Welcome to Wednesday’s Overnight Health Care.

The Trump administration is taking action on e-cigarette flavors, Purdue Pharma is close to settling a multitude of lawsuits, a new poll shows the popularity of Joe Biden’s public option health plan, and Senate appropriators have canceled votes on an HHS spending bill.  

We’ll start with vaping news: 

Trump seeks ban on flavored e-cigarettes

The Trump administration is seeking to ban all non-tobacco flavors of e-cigarettes in the wake of a massive spike in teen vaping and the spread of a mysterious illness that has sickened hundreds of people across the country.

President Trump told reporters in the Oval Office that vaping is a problem “especially vaping as it pertains to innocent children.”

Youth vaping has skyrocketed in the past year, driven largely by teenagers becoming drawn to sweet and fruit-flavored e-cigarette pods easily accessible in stores. 

The Food and Drug Administration is working on releasing final guidance to implement the ban, but Health and Human Services Secretary Alex Azar said it will take several weeks to develop. 

Azar said after a 30-day effective date, all flavored e-cigarettes would be removed from the market, pending FDA approval. 

Backstory: FDA has struggled with regulating vaping products. Most e-cigarette brands sold in the U.S. are legal, but none of them have been subject to FDA review, leaving a regulatory gray area as more and more products flood the market. Former FDA Commissioner Scott Gottlieb previously proposed restrictions on the sale of e-cigarettes that would essentially prohibit them from being sold at gas stations and convenience stores.

Context: Trump cited the six vaping deaths as part of the reason for removing flavored e-cigarettes from the market. But the vaping industry argues those deaths are likely tied to people who are vaping THC products purchased from the black market. 

The FDA had already faced pressure from health groups to remove flavored e-cigarettes from the market because they’re enticing to children. Health and Human Services Secretary Alex Azar said “Kids are getting access to these products despite our best efforts at enforcement… they’ve been going at it so we simply have to remove these attractive flavored products from the marketplace until they’ve secured FDA approval if they can.” 

What of Juul? Juul, the e-cigarette company with the biggest share of the market, last year pulled mango, fruit, creme and cucumber flavors from brick and mortar stores amid an FDA crackdown. But the company still sells several flavors online.

Read more here

 

 

Purdue Pharma nears settlement with states, cities over alleged role in opioid epidemic

Purdue Pharma reached a tentative settlement with state and local governments in a lawsuit over its alleged role in the opioid epidemic.

Lawyers representing the thousands of cities and counties in a federal lawsuit against Purdue recommended Wednesday that the multibillion-dollar settlement be accepted. 

“We believe that this settlement would bring desperately needed recovery resources into local communities that, for years, have been forced to shoulder the devastating consequences and financial burden of the opioid epidemic,” the attorneys said in a statement. 

Purdue Pharma has been a top target of blame in the opioid epidemic, with governments arguing the company knew OxyContin was highly addictive and profited off of it.

Thousands of local governments sued Purdue Pharma, and other drugmakers and distributors, for their role in the opioid epidemic. Those lawsuits were consolidated into one case to be heard by a federal judge in Ohio in October. 

What’s next: 22 states have tentatively agreed to the settlement. The other half aren’t on board and vow to continue going after Purdue and the Sacklers. 

Read more here.

 

Poll: Biden proposal more popular than ‘Medicare for All’ in general election

A new poll finds that more voters favor an optional government-run health insurance plan, as former Vice President Joe Biden advocates, than full-scale “Medicare for All” that eliminates private health insurance, as advocated by Sen. Bernie Sanders (I-Vt.). 

The poll could give credence to Biden’s argument against his main two rivals in the Democratic White House race, Sanders and Sen. Elizabeth Warren (D-Mass.), that an optional plan is more popular in a general election than the full-scale Medicare for All that Sanders and Warren advocate. 

The USC/Los Angeles Times poll finds that 48 percent of eligible voters surveyed support giving everyone the option of a government-run health insurance plan, compared to just 14 percent who oppose it. Thirty-eight percent had not heard enough to have an opinion.

The full-scale Medicare for All, which eliminates private health insurance, polls somewhat worse. That proposal gets 39 percent support to 34 percent opposition. 

Warren and Sanders are outspoken supporters of that full-scale Medicare for All, brushing aside worries about eliminating private insurance by arguing that people will not miss having to deal with private health insurance companies and that their new coverage will be more generous, with no copays or deductibles. 

Read more here.

 

Senate panel cancels vote on key spending bill amid standoff

The Senate Appropriations Committee on Wednesday canceled votes on two spending bills that had been scheduled for the following day, marking the latest sign of turmoil as lawmakers try to fund the government beyond Sept. 30.

The panel had been scheduled to vote Thursday on spending bills covering the departments of Health and Human Services (HHS), Labor and Education, as well as the State Department and foreign operations.

HHS-Labor-Education, in particular, is viewed as a key priority for Democrats, but had emerged as a headache this week because of fights on controversial issues including abortion and President Trump‘s border wall.

Senate Appropriations Committee Chairman Richard Shelby (R-Ala.) told a small group of reporters on Tuesday that he was likely to cancel the panel vote on the legislation unless he could work out a deal with Democrats on how to proceed.

The sticking point? Democrats want to attach an amendment that would block the administration from implementing its Title X rule, which bans family planning providers from referring women for abortions. 

Read more here.

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Wyden wants to tax e-cigarettes

The hits keep coming for e-cigarettes. Legislation introduced Wednesday by Sen. Ron Wyden (D-Ore.)  introduced legislation to tax e-cigarettes the same as other tobacco products.

 Despite the Food and Drug Administration officially designating e-cigarettes as regulated tobacco products and at least 15 states establishing e-cigarette taxes, Wyden said they remain exempt from federal tobacco taxes. 

The bill would calculate the tax on a per-milligram of nicotine basis, because the nicotine content and delivery method of alternative nicotine products vary significantly.

 What we’re reading

AP FACT CHECK: Trump overstates his influence on drug prices (Associated Press)

In a CRISPR first, therapy intended to cure HIV patient appears safe — though ineffective (Stat) 

Democrats’ leftward shift on third-trimester abortion (Washington Post) 

State by state

Pressed on “Medicare for all” Kilmer says loss of private insurance would threaten rural hospitals (News Tribune)

Texas has the most people without health insurance in the nation — again (Texas Tribune)

N.J. lawmakers consider barring pharmacies from selling tobacco, e-cigarettes (WHYY)

From The Hill’s opinion page:

Here’s why diabetes increases the risk of cancer

We spend billions after child sexual abuse happens and nothing to prevent it