If you or someone around you exhibits any combination of these signs, call 911 immediately.


Check out more hot weather resources here



Photo Credit: AP
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<![CDATA[Investors: 'Pharma Bro' Shkreli Was Shady -- and Profitable]]>Thu, 13 Jul 2017 11:59:31 -0500https://media.nbcnewyork.com/images/213*120/shkreli2.jpg

The jury at the securities fraud trial of "Pharma Bro" Martin Shkreli has heard investors accuse the quirky former biotech CEO of repeatedly giving them the runaround when they tried to pull their money out of his failing health care hedge fund.

But the government witnesses have made a concession that the defense hopes plays in its favor: In the end, they made a killing.

Whether jurors at the trial that began June 26 in federal court in Brooklyn will see Shkreli's clients as victims of a crime is central to a case that's featured odd subplots, including a self-serving rant by the defendant to reporters and email evidence by a mentor about wanting to touch his "soft skin."

Testimony was to resume Thursday with the government still in the middle of its case.

The lack of clear-cut financial harm separates the alleged fraud from others like Bernard Madoff's notorious Ponzi scheme, which wiped out the nest eggs of ordinary investors. Prosecutors have argued it doesn't matter because Shkreli still broke the law by blowing investors' funds with bad stock picks and then lying to them for months - or even years - while he cooked up a way to get out of it.

"I don't think it mattered to him - it was just what he thought he could get away with," said Richard Kocher, a New Jersey construction company owner who invested $200,000 in with Shkreli in 2012. "It was insulting."

Darren Blanton, a Dallas-based investment firm founder, testified Shkreli stalled for three years when he tried to redeem his $1.3 million investment.

Over time, "I was worried Martin might be lying to me and not credible," Blanton, who notified the Securities and Exchange Commission.

Shkreli, 34, was arrested in 2015 after he already had gained notoriety by using his drug company to raise the price of a life-saving medication by 5,000 percent and for his nonstop posturing and trolling on social media, a compulsion that spawned the "Pharma Bro" nickname.

Federal authorities focused instead on his MSMB Capital hedge fund, accusing him of lying to investors by boasting about too-good-to-be-true returns at a time when he had lost more than $7 million on a 2011 trade and let the fund dwindle to about $2 million in assets. He's also charged with starting a new drug company, Retrophin, and looting it for $11 million to pay his investors back.

An unrepentant Shkreli has denied wrongdoing, complaining to reporters last month that prosecutors "blame me for everything. They blame me for capitalism." The comments prompted the judge to order him to shut up about the case in and around the courthouse.

On cross-examination, the investor witnesses have admitted that Shkreli made settlement deals that ultimately proved profitable. Blanton got $2.6 million - $200,000 in cash and the balance from shares of Retrophin he sold, and in addition still holds shares worth $3 million; Kocher made an estimated $350,000 the same way; a third witness, Schuyler Marshall, doubled his initial $200,000 investment.

Marshall, another Dallas-based financier, testified that Shkreli reminded him of "Rain Man," but that didn't mean he was making fun of him, as the defense has suggested.

Marshall saw Shkreli as more of a potential rainmaker "who was intensely focused on one small segment of the stock market, and just lived it day and night, and that was his investing advantage," he said.

The trial got got personal this week when another investor, former American Express executive Steven Richardson, testified about growing close to Shkreli after meeting him at cocktail party, helping him launch Retrophin and becoming the company's chairman before Shkreli was fired in 2014.

The 63-year-old gay witness testified Shkreli made him uncomfortable with comments about gay sex and sought assurances that their relationship was platonic, even as he told him he loved him as a friend and bought him clothes to clean up his "disheveled" appearance.

Richardson struggled on cross-examination to explain emails he wrote saying he'd with Shkreli "only if I can touch your soft skin" and another asking, "I'm drunk, where are you?" He insisted he was referring to how a rash on Shkreli's neck had cleared up and that he couldn't remember writing the "drunk" email.

He also testified that his $400,000 stake in Retrophin is now worth $1.9 million.

"That's a good investment, fair to say?" Shkreli's lawyer asked.

He could only answer "Yes."


Copyright Associated Press / NBC New York



Photo Credit: Seth Wenig/AP]]>
<![CDATA[Connecticut Doctor Arrested While Feds Search for Other in Major Health Fraud Scheme]]>Thu, 13 Jul 2017 18:39:48 -0500https://media.nbcnewyork.com/images/213*120/Family+Health+Urgent+Care+Doctor+Rhamil+Mansourov.JPG

Federal officials have located a Connecticut doctor accused of fleeing the country after being named a suspect in an investigation into what authorities are calling the largest ever health care fraud enforcement action by the federal Medicare Fraud Strike Force in the country.

Dr. Bharat Patel, 70, of Milford, and 47-year-old Dr. Ramil Mansourov, of Darien, are accused of running a “pill mill” and selling prescriptions for drugs, including oxycodone and hydrocodone, to addicts and drug dealers, who would then sell the drugs on the streets.

In all, 412 defendants have been charged across the country, including 115 doctors, nurses and other licensed medical professionals, for alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings.

Patel was arrested at his Milford home Wednesday, has been detained and is scheduled to appear in court on July 17.

Federal authorities were searching for Mansourov, who they believed fled to Canada. He was taken into custody at a Marriott in Montreal Thursday.

The local investigation began after allegations that the two doctors might be writing prescriptions outside the scope of legitimate medical practice.

Patel and Mansourov operated out of Family Health Urgent Care, at 235 Main Street in Norwalk, which is closed until further notice.

Some of those addicts they are accused of selling to referred to the defendants’ medical practice as “The Candy Shop,” according to a news release from the U.S. Attorney’s Office.

Patel owned the previous practice, which was known as Immediate Health Care, and sold it in 2012 to Mansourov, who renamed it, according to the United States Attorney’s Office.

Authorities said Patel regularly provided prescriptions for narcotics, including oxycodone and hydrocodone, to patients he knew were addicted or had been arrested for distributing or possessing controlled substances.

On several occasions, he sold the prescriptions to patients under the table for $100, including to some who used a state Medicaid card, then distributed the drugs, officials said.

In some instances, Patel wrote prescriptions for people who were not his patients in exchange for cash, federal officials said, and Mansourov provided Patel’s patients with unnecessary prescriptions.

In 2014 alone, more than $50,000 in cash was deposited into Patel and his wife’s bank accounts and some of that money went to buy the house Patel currently lives in, according to federal authorities.

These two doctors are charged with violating their oaths and recklessly prescribing highly addictive painkillers,” U.S. Attorney Deidre Daly said in a statement. “Dr. Patel is alleged to have regularly sold to addicts solely for his own profit. Many of these patients filled the prescriptions using state healthcare benefits, and then turned around and sold the pills on the street, contributing to our devastating opioid epidemic.”

Mansourov is accused of defrauding the state’s Medicaid program of more than $4 million between November 2013 and December 2016 and moving some of that money to a bank account in Switzerland.

He is accused of billing for home visits he never made, billing for nursing home visits he never made, billing for office visits that never happened and billing for visits that he claimed took place on dates on which he was actually out of state or out of the country, according to the U.S. Attorney’s Office.

“Too many trusted medical professionals like doctors, nurses, and pharmacists have chosen to violate their oaths and put greed ahead of their patients,” Attorney General Jeff Sessions said in a statement about the nationwide crackdown.

“Amazingly, some have made their practices into multimillion dollar criminal enterprises. They seem oblivious to the disastrous consequences of their greed. Their actions not only enrich themselves often at the expense of taxpayers but also feed addictions and cause addictions to start. The consequences are real: emergency rooms, jail cells, futures lost, and graveyards. While today is a historic day, the Department's work is not finished. In fact, it is just beginning. We will continue to find, arrest, prosecute, convict, and incarcerate fraudsters and drug dealers wherever they are,” Sessions added.



Photo Credit: NBCConnecticut.com and the U.S. Department of Justice]]>
<![CDATA[US Charges Hundreds in Health Fraud Schemes Worth $1.3B]]>Thu, 13 Jul 2017 09:48:01 -0500https://media.nbcnewyork.com/images/213*120/jeffsessions400charged_1200x675.jpg

More than 400 people have been charged with taking part in health care fraud and opioid scams that totaled $1.3 billion in false billing, Attorney General Jeff Sessions announced Thursday.

Sessions called the collective action the "largest health care fraud takedown operation in American history" and said it indicates that some doctors, nurses and pharmacists "have chosen to violate their oaths and put greed ahead of their patients."

Among those charged are six Michigan doctors accused of a scheme to prescribe unnecessary opioids. A Florida rehab facility is alleged to have recruited addicts with gift cards and visits to strip clubs, leading to $58 million in false treatments and tests.

Officials said those charged in the schemes include more than 120 people involved in illegally prescribing and distributing narcotic painkillers. Such prescription opioids are behind the deadliest drug overdose epidemic in U.S. history. More than 52,000 Americans died of overdoses in 2015 — a record — and experts believe the numbers have continued to rise.

"In some cases, we had addicts packed into standing-room-only waiting rooms waiting for these prescriptions," acting FBI director Andrew McCabe said. "They are a death sentence, plain and simple."

Nearly 300 health care providers are being suspended or banned from participating in federal health care programs, Sessions said.

"They seem oblivious to the disastrous consequences of their greed. Their actions not only enrich themselves, often at the expense of taxpayers, but also feed addictions and cause addictions to start," Sessions said.

Health care fraud sweeps like Thursday's happen each year across the country, but law enforcement officials continue to grapple over the best way to fight the problem.

The people charged were illegally billing Medicare, Medicaid and the health insurance program that serves members of the armed forces, retired service members and their families, the Justice Department said. The allegations include claims that those charged billed the programs for unnecessary drugs that were never purchased or given to the patients.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Jacquelyn Martin]]>
<![CDATA[McConnell Reveals New Health Bill; Will His GOP Support It?]]>Thu, 13 Jul 2017 16:15:50 -0500https://media.nbcnewyork.com/images/213*120/812745510-McConnell-Health-Care-Bill-Release.jpg

Republican leaders unveiled a new health care bill Thursday in their increasingly desperate effort to deliver on seven years of promises to repeal and replace "Obamacare." They immediately lost two key votes, leaving none to spare as the party's own divisions put its top campaign pledge in serious jeopardy.

President Donald Trump declared a day earlier that failure would make him "very angry" and that he would blame Majority Leader Mitch McConnell, R-Ky.

But talking with reporters aboard Air Force One en route to France, Trump also acknowledged the challenges lawmakers face.

"I'd say the only thing more difficult than peace between Israel and the Palestinians is health care," Trump said. "But I think we're going to have something that's really good and that people are going to like."

The reworked bill McConnell presented to fellow Republicans aims to win conservatives' support by letting insurers sell low-cost, skimpy policies. At the same time, he seeks to placate hesitant moderates by adding billions to combat opioid abuse and help consumers with skyrocketing insurance costs.

But it was not clear whether the Republican leader has achieved the delicate balance he needs after an embarrassing setback last month when he abruptly canceled a vote in the face of widespread opposition to a bill he crafted largely in secret.

Moderate Sen. Susan Collins of Maine told reporters she had informed McConnell she would be voting against beginning debate on the bill, citing in part cuts in the Medicaid health program for the poor and disabled. Sen. Rand Paul of Kentucky, who has repeatedly complained that McConnell's efforts don't amount to a full-blown repeal of Obamacare, also announced he was a "no."

That means McConnell cannot lose any other Republican senators. With Democrats unanimously opposed in a Senate split 52-48 in favor of the GOP, he needs 50 votes, with Vice President Mike Pence breaking the tie, to get past a procedural hurdle and begin debate on the bill.

The showdown vote is set for next week, though McConnell could cancel again if he's short of support. He and other GOP leaders are urging senators to at least vote in favor of opening debate, which would open the measure up to amendments. And GOP leaders express optimism that they are getting closer to a version that could pass the Senate.

"It's in the best shape it's been in so far," said Sen. Roy Blunt of Missouri. "Now that members actually have paper in their hand they can look at what is likely to be very close to the final bill we'll be voting on and move forward."

McConnell said the 172-page legislation is the senators' opportunity to make good on years of promises.

"This is our chance to bring about changes we've been talking about since Obamacare was forced on the American people," he said.

Many Republicans believe the party could face electoral catastrophe if it alienates GOP voters by failing to deliver after taking control of both chambers of Congress and the White House while vowing to get rid of former President Barack Obama's law.

"It could be the biggest political broken promise in many years," said conservative former Sen. Jim DeMint, former president of the Heritage Foundation, as he passed through the Capitol.

Throughout the day McConnell huddled in his office with holdouts, including Dean Heller of Nevada, the most endangered Senate Republican in next year's midterms, Shelley Moore Capito of West Virginia, Rob Portman of Ohio and John Hoeven of North Dakota.

The lawmakers wanted details and numbers on how the bill would impact rural and Medicaid-dependent people in their states. All had opposed McConnell's earlier bill, but this time around several exited their meetings saying they were undecided and needed more time to evaluate the legislation.

Hoeven said of McConnell: "He's asking everybody to work with him, and a lot of us are saying 'yeah,' and we've got more work to do."

Like legislation earlier passed by the House after struggles of its own, the Senate bill would get rid of Obamacare's mandates for individuals to buy insurance and for companies to offer it, repeal taxes and unwind the Medicaid expansion created by the Affordable Care Act. Analyses by the Congressional Budget Office have found the House bill and the earlier Senate version both would kick more than 20 million people off the insurance roles over the next decade.

The new bill contains language demanded by conservative Sen. Ted Cruz of Texas letting insurers sell plans with minimal coverage, as long as they also sell policies that meet strict coverage requirements set by Obama's 2010 statute. Moderate Republicans have objected that that would make policies excessively costly for people with serious illnesses because healthy people would flock to the cheaper coverage.

The Cruz provision appears in the legislative text in brackets, meaning specific language is still being composed. That could give McConnell, Cruz and other conservatives time to work out a provision with broader support.

The retooled measure retains McConnell's plan to phase out the extra money 31 states have used to expand Medicaid under Obama's statute, and to tightly limit the overall program's future growth. Since its creation in 1965, Medicaid has provided open-ended federal funds to help states pay the program's costs.

The rewritten package would add $70 billion to the $112 billion McConnell originally sought that states could use to help insurers curb the growth of premiums and consumers' other out-of-pocket costs.

It has an added $45 billion for states to combat the misuse of drugs like opioids. That's a boost over the $2 billion in the initial bill, an addition demanded by Republicans from states in the Midwest and Northeast that have been ravaged by the drugs.

To help pay for the added spending, the measure would retain three tax increases Obama's law slapped on higher- earning people.

Copyright Associated Press / NBC New York



Photo Credit: Alex Wong/Getty Images]]>
<![CDATA[Senate Consumer Choice Idea Could Raise Premiums for Sick]]>Thu, 13 Jul 2017 21:37:14 -0500https://media.nbcnewyork.com/images/213*120/tedcruzinAustin_1200x675.jpg

A health care proposal from Senate conservatives would let insurers sell skimpy policies provided they also offer a comprehensive plan. It's being billed as pro-consumer, allowing freedom of choice and potential savings for many.

But critics including the insurance industry say it would split the sick and the healthy, leading to unsustainably high premiums for people with medical problems and pre-existing conditions, who may get priced out of the market unless taxpayers bail them out.

Senate Republican leaders trying to resolve differences between moderates and conservatives ahead of a health care showdown are taking a close look at the proposal from Sens. Ted Cruz, R-Texas, and Mike Lee, R-Utah, dubbed the Consumer Freedom Amendment. No final text has been made public, but the concept has been endorsed by Vice President Mike Pence.

A health care factoid can help frame the issue: U.S. health care spending is highly skewed toward the sickest people. According to government estimates, 5 percent of the population accounts for nearly half of health care spending. And half the population — the healthier half — accounts for only about 3 percent of spending. The traditional idea behind insurance is that the healthy subsidize the sick.

The Cruz-Lee proposal would affect people who buy individual health insurance policies, not those covered by employers. Under current law — the 2010 overhaul passed by former President Barack Obama — insurers cannot turn away people with medical problems, or charge them more, and policies have to provide comprehensive benefits. That has made coverage more robust, but it's also raised premiums for relatively healthy people.

The Cruz-Lee amendment would technically leave in place Obama-era insurance rules and consumer protections. But it would also allow insurers to offer plans that don't follow those rules, provided the insurer also sells a plan that complies. Insurers could offer plans with reduced benefits, no maternity coverage, for example.

Cruz says his approach can bring down premiums for most people, delivering on a core promise by Republicans in their quest to repeal and replace "Obamacare."

"You the consumer, you the patient, should have the freedom to choose the insurance you want," Cruz said recently on CBS. "It shouldn't be the government dictating what insurance you can buy."

Several conservative groups said Wednesday the Cruz-Lee option must be included for the Senate bill to have their support. The Club for Growth, Tea Party Patriots, and FreedomWorks said that without an option for individuals to opt out of current insurance rules, the Senate bill would amount to perpetuating "Obamacare."

But critics say the plan would siphon premium dollars paid by healthy people out of the insurance pool that covers the sick. Premiums for those who need comprehensive coverage would shoot up. The two main insurance industry lobbying groups, America's Health Insurance Plans and the BlueCross BlueShield Association have joined in opposing the plan.

"You have the possibility of two different risk pools," explained economist Douglas Holtz-Eakin, a longtime Republican adviser. The markets functioning under Obama-era rules "turn into expensive high-risk pools. If they are not heavily subsidized, they run the risk of becoming unsustainable and going into a death spiral."

GOP leaders might want to think that over, added Holtz-Eakin. "It would seem like an undesirable outcome for an exercise intended to rescue Obamacare (markets) that are melting down," he said.

A former Obama administration official agrees that the Cruz-Lee idea could create new problems. Insurance expert Karen Pollitz, now with the nonpartisan Kaiser Family Foundation, said several states tried a similar approach in the past, and it didn't go well.

"When you create an uneven playing field in health insurance regulation, you create instability," said Pollitz. "People who need (comprehensive) benefits go to those policies, which become more expensive. People who think they can live without those protections go to the cheaper policies and take with them their premium dollars."

Cruz says that doesn't have to happen. Both the Senate and House GOP bills would set up a pool of money that states can tap to stabilize insurance markets. Those funds could be used to subsidize premiums for people with health problems. But critics say that would depend on how much money is provided.

The insurance industry says the Cruz-Lee approach is bad policy. "The 'Consumer Freedom Option' is unworkable as it would undermine pre-existing condition protections, increase premiums and destabilize the market," BlueCross BlueShield President Scott Serota wrote the senators in a letter released Wednesday.

Senate Republican leaders plan to unveil their revised bill on Thursday, with the goal of holding a vote next week on legislation that would roll back much of the Obama-era health law.


Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>