Overnight Health Care: Trump officials accuse hospital of forcing nurse to assist in abortion | Johnson & Johnson ruling becomes pivotal moment in opioid fight | Advocates sue to speed up Nebraska Medicaid expansion

Welcome to Wednesday’s Overnight Health Care.

Today, the Trump administration put a Vermont hospital on notice over allegations it violated a conscience protection statute, the U.S. is reportedly on the verge of seeing measles return, and advocates are suing over Medicaid expansion in Nebraska.

We’ll start in Vermont…


Trump administration accuses hospital of forcing nurse to assist in abortion

The Trump administration is threatening to pull federal funding from a Vermont hospital because of allegations that a nurse was forced to participate in what federal officials said was an abortion procedure, despite her religious objections.

The Department of Health and Human Services Office for Civil Rights (OCR) on Wednesday announced it told the University of Vermont Medical Center (UVMC) that it had violated the law “by forcing a nurse to assist in an elective abortion procedure over the nurse’s conscience-based objections.”

The agency said it has given the hospital 30 days to bring its conscience protection and staffing policies into compliance with federal law or face the loss of federal funding.

Hospital disputes the allegations: Hospital spokeswoman Annie Mackin said the allegations are false, and come from a former employee.

“When the UVM Medical Center first learned of the allegations that are the subject of OCR’s letter, we promptly and thoroughly investigated them and determined that they were not supported by the facts,” Mackin said in a statement to The Hill. “We do not discriminate against any employees for exercising their rights to opt out of procedures to which they object.”

Context: The Trump administration has made it a priority to protect Christians and other health workers who oppose abortion, or who object to providing transition-related care for transgender individuals. 

Wednesday’s announcement was the first conscience protection case alleging that a health care worker was forced to participate in an abortion since Health and Human Services established its new conscience and religious freedom division last year, although the action was taken under existing law. New conscience protection rules are scheduled to take effect in November but are facing numerous lawsuits. 

Read more here.


CDC: U.S. on verge of losing measles elimination status 

The Centers for Disease Control and Prevention (CDC) this week sounded the alarm that recent measles outbreaks have put the 2000 declaration of the disease having been eliminated at risk, according to a CNN report.

The ongoing outbreaks have created a “reasonable chance” the nation will lose measles elimination status in October, Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, told the network.

“It certainly is incredibly frustrating and upsetting to the public health community that we may lose measles elimination status, because we do have a safe and effective vaccine,” she told CNN.

The CDC will release a more detailed statement on the U.S.’s measles elimination status next week, Messonnier told CNN.

Why it matters: Measles was declared eliminated in 2000. For a country to have its elimination status rescinded, measles must have been spreading continuously for a year. Two outbreaks began in New York City and Rockland County, New York, in autumn 2018, with more than 900 cases between the two locations.

Overall, there have been 1,215 measles cases in 30 states in 2019.

Read more here.


Johnson & Johnson ruling becomes pivotal moment in opioid fight

A judge’s ruling on Monday that Johnson & Johnson caused an opioid epidemic in Oklahoma is a good sign for other cities and states suing drugmakers over their alleged role in the crisis.

The groundbreaking ruling could be a harbinger of things to come in other cases where localities are trying to extract billions of dollars from drug companies to pay for addiction treatment and other services for victims.

It could also pressure drug companies involved in 2,000 lawsuits to settle out of court, deferring lengthy legal battles in the process.

“Any way you slice it, yesterday’s judgment is a landmark judgement,” said Leslie Kendrick, the vice dean of the University of Virginia’s School of Law.

“A judgment like this in the short-term gives defendants incentive to settle. They’ve now seen you can have a big judgment like this, and this case was before a judge, not a jury. You might see bigger numbers before a jury,” Kendrick said.

Why it matters: The Johnson & Johnson ruling is the first of its kind and indicates drugmakers won’t be able to escape liability in the opioid crisis. Hearings in a huge opioids case involving 2,000 localities challenging dozens of drugmakers begins in October. Purdue Pharma is already indicating it will settle. 

Read more here.


Advocates sue in attempt to speed up Nebraska Medicaid expansion

Medicaid advocates in Nebraska have filed a lawsuit to try to force state officials to offer coverage sooner than the official 2020 rollout date.

According to the lawsuit filed Wednesday by Nebraska Appleseed, the state will miss out on approximately $149 million in federal funding by delaying implementation of Medicaid expansion until Oct. 1, 2020.

The lawsuit asks the state supreme court to rule that expansion must begin no later than November 17, 2019. According to the suit, this is the latest possible date to open enrollment that would allow federal funds to pay for 93 percent of the costs of Medicaid expansion.

Backstory: Nebraska voters approved a Medicaid expansion ballot measure last November with an overwhelming 54 percent of the vote. Gov. Pete Ricketts (R) had long been opposed to Medicaid expansion but said he would follow the will of the voters. 

State officials have argued they need to implement expansion methodically, and the 2020 date gives them time to make sure the rollout is done relatively glitch-free. However, critics argue expanding coverage shouldn’t take 18 months, and have accused the administration of deliberately dragging its feet. 

Read more on the lawsuit here.


2020 Democrats sit for interviews with health care activist

A slate of Democrats running for president in 2020 are sitting down for interviews with activist Ady Barkan to discuss health care policies as the party’s presidential primary heats up.

Barkan, who was diagnosed with ALS in 2016 and has garnered social media fame with his activism fighting for more affordable health insurance, said the current primary is not engendering substantial discussions or plans on the topic.

“For the last three years, I’ve been fighting our representatives in Washington to replace our unjust, predatory and discriminatory health care system with coverage that protects the American people,” he said in a video. “But the composed speeches, the empty one-liners and stilted debates haven’t given us better health care.” 

Be A Hero, Barkan’s advocacy group, added in a statement that the new series is intended to “foster personal, unguarded moments between a dying father and those vying for the most powerful office in the country.”

Barkan is a Medicare for all supporter and testified in support of the bill before Congress earlier this year. 

Read more here.


Juul CEO says vaping illnesses are ‘worrisome’ 

Juul Labs CEO Kevin Burns said reports of a mysterious illness striking e-cigarette user is “worrisome.” 

“Worrisome for the category,” he said during an interview on CBS This Morning. “Worrisome for us if we contributed to it.

“We’d like to get all the specifics that we can,” he continued. “We want to make sure we have access to the information, so if there’s any issue that was driven, associated with us, that we can get to the root cause and understand that.”

Burns noted that most of the early reports have indicated the illness is related to THC, the psychoactive component in marijuana, rather than tobacco products. Burns said he would take action if more information proves there have been adverse events directly linked to tobacco products. 

The Centers for Disease Control and Prevention (CDC) is investigating 200 possible cases of lung disease associated with vaping. The CDC says it hasn’t identified which products are involved. 

Illinois state officials announced the first death from the illness Friday.

See the interview with CBS here.


What we’re reading

Biden calls health care ‘personal’ in new campaign ad (CBS)

Pharma cash rolls into Congress to defend an embattled industry (Kaiser Health News)

Beset by lawsuits and criticism in U.S., opioid makers eye new market in India (Kaiser Health News)


State by state

Minnesota owes the feds $48 million for improper Medicaid payments (

Florida won’t disclose public comments in Medicaid overhaul plan (

Medicaid transformation bill gains preliminary approval in N.C. Senate (

Governor’s ‘mental health czar’ seeks new blueprint for care in California (California Healthline)

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