Immigration and Boarders, Misanthropy

The Health 202: House Republicans move to indefinitely detain migrant kids with families

This post was originally published on this siteTHE PROGNOSIS In this July 13, 2018, file photo, Allison, 6, and her…

This post was originally published on this site

THE PROGNOSIS

The Trump administration is working under a court under to reunify migrant kids that were taken from their parents trying to illegally enter the United States from the southern border. But in Congress, a faction of House Republicans is moving ahead with a measure that would indefinitely detain kids who cross the border with their parents.

A California District judge rejected last week the Justice Department’s request to lift a two-decades-old agreement that limited how long a child could be held in a detention center. But some Republicans in Congress are supporting a legislative fix to the so-called Flores agreement that prevents children from being held by the government for more than 20 days.

It’s the latest twist in an immigration debate that has roiled Republicans and sparked conflicting messages from President Trump, who has both urged and panned Republican attempts to pass more comprehensive immigration legislation that would include funding for his wall along the U.S.-Mexico border. The latest attempt by House Republicans to pass an immigration bill failed spectacularly.

The new House measure would nullify the Flores agreement, but Roll Call reports the GOP is “still waiting on the administration to say what else it wants to be included in that bill.” 

The debate played out at last week’s House Appropriations Committee markup of the Department of Health and Human Services funding bill. During that hearing, Rep. Tom Cole (R-Okla.) offered an amendment to override the Flores agreement restrictions, which spurred passionate opposition from Democratic lawmakers. But it was a one-sided debate with only Democrats asking to speak on the subject, and no Republicans other than Cole speaking up to defend it.

The amendment passed along party lines. And Democrats were outraged.

“This amendment will be characterized as keeping families together; in reality it would put families in cages and hold immigrant children in jail-like conditions for indefinite periods of time,” said Rep. Rosa DeLauro (D-Conn.). “It is not a solution to the manufactured crisis … it simply trades one abhorrent policy for another. It creates a false choice; either we take the children away or we jail  everyone together.”

“Locking kids up is child abuse and it’s a violation of their human rights,” said Rep. Barbara Lee (D-Calif.) “The world is watching. These policies are a disgrace and another stain on this country.”

You can watch the debate around the 1:29-hour mark:

Here are the politics of the issue: Democrats want to claim the moral high ground, especially as the midterm elections inch closer. Republicans find themselves in a difficult position of being tough on immigration issues that energize their base, but they’re also fully aware that images this summer of small children being taken away from their parents could turn off voters, especially women, in the swing districts they desperately need to maintain their majority.

During the HHS appropriations hearing, Republicans sided with Democrats unanimously on a proposal to cut $100,000 from Secretary Alex Azar’s office budget every day after Aug. 1 if the agency had not submitted its reunification plans to Congress. 

And Democrats know that it isn’t just Trump with this problem — it also plagued the Obama administration as it tried to deal with the influx of migrant families crossing the border in 2014. The Obama administration also asked the court to waive the Flores agreement and the same federal judge denied the request then, too. The Obama White House hoped the threat of family detention would act as a deterrence to crossing the border illegally. 

The Obama administration ultimately released families together, assigned them caseworkers, and in nearly every instance the families showed up for their scheduled court hearings. But the Trump administration shuttered that program. 

But the truth is, detaining children along with their parents isn’t as politically toxic as Trump’s separation policy. In fact, while one in seven Americans opposed separating families, a majority of Americans believe children and their parents who come into the country illegally should be detained together: “A 58 percent majority said they prefer that these families be held together in a detention facility until their immigration case is resolved, while 39 percent said they should be temporarily released until a deportation court hearing,” according to a Washington Post-Schar School poll released on July 6. 

Meanwhile on Monday, a federal judge ordered a stay on deportations of reunified families and over the weekend the Trump administration laid out its plan for reuniting the more than 2,000 remaining minors who were separated from their parents these past several months. (The tweet below from NBC’s Jacob Soboroff shows the flow chart the government submitted to the court.)

HHS’s Jonathan White, a senior official tasked with the reunification effort, told the court  the agency has cleared 1,317 children to be reunited with their parents, according to the New York Times. The government still couldn’t locate parents of 71 children, he said. 

Expect Democrats to keep this issue at the forefront especially in August when they’re back home campaigning.

AHH, OOF and OUCH

AHH: The White House is warning members of Congress against increasing spending caps for veterans’ health-care programs, a move that could end up blowing up any funding agreement to keep the government open past Sept. 30, Politico’s Sarah Ferris and Jennifer Scholtes report.

It’s the first major showdown in Congress ahead of that deadline before funding for the government runs out for the fiscal year. Some lawmakers on both sides of the aisle are seeking to raise budget caps by billions in order to fund the popular health-care program after Congress recently changed the way money for it was allocated. But yesterday, White House officials sent a letter to lawmakers about the spending, stopping short of threatening a veto, per Sarah and Jennifer.

The letter called the current spending levels “more than sufficient.”

“Although funding for veterans programs is riding within a package that houses just three of the 12 annual funding bills, the breakdown does not bode well for broader spending negotiations leading up to the fiscal 2019 deadline,” Sarah and Jennifer write.

OOF: Urgent care clinics are doling out antibiotic prescriptions to nearly half the patients who show up looking for treatment for illnesses such as the flu or a cold,  which amounts to nearly three times as frequently as in traditional doctors’ offices, according to a new study.

The new study published in the journal JAMA Internal Medicine assessed antibiotic prescription in urgent health care and retail health clinics, a growing destination for patients who have urgent injuries or illnesses but don’t necessarily need to go to the emergency room. Our Post colleague Lena H. Sun reports urgent care centers have become an $18 billion industry with 8,000 locations nationwide.

“Antibiotic overuse is an enormous and growing problem around the world,” Lena reports. “If left unchecked, a United Kingdom report has forecast, antibiotic-resistant bacteria could result in 10 million deaths each year by 2050 — more than the number of people killed by cancer — at a cost of $100 trillion to the global economy.”

Lena writes that taking antibiotics unnecessarily can lead to major side effects, and overuse can also cause certain bacteria to develop a resistance, which would also put others as risk.

A 2016 study from the Centers for Disease Control and Prevention and the Pew Charitable Trusts found that about a third of antibiotic prescriptions are unnecessary. That’s 47 million potentially unnecessarily prescriptions dispensed each year.

But urgent-care doctors also warn that patients come to such clinics explicitly asking for antibiotics, and if and when they don’t get them they can leave negative reviews for the clinic, leaving them vulnerable to the “Yelp Effect,” Lena writes.

OUCH: All the media coverage of the cognitive test taken by Trump may have been undermined it for future use after then-White House physician Ronny L. Jackson publicly shared test details and questions in January, the New York Times’s Niraj Chokshi reports.

“When I saw that this test was being disseminated to the mass population, and in some cases individuals were being invited to take it online, I wondered whether there would be an effect,” the University of Toronto’s Hourmazd Haghbayan and some colleagues wrote in a letter published in the journal JAMA Neurology.

The doctors are warning physicians to perhaps use other alternatives to the Montreal Cognitive Assessment, Niraj reports, noting it’s not yet clear “what effect the exposure has had on the effectiveness of the test.”  

“Given ongoing interest in age-associated cognitive function, public awareness of specific cognitive tests, such as the MoCA, may continue to increase,” the doctors wrote. “It is possible that the MoCA’s applicability may be compromised in individuals exposed to its contents via such mainstream media reporting.”

HEALTH ON THE HILL

— Sen. Susan Collins (R-Maine) said she’s not “convinced” the Trump administration will be able to require companies to list the cost of their drugs in advertisements. “I’m not convinced that’s the answer, but we do need to address that,” Collins said at a Pew Charitable Trusts event, the Washington Examiner’s Kimberly Leonard reports.

“Collins said she was concerned that patients would tune out when given these advisories because several factors play into how much a customer ultimately pays for drugs,” Kimberly writes. “It’s possible that all the different contingencies would be listed in an ad, including whether someone is insured or covered under Medicare, or mentioned that rebates could be part of the ultimate cost of a drug, she said.”

“I don’t know how you would figure out what price to list,” Collins said. “We have to find a better way to figure out this opaque system.”

— In a Senate Health, Education, Labor and Pensions Committee hearing today, Chairman Lamar Alexander (R-Tenn.) is set to address wasted spending in the health-care system, saying the system produced $750 billion in unnecessary costs in 2009, according to prepared remarks from his office.

Alexander notes such spending, which was 30 percent of total health-care spending that year, was spent on “unnecessary services, excessive administrative costs, fraud” and “does not actually help patients get better or was spent on unnecessary medical tests, services, procedures, or medications,” according to the remarks. He will also note a lack of preventive care that could help the patient avoid certain medical costs.

STATE SCAN

— Virginia Attorney General Mark R. Herring (D) filed a motion late last week to dismiss a federal lawsuit challenging state abortion restrictions, putting the abortion-rights supporter in an awkward spot, as our Post colleague Laura Vozzella reports.

“In the motion filed Friday, Herring seemed to walk a fine line — noting the plaintiffs’ ‘powerful arguments’ against certain abortion restrictions while also contending that the place to challenge them is the legislature, not the courts,” Laura writes. Planned Parenthood and other groups filed the lawsuit against the state in June.

Republican state lawmakers were worried that Herring would “side with the plaintiffs and refuse to defend the state’s restrictions on abortion,” Laura writes, but were subsequently pleased with his move on Friday. Majority Leader C. Todd Gilbert (R-Shenandoah) said in a Friday statement: “Virginia’s pro-life laws are so reasonable, sensible and constitutionally sound that even a pro-abortion Attorney General who accepted tens of thousands of dollars from Planned Parenthood feels they must be defended.”

— On Monday, New Jersey Gov. Philip Murphy’s (D) office said it will allow up to six new applicants for medicinal marijuana dispensaries in the state, part of Murphy’s promise to expand such programs.

Murphy has vowed to make New Jersey the 10th state to legalize marijuana for recreational use, which the governor’s budget proposal said would rake in $80 million in annual tax revenue, the New York Times’s Nick Corasaniti reports. “Yet more than halfway through the governor’s first year, the effort has stalled,” Nick writes. “It once looked like the plan could sail through the state Legislature … But an intraparty battle over the state budget consumed Trenton’s recent attention. And resistance from some Democratic lawmakers has emerged as an obstacle.”

Meanwhile, medical marijuana expansion has been on track. The Monday request for applications would “essentially double the state’s current marijuana infrastructure,” Nick writes.

INDUSTRY RX

— Starting next month, all Southwest Airlines flights will stop offering peanuts in an effort to protect passengers with peanut allergies. Instead, the popular snack served by the airline since the 1970s will be replaced with pretzels.

Since the airline can’t prohibit individual passengers from bringing on their own supply of peanuts, passengers with allergies can alert the airline in advance in order to board the flight early and wipe down their seat and tray table, The Post’s Andrea Sachs writes.

“Peanuts forever will be part of Southwest’s history and DNA,” Southwest said in a statement. “However, to ensure the best onboard experience for everyone, especially for customers with peanut-related allergies, we’ve made the difficult decision to discontinue serving peanuts on all flights.”

— New research suggests CRISPR-based therapy can lead to significantly more DNA damage than experts previously thought and could put patients’ health at risk, Stat’s Sharon Begley reports.

“The DNA damage found in the new study included deletions of thousands of DNA bases, including at spots far from the edit,” Sharon writes. “Some of the deletions can silence genes that should be active and activate genes that should be silent, including cancer-causing genes.” Study author and geneticist Allan Bradley of England’s Wellcome Sanger Center told Stat such DNA damage that can result from CRISPR has been “seriously underestimated.”

While top CRISPR companies attempted to play down the impact of the study’s findings, Sharon reports the three publicly traded firms lost more than $300 million in value yesterday in the first 20 minutes after the report was published. 

“The possibility of adverse consequences from CRISPR’d cells has caused some company officials to argue that if, say, their therapy cures a child of a devastating disease, but increases her risk of cancer, that might be an acceptable trade-off,” Sharon writes. “That argument may well prevail.”

— And here are a few more good reads: 

MEDICAL MISSIVES

TRUMP TEMPERATURE

REPRODUCTIVE WARS

DAYBOOK

Today

  • The House Veterans Affairs Subcommittee on Oversight and Investigations holds a joint hearing with the House Small Business Subcommittee on Investigations, Oversight and Regulations on “Achieving Government-wide Verification of Service Disabled Veteran Owned Small Businesses.”
  • The House Veterans Affairs Committee holds a hearing on “The VA Accountability and Whistleblower Protection Act: One Year Later.”
  • The Senate Health, Education, Labor and Pensions Committee holds a hearing on health care costs.
  • The House Ways and Means Subcommittee on Oversight holds a hearing on combating Medicare fraud.
  • The House Ways and Means Subcomittee on Health holds a hearing on “Modernizing Stark Law to Ensure the Successful Transition from Volume to Value in the Medicare Program.”
  • PhRMA holds an event on “The State of Care: Innovation & Access.”
  • Politico holds its second Pro Summit.

Coming Up

  • The Senate Special Committee on Aging holds a hearing on “Supporting Economic Stability and Self-Sufficiency as Americans with Disabilities and their Families Age” on Wednesday.
  • Brookings Institution holds a event with FDA Commissioner Scott Gottlieb on Wednesday.
  • The FDA’s Blood Products Advisory Committee holds an open session on Wednesday.
  • The National Academies of Sciences, Engineering, and Medicine holds a workshop on the integration of health care and social services on Thursday.
  • The House Energy and Commerce Subcommittee on Health holds a hearing on “21st Century Cures Implementation: Examining Mental Health Initiatives” on Thursday.
  • The Alliance for Health Policy holds an event on “State Responses to the Evolving Individual Health Insurance Market” on Friday.

SUGAR RUSH

Late-night hosts react to the Trump-Putin news conference: 

And here’s how network news anchors reacted to Trump’s denial of Russian election hacking: 

C-SPAN caller thanks Russia for interfering in 2016 election:

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