Jun 19, 2018

Axios Vitals

Good morning ... Situational awareness: The Trump administration's final rules on association health plans likely are imminent.

1 big thing: Top pediatrician says detention is “child abuse”

Border agents take a father and son into custody in Texas. Photo: John Moore/Getty Images

Separating children from their parents at the border and keeping them in temporary detention centers is a form of child abuse, the head of the American Academy of Pediatrics said yesterday.

“This does amount to child abuse. These children have been traumatized in their trip up to the border, and the first thing that happens is we take away the one constant in their life that helps them buffer all of these horrible experiences,” AAP president Colleen Kraft said on CNN.

  • Kraft, who has visited one of the detention centers, was talking less about day-to-day functions like providing meals and changing diapers, and more about the separation from parents.
  • The process produces “toxic stress,” Kraft said. “It inhibits the development of their brains. It disrupts their brain architecture and keeps them from developing language and social, emotional bonds.”

Go deeper: If you’ve been confused about how this process unfolds and when the Department of Health and Human Services gets involved, Axios’ Stef Kight has you covered.

2. Dems see an advantage in ACA lawsuit

Democrats clearly see a winning 2018 issue in the Trump administration’s approach to pre-existing conditions. They — and vulnerable incumbents in particular — have been hammering away at the Justice Department’s attempts to strike down the Affordable Care Act protections for sick people.

  • Sen. Joe Manchin wrote an op-ed about it.
  • Florida is part of the lawsuit that got all this started, as Sen. Bill Nelson — who’s being challenged by Gov. Rick Scott in November — will remind you.

Moderate GOP governors joined in yesterday. Ohio’s John Kasich, Maryland’s Larry Hogan and Nevada’s Brian Sandoval signed a statement calling on the Justice Department to reverse its position.

What’s next: Conservatives are expected to release some details of their new ACA repeal plan today, ahead of a formal rollout Wednesday.

  • It has little chance of passing, but more potential to rile up both parties’ bases — conservatives who are still upset over last year’s repeal failure, and liberals who are on the hunt for health care attacks ahead of the midterms.
3. Google’s plans for AI in medicine

Vitals reported last month on the shocking accuracy with which Google’s artificial-intelligence tools can predict patients’ deaths. But that’s just the beginning of what the tech giant has in mind.

Bloomberg describes some of Google's other aspirations:

  • “Medical Brain has unfurled AI systems for radiology, ophthalmology and cardiology. They’re flirting with dermatology, too. Staff created an app for spotting malignant skin lesions; a product manager walks around the office with 15 fake tattoos on her arms to test it."
  • "Google is starting a new trial in India that uses its AI software to screen images of eyes for early signs of a condition called diabetic retinopathy."
  • "Over time, Google could license these systems to clinics, or sell them through the company’s cloud-computing division as a sort of diagnostics-as-a-service."
4. Judge to LePage: No, seriously, expand Medicaid

Maine Gov. Paul LePage is appealing a judge’s order requiring him to carry out the state’s Medicaid expansion. But that court has told LePage he still needs to comply with that ruling even while he appeals it, according to the Associated Press.

  • The judge told LePage that his continued obstinance could, in AP’s words, “promote disrespect for laws.”

The big question: LePage is clearly going to fight this as long as he can. The only question is whether he’ll run out of options before he leaves office in January.

What we're watching today: Senate health committee hearing on the 340B drug discount program.

What we're watching this week: Senate oversight committee hearing Wednesday on Medicaid overpayments. Energy and Commerce oversight subcommittee hearing Wednesday on HHS' cybersecurity.

What's on your mind? Unburden yourself: baker@axios.com.