THE PROGNOSIS

The American Civil Liberties Union is asking a court to require the government to take on the cost of reuniting migrant parents with the children separated from them at the border. 

As the government rushed to meet a court-ordered deadline to bring the families back together, some reported they were forced to pay for all transportation to reunite with their kids. 

"It is not acceptable for Defendants to make compliance with this Court's injunction contingent on Class Members paying thousands of dollars to reunify with their children," wrote the ACLU's lawyers in a new filing Thursday for the Southern California district court. The ACLU is representing the families in a class action suit against the government that resulted in a judge ordering the swift return of children under 5 years old to their parents.

The ACLU says in the filing that one migrant parent was told to wire $1,900 to Western Union to cover transportation costs. That is reminiscent of a separate anecdote described by The New York Times's Miriam Jordan this month about a Salvadoran migrant who was separated from her 7-year-old son in late May and charged $576.20 to pay for his flight from Miami to VirginiaThe family's attorney said that she'd never heard of the government asking families to pay out of pocket -- but also, as Miriam wrote, she'd never “encountered children placed in facilities thousands of miles from their ultimate destination."

The ACLU's suit is against Immigration and Customs Enforcement, the agency that has been physically separating parents from their children at the border when they cross illegally. But it isn't clear which agency is making these families pay. 

Typically, families do pay to get unaccompanied minors out of government custody. The Office of Refugee Resettlement (ORR) at the Department of Health and Human Services is responsible for their care once they cross the border. The office shelters those children until a relative or family friend living in the United States comes forward to sponsor them. In those instances, that sponsor is responsible for the travel costs of getting the child. 

But in this case, the kids were separated from their parents as a result of the Trump administration's "zero tolerance" policy to prosecute every illegal border crossing. And the government has designated the approximately 3,000 separated children as “unaccompanied” and put them in HHS custody even though they crossed with a parent and did not necessarily plan to reconnect with someone once they got here.

Given this, the ACLU's lawyers contend that parents shouldn't be forced to pay to rejoin their children when the separation was forced. 

HHS did not immediately return a request for comment. For a greater understanding of how this process normally works we contacted Mark Greenberg, who led the Administration for Children and Families at HHS, which houses ORR, for three years during the Obama administration. Greenberg, who now works for the Migration Policy Institute, told me it is standard policy that for sponsors who can't come to the shelter to pick up the unaccompanied child, they're expected to pay the child's transportation costs and that of any care provider escorting the child. 

“This is a policy that makes sense for the way the program usually works, but makes no sense in the context of helping parents reunify,” Greenberg said. “That's really different from what are the responsibilities of the government when it has wrongfully separated parents and children. This one should be based on the responsibly to correct the wrong as quickly as possible.”

There is some precedent for waiving the fees, Greenberg said. The former official said when he was there ORR would sometimes waive the child's travel costs, especially when it was more cost effective for the government to pay for that transportation than keep the child in the shelter until the sponsor was able to get them. 

Recent reporting and the ACLU's lawyers suggest that parents, who have been in detention centers with their children sometimes hundreds of miles away, are struggling to find the money or leaning on volunteers to get back to their children. This week, the Post's Marissa Lang and Arelis R. Hernández detailed how one mother traveled 3,000 miles from Arizona to New York to reunite with her daughter. Traveling in eight different cars over five days, the Guatemalan woman was cared for by a team of volunteers who call themselves "Immigrant Families Together" and are helping to reunite parents and children. 

Mira Sussman, a Michigan mother of three drove the woman from Ann Arbor to Pittsburgh, “I’m glad we have the opportunity to show her that there are people with morals and courage in this country," Sussman told Marissa and Arelis, "but it’s just disgusting that we have to do this at all.”

The government reported Thursday night that 58 of the 103 migrant children under the age of 5 have been reunited with their parents, sometimes late at night and across great distances, our Post colleague Maria Sacchetti reports. Children or parents were scattered nationwide, including in Maryland, Texas, New York, Georgia, Louisiana, Arizona and Illinois.

The remaining 45 children could not be returned for what the government described as safety and health reasons, and because some adults are in criminal custody or were already deported. Here’s a brief breakdown of some of the issues the government cited:

  • 24 parents are in criminal custody or have been deported
  • 11 adults had “serious criminal histories”
  • 7 adults were not the parents of the migrant children they brought into the country
  • 1 parent is being treated for a “communicable disease”
  • 1 adult had a false birth certificate
  • 1 parent allegedly abused the child
  • 1 parent had planned to share a house with an adult charged with child sexual abuse

The government faces a court-ordered July 26 deadline to reunite the older children held in HHS custody with their parents. Officials are expected to provide a list of those children to the ACLU today as the two sides meet in court for a status conference on the case. 

AHH, OOF and OUCH

AHH: Attorney General Jeff Sessions yesterday ordered federal prosecutors to crack down on the sale of fentanyl. An additional prosecutor will be deployed to designated areas in California, Kentucky, Maine, New Hampshire, Ohio, Pennsylvania, Tennessee and West Virginia, our colleague Sari Horwitz reports.

“Fentanyl is a killer drug,” Sessions said in an interview with The Post. “Fentanyl is so powerful that the slightest error in how much you take can go from this extremely pleasurable feeling to death.”

Brian Boyle, the Drug Enforcement Administration special agent in charge of the New England Field Division told the Post having dedicated prosecutors in these areas “is going to be a huge, enormous benefit to us here.” “The amount of fentanyl we’re seeing is affecting everybody, all walks of life, all communities,” Boyle added. “You’re seeing it in rural areas, urban areas, big cities, middle-of-nowhere areas in New England.”

In 2016, West Virginia had the highest number of drug overdoses with 52 deaths per 100,000 residents. New Hampshire and Ohio had the next highest with 39 deaths, Sari reports.

“Sessions’s fentanyl crackdown is the latest step he is taking to combat its use,” she writes. “The department has tripled fentanyl prosecutions across the country and brought the first cases charging Chinese nationals with selling large quantities of the drug to Americans. Sessions has also proposed a change to national drug policy by limiting the amount of opioids that companies can manufacture each year. He has created a team of federal agents and analysts to try to disrupt illicit opioid sales online, and started an opioid fraud and abuse detection unit to target opioid-related health-care fraud.”

OOF: In just the first 10 days of this month, 10 drugmakers and biotechnology companies increased the prices of at least 20 brand-name drugs including those for cancer, diabetes, multiple sclerosis and liver disease, Bloomberg News’s Robert Langreth and Cynthia Koons report.

The price hikes were generally less than 10 percent, Robert and Cynthia report. But they come as the Trump administration continues to zoom in on high drug costs, and as the president has pressured at least one major drugmaker to delay its price hikes.

In one such example, Celgene Corp. this month increased the price of cancer medication Revlimid by 5 percent to $695.48 per capsule, Robert and Cynthia report via data from Bloomberg Intelligence and First Databank. Since President Trump’s election, the cost of that drug has jumped four times for a total 25 percent hike.

“The number of price increases in a short period suggests that Trump’s use of the bully pulpit is likely to have little impact on drug prices in the long term,” Robert and Cynthia write, citing Michael Rea, chief executive of Rx Savings Solutions. “Some other drugmakers, under pressure from a new California price-transparency law and the broader political climate, have canceled plans to raise prices. Nevertheless, the number of increases ‘signals that the fear from government threat is waning,’ said Rea.”

OUCH: Check your cabinets. The Centers for Disease Control and Prevention published a warning yesterday about a salmonella outbreak linked to Honey Smacks, a popular Kellogg’s branded cereal. The outbreak has so far infected 100 people, our colleague Eli Rosenberg reports, and the CDC is warning consumers to avoid the cereal that has been under a recall by the company since June. “Do not eat Kellogg’s Honey Smacks cereal of any size package or with any 'best if used by' date,” the CDC wrote.

No deaths have yet been reported, but at least 30 of the 100 people in the reported outbreak have been hospitalized. “The agency has said that it has found salmonella strains in unopened and leftover samples of Honey Smacks,” Eli writes. “Though the recall covers cereal with a best-by date of June 14, 2018, through June 14, 2019, the agency is recommending people avoid the cereal altogether.”

AGENCY ALERT

The FDA announced yesterday the launch of a new task force that will work toward combating the prevalence of drug shortages that can disrupt medical services and hospital operations.

The Drug Shortages Task Force will assess the reason behind the persistent drug shortages and look for ways to solve them. For example, it will look into potential incentives to bulk up manufacturing for certain critical drugs, and potential regulations and financial incentives to market the drugs, according to the agency. The task force will include resources from the FDA, CMS and Veterans Affairs.

“Even shortages of a small number of key drugs can place a serious burden on providers,” FDA commissioner Scott Gottlieb said in a statement. “While we’ve made progress to mitigate individual shortages, we haven’t firmly impacted the underlying structural concerns that give rise to these recurring challenges … I believe that more can and must be done across our health care system to achieve more enduring solutions.”

REPRODUCTIVE WARS

— The antiabortion group Susan B. Anthony List yesterday released six digital ads calling on red-state Democrats to “protect life” by voting to confirm Supreme Court nominee Brett Kavanaugh.

The ads target Sens. Joe Donnelly (Ind.), Doug Jones (Ala.), Heidi Heitkamp (N.D.), Joe Manchin III (W.Va.), Claire McCaskill (Mo.) and Bill Nelson (Fla.). The group says the advertisements will reach 250,000 people across the six states and will first launch through a texting campaign this week.

In an op-ed in the Washington Examiner published earlier this week, SBA List President Marjorie Dannenfelser said Kavanaugh and Trump “will need grassroots support in the coming battle with the extreme abortion lobby. We urge pro-lifers nationwide to unite behind him now.”

— Meanwhile, states are gearing up for a fight over abortion laws following Kavanaugh’s nomination. Some Democratic state lawmakers and governors are working toward establishing new abortion protections and gutting any laws that criminalize abortion, the Associated Press reports.

Democrats even want to eliminate any dormant laws “so they cannot be revived in the future,” David A. Lieb and Steve LeBlanc report. In Massachusetts, for example, Democratic state Senate President Harriette Chandler wants to repeal a 19th-century law banning abortion that has gone unenforced. The state House is set to take up the bill before the end of the month, per the AP.

“Seventeen states already have laws that could be used to restrict the legal status of abortions if Roe is overturned or severely limited,” David and Steve report. “Of those, Massachusetts is one of 10 states that still have pre-Roe abortion bans on the books, according to the Guttmacher Institute, a national research group that supports abortion rights. The institute says nine other states have laws specifically protecting abortion rights.”

In Missouri, Republican state Rep. Mike Moon is hoping the renewed debate over abortion and Trumps nominee can push forward an antiabortion state constitutional amendment that stalled this year. “The time is right. We need to act on it,” Moon said.

— A new Gallup poll found that a strong majority of 64 percent of Americans want Roe v. Wade to remain the law of the land, compared with 28 percent who want it overturned. The poll was conducted from July 2-8, just days ahead of Trump’s announcement of his second high court nominee. Gallup reported mixed results about whether senators should vote to confirm Supreme Court nominees based on their views on specific issues such as abortion. It found 49 percent of respondents said senators would be justified in voting against a nominee over the nominee’s views, whereas 46 percent said it would not be justified.

OPIOID OPTICS

— The CDC is warning that extremely potent fentanyl may require multiple doses of the opioid antidote naloxone. The new health alert posted Wednesday comes as the agency notes deaths related to the illicit use of the synthetic opioid have seen a dramatic rise.

“Multiple dosages of naloxone may need to be administered per overdose event because of fentanyl and fentanyl analog’s increased potency relative to other opioids,” the warning reads, adding that “orally-ingested counterfeit pills laced with fentanyl or fentanyl analogs” could require prolonged doses of the opioid antidote at the hospital “due to delayed toxicity.”

The CDC alert noted the rate of deaths in the United States related to synthetic opioid overdoses jumped from 3.1 to 6.2 deaths per 100,000 from 2015 to 2016, “marking the first year that synthetic opioids became the most common type of opioid involved in all opioid overdose deaths.” That trend also continued into 2017, per the agency.

HEALTH ON THE HILL

— Congressional appropriators canceled a meeting yesterday that was scheduled to debate three of 12 funding bills, including one that pays for veterans health care, that will need to be signed by Trump by the end of September in order to avoid a government shutdown.

“The 11th-hour cancellation came amid a cross-Congress showdown over how to pay for a program that allows some veterans to spend taxpayer money on private doctors and hospitals,” Politico’s Sarah Ferris and Jennifer Scholtes report. “The question is whether to break budget limits, known as caps, to come up with the cash.”

 “The suggestion that Congress ‘break the caps’ set by the budget deal, H.R. 1892 (115), struck this year is already irking House conservatives, who would be loath to vote on any final spending bill that goes above those limits — even in the face of an impending shutdown this fall,” Sarah and Jennifer write.

“They canceled the meeting. But it’s all about the VA,” Sen. Richard Shelby (R-Ala.), chairman of the Senate Appropriations Committee, told reporters, according to Politico. “Do we break the caps? Do we prorate everything else? Do we cut other veterans programs to fund this? We got a shortfall, and we got to work it out. And we’re not there yet.”

— The House Ways and Means Committee yesterday advanced a bill that dismantles parts of Obamacare and includes a measure to temporarily halt the health care law’s employer mandate, The Hill’s Jessie Hellman reports. The measure follows lawmakers repeal of the law’s individual mandate last year. “The bill sponsored by GOP Reps. Devin Nunes (Calif.) and Mike Kelly (R-Pa.) would suspend penalties for the employer mandate for 2015 through 2019 and delay implementation of the tax on high-cost employer-sponsored health plans for another year, pushing it back to 2022,” Jessie reports.

MEDICAL MISSIVES

— If you’ve been on some sort of diet in the past year, you’re not alone. The CDC released a new report that found nearly 50 percent of American adults surveyed from 2013-2016 tried to lose weight in the past 12 months. Odds were even higher for women (and in every age group): 56.4 percent of women overall tried to lose weight in the past year compared with 41.7 percent of men.

Americans’ body mass index, age and income category affected the likelihood of whether an individual had dieted in the past year, while race and ethnicity did not have a significant impact, the Los Angeles Times's Karen Kaplan reports

The CDC report also assessed the most likely methods people used in trying to lose weight and found 62.9 percent of dieters tried both exercise and eating less. The report did not note whether any specific method worked best or how many of the surveyed people succeeded in losing weight, Karen added.

—And here are a few more good reads from The Post and beyond: 

TRUMP TEMPERATURE
Health & Science
Supreme Court is most likely to face questions about Trump’s moves to undermine the ACA.
Amy Goldstein
As Sen. Marco Rubio gets ready to introduce new paid family leave legislation, Ivanka Trump told us her ideal plan would be more ambitious.
Refinery29
The Secret Service released a guide to help schools, communities and law-enforcement agencies better assess and respond to students exhibiting troubling behavior before they launch an attack.
WSJ
STATE SCAN
The new Iowa option, which Republicans and some Democrats in the Legislature pushed through before knowing many of the details, represents another attempt by GOP-controlled states to chip away at some of the federal rules imposed under the 2010 law championed by former President Barack Obama.
Associated Press
A new report found that nearly 5,000 beneficiaries of Ohio’s Medicaid program received an excessive amount of unnecessary opioids.
Washington Examiner
INDUSTRY RX
Shares of CVS Health Corp and health insurer Aetna Inc rose more than 2 percent on Thursday after CNBC reported that the U.S. Justice Department will not challenge their planned merger.
Reuters
A Missouri jury on Thursday ordered Johnson & Johnson to pay a record $4.69 billion to 22 women who alleged the company's talc-based products, including its baby powder, contain asbestos and caused them to develop ovarian cancer.
Reuters
As cities and companies — including Starbucks — move to oust straws in a bid to reduce pollution, people with disabilities say they're losing access to a necessary, lifesaving tool.
NPR
DAYBOOK

Today

  • The Brookings Institution holds an event on “(De)stabilizing the ACA’s individual market: A view from the states."
SUGAR RUSH

House Speaker Paul D. Ryan defends food stamp work requirements after Senate vote:

Sen. Patty Murray (D-Wash.) said she had not spoken to Republican Sens. Lisa Murkowski or Susan Collins yet about Supreme Court nominee Brett Kavanaugh:

A young Kavanaugh talks impeachment v. indictment: