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Republican senators are having early discussions about modifying enhanced Affordable Care Act tax credits to allow for an extension of the subsidies before they expire at year's end. ... GOP leaders insist an ACA extension won't be part of any stopgap legislation to keep the government funded into November. (Sullivan, 9/22)

Congress headed out of Washington on Friday after spending legislation stalled in the Senate, leaving only two workdays to resolve a stalemate before a potential government shutdown would begin on Oct. 1. The House passed a Republican-backed measure earlier in the day, largely along party lines, that would push the shutdown deadline to Nov. 21. But then the Senate rejected a Democrat-led proposal that would keep the government open through Oct. 31, as well as implement several Democratic priorities on health care and government spending, and also failed to pass the House bill. (Beggin and Meyer, 9/19)

The legal authorities for telehealth and hospital-at-home programs and funding for community health centers and other priorities remain in limbo after Congress failed to approve a spending bill Friday. These and other healthcare issues are swept up in broader partisan fights about government spending. Fiscal 2025 ends Sept. 30, lending urgency to the Republican majority’s push to send President Donald Trump a stopgap appropriations bill to prevent a federal government shutdown. Numerous healthcare programs and funding streams are set to expire on the same date. (McAuliff, 9/19)

Medicaid developments —

Hospitals in Medicaid expansion states could see double-digit declines in 2027 operating margins as a result of new Medicaid work requirements, according to a study released Thursday. The analysis by the Commonwealth Fund, a nonprofit foundation focused on healthcare policy, found that hospitals in expansion states could see their operating margins decrease by 0.4 to 0.5 percentage point, or a drop of -11.7% to -13.3%. (Broderick, 9/19)

�鶹Ů�� Health News: States Are Cutting Medicaid Provider Payments Long Before Trump Cuts Hit 
Every day for nearly 18 years, Alessandra Fabrello has been a medical caregiver for her son, on top of being his mom. “It is almost impossible to explain what it takes to keep a child alive who should be dead,” said Fabrello, whose son, Ysadore Maklakoff, experienced a rare brain condition called acute necrotizing encephalopathy at 9 months old. ... Now, broad cuts to North Carolina Medicaid will make finding and paying for care even more difficult. (Sable-Smith and Tribble, 9/22)

Health Secretary Robert F. Kennedy Jr.’s new vaccine advisers added confusion Friday to this fall’s COVID-19 vaccinations — declining to recommend them for anyone and leaving the choice up to those who want a shot. Until now, the vaccinations had been recommended as a routine step in the fall for nearly all Americans — just like a yearly flu vaccine. (Stobbe and Neergaard, 9/20)

The US Centers for Disease Control and Prevention (CDC) vaccine advisory panel today voted to postpone a vote on delaying the birth dose of hepatitis B vaccine, given that most members felt more data was needed to inform the wording of the recommendation. In another vote, the Advisory Committee on Immunization Practices (ACIP) reversed a Vaccines for Children (VFC) program vote it took yesterday on the measles, mumps, rubella, and varicella (MMRV) vaccine for children younger than 4 years old. The reversal removes the vaccine from the federal program that provides free vaccine to uninsured and underinsured children. (Schnirring, 9/19)

US Health Secretary Robert F. Kennedy Jr.’s handpicked panel was expected to overhaul longstanding immunization recommendations for children this week. It didn’t go as smoothly as planned. Public-health experts had been bracing for the Centers for Disease Control and Prevention’s Advisory Committee for Immunization Practices, or ACIP, to upend the established rhythm of childhood shots in the US. The regimen is credited with controlling scores of diseases that previously disabled or killed millions of Americans. (Muller, 9/20)

Richard Besser, the former acting director of the Centers for Disease Control and Prevention (CDC), says he “can’t look” to the CDC for trustworthy medical information on Sunday. “My biggest takeaway as a doctor is that I can’t look to the CDC anymore for the trusted information,” Besser said on ABC’s “This Week.” “I’m going to need to look to medical societies and other groups to provide that information. (Rego, 9/21)

�鶹Ů�� Health News: Mercury In Your Hot Dog? Vaccine Skeptics Face Their Limits At Crucial CDC Meeting
Public health officials watched with dread as a panel shaped by the Trump administration took up an agenda to begin dismantling six decades of vaccination development and progress. But while the result seemed foretold, the debate was far from unanimous. (Allen and Rayasam, 9/19)

States offer their own vaccine guidance —

Seven Northeast states and New York City have formed the Northeast Public Health Collaborative (NPHC) to make evidence-based public health recommendations—including on vaccines—while Vermont and the District of Columbia are the latest US jurisdictions to announce safeguards for access to COVID-19 vaccines. (Wappes, 9/19)

The Trump administration is expected to unveil new efforts Monday exploring how one medication may be linked to autism and another one can treat it, according to four people with knowledge of the plans who spoke on the condition of anonymity because the announcement was not yet public. Federal health officials are expected to raise concerns about pregnant women’s use of acetaminophen, the active ingredient in Tylenol and one of the most widely used medications globally. (Diamond and Eunjung Cha, 9/21)

The Trump administration is terminating the federal government’s annual report on food insecurity in America, saying it had become “redundant, costly and politicized” and noting that “extraneous studies do nothing more than fear monger.” “For 30 years, this study — initially created by the Clinton administration as a means to support the increase of SNAP eligibility and benefit allotment —failed to present anything more than subjective, liberal fodder,” the US Department of Agriculture said in a statement Saturday, referring to the Supplemental Nutrition Assistance Program, the formal name for food stamps. (Luhby, 9/21)

Administration officials are discussing creating a website — potentially branded with President Donald Trump’s own name — that would make it easier for patients to buy prescription medicines at a discount directly from pharmaceutical companies, people familiar with the talks said. The initiative is part of Trump’s demands that drugmakers reduce their prices to align them with what other developed countries pay, according to the people, who spoke on condition of anonymity to discuss plans that are not yet public. (Cohrs Zhang and Woodhouse, 9/19)

From the FDA and CDC —

The surreal world of TV pharmaceutical ads, where people with terrible diseases tend to be young, beautiful and living life to the fullest—sometimes with animated monsters—has been parodied on late night sketch comedy shows. But the drug industry’s biggest critic may turn out to be government regulators inside the Food and Drug Administration. (Walker and Vranica, 9/21)

The cancer medication Keytruda is the world’s best-selling drug. But with lower-priced competition set to arrive as soon as 2028, Keytruda’s manufacturer, Merck, is on the brink of losing tens of billions of dollars in sales. To keep Keytruda revenue flowing, Merck followed a well-worn playbook. It developed a new version of the drug, given as a shot under the skin, which the Food and Drug Administration approved on Friday. (Robbins, 9/19)

�鶹Ů�� Health News: �鶹Ů�� Health News’ ‘On Air’: Journalists Follow The Fallout Of CDC Director's Firing And Trump's Health Policies
�鶹Ů�� Health News chief Washington correspondent Julie Rovner discussed the Senate hearing of former Centers for Disease Control and Prevention director Susan Monarez on WBUR’s “Here & Now” on Sept. 17. Rovner also delved into the “Make America Healthy Again” report on children’s health on WNYC’s “The Brian Lehrer Show” on Sept. 16 and on C-SPAN’s “Washington Journal” on Sept. 12. During that C-SPAN appearance, she also covered the debate over extending the Affordable Care Act subsidies. (9/21)

Federal funding updates —

In St. Louis, a team of students aboard a well-equipped van visits senior centers, a nursing home, a church and other sites, learning to conduct comprehensive, hourlong geriatric assessments. The team — future doctors, social workers, psychologists and therapists — looks for such common problems as frailty, muscle weakness and cognitive decline. The patients they evaluate, free of charge, receive printed plans to help guide their care. (Span, 9/21)

Harvard University said Friday it has received $46 million in federal research funding, part of the more than $2 billion the Trump administration froze after allegations the school didn’t adequately move to curb antisemitism on campus. The receipt of money from the Department of Health and Human Services followed a court victory for Harvard this month in which a federal judge ruled that the US illegally froze the funding. The administration has said it would appeal. (Lorin, 9/19)

Also —

The Trump administration's changes at the Social Security Administration have hurt many disabled and poor Americans, says a report coming out next month. Why it matters: The findings, based on interviews with 14 benefits specialists, attorneys and others who help multiple people apply for benefits, show how the process is pushing many of the poorest Americans closer to the financial edges: potential homelessness, food insecurity and suicidal ideation. (Peck, 9/22)

Public confidence in top US Health and Human Services (HHS) agencies like the Centers for Disease Control and Prevention (CDC) is above 60% but has dropped substantially from a year ago, while trust in HHS Secretary Robert F. Kennedy Jr. is below 40%, according to a poll of 1,699 US adults released yesterday by the Annenberg Public Policy Center (APPC) at the University of Pennsylvania. (Wappes, 9/19)

Novo Nordisk has a reputation for squandering its lead. It was first with the weight-loss injection Wegovy, yet Eli Lilly’s Zepbound seized the top position. Now Novo is poised to debut a Wegovy pill early next year, pending U.S. regulatory approval. But Lilly’s rival tablet is expected soon after—and could once again come out on top. Playing second fiddle to Lilly has weighed heavily. Novo’s stock is down more than 50% in the past year. (Wainer, 9/21)

Discharging patients who are at risk of harming themselves or others is illegal. But dozens of psychiatric hospitals aren’t honoring the law — and the government isn’t following up. (Cahan, 9/22)

The promise of telehealth for rural health still has a ways to go, according to a new survey. As states put together their applications for a piece of the $50 billion Rural Health Transformation Fund, a survey from public brokerage firm JLL (Jones Lang LaSalle Incorporated) published Tuesday found that rural patients are the least likely to use telehealth despite having the longest to travel to a healthcare facility. (Broderick, 9/19)

Health systems are working directly with employers to improve cancer care and lower costs as demand — and employers’ healthcare expenses — surge. Providers are gearing up to treat more cancer patients, hoping to ease employers’ mounting frustration with steep premium increases, long appointment wait times and unnecessary treatment, health system and care navigation company executives said. Cutting out insurers through direct contracts could add transparency to employers’ healthcare costs and help standardize treatment strategies, they said. (Kacik, 9/19)

Carolina NeuroSurgery & Spine Associates, one of the nation’s largest independent neurosurgery practices, will join Atrium Health on Oct. 1, 2025, the two providers announced last week. Nearly 300 Carolina NeuroSurgery & Spine staff members across seven Charlotte-area clinics will become part of Atrium, which operates under the corporate banner of Advocate Health, the country’s third-largest public health care system with $34.8 billion in annual revenue. (Crouch, 9/22)

On Sunday, more than a hundred doctors and specialists from around the world will convene in Rochester to help patients whose conditions have eluded diagnosis. Mayo Clinic will host the four-day event, known as the “Undiagnosed Hackathon” — a global effort to solve rare diseases that have long gone unexplained. Eric Klee, a co-director, said he’s hopeful that this opportunity to collaborate across disciplines and backgrounds will help participating patients finally get answers. (Castle Work, 9/21)

UnitedHealth developments —

UnitedHealth Group has named Sandeep Dadlani CEO of its Optum Insight technology arm, Dadlani announced in a social media post Thursday. Dadlani previously served as UnitedHealth’s executive vice president and chief digital and technology officer. He succeeds Dhivya Suryadevara, who had served in that role and CEO of the Optum Financial healthcare banking division since May. (Tepper, 9/19)

Luigi Mangione’s lawyers urged a judge on Saturday to bar federal prosecutors from seeking the death penalty in the killing of UnitedHealthcare CEO Brian Thompson, arguing that authorities prejudiced his case by turning his arrest into a “Marvel movie” spectacle and by publicly declaring their desire to see him executed. (Sisak, 9/20)

Scientists have developed and tested a deep-learning model that could support clinicians by providing accurate results and clear, explainable insights—including a model-estimated probability score for autism. The model, outlined in a study published in eClinicalMedicine, was used to analyze resting-state fMRI data—a non-invasive method that indirectly reflects brain activity via blood-oxygenation changes. (9/18)

When a hospitalized patient shows signs of a dangerous, potentially deadly infection, you’d expect clinicians to move quickly: testing to figure out what’s wrong, then treating with the right medicines. But that’s not always what happens. And the reason is often financial: Federal regulators can fine hospitals hundreds of thousands or even millions of dollars if too many of their patients get hospital-acquired infections. (Bannow, 9/22)

A study of COVID-19 patients from 33 states found that those aged 70 and older were less likely to be classified as having long COVID compared with younger adults, US researchers reported earlier this month in the Journal of the American Geriatrics Society. (Dall, 9/19)

Regarding medical treatments —

Roche said a drug combination including its investigational giredestrant met the main goals in a late-stage clinical trial for breast cancer. The Swiss pharmaceutical company said Monday that the study achieved positive results, showing that giredestrant in combination with everolimus significantly improved progression-free survival in patients with advanced breast cancer. The trial evaluated the efficacy of the all-oral drug combination against standard-of-care endocrine therapy plus everolimus, Roche said. (Calatayud, 9/22)

An analysis of antibiotic sales data from 37 countries found that implementation of national action plans (NAPs) for addressing antimicrobial resistance (AMR) was not associated with changes in antibiotic sales, researchers reported yesterday in Infection Control & Hospital Epidemiology. The study by researchers with the University of Pittsburgh School of Medicine and the University of Toronto looked at pharmaceutical sales data from 37 countries 2 years before and 2 years after they implemented their NAPs. (Dall, 9/19)

Earlier initiation of biologic therapy for psoriasis led to complete skin clearance sooner and significantly more often as compared with starting later, a new analysis of a randomized trial showed. Patients who started guselkumab (Tremfya) within 2 years of diagnosis had a 50% higher rate of complete skin clearance after 20 weeks (53% vs 34%) and remained significantly higher at 28 weeks (56% vs 42%). A significant difference favoring earlier treatment persisted through 68 weeks of follow-up. (Bankhead, 9/20)

A quadruplet regimen elicited favorable outcomes in an older population of transplant-ineligible patients with newly diagnosed multiple myeloma (NDMM), according to phase II trial data. (Bassett, 9/20)

A Missouri judge has struck down a ballot summary for an anti-abortion amendment backed by Republican state lawmakers while concluding that it presented an unfair and insufficient description to voters. Cole County Circuit Judge Daniel Green ruled Friday that the ballot summary must be rewritten, but he rejected a request by abortion-rights advocates to block the proposed constitutional amendment from going to voters. (Lieb, 9/20)

A few weeks after arriving at the immigrant detention center in Bakersfield, Angie Rodriguez felt sick to her stomach. It ached, her head throbbed, even her teeth hurt. Suspecting an infection, the 26-year-old asylum-seeker — who had been living in San Jose before her July arrest at San Francisco’s immigration court — used one of the tablets in the Mesa Verde ICE Processing Center women’s dormitory to request medical attention. The next day, she said, she was seen by a medic who took a urine sample that proved an inconvenient miracle: Rodriguez was pregnant. (Hosseini, 9/21)

Women who are pregnant, planning a pregnancy or breastfeeding should be screened for cannabis use and strongly discouraged from it, the American College of Obstetricians and Gynecologists said in new clinical guidelines published on Friday. Cannabis use during pregnancy has been rising for years. Many women rely on the drug to cope with nausea and other pregnancy symptoms. (Caryn Rabin, 9/19)

Earlier this year, clinical epidemiologist Gordon Guyatt co-authored three systematic reviews on different types of gender-affirming care for children and young adults: puberty blockers, hormones, and top surgery. The studies were led by a Ph.D. student, and Guyatt was specifically pulled onto the team to make sure the assessment was as objective as possible. It’s a strength of his. Guyatt, a professor of health research methods, evidence, and impact at McMaster University in Canada, coined the term “evidence-based medicine” in 1991, and has spent more than 45 years focused on reviewing the safety and effectiveness of myriad medical interventions by authoring systematic evidence reviews and contributing to clinical guidelines. His process for the reviews on gender-affirming care was the same as it always is. (Gaffney, 9/22)

In other public health news —

A fifth person has died after contracting a rare, flesh-eating bacteria in Louisiana, state health officials said this week. Vibrio vulnificus is a bacteria that occurs in warm coastal waters, CBS News previously reported, and is more common between May and October. It can cause illness including life-threatening necrotizing fasciitis, according to the Centers for Disease Control and Prevention. About one in five people with a Vibrio vulnificus infection die, according to the CDC. It's not clear how the person contracted the bacteria. (Breen, 9/19)

The Food and Drug Administration issued a recall for a dozen brands of cinnamon sold nationwide for elevated lead levels. Consuming the cinnamon “may be unsafe,” and consumers should throw away the products immediately, the FDA warned. (Kutz, 9/19)

Over 3,300 pounds of Ahi Tuna Wasabi Poke sold under Costco’s Kirkland Signature brand have been recalled because potential listeria contamination in the green onions used in the product. Western United Fish Co. announced the recall with the knowledge of the Food and Drug Administration on Saturday after its green onion supplier reported a positive listeria monocytogenes test result on Sept. 17. (Lenthang, 9/22)

In one of the most comprehensive pictures yet of the growing health risks associated with wildfire smoke, new research suggests ash and soot from burning wildlands has caused more than 41,000 excess deaths annually from 2011 to 2020. By 2050, as global warming makes large swaths of North America hotter and drier, the annual death toll from smoke could reach between 68,000 and 71,000, without stronger preventive and public health measures. (Briscoe, 9/21)

Also of note —

In New York, residents are able to access to abortion through the 24th week of pregnancy, are banned from carrying concealed firearms in sensitive places and can easily obtain the new Covid vaccines. In Florida, abortions are available only through the sixth week of pregnancy, people can now openly carry guns without permits in most places, and the state’s surgeon general is eliminating vaccine mandates while signaling he wants to ban the Covid shot. Politically, these two states haven’t had much in common for decades. (Edelman, 9/20)

The future of vaccine policy is uncertain under Robert F. Kennedy Jr., the secretary of health and human services, given his history of criticizing vaccines and his desire to change the childhood vaccine schedule. This week, many doctors watched nervously as his handpicked Centers for Disease Control and Prevention vaccine advisory panel met to debate multiple vaccines. (Daniela J. Lamas, 9/20)

Well, that was close. The Centers for Disease Control and Prevention’s vaccine advisory committee voted 6-6 Friday afternoon against adding a prescription requirement to its recommendations for coronavirus vaccines. (9/19)

In a stunning display of procedural subversion, Robert F. Kennedy Jr.’s newly installed vaccine advisers to the Centers for Disease Control and Prevention moved to upend two cornerstones of the childhood immunization schedule. This week’s actions are the clearest demonstration yet that the health secretary intends to use his handpicked panel to erode the nation’s vaccine safeguards, undermining decades of scientific consensus and inviting the spread of devastating diseases. (Leana S. Wen, 9/19)

This obsession with Trump’s health is part of a broader transformation of American life by what the sociologist Peter Conrad described in a 2007 book as “the medicalization of society.” The concept originally referred to the tendency to recast more and more dimensions of human experience — from childbirth and addiction to shyness, boredom, and distraction — as medical problems in need of professional diagnosis and treatment. (Eric Reinhart, 9/22)

Why has health data — perhaps the most private information in modern society — become so accessible? When it comes to professional athletes, the answer involves sports betting. (Trevan Klug, Yaron Covo, and Mihir Gupta, 9/21)

The largest professional organization representing ear, nose, and throat doctors in the United States endorsed gun silencers last year, ostensibly as a way to prevent hearing loss caused by loud gunfire. (Aru Panwar, 9/22)