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    California lawmakers are headed toward a confrontation with Gov. Gavin Newsom over whether to keep a tax that can generate nearly $2 billion for low-income health benefits but means approval from the Trump administration amid a feud between state and federal officials. Senate and Assembly budget committees finished their versions of the $214 billion annual budget this week and want to keep a tax on managed care organizations. The companies manage Medicaid plans in California, the joint federal-state program that provides health coverage for the poor and people with disabilities. California uses the money from those taxes to pay its share of Medicaid costs, which then trigger payments from the federal government. When fully implemented, the tax saves the state about $1.8 billion. The tax is set to expire June 30, and California needs permission from the federal government to keep it. Newsom is worried that might not happen and did not include it in his budget proposal. California has a rocky relationship with President Donald Trump's administration. The state is poised to extend Medicaid to cover some adults in the country illegally , which goes against Trump's immigration policy. State Attorney General Xavier Becerra also has filed at least 50 lawsuits challenging the administration's executive actions and policies. And the federal government last week canceled more than $1 billion it had promised to help California build a high-speed rail network. 'I thought it would be imprudent to include it until we had more confidence,' Newsom said of the tax. Lawmakers disagree, noting that the federal government already has approved a similar tax for Michigan. 'Closed mouths don't get fed, as my father used to say,' said Holly Mitchell, a Los Angeles Democrat who heads the Senate Budget and Fiscal Review Committee. 'I couldn't support not trying, based on an assumption because (Trump) changes his mind apparently every day.' The tax is unusual because many managed care organizations want to keep paying it. The money they send to the state is used to draw down federal cash that's sent back to them for providing coverage to Medicaid recipients. 'The stakes are too high for (the tax) to be disapproved or rejected,' said Brianna Lierman, CEO of Local Health Plans of California, which represents managed care organizations. 'We agree with and support the cautious approach to both structuring this tax and seeking approval for it. There is just too much to lose.' The Senate and Assembly will begin budget negotiations with Newsom next week. Lawmakers adopted his revenue projections, which call for a $21.5 billion surplus, the largest in at least 20 years. Lawmakers must pass a budget by June 15 or they stop getting paid. The two legislative versions have vastly different health care proposals. The Senate, following Newsom's lead, wants to tax people who don't have health insurance and use that money to help middle-income families pay their monthly insurance premiums. The Assembly did not include money for that, with budget chairman Phil Ting saying representatives preferred to consider those options later this year. Advocates worry that would significantly delay new benefits. The Senate also wants to expand Medicaid to include adults in the country illegally if they're between the 19 and 26 or at least 65 and older. But the Assembly only included money to cover young adults. 'Whenever you do a budget, there are thousands of phenomenal proposals that just don't make it in. And it's not that we don't care, it's really because we couldn't quite make room,' said Ting, a San Francisco Democrat. Another issue dividing lawmakers and the governor: How to improve the state's drinking water. Health advocates say more than a million people in the state don't have access to clean drinking water because of problems with public water systems. Newsom proposed a 95-cent tax on most residential water customers to help pay for improvements. The Senate rejected the tax but recommended spending $150 million a year in existing tax dollars to make the improvements. The Assembly did not include any money for it, deferring the issue until later in the year.
  • Democratic Gov. Janet Mills on Friday signed into law a bill that eliminates religious and philosophical exemptions for vaccinations in Maine. Maine has one of the highest rates of non-medical vaccine exemptions in the nation, and health officials say the opt-out rates appear to be rising. 'As we hear more reports of measles and other preventable diseases in Maine and across the country, it has become clear that we must act to ensure the health of our communities,' said Democratic Rep. Ryan Tipping of Orono, the bill's sponsor. Maine will end non-medical vaccine opt-outs by 2021 for students at public and private schools and universities, including nursery school. Health care facility employees are also subject to the law. Supporters say unvaccinated children put others at risk, especially those who cannot receive inoculations for medical reasons. But opponents of the legislation say it infringes on parental rights and stigmatizes children who remain unvaccinated. The Maine Center for Disease Control recently announced the first case of the measles in the state since 2017. The state also is dealing with an outbreak of whooping cough, for which there is a vaccine. Maine joins California, Mississippi and West Virginia to become the fourth state without religious exemptions for vaccine requirements. Opponents warn that a legal fight is brewing over whether the Maine law goes too far in infringing on religious liberty. The Maine Constitution says 'no person shall be hurt, molested or retrained' for following God according to his or her 'own conscience.
  • U.S. regulators have approved the most expensive medicine ever, for a rare disorder that destroys a baby's muscle control and kills nearly all of those with the most common type of the disease within a couple of years. The treatment is priced at $2.125 million. Out-of-pocket costs for patients will vary based on insurance coverage. The medicine, sold by the Swiss drugmaker Novartis, is a gene therapy that treats an inherited condition called spinal muscular atrophy. The treatment targets a defective gene that weakens a child's muscles so dramatically that they become unable to move, and eventually unable to swallow or breathe. It strikes about 400 babies born in the U.S. each year. The Food and Drug Administration on Friday approved the treatment, called Zolgensma, for all children under age 2 who are confirmed by a genetic test to have any of the three types of the disease. The therapy is a one-time infusion that takes about an hour. Novartis said it will let insurers make payments over five years, at $425,000 per year, and will give partial rebates if the treatment doesn't work. The one other medicine for the disease approved in the U.S. is a drug called Spinraza. Instead of a one-time treatment, it must be given every four months. Biogen, Spinraza's maker, charges a list price of $750,000 for the first year and then $350,000 per year after that. The independent nonprofit group Institute for Clinical and Economic Review, which rates the value of expensive new medicines, calculated that the price of the new gene therapy is justifiable at a cost of $1.2 million to $2.1 million because it 'dramatically transforms the lives of families affected by this devastating disease.' ICER's president, Dr. Steven D. Pearson, called the treatment's price 'a positive outcome for patients and the entire health system.' The defective gene that causes spinal muscular atrophy prevents the body from making enough of a protein that allows nerves that control movement to work normally. The nerves die off without the protein. In the most common type, which is also the most severe, at least 90% of patients die by age 2, and any still alive need a ventilator to breathe. Children with less-severe types become disabled more slowly and can live for up to a couple decades. Zolgensma works by supplying a healthy copy of the faulty gene, which allows nerve cells to then start producing the needed protein. That halts deterioration of the nerve cells and allows the baby to develop more normally. In patient testing, babies with the most severe form of the disease who got Zolgensma within 6 months of birth had limited muscle problems. Those who got the treatment earliest did best. Babies given Zolgensma after six months stopped losing muscle control, but the medicine can't reverse damage already done. Evelyn Villarreal was one of the first children treated, at eight weeks. Her family, from Centreville, Virginia, had lost their first child to spinal muscular atrophy at 15 months. Two years later when Evelyn was born a test showed she also had the disease, so the family enrolled her in the gene therapy study at Nationwide Children's Hospital in Columbus, Ohio. Evelyn is now 4½ years old and showing no muscle problems other than minor trouble standing up, said her mother, Elena Villarreal. She has been feeding herself for a long time, she draws and speaks well, and will be starting kindergarten in the fall. 'She's very active and goes to the playground a lot,' said Elena Villarreal. 'She's walking and even jumping.' It is too early to know how long the benefit of the treatment lasts, but doctors' hopes are rising that they could last a lifetime, according to Dr. Jerry Mendell, a neurologist at Nationwide Children's. Mendell led one of the early patient studies and is Evelyn's doctor. 'It's beginning to look that way,' he said, because a few children treated who are now 4 or 5 still have no symptoms. Early diagnosis is crucial, so Novartis has been working with states to get genetic testing for newborns required at birth. It expects most states will have that requirement by next year. The FDA said side effects included vomiting and potential liver damage, so patients must be monitored for the first few months after treatment. ___ Follow Linda A. Johnson at https://twitter.com/LindaJ_onPharma . ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.
  • Texas health officials have lifted some advisories that warned against eating seafood from parts of two Houston-area bays following a maritime accident and toxic spill this month. The Texas Department of State Health Services on Friday announced water testing results show contaminants from the collision no longer present a risk for humans consuming fish. Cleanup continues following the May 10 accident involving barges, a tanker and a tugboat near Bayport that leaked several thousand barrels of a gasoline blend stock. The health advisory was issued the next day. Coast Guard Petty Officer 2nd Class Johanna (joh-HAH'-nuh) Strickland said Friday that crews are finishing shoreline remediation. The Houston Ship Channel fully reopened a few days after the accident. Health department officials say private oyster harvesting in Galveston Bay reopens Saturday, subject to other restrictions.
  • Pro football players may be more likely to die from degenerative brain diseases and heart problems than baseball players but the reasons are unclear, a new study suggests. The differences may seem obvious. Repeated head blows have been linked with a wasting brain disease in football players. Also, girth can contribute to heart problems, and football players are generally bigger and heavier than baseball players. But the researchers emphasized that they lacked information on family history, genetics and lifestyle that all affect risks for specific diseases and death. Some studies have suggested NFL players may live longer than the general population, but the researchers said comparing athletes from two elite sports provides a better perspective on risks that may be inherent to football or baseball. They focused on 6,100 athletes born before 1965 who competed for at least five seasons in the NFL or Major League Baseball and who died between 1979 through 2013. Among NFL players, there were 517 deaths at an average age of 60. That compares with 431 deaths at age 67 on average among baseball players. The researchers, led by Marc Weisskopf from Harvard's public health school, wrote that their results may be 'limited to NFL players in the playing years considered because there have been changes in sports characteristics over time, such as helmet use, training regimen, and smoking prevalence.' They said more studies are needed to determine reasons for the differences they found. Their study was published Friday in JAMA Network Open. Zachary Kerr, a sports injury researcher at the University of North Carolina, called the study important but said it leaves many questions unanswered, including whether young amateur athletes face similar risks. Kerr co-authored a journal editorial. Brain diseases caused or contributed to 39 NFL deaths compared with 16 deaths among baseball players. That amounts to a nearly three times greater risk for NFL players, results that echo an earlier study comparing brain disease deaths in NFL players with the general population. Heart disease caused or contributed to 498 deaths among NFL players, more than double the 225 deaths among the baseball group. Brain diseases in the data included Alzheimer's disease and other dementias but there was no information on chronic traumatic encephalopathy, the degenerative disease that has been found in brain autopsies of some former NFL players. Memory problems are among possible signs of the disease, and some cases may be misdiagnosed as Alzheimer's disease. Some studies have suggested that head blows also may increase risks for Alzheimer's. ___ Follow AP Medical Writer Lindsey Tanner at @LindseyTanner. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.
  • The Trump administration moved Friday to revoke newly won health care discrimination protections for transgender people, the latest in a series of actions that aim to reverse gains by LGBTQ Americans in areas ranging from the military to housing and education. The Health and Human Services Department released a proposed regulation that in effect says 'gender identity' is not protected under federal laws that prohibit sex discrimination in health care. It would reverse an Obama-era policy that the Trump administration already is not enforcing. 'The actions today are part and parcel of this administration's efforts to erase LGBTQ people from federal regulations and to undermine nondiscrimination protections across the board,' said Omar Gonzalez-Pagan, a senior attorney on health care at Lambda Legal, a civil rights organization representing LGBT people. House Speaker Nancy Pelosi, D-Calif, said the action shows 'utter contempt for the health, safety and humanity of women and transgender Americans.' The administration also has moved to restrict military service by transgender men and women , proposed allowing certain homeless shelters to take gender identity into account in offering someone a bed for the night and concluded in a 2017 Justice Department memo that federal civil rights law does not protect transgender people from discrimination at work. As one of her first policy moves, Education Secretary Betsy DeVos withdrew guidance that allowed students to use bathrooms matching their gender identity. More than 1.5 million Americans identify as transgender , according to the Williams Institute, a think tank focusing on LGBT policy at the UCLA School of Law. A bigger number — 4.5% of the population— identify as lesbian, gay, bisexual or transgender (LGBT), according to Gallup. Pushing back against critics, the HHS official overseeing the new regulation said transgender patients would continue to be protected by other federal laws that bar discrimination on the basis of race, color, national origin, sex, age and disability. 'Everyone deserves to be treated with dignity and respect,' said Roger Severino, who heads the HHS Office for Civil Rights. 'We intend to fully enforce federal laws that prohibit discrimination.' Asked about the charge that the administration has opened the door to discrimination against transgender people seeking needed medical care of any type, Severino responded, 'I don't want to see that happen.' In some places LGBT people are protected by state laws, said Lambda Legal attorney Gonzalez-Pagan, 'but what do you say to people living in a state that doesn't have state-explicit protections? Do they move their home?' Behind the dispute over legal rights is a medically recognized condition called 'gender dysphoria' — discomfort or distress caused by a discrepancy between the gender that a person identifies as and the gender at birth. Consequences can include severe depression. Treatment can range from sex-reassignment surgery and hormones to people changing their outward appearance by adopting a different hairstyle or clothing. Many social conservatives disagree with the concept. 'Sex is not subjective, it is an objective biological reality,' Tony Perkins, president of the Family Research Council, said in a statement supporting the Trump administration's move. The proposed rule will ensure that federal law 'isn't used as a vehicle to advance transgender or abortion politics,' he said. Under the Obama-era federal rule, a hospital could be required to perform gender-transition procedures such as hysterectomies if the facility provided that kind of treatment for other medical conditions. The rule was meant to carry out the anti-discrimination section of the Affordable Care Act, which bars sex discrimination in health care but does not use the term 'gender identity.' The proposed new rule would also affect the notices that millions of patients get in multiple languages about their rights to translation services. Such notices often come with insurer 'explanation of benefits' forms. The Trump administration says the notice requirement has become a needless burden on health care providers, requiring billions of paper notices to be mailed annually at an estimated five-year cost of $3.2 billion. The American Civil Liberties Union served notice it expects to challenge the rule in court when it is final. Louise Melling, ACLU deputy legal director said the potential impact could go beyond LGBT people and also subject women to discrimination for having had an abortion. That's because the proposal would remove 'termination of pregnancy' as grounds for making a legal claim of sex discrimination in health care, one of the protections created in the Obama years. Abortion opponents had argued that the Obama regulation could be construed to make a legal argument for federal funding of abortions. UCLA legal scholar Jocelyn Samuels, who oversaw the drafting of the HHS transgender anti-discrimination rule under Obama, said that rule reflected established legal precedent that transgender people are protected by federal anti-discrimination laws. 'This administration has manifested its intent to roll back that well-considered understanding in every context,' she said. Samuels questioned the timing of the Trump action, since the U.S. Supreme Court has agreed to hear three cases this year looking at whether federal civil rights law bans job discrimination on the basis of sexual orientation and gender identity. The proposed rule change is unlikely to have immediate consequences beyond the realm of political and legal debate. It faces a 60-day comment period and another layer of review before it can be finalized. HHS official Severino said the Trump administration is going back to the literal text of the ACA's anti-discrimination law to correct an overly broad interpretation. The Obama rule dates to a time when LGBT people were gaining political and social recognition. But a federal judge in Texas has said the rule went too far by concluding that discrimination on the basis of gender identity is a form of sex discrimination. Severino said the proposed rule does not come with a new definition of a person's sex. Earlier, a leaked internal document suggested the administration was debating whether to issue an immutable definition of sex, as based on a person's genital organs at birth. ___ AP writer David Crary in New York contributed to this report.
  • Even as the anti-abortion movement celebrates the sweeping bans passed in several states, it's divided by a widening rift over whether those prohibitions should apply to victims of rape and incest. The debate pits those who believe any abortion is immoral against those who worry that a no-exception stance could be harmful to some Republican candidates in upcoming elections. A Gallup poll last year found that 77% of Americans support exceptions in cases of rape and incest. 'There is a media spotlight shining on this issue,' said Clarke Forsythe, senior counsel with Americans United for Life. 'State leaders need to be prudent and reflect not only on state elections but also national elections, and the pace of change the public might accept.' There's potential for even more division. The Federalist, an online magazine influential in conservative and anti-abortion circles, ran an article this week by two abortion opponents suggesting that women who induce their own abortions should be prosecuted for murder. The position is at odds with the pro-women rhetoric of leading anti-abortion groups. 'We're 100% percent against prosecuting women.' said Kristi Hamrick, spokeswoman for Students for Life of America. Divisions over rape-and-incest exceptions have existed within the anti-abortion movement for years, but have become more apparent as several states in the South and Midwest enacted tough bans on abortion. Only the ban in Georgia includes an exception for victims of rape or incest — and then only if the woman files a police report first. Measures enacted in Alabama, Ohio, Kentucky, Mississippi and Missouri do not contain those exceptions, nor does a measure nearing final approval in Louisiana. Alabama's ban is the toughest: Performing an abortion at any stage of pregnancy would be a felony punishable by up to 99 years or life in prison. The only exception would be when the woman's health is at serious risk. Some Republicans in Alabama's GOP-controlled Senate, as well as minority Democrats, were enraged when an exemption for rape and incest was removed without a roll call vote. The flare-up prompted a five-day postponement before final approval came on May 14. Emboldened by the bans, 17 anti-abortion leaders sent a letter Wednesday to Republican National Committee chairwoman Ronna McDaniel requesting a meeting and urging the GOP to explicitly oppose exceptions for rape and incest. The signatories included Kristan Hawkins, president of Students for Life, the Rev. Frank Pavone, director of Priests for Life, and activist Ryan Bomberger , the son of a woman who was impregnated by a rapist but opted against having an abortion. 'We understand that issues like rape and incest are difficult topics to tackle.' the letter said. 'Nevertheless, it is our view that the value of human life is not determined by the circumstances of one's conception or birth.' McDaniel, in reply, described the GOP as 'the party of life' and added, 'I welcome any discussion about how to protect it.' Discussing the bans in an interview with CNN on May 17, McDaniel said, 'Personally, I would have the exceptions. ... But we are a party that is a broad tent.' President Donald Trump, House Minority Leader Kevin McCarthy of California and Senate Majority Leader Mitch McConnell of Kentucky also have distanced themselves from the no-exceptions bans. 'I am strongly Pro-Life, with the three exceptions - Rape, Incest and protecting the Life of the mother,' Trump tweeted on May 18. 'We must stick together and Win.... ....for Life in 2020. If we are foolish and do not stay UNITED as one, all of our hard fought gains for Life can, and will, rapidly disappear!' In several state legislatures, debate over the exceptions produced dramatic moments. Samantha Blakely, 25, a travel industry employee from Birmingham, testified at a hearing on the Alabama ban about her decision to have an abortion after a rape in 2017 resulted in pregnancy. She says ban supporters ignore the difficult situations faced by women like her. 'They have absolutely lost sight of victims,' Blakely told The Associated Press. 'There are blinders on, to block out victims of rape and incest.' If the new law had been in effect when she was raped, Blakely said, she would have done anything to end the pregnancy — possibly including suicide. 'I knew I would not be emotionally or mentally or financially stable enough to give that child what they needed,' Blakely said. 'And I didn't know exactly how dangerous my rapist was at the time. ... I knew he would try to somehow stay in my life and use that child to control me. And the thought of those things, I'd rather be dead.' In South Carolina, where the legislative session ended before a proposed abortion ban could be passed, there was bitter debate over whether to include an exception for rape and incest. GOP state Rep. Nancy Mace objected angrily after a fellow Republican lawmaker passed out a flier suggesting that a rapist who impregnates his victim should be referred to as a 'sperm donor.' After Mace proposed adding the exceptions to the bill, another GOP colleague protested, while referring to rape in a way that appeared to diminish its seriousness as a violent crime. 'The question is whether another life should be taken because of a bad act,' said Rep. John McCravy told fellow lawmakers. In arguing for the exemption, Mace had shared her own story of being raped, one of several female lawmakers to do so amid the heated state abortion debates. The abortion bill eventually passed the House with the rape-and-incest provision included, but did not get traction in the South Carolina Senate. Stephen Schneck, a retired political science professor at the Catholic University of America, personally opposes abortion but believes most Americans have a nuanced view — favoring neither Alabama-style bans nor unrestricted abortion access at any phase of pregnancy. 'Politically, promoting the all-or-nothing positions makes sense for fundraising and mobilizing activists on both sides,' he said via email. 'But it also makes it impossible for the country as a whole to come together on the issue.' None of the abortion bans enacted this year has taken effect. All are expected to be blocked by federal courts, with ban supporters hoping appeals might lead to the U.S. Supreme Court. The recent Federalist article, by Georgi Boorman and James Silberman, took aim at the growing interest in do-it-yourself abortions, in which a woman could receive the abortion drug misoprostol by mail and terminate a pregnancy without involvement of a medical professional. The authors called for total abolition of abortion, so that 'the murder of an unborn boy or girl will be treated exactly the same as the murder of a toddler or older child.' ___ Associated Press writers Ricardo Alonso-Zaldivar in Washington, D.C., and Christina A. Cassidy in Atlanta contributed to this report.
  • The parents of an incapacitated woman who was raped and later gave birth at a Phoenix long-term care center alleges in a $45 million legal claim that the facility and state broke their promise to have only female caregivers tend to their daughter. A nurse charged with sexually assaulting the 30-year-old patient had cared for her more than 1,000 times in the 13 months leading up to the birth, according to an expert cited in the claim filed Wednesday against Arizona. Many of Nathan Sutherland's encounters with the patient at Hacienda HealthCare occurred overnight, when fewer staff members and visitors were around, said Christopher Cherney, a professor with more than 20 years of experience as a long-term care facility administrator who reviewed the woman's medical records. The family alleges in the precursor to a lawsuit that Hacienda missed dozens of signs that the woman was carrying a baby and discovered the pregnancy only after another nurse saw the boy's head. The patient, who has a feeding tube and whose nutrition was reduced in response to her weight gain during the pregnancy, delivered the boy while severely dehydrated and without pain medications, the claim said. The family's lawyers say the woman suffered injuries from repeated sexual assault. Notes from the hospital where she was treated say her injuries suggest it wasn't her first pregnancy, but no other details were provided. The surprise birth on Dec. 29 triggered reviews by state agencies, highlighted safety concerns for patients who are severely disabled or incapacitated and prompted the resignations of Hacienda's chief executive and one of the victim's doctors. A spokeswoman for the Arizona Department of Economic Security, which oversaw the woman's care, did not return a message seeking comment. Hacienda spokesman David Leibowitz and Sutherland's lawyer, Edwin Molina, declined to comment. Representatives from Hacienda and the state had told the woman's parents that their daughter would have only female caregivers, the claim said. Documents from the Department of Economic Security note that only female staff members should provide her personal care, such as bathing and dressing. Cherney, the expert for the family, said Sutherland conducted safety checks, administered medications and wrote notes on the woman's status during his many encounters with her. Investigators say Sutherland's DNA matched a sample from the woman's son, who is being cared for by her family. Sutherland has pleaded not guilty to charges of sexual abuse and abuse of a vulnerable adult. He is challenging a court order requiring tests to see whether he has HIV or other sexually transmitted diseases. The victim began suffering seizures at 2 months old and her medical conditions stem from a brain disorder diagnosed afterward, family attorney John Micheaels said. The disorder caused motor and cognitive impairments and vision loss. She was also left with no functional use of her limbs. News organizations, including The Associated Press, previously reported that she was in long-term care after a near-drowning. Despite her disabilities, her family says she responds to some sensory stimuli. She turns her head toward sounds she finds pleasing like soft music or being read to, the claim said. She can groan and smile. Despite being non-verbal, she will cry and make 'throaty sounds' if she is feeling pain or discomfort. The claim said that Arizona has a duty to provide services to people with developmental disabilities by contracting with companies like Hacienda and that the state did a poor job of monitoring its operations. While the claim heavily criticizes Hacienda and Sutherland, it seeks money only from the state. It said Hacienda missed 83 opportunities to diagnose the woman's pregnancy. She gained weight, had a swollen belly and missed menstrual periods in the months before the child was born. The family's lawyers said a simple blood test would have revealed the pregnancy. ___ Follow Terry Tang on Twitter at twitter.com/ttangAP and Jacques Billeaud at twitter.com/jacquesbilleaud.
  • Plunging ahead despite paralyzing partisanship in the nation's capital, senior lawmakers of both parties Thursday proposed legislation to tackle surprise medical bills and other concerns, from prescription drug costs to uneven vaccination rates. The draft bill from Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., echoes a time when health care issues often led to dialogue and cooperation between political parties. Alexander chairs the Health, Education, Labor and Pensions committee, while Murray is the ranking Democrat. 'We can make progress when both sides are at the table ready to put patients and families first,' Murray said in a statement. Alexander said he wants to bring the bill to the Senate floor in July and get legislation on President Donald Trump's desk. But with Trump threatening to halt all cooperation with Democrats unless House Democrats stop investigating him, the outlook is unclear. Alexander says his bill represents 'common sense steps' — more than 30 specific ideas — that are readily achievable. 'Surprise medical bills' are the shockingly high charges insured patients can get hit with when a hospital or doctor is not in their insurers' network. Earlier this month, Trump held a White House event to declare his eagerness to sign a fix into law. The Alexander-Murray legislation would protect patients by limiting their financial responsibility to their own plan's in-network rates, when they receive emergency care at an out-of-network hospital, or when an out-of-network clinician provides services at an in-network facility. But the legislation remains a work in progress, since lawmakers still have to figure out how hospitals, doctors and insurers would settle the costs among themselves. Insurers and employers who sponsor workplace coverage favor a set formula for calculating fees, while hospitals and doctors are calling for arbitration. Alexander and Murray have plenty of company on surprise medical bills, since lawmakers in both chambers of Congress have advanced various proposals. A lobbying war has broken out between insurers and employers on one side, and hospitals and doctors on the other, over how to determine payments once patients are no longer liable for out-of-network care. On prescription drugs, the bill includes a smorgasbord of measures aimed at indirectly lowering drug prices. But none of the proposals would require drugmakers to lower their prices or authorize the government to negotiate better deals. Instead, several sections of the bill would discourage industry tactics long used to delay the launch of lower-priced generic medications. For instance, branded drug manufacturers routinely file frivolous petitions with the Food and Drug Administration against potential generic competitors, often delaying their entry to the market for months. The bill would empower the FDA to ignore such petitions. Among other provisions, the bill would: — Authorize a national campaign to promote vaccination to prevent disease and control its spread. The campaign would 'combat misinformation' and circulate scientific evidence making the case for vaccinations. The recent U.S. measles outbreak has been blamed on lagging vaccination rates in parts of the country. — Call on the Health and Human Services Department to set up a grant program for improving medical care for pregnant women, with the aim of preventing maternal deaths and complications. Another grant program would focus on improving care for infants. — Broaden consumer access to information from their health plans, including readily accessible lists of network providers, calculators for estimating out-of-pocket costs and medical claims data. — Take steps to promote disclosure of contracting information in the health care industry, where accurate pricing information remains hard to obtain. Missing from the legislation are any provisions to stabilize coverage under the Affordable Care Act, or mitigate the potentially far-reaching consequences if opponents succeed in a lawsuit to strike down the law as unconstitutional. Alexander and Murray had earlier written a bipartisan bill to shore up the health law's insurance markets, but the effort failed. Before the political wars over the Obama-era health law, it was not uncommon to see lawmakers of both parties working side by side on health care. Federal mental health parity legislation grew out of bipartisan collaboration. The Medicare prescription drug benefit under Republican President George W. Bush had support from key Senate Democrats. ___ Associated Press Health Writer Matthew Perrone contributed to this report.
  • The World Health Organization is publishing its first-ever global strategy to tackle the problem of snakebites, aiming to halve the number of people killed or disabled by snakes by 2030. Nearly 3 million people are bitten by potentially poisonous snakes every year, resulting in as many as 138,000 deaths. Last week, Britain's Wellcome Trust announced an 80 million-pound ($100 million) program to address the problem, saying there were new potential drugs that could be tested. In a statement, Doctors Without Borders said it was 'cautiously optimistic' WHO's snakebite strategy could be a 'turning point' in addressing snakebites. The agency called the problem of snakebites 'a hidden epidemic' and said most bites are treatable. WHO's strategy includes plans to increase global access to treatment and anti-venom.

News

  • In the Book of Genesis, Noah’s ark survived a flood in the Middle East. A replica of the biblical boat was not as lucky, and its owners are suing -- for damages caused by heavy rains in northern Kentucky. >> Read more trending news  The owners of Ark Encounter are suing their five insurance carriers for refusing to cover nearly $1 million in damages after flooding in 2017 and 2018 caused a landslide on its access road, the Louisville Courier Journal reported. In a 77-page lawsuit in U.S. District Court in Kentucky, Crosswater Canyon Inc. and the Ark Encounter sued the business’ insurance underwriters, WLWT reported. The ark’s owners are seeking compensatory and punitive damages, the Courier Journal reported. The ark, located in Williamstown, was not damaged.  According to the lawsuit, 'A significant landslide occurred along portions of the slope,” which caused “significant damage” to the road surface, making portions of the road “unsafe and unfit for use.” The road was fixed by engineers at a cost of $1 million, WLEX reported. But when the Ark Encounter asked its insurance underwriters to cover the cost of repairs, they were rebuffed, the television station reported. The Allied World Assurance Co. is named as a defendant, along with three other carriers, according to The Washington Post. Initially, the suit alleges, defendants cited faulty craftsmanship as the reason for the property damage and claimed they were not liable, WLEX reported. After an appeal, the defendants admitted that only a small amount was covered by the policy. The Ark Encounter, built at a cost of $120 million, opened in July 2016 with a zoo, zip lines and a restaurant in addition to the five-story replica of the ark, the Post reported. It was founded by Ken Ham and his ministry, Answers in Genesis, the newspaper reported. Ark Encounter spokeswoman Melany Ethridge distributed a statement that said “the lawsuit speaks for itself,” noting the park remained open. 'You got to get to the boat to be on the boat,' Ethridge told the Courier Journal.
  • Amanda Eller, who went missing more than two weeks ago in Maui has reportedly been found alive according to KHNL in Hawaii. >> Read more trending news The the 35-year-old woman was spotted by a helicopter in a wooded area sources told KHNL. Eller hadn’t been seen since May 8, when she disappeared after a hike in a Maui Forest Reserve, known for its steep and rugged terrain. Her vehicle was found with her cellphone and wallet inside in a parking lot at the reserve. WSOC-TV confirmed the news with Eller's aunt, Lynn Eller Ansley, by phone Friday night. Ansley is one of several relatives who live in North Carolina. Eller’s parents had offered a $10,000 reward for information leading to her safe return. The Associated Press contributed to this report.
  • Officers found snakes, alligators and talking birds inside a Marion, Arkansas, home. >> Read more trending news William Hale, 47, is charged with 60 counts of aggravated animal cruelty after investigators found the exotic animals inside his home. One neighbor took pictures of the snakes he saw investigators taking out of the home. WHBQ-TV received a tip yesterday from a source who said the conditions were so unbearable that even the hazmat team could not handle it. He said the birds they found in that home were having full conversations with the investigators. “Tropical birds, I seen a parrot. Actually he had, like, seven of those, different type of birds, and I seen, like, 30 snakes,” Terrence Blackburn, a neighbor, said. “The bulldog was one of the first animals to come out, and there were five of those. I seen a poodle,” Blackburn said. Yellow caution tape surrounds the home. “I seen the alligator, which they had, it was a small baby alligator and I heard it was like nine of them,” Blackburn said. Investigators with the Marion Police Department told WHBQ-TV Animal Control officers responded to the home after complaints about barking dogs. “And you had no idea this was going on, no idea,” Blackburn said. Hale was not home at the time. He did not show up after officers spoke with him over the phone requesting his return. According to officers, that is when they conducted a search warrant and found several exotic animals that were not being properly cared for. “I would let him know that was kind of wrong. You know, we have kids over here, and them are dangerous animals,” Blackburn said. A source gave confirmation that there were several alligators inside that home yesterday.
  • Officials at Muskogee War Memorial Park said the Oklahoma Department of Emergency Management and the National Guard took over the site Friday due to severe flooding. >> Read more trending news The park is home to the USS Batfish, a World War II-era submarine that now serves as a museum. Park staff and volunteers are being used to support emergency officials in managing the scene. Officials said at least one line on the Batfish has broken and they are working to keep it from floating away. Crews are filling the ballast tanks on board the USS Batfish to keep it inside the park's bowl. The National Guard also tied a new line to the boat to add leverage. Those interested in helping support the memorial and any potential repair costs can visit this link for more information.
  • A Walt Disney World employee from Clermont, Florida, was arrested on charges of trying to have sex with an 8-year-old girl. >> Read more trending news Investigators said Frederick Pohl Jr., 40, thought he was chatting with the father of the victim, but he was chatting with an undercover agent. The two arranged to meet at an Orlando hotel Tuesday and that's where Pohl was arrested. Investigators said Pohl was in possession of condoms and a child-sized pink dress. Authorities said Pohl was charged with transferring obscene materials to a minor and attempting to entice a minor. If convicted, Pohl faces a maximum penalty of life in federal prison. Disney said Pohl was placed on unpaid leave of absence.
  • A Gwinnett County, Georgia, police K-9 died Thursday after pursuing a man in 90-degree heat, authorities said. >> Read more trending news Eli, a 9-year-old police dog, had been tracking a man in Grayson, Georgia, for about 30 minutes when he began to show signs of distress believed to be related to the heat, Gwinnett police said in a news release. Eli and his handler, Officer Matthew Bonanno, were assisting Snellville police in a pursuit after a man fled from officers near North Crestview Drive and Grayson Parkway, police said. After showing signs of distress, the dog was removed from the chase, according to police. As Eli and officers walked back to their patrol vehicles, the dog fell to the ground and began to act abnormally, police said.  In an effort to cool him down, officers covered Eli’s body with water. He was taken to a nearby veterinarian for treatment, where he stopped breathing. Vets performed CPR for about 30 minutes before he was pronounced dead just before 5 p.m. “We mourn the loss of this courageous K-9 and will provide more details at a later time,” Gwinnett police said, calling the situation tragic. “Please keep Officer Bonnano and his family in your thoughts.” Eli had been with the department for eight years. His body was taken to the University of Georgia, where a necropsy is being conducted to determine a cause of death, Gwinnett police said Friday. Snellville police said the pursuit began when a woman called 911 to report that her ex-boyfriend was following her in his car. At one point, the man reportedly struck the woman from behind in traffic, authorities said. The altercation began on U.S. 78 in DeKalb County before continuing into Gwinnett, police said. Snellville officers pursued the man into a neighborhood, where he abandoned his vehicle and ran away, prompting officers to call for a K-9. The man, whose name was not released, has still not been found.