Overnight Health Care: Massachusetts governor signs groundbreaking vaping flavor ban | Disability advocates questions 2020 Dems' mental health plans | US birth rate falls for fourth straight year

Overnight Health Care: Massachusetts governor signs groundbreaking vaping flavor ban | Disability advocates questions 2020 Dems' mental health plans | US birth rate falls for fourth straight year

Welcome to Wednesday's Overnight Health Care. 

First, a quick programming note. We'll be off the rest of the week for Thanksgiving but back on Monday with the latest health care news.

There's plenty of news today though ahead of the holiday. The abortion rate is falling, the Massachusetts vaping ban is now law, the birth rate is down, we have new ObamaCare signup numbers, and disability advocates are questioning the mental health platforms of 2020 Democrats.


We'll start in Massachusetts...


Massachsetts governor signs groundbreaking vaping flavor ban into law

The fate of a federal ban on vaping flavors is unknown, but Massachusetts is taking matters into its own hands

Gov. Charlie Baker (R) on Wednesday signed into law the country's most stringent ban on flavored vaping products, as well as menthol cigarettes.

The new law immediately restricts the sale of all flavored nicotine vaping products, and will ban menthol cigarettes starting June 1. 

Under the law, flavored vaping products will only be sold in licensed smoking bars, and they must be consumed onsite. It will also impose a steep 75 percent excise tax on e-cigarettes and require health insurers to cover tobacco cessation programs.


In September, Baker declared a public health emergency and ordered a temporary ban on the sale of all vaping products. The emergency ban will remain in place while the state's Department of Public Health drafts new regulations, Baker said, and will be lifted Dec. 11.

"When enacted, these permanent regulations will ensure the risks are known to consumers ... and will ensure sellers are not skirting the new law and selling to kids," Baker said. 

What about a federal ban? Advocates have been pushing for a federal ban on e-cigarette flavors, but President TrumpDonald John TrumpTrump alludes to possible 2024 run in White House remarks Trump threatens to veto defense bill over tech liability shield Tiger King's attorney believes they're close to getting pardon from Trump MORE has seemingly balked at implementing a ban on flavors he promised more than two months ago. So for now, the future for any federal rules is up in the air. 

Read more here.


Disability advocates raise concerns about Democratic candidates' mental health plans

Mental health proposals from Sen. Kamala HarrisKamala HarrisSenate GOP's campaign arm rakes in M as Georgia runoffs heat up Biden, Harris to sit with CNN's Tapper in first post-election joint interview The Hill's 12:30 Report — Presented by Capital One — Giuliani denies discussing preemptive pardon with Trump MORE (D-Calif.), Sen. Amy KlobucharAmy KlobucharHillicon Valley: YouTube suspends OANN amid lawmaker pressure | Dems probe Facebook, Twitter over Georgia runoff | FCC reaffirms ZTE's national security risk Democrats urge YouTube to remove election misinformation, step up efforts ahead of Georgia runoff YouTube temporarily suspends OANN account after spreading coronavirus misinformation MORE (D-Minn.) and South Bend, Ind., Mayor Pete ButtigiegPete ButtigiegJuan Williams: Clyburn is my choice as politician of the year 'Biff is president': Michael J. Fox says Trump has played on 'every worst instinct in mankind' Buttigieg: Denying Biden intelligence briefings is about protecting Trump's 'ego' MORE (D) have sparked backlash from some advocates with disabilities, who argue that the plans would increase involuntary institutionalization.

Advocates said the plans, while well-intentioned, were reminiscent of policies frequently advanced by family members of people with disabilities rather than the patients themselves. They said the plans illustrate the need for people with disabilities to be front and center in lobbying on such policies.

For examples: Plans by all three presidential candidates embrace a repeal of Medicaid's Institutions for Mental Diseases (IMD) exclusion, which bars the federal program from paying for inpatient psychiatric treatment in facilities with more than 16 beds.

"The idea behind it is to prevent the government from paying for warehousing people with mental health conditions in asylums like we used to in the 1950s," Sara Luterman, a Washington, D.C.-area journalist focusing on disability issues, told The Hill. "Many parent and provider advocates would like to repeal the IMD exclusion. They use 'access to care' in an Orwellian sense -- it's access to coercive treatment, forced medication and locked wards."

More on the backlash here.


ObamaCare signups continue to lag

Nearly 704,000 people selected plans on healthcare.gov in week four of open enrollment, which ran Nov 17 to Nov. 23. In all, nearly 2.4 million people have signed up for plans, but that's still below the number of people who had enrolled in coverage by this point last year.

Week 4 sign-ups cannot be accurately compared to week 4 sign-ups last year, however, because Thanksgiving, which is generally a slower time, takes place during Week 5 this year.

But according to Joshua Peck, who ran ObamaCare outreach for the Obama administration and founded Get America Covered, an organization that promotes open enrollment, the numbers this week don't do anything to refute the trend he's noticed from the start: sign-ups still appear to be on track to lag behind last year's totals.


US sees further drop in number of abortions: CDC

The U.S. has continued to see a drop in the number of reported abortions, according to data released Wednesday by the Centers for Disease Control and Prevention (CDC).

There were 623,471 abortions performed in areas across the country that reported data to federal officials in 2016, the latest available year for data, down from 636,902 the previous year.

The 2016 abortion figures were based on counts provided to the CDC from 47 states and New York City. California, Maryland, New Hampshire and Washington, D.C., did not provide data. The three states also did not provide data in previous years.


The latest abortion rate was 11.6 abortions per 1,000 women between the ages of 15 and 44 -- down slightly from 11.8 in 2015 -- while the overall abortion ratio ticked down to 186 abortions per 1,000 live births.

More on the numbers here.


In other CDC news…


Birth rate falls for fourth consecutive year

Birth rates in the U.S. fell for the fourth year in a row in 2018, according to data released by the Centers for Disease Control and Prevention (CDC) on Wednesday.


The total number of babies born in the country is the lowest in more than three decades, according to the CDC's National Center for Health Statistics. There were 3,791,712 babies born in the U.S. in 2018, down 2 percent from 2017. That number marks the lowest number of births in 32 years, according to the CDC. 

What's the explanation? The drop is driven by women waiting longer to have children, into their 20s and early 30s, as well as a decline in the teen birth rate. Births dropped approximately 7.4 percent for girls and women between the ages of 15 and 19 between 2017 and 2018.

The number of births increased slightly in 2018 for women 35 to 44. Alison Gemmill, a demographer at Johns Hopkins University, said the data shows that Americans who give birth "want to establish themselves before having children."

The consequence: The data released Wednesday shows that Americans are not having enough children for the population to remain stable. According to the CDC, there would need to be 2,100 births per 1,000 women in order for the population to not decline. 

Read more here


What we're reading

Clashes among top HHS officials undermine Trump agenda (Politico)

Warren's big bet on Medicare for All is not paying off (Daily Beast)

This doctors group is owned by a private equity firm and repeatedly sued the poor until we called them (ProPublica)

Pfizer, Novartis lead $2 billion spending spree on gene therapy production (Reuters)


State by state

Coping with (power) loss: California's hospitals, clinics, patients face new reality (California Healthline)

More kids on Medicaid to get health care in school (Stateline)