Several states wary of $48 billion opioid settlement proposal

Several states wary of $48 billion opioid settlement proposal
By Tom Hals and Nate Raymond

(Reuters) – Several U.S. states that have been ravaged by the opioid epidemic are pushing back on a proposed $48 billion settlement framework that would resolve thousands of lawsuits against five drug companies accused of fueling the addiction crisis.

The proposal would bring an end to all opioid litigation against AmerisourceBergen Corp<ABC.N>, Cardinal Health Inc<CAH.N> and McKesson Corp<MCK.N>, drugmaker Teva Pharmaceutical Industries Inc<TEVA.TA><TEVA.N>, and Johnson & Johnson<JNJ.J>.

The companies have proposed paying $22.25 billion cash mostly over 18 years, while services and drugs to treat addiction valued at $26 billion by the companies would be provided over the coming decade, mostly by Teva.

Officials in states such as Ohio, New Hampshire and West Virginia — all hard hit by the deadly drug addition crisis — voiced concerns about the proposal.

James Boffetti, the associate attorney general for New Hampshire, said in an interview he was troubled that payments were stretched over many years.

“The concern is, I think, the states need money now to create the infrastructure for treatment,” he said.

Small states fear the money will be divvied up by population rather than need.

“Any global opioid settlement that doesn’t reflect the unique and unprecedented damage imposed on West Virginia through the opioid epidemic should be DOA,” West Virginia Attorney General Patrick Morrisey said on Twitter on Tuesday.

Some 400,000 U.S. overdose deaths between 1997 and 2017 were linked to opioids, according to government data. Roughly 2,600 lawsuits have been brought nationwide by states, local and tribal governments.

The three distributors in a joint statement said they were committed to finalizing a global settlement and would continue working with the other parties on the details of the framework. Teva declined to comment.

J&J said in a securities filing on Wednesday the deal would lower third quarter profit by $3 billion.

The proposal, announced on Monday, was hammered out by the companies and attorneys general in North Carolina, Pennsylvania, Tennessee and Texas.

It will need broad support among state attorneys general and will have to overcome opposition from the lawyers representing local governments that sued. Those lawyers declined to sign on when presented the proposal last week.

Under the settlement framework, money for each state would be divvied up, with 15% going to the state treasury, 15% for local governments that filed lawsuits and 70% going to a proposed state fund aimed at addressing the crisis.

Boffetti predicted it would takes weeks for states to determine whether they back the settlement framework.

North Carolina’s attorney general, Josh Stein, acknowledged that a detailed term sheet needs to be developed.

“There are a lot of details and mechanics that need to be added to it,” Stein told Reuters in an interview. “That will happen in the coming weeks.”

The proposal did win a major supporter on Tuesday. Tom Miller of Iowa, the longest-serving attorney general, publicly backed the proposal, calling the framework “an important step in addressing the crisis.”

Colorado’s attorney general, Phil Weiser, called it a “very promising development.”

The lawsuits accuse distributors of failing to flag and halt a rising tide of suspicious orders and drugmakers of overstating the benefits of opioids while downplaying the risks.

The companies have denied any wrongdoing. Drugmakers say their products carried government-approved labels that warned of the addictive risks of opioids, while distributors argue their role was to make sure medicines prescribed by licensed doctors were available for patients.

The proposed deal has widened a fault line between attorneys general and local governments.

Cities and counties generally hired private attorneys to bring their cases, and attorneys general want to limit the amount of the settlement that goes to pay private lawyers. The attorneys for local governments also generally opposed Teva contributing opioid treatment drugs to the settlement, instead of cash, in part because of concerns that the framework placed an inflated value on those drugs.

Last week’s talks failed to reach a global deal, and on Monday, the three wholesale distributors and Teva struck a last-minute $260 million settlement with two Ohio counties, averting the first federal trial over opioids.

North Carolina’s Stein said he looked forward to resolving concerns about the proposal and warned that settling lawsuits individually was unsustainable.

“If we proceed on the current path and each county and city brings their case and extracts whatever amount they may be able to get from these companies, the companies will end up bankrupt,” he said. “The opioid crisis is a national problem that demands a national solution.”

(Reporting by Tom Hals in Wilmington, Delaware and Nate Raymond in Boston, Massachusetts; Editing by Noeleen Walder and Sandra Maler)

Trump administration will allow states to test Medicaid work requirements

U.S. President Donald Trump attends the Women in Healthcare panel hosted by Seema Verma (R), Administrator of the Centers for Medicare and Medicaid Services, at the White House in Washington, U.S., March 22, 2017.

By Yasmeen Abutaleb

WASHINGTON (Reuters) – The Trump administration said on Thursday it would allow states to test requiring some Medicaid recipients to work or participate in community activities such as volunteering or jobs training as a condition of eligibility for the government health insurance program for the poor.

The Centers for Medicare and Medicaid Services issued guidance making it easier for states to design and propose test programs that implement such requirements. States must propose such changes through waivers and receive federal approval.

Seema Verma, the agency’s administrator, said the policy guidance came in response to requests from at least 10 states that have proposed requiring some Medicaid recipients to work or participate in activities that may include skills training, education, job search, volunteering or caregiving. Those states include Kentucky, Maine, New Hampshire, Arizona, Indiana and Utah.

Certain Medicaid populations would be exempt from the rules, including those with disabilities, the elderly, children and pregnant women. Verma also said states would have to make “reasonable modifications” for those battling opioid addiction and other substance use disorders.

“This gives us a pathway to start approving waivers,” Verma said on a call with reporters on Wednesday. “This is about helping those individuals rise out of poverty.”

Under the 2010 Affordable Care Act, former Democratic President Barack Obama’s signature domestic policy achievement commonly known as Obamacare, 31 states expanded Medicaid to those making up to 138 percent of the federal poverty level, adding millions of people to the rolls.

Republicans have repeatedly failed to repeal and replace Obamacare, a top campaign promise of President Donald Trump. Instead, the Trump administration has sought to weaken the program through executive orders and administrative rules.

The Obama administration opposed state efforts to implement work requirements in Medicaid because it could result in fewer people having access to health insurance.

For instance, Kentucky last year proposed work requirements for able-bodied adults to get insurance and establishing new fees for all members based on income. A study found the proposal would reduce the number of residents on Medicaid by nearly 86,000 within five years, saving more than $330 million.

Republicans argue that Medicaid was created to serve the most vulnerable and has become bloated under Obamacare. Verma and other Republicans said implementing work and community engagement requirements could help improve health outcomes by connecting people with jobs and training.

(Reporting by Yasmeen Abutaleb; Editing by Peter Cooney)

U.S. life expectancy fell in 2016 as opioid overdoses surged: CDC

A used container of the drug Narcan used against opioid overdoses lies on the ground in a park in the Kensington section of Philadelphia, Pennsylvania, U.S. October 26, 2017. REUTERS/Charles Mostoller

NEW YORK (Reuters) – Life expectancy in the United States dipped in 2016 as the number of deaths due to opioid drug overdoses surged and total drug overdose deaths rose 21 percent to 63,600, the U.S. Centers for Disease Control and Prevention said on Thursday.

Life expectancy fell to 78.6 years, a decrease of 0.1 year from 2015, the second annual decline in a row and the first two-year decline since a drop in 1962 and 1963.

Opioid-related overdose deaths have been on the rise since 1999, but surged from 2014 to 2016, with an average annual increase of 18 percent, to become a national epidemic. From 2006 to 2014 the rise was only 3 percent annually on average and between 1999 to 2006 averaged 10 percent per year.

In 2016, 42,249 people died from opioid-related overdoses, up 28 percent from 2015, while the number of deaths from synthetic opioids other than methadone, such as fentanyl and tramadol, more than doubled to 19,413, the CDC said.

The 2016 rate of overdose deaths was up across all age groups but was highest rate among people aged 25 to 54.

West Virginia, Ohio, New Hampshire, the District of Columbia and Pennsylvania had the highest age-adjusted drug overdose death rates in 2016.

The number of drug overdose deaths involving natural and semisynthetic opioids, which include drugs like oxycodone and hydrocodone, was 14,487 in 2016.

As the U.S. opioid addiction epidemic has worsened, many state attorneys general have sued makers of these drugs as they investigate whether manufacturers and distributors engaged in unlawful marketing behavior.

President Donald Trump in October declared the opioid crisis a public health emergency, which senior administration officials said would redirect federal resources and loosen regulations to combat abuse of the drugs. However, he stopped short of declaring a national emergency he had promised months before, which would have freed up more federal money.

(Reporting by Caroline Humer; editing by Lisa Von Ahn and Jonathan Oatis)

Windy rainstorm whips U.S. Northeast, cutting power to hundreds of thousands

Storm Summary has been initialized for the deep low pressure system which is bringing damaging winds, heavy rain across the Northeast, even some snow over West Virginia.

NEW YORK (Reuters) – Fierce winds and heavy rain downed trees and knocked out power across the U.S. Northeast, halting trains during the Monday morning commute and leaving neighborhoods from Boston to Washington in the dark.

Wind gusts of 82 miles (131.97 km) per hour were reported on Massachusetts’ Cape Cod, while steady rain from Sunday into Monday dumped up to 4 inches (10.16 cm) of water across New England, said National Weather Service meteorologist Marc Chenard.

“There has been quite a bit of wind, and when the ground gets wet like this, trees fall,” Chenard said.

Amtrak train service between Boston and New Haven, Connecticut, was suspended early on Monday as crews scrambled to clear branches and restore power, authorities said.

Connecticut commuters piled onto buses or sought alternative routes after Metro-North Railroad suspended service on its New Canaan line and on its Danbury line, which it said on Twitter was hampered by a mudslide and related signal problems.

More than 800,000 homes and businesses lost electricity overnight throughout the Northeast, including about 300,000 customers in Massachusetts, 270,000 in New Hampshire, 142,000 in Rhode Island, 30,000 on New York’s Long Island, 56,000 in Maine and 35,000 in Vermont, according to local media.

Early on Monday, traffic lights in parts of Washington remained dark due to power outages.

The storm hit the East Coast on the fifth anniversary of Superstorm Sandy. That late-season hurricane killed at least 159 people in New York, New Jersey and other parts of the East Coast on Oct. 29, 2012, and damaged or destroyed more than 650,000 homes.

The National Weather Service said the heaviest rains and winds ended late on Monday morning, but lighter precipitation and some gusts would persist throughout the day.

“The biggest potential now is for more trees to come down and for minor-to-moderate river flooding in eastern New York and much of New England today into tomorrow,” Chenard said.

It was not immediately known how long it would be until power is fully restored.

 

(Reporting by Barbara Goldberg in New York; Editing by Lisa Von Ahn)

 

New Hampshire legislature blocks bill on transgender rights

File Photo: A man holds a flag as he takes part in an annual Gay Pride Parade in Toronto June 28, 2009. REUTERS/Mark Blinch

By Scott Malone

(Reuters) – State legislators in New Hampshire narrowly blocked a bill on Thursday that would have prohibited discrimination against transgender people, including allowing them to use the public bathrooms that match the gender with which they identify.

Transgender rights are a politically charged issue in the United States. Supporters say bills like the one blocked on Thursday protect people who do not conform to their birth gender, while opponents say they could give cover to voyeurs and sexual predators.

The 187-179 vote by the Republican-controlled New Hampshire House of Representatives to table the bill without debate came one day after Governor Chris Sununu, also a Republican, said he had no position on the matter.

Many Democrats had supported the bill.

“With Sununu’s support, the bill, which was tabled by a slim margin, would be on its way to the corner office,” said Ray Buckley, chairman of the New Hampshire Democratic Party. “His silence and apathy are a tacit endorsement of discrimination, and he will have to live with the fact that he denied many transgender people the freedom that is granted through equality under the law.”

A spokesman for Sununu whose father, John Sununu, was a New Hampshire governor and later White House chief of staff in the first Bush administration, did not immediately respond to a request for comment.

This was the latest in a string of defeats for transgender rights this week. The U.S. Supreme Court on Monday threw out a lower court ruling in favor of a Virginia transgender student after President Donald Trump rescinded a policy put in place last year protecting such youths.

A Texas Senate committee on Wednesday approved a bill that would require people to use public restrooms that match the gender on their birth certificates.

That measure is similar to one passed last year in North Carolina, which sparked boycotts that are estimated to have cost the state hundreds of millions of dollars. Due to economic concerns, analysts do not expect the Texas measure to pass the state House.

Despite their dominance in New Hampshire’s government, Republicans in the state legislature do not unanimously support the party’s national agenda. Last month state legislators blocked a bill that would have allowed employees in union-represented jobs not to pay dues.

(Reporting by Scott Malone in Boston; Editing by Lisa Von Ahn)

U.S. top court rejects Exxon appeal in groundwater contamination case

Exxon Storage Tanks

By Lawrence Hurley

WASHINGTON (Reuters) – The U.S. Supreme Court on Monday rejected Exxon Mobil Corp’s appeal of a $236 million judgment against the oil company in a case brought by the state of New Hampshire over groundwater contamination linked to a gasoline additive.

The justices left in place the New Hampshire Supreme Court’s 2015 ruling upholding the judgment by a jury that in 2013 spurned Exxon’s claims that the contamination linked to its fuel additive was not its fault but rather the fault of the local gas stations and storage facilities that spilled it.

Exxon argued in its appeal that its due process rights were violated because New Hampshire had not proved the company’s liability for the alleged pollution at each individual site.

The additive at the center of the case is called methyl tertiary butyl ether, or MTBE. It is an oxygen-containing substance that was added to gasoline to promote more complete combustion and reduce air pollution.

It was one of several additives that had been recommended by regulators to reduce emissions but has now largely been phased out of the U.S. fuel supply because of the hazard it poses to groundwater.

New Hampshire’s lawsuit against Exxon, headquartered in Irving, Texas, dates back to 2003.

State officials called the $236 million judgment the largest MTBE-related verdict since states and other agencies began making claims for remediation and other damages. Exxon said in court papers it is the largest-ever jury verdict in New Hampshire.

In 2014, Exxon also appealed to the U.S. Supreme Court a $105 million jury verdict in favor of New York City over MTBE contamination, but the court declined to hear the case.

The case is Exxon Mobil v. New Hampshire, U.S. Supreme Court, No. 15-933.

(Reporting by Lawrence Hurley; Editing by Will Dunham)

Fireball Seen In Eastern Sky

A fireball was seen in the eastern sky by residents of Atlantic Coast states.

The American Meteor Society says that more than 330 reports have been recorded from people who saw a “huge, bright ball” streaking through the sky Monday night.

The fireball was seen from Maryland and Delaware through Montreal, Canada.

Some witnesses were able to capture video of the fireball through dashboard camera while they traveled on interstates.  One report from New Jersey said the driver thought at first they were looking at fireworks because of the intensity of the flame.

One New Hampshire resident reported seeing flames as if the object landed near them but no object was found.

Republican Senate Candidate Reject Pro-Life Platform

Scott Brown, the Republican candidate for the Senate in New Hampshire, has rejected the party’s stance of standing for the life of unborn children.

Scott Brown said he supports a woman’s “right” to kill her baby via abortion.

The New Hampshire Republican Party announced over the weekend they are supporting “the pre-born child’s fundamental right to life and personhood under the Fourteenth Amendment,” as well as its support for the “Life at Conception Act.”  Pro-abortion Democrat Senator Jeanne Shaheen immediately condemned the move and tried to say Brown supported the position.

“I’m a pro-choice, independent Republican,” Brown said Monday at the UNH School of Law. “So I don’t agree with that particular part of the platform, however I have always felt that we are a big tent party, we have the opportunity to agree or disagree.”

Those fighting for the lives of unborn children were outraged by Brown’s comments.

“Can you imagine a Democratic Senate candidate doubling down on his unqualified hostility for the Democratic Party platform on such an important issue?” Keith Mason of Personhood USA asked. “There’s no way the Democratic party bosses would allow it to happen. This is a clarion call for the Republican Party to stand up to poseurs in its own party who undermine principles of human rights and dignity.”

“Scott Brown has staked out an extreme position on abortion that contradicts the conservative values of his electorate. I commend the New Hampshire Republican Party for following in the steps of President Reagan by taking this principled stand on the most important human rights issue facing our nation.”