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Morning Rounds Megan Thielking

A federal judge ruled the ACA is unconstitutional. Here's what you need to know

A federal judge in Texas struck down the Affordable Care Act late Friday, ruling that the landmark health law is unconstitutional just as open enrollment for next year's ACA marketplaces wrapped up. Here's what you need to know:

  • The background: Earlier this year, 22 GOP state attorneys general filed a lawsuit taking aim at the ACA. They argue that without the penalty fee — which Congress axed late last year — the ACA's individual mandate is unconstitutional. And since the mandate is the "heart of the ACA," they argue the rest of the law “must also fall.”

  • The Trump administration's take: The Justice Department, which filed a brief in the lawsuit, didn't defend the individual mandate or the law's protections for pre-existing conditions, but said the rest of the ACA could stand. A group of 16 states and D.C. stepped in to defend the law fully.

  • The next steps: The ruling likely won't have any effect right now on ACA enrollees. The lawsuit will likely be appealed to a federal appellate court, and from there could make its way to the Supreme Court. It's not clear yet what the ruling might mean for ACA enrollees in the long run — or how the court fight might play out.

Inside STAT: How genome-editing scientist He Jiankui rose from obscurity to stun the world

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(eros dervishi for stat)

The day after He Jiankui made world news by claiming he had created the world's first "CRISPR babies,” the scientist met with Jennifer Doudna, CRISPR pioneer and one of the world’s most celebrated biologists. Jiankui, who was scheduled to speak later that week at a Hong Kong genome-editing summit, had asked to meet privately with Doudna, one of the summit's organizers. Doudna walked away struggling to process the meeting. “His demeanor was an odd combination of hubris and naivete,” Doudna told STAT. 

In the three weeks since news broke about the birth of the twins, STAT has pieced together the story of the years leading up to the announcement by interviewing experts across the world, talking to people who crossed paths with He, and reviewing documents. STAT’s Sharon Begley and Andrew Joseph have more in a fascinating account with details reported for the first time — read here.

Purdue’s secret OxyContin papers should be released, appeals court rules

A Kentucky appeals court has unanimously upheld an earlier ruling that would unseal secret records about Purdue Pharma's marketing of the prescription painkiller OxyContin, including a deposition of Richard Sackler, a former Purdue president and a member of the family that controls the company. The court decision comes as a result of a suit brought by STAT more than two years ago to have the records publicly released — but it could still take some time before the records see the light of day. Purdue can ask for a rehearing or appeal, which the company has indicated it plans to do. And the ruling is the product of an already lengthy process. The appeals panel heard oral arguments in June 2017, and the justices said they would try to issue a ruling within 45 days. It took nearly a year and a half for the decision to land. 

Flu vaccinations are up after last year's bad season

How do you get more people to get flu shots? A bad flu season will do the trick, it seems. There’s been a significant increase in influenza vaccine uptake this year compared to last, according to the CDC. By mid-November, the rate of children vaccinated was up nearly 7 percentage points over the same time last year and adult vaccinations were up 6.4 percentage points. But it’s too soon to tell whether more people will be vaccinated this year.

In other flu news, the Biomedical Advanced Research and Development Authority published a new study showing that bird flu vaccine made over a decade ago is still safe to use and is effective in generating an immune response. Typically, a flu vaccine is used within the year it is made. But BARDA has been making and stockpiling vaccines to protect against possible pandemic viruses and tests them periodically to see if they are still viable. 

Pediatricians push for depression screening in new moms

The American Academy of Pediatrics is renewing its call for physicians to screen women for depression during and after pregnancy. Though maternal depression is one of the most common conditions that can occur during and after pregnancy, it often goes undiagnosed and untreated, according to AAP. The organization says that all mothers should be screened for depression once during pregnancy and again at each of a baby’s first few check-ups with a pediatrician. Experts say it’s important to make sure that women aren’t just being screened, but are also able to get the support and mental health care they might need.

School nutrition policies can help keep kids healthy

A new study finds that school nutrition programs and policies can help middle school kids to eat healthier — and be healthier. Researchers followed nearly 600 students from a dozen schools in New Haven, Conn. Some of the schools beefed up their focus on nutrition by sending out newsletters about healthy eating, promoting water instead of sugary drinks, and similar steps. In the schools with more robust policies, students had an increase in body mass index of less than 1 percent by the end of the study, compared to increases of 3 to 4 percent in kids in other schools. The authors say the findings show that nutrition education and school policies can help improve children’s health.

What to read around the web today

  • A dying boy, a desperate family, a floppy dog. Tampa Bay Times
  • Assisted living's breakneck growth leaves patient safety behind. Kaiser Health News
  • Can precision medicine rescue a multibillion-dollar pharma debacle? STAT Plus
  • My father needed a liver. Did it have to be from me? New York Times
  • There aren’t any good alternatives to fetal tissue research, scientists warn. STAT

Thanks for reading! More tomorrow,

Megan

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Monday, December 17, 2018

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