KHN Original Reporting & Guest Opinion
Now on the Kaiser Health News blog, Mary Agnes Carey reports: "While hospitals, physicians and some members of Congress want to use war savings as a way to get rid of Medicare's sustainable growth rate formula, congressional rules could complicate things. Even if there's enough support for the idea among Republicans — and it's unclear there is, especially in the House – there's the issue of 'scope,' or what's currently included in the House and Senate bills" (Carey, 2/3).
Christian Torres, writing on the blog, details a recent "moot court" version of the upcoming Supreme Court consideration of the 2010 health law: "A group of experienced lawyers argued the constitutionality of the law’s individual mandate in an afternoon of legal theater. The “moot court” aired debate points and gave a stuffy auditorium full of law students – many on the edge of their seat – a peek at the legal fireworks set for this March" (Torres, 2/3).
Also on Capsules, Shefali S. Kulkarni reports on health workers and the flu vaccine: "Despite nearly 20 years of recommendations that health workers get flu shots, the most recent data from the Centers for Disease Control and Prevention show that less than 64 percent of them do. Consumer and business groups met in Washington Thursday to show their support for a recommendation from the National Business Group on Health (NBGH) that hospitals require all health care workers to be vaccinated annually against the flu" (Kulkarni, 2/2). Check out what else is on the blog.
This Story: Email | Print | Link to | Top
Kaiser Health News provides a fresh take on health policy developments with "The Devil You Know? by Lisa Benson.
This Story: Email | Print | Link to | Top
Capitol Hill Watch
House Ways and Means Chairman Dave Camp said that using war savings to pay for an overhaul of the Medicare physician payment formula is likely out of the scope of the conference committee's deliberations. In addition, the proposal faces political obstacles.
CQ HealthBeat: Camp Says War Savings Might Be Outside Scope Of Conference Committee
The chairman of the conference committee that's working to avert a looming cut in Medicare physician payment rates said Thursday that suggestions about using war savings to pay for a long-term "doc fix" likely are outside the scope of the panel's deliberations. But Rep. Dave Camp, chairman of the Ways and Means Committee, also said that he doesn't yet want to discuss any ways of paying for policy debated by the panel, which is also considering extensions of unemployment insurance and a Social Security payroll tax cut that were included in a House-passed bill (Norman, 2/2).
Kaiser Health News: Capsules: Using War Savings For 'Doc Fix' Complicated By Congressionial Rules
While hospitals, physicians and some members of Congress want to use war savings as a way to get rid of Medicare's sustainable growth rate formula, congressional rules could complicate things. Even if there's enough support for the idea among Republicans — and it's unclear there is, especially in the House – there's the issue of 'scope,' or what's currently included in the House and Senate bills (Carey, 2/3).
Politico Pro: War Fund Fix Gains Steam, Faces Obstacles
Injecting the war savings into the SGR mix gave new life to an idea left for dead in December — permanently doing away with the dysfunctional Medicare physician pay formula once and for all. But the idea still faces obstacles — political and procedural. Which can turn out to be the same thing. Members of the payroll/SGR conference committee are definitely considering ways of tapping into the Overseas Contingency Operations funds. And physician and hospital groups are behind the idea, which would be less painful for them than the options that have been on the table. But not everyone — including some top Republicans and conference committee Chairman Dave Camp — is sold. And budget rules also make it anything but a slam-dunk. CBO Director Douglas Elmendorf this week said that war savings would not count as an offset for SGR repeal under pay-go rules (Feder and DoBias, 2/2).
Modern Healthcare: Shall They Beat Their Swords Into Medicare Doctor Pay?
A House GOP lawmaker on Wednesday sounded open to the idea of using unspent war funds as a way to pay for a long-term fix to Medicare's contentious sustainable growth rate formula. Earlier Wednesday, the House-Senate negotiating committee responsible for devising long-term solutions to a middle-class payroll tax holiday, unemployment insurance, the SGR, and extensions for certain Medicare programs met for the second time. Some committee members during and after the meeting highlighted an earlier-proposed idea of using potential spending reductions from Overseas Contingency Operations funds to pay for a long-term SGR fix (Zigmond, 2/2).
Politico Pro: Lieberman, Coburn Fight War Savings For SGR
Sens. Joe Lieberman and Tom Coburn released a letter Thursday afternoon in which they blast the idea of using war savings as an offset for repealing Medicare's physician payment formula. The letter from Lieberman (I-Conn.) and Coburn (R-Okla.) says in part, "The funds allocated for OCO or 'war savings' are not real, and every member of Congress knows this. "While our colleagues may be well-intentioned, we believe this approach is financially misguided and will undoubtedly increase our nation's debt and deficit in real terms," the letter states (Feder, 2/2).
In other Capitol Hill action -
The New York Times: To Fix Image, Republicans In House Think Small
Unpopular and divided, the once mighty House Republicans are laboring to repair their image and frame a new agenda. Members are still struggling to sing from the same legislative hymnal. Many want to do bigger things, like a tax code overhaul and changes to the Medicare program. Others, including Mr. Cantor, knowing they will get no help from Senate Democrats, seem to favor more incremental steps (Steinhauer and Weisman, 2/2).
CQ HealthBeat: GOP Lawmakers Ask AARP To Recommend Medicare Changes
GOP members of the House and Senate challenged AARP on Thursday to join their efforts to overhaul Medicare, as House Republicans investigate the powerful advocacy group for possible financial conflicts of interest. The 18 lawmakers — all medical providers — wrote to AARP chief executive A. Barry Rand that politics must be put aside in order to find ways to financially bolster Medicare, and they asked the group to identify detailed policy proposals that it would support (Ethridge, 2/2).
This Story: Email | Print | Link to | Top
Medicare
A provision in the health law was intended to help fill a gap in Medicare's prescription drug coverage. On Thursday, administration officials said 3.6 million beneficiaries saved $2.1 billion on prescription drugs in 2011.
Los Angeles Times: Health Law Delivers $2.1 Billion In Savings On Drugs For Seniors
In the first full year of the new healthcare law, 3.6 million people in the government Medicare program saved $2.1 billion on prescription drugs in 2011, the Obama administration announced Thursday (Levey, 2/2).
The Wall Street Journal's Health Blog: Obama Says Seniors Have Saved On Medicare 'Doughnut Hole'
Part of the law was intended to fill the gap in prescription-drug coverage, the so-called doughnut hole, when Medicare beneficiaries have to pay up to $4,550 out of pocket for drugs after their costs pass $2,840 for the year. Under the law, drug companies have to offer discounts on brand-name and generic drugs for Medicare beneficiaries after they reach the gap. Discounts increase annually until 2020, when the hole is supposed to be filled entirely. In 2010, the first year when the discounts were in effect, seniors also got a $250 rebate check if they hit the doughnut hole (Radnofsky, 2/2).
Modern Healthcare: Reform Shrinking 'Doughnut Hole': HHS
About 3.6 million Americans with Medicare who reached the "doughnut hole" saved about $604 on their prescription drugs in 2011, according to data from HHS. ... HHS reported Thursday that the Patient Protection and Affordable Care Act—which provides a 50% discount on brand-name prescription drugs, and, in 2012, a 14% discount on generics—saved those 3.6 million beneficiaries about $2.1 billion on their prescription-drug costs last year (Zigmond, 2/2).
This Story: Email | Print | Link to | Top
Bloomberg: Hospices Dump Patients While Escaping Multimillion-Dollar Taxpayer Refunds
Lois Armstrong and David Daucher closed their for-profit hospice in October to get out from under more than $27 million in refunds it owed the federal Medicare program, they said. The same week, they opened a new hospice with new owners. ... The demise of Sojourn Care, and the creation of its successor, RoseRock Healthcare, illustrate how hundreds of hospices across the U.S. exploit quirks in the Medicare payment system that yield higher reimbursements -- with results that can hurt taxpayers and patients, said Tulsa physician Sandra Dimmitt (Waldman, 2/3).
This Story: Email | Print | Link to | Top
Campaign 2012
Reuters offers an analysis based on a recent poll and finds that people, shaken by the difficult economy, worry about the impact of efforts to address the nation's deficit. This concept could lead to Democrats finding traction for their positions on Medicare.
Reuters: Insight: Deficits, The U.S. Election And Politics Of Fear
With the public shaken by high unemployment, some voters worry aggressive measures to shrink deficits could leave people in the cold. Obama frequently paints the Republican vision of government as "you're-on-your-own" economics. He says Republicans would "gut" funding for Medicare, the federal program that pays for elderly health care and which is often flagged as the top threat to long-term budget sustainability. ... Polls suggest this approach could have some bite. When Americans were asked in a Pew poll late last year to choose between fixing the deficit and keeping Medicare unchanged, they favored Medicare by a wide margin (Lange and MacInnis, 2/2).
Meanwhile, more reports from the GOP presidential primary campaign trail -
Boston Globe: Romney Shifted On 'Conscience' Issue
Mitt Romney accused President Obama this week of ordering "religious organizations to violate their conscience," referring to a White House decision that requires all health plans - even those covering employees at Catholic hospitals, charities, and colleges - to provide free birth control. But a review of Romney's tenure as Massachusetts governor shows that he once took a similar step. In December 2005, Romney required all Massachusetts hospitals, including Catholic ones, to provide emergency contraception to rape victims, even though some Catholics view the morning-after pill as a form of abortion (Jan, 2/3).
The Associated Press: Santorum Warns Voters Of Country's Likely Demise
Rick Santorum's campaign slogan could very well be one word: doomsday. To hear him tell it, the United States will collapse under the weight of its health care system and basic freedoms will be history. ... On the health care overhaul, Santorum warns: "Be careful what you do ... because once the government creates a right, it can tell you how to exercise that right" (Elliott, 2/3).
This Story: Email | Print | Link to | Top
Public Health & Education
As backlash grows, Planned Parenthood reports increasing contributions to help cover the lost funding.
The Washington Post: Komen Gives New Explanation For Cutting Funds To Planned Parenthood
Komen had said the decision was the result of newly adopted criteria barring grants to organizations under investigation — affecting Planned Parenthood because of an inquiry by a Republican congressman. On Thursday, Komen President Elizabeth Thompson told reporters that the funding decision was unrelated to the investigation into whether Planned Parenthood was illegally using federal funds to pay for abortions. Komen founder Nancy Brinker said the organization wants to support groups that directly provide breast health services, such as mammograms. She noted that Planned Parenthood was providing only mammogram referrals (Sun, Kliff and Aizenman, 2/2).
Politico: Susan G. Komen Fights To Contain Planned Parenthood Damage
If this was supposed to be damage control, Susan G. Komen for the Cure proved Thursday that it has a lot to learn. On a day when the breast cancer charity's top official made the rounds with the national media, insisting the organization's decision to stop giving grants to Planned Parenthood wasn't political, the firestorm only got worse. Top Democrats piled on; the head of the Komen chapter in Los Angeles quit; and New York Mayor Michael Bloomberg is giving a $250,000 matching gift to Planned Parenthood (Nocera and Nather, 2/2).
USA Today: Komen Says Planned Parenthood Plans Are Mischaracterized
The founder of Susan G. Komen for the Cure said Thursday that there had been a "gross mischaracterization" about the group's controversial decision to stop funding breast exams at Planned Parenthood. … Brinker denied that the decision to not renew grants to groups under investigation was directed specifically at Planned Parenthood. She said other institutions also have been affected by Komen's policy (Szabo, 2/3).
The New York Times: Outcry Grows Fiercer After Funding Cut By Cancer Group
The nation's leading breast cancer advocacy organization confronted the growing furor Thursday over its decision to largely end its decades-long partnership with Planned Parenthood, with rising dissension in its own ranks and a roiling anger on the Internet showing the power of social media to harness protest. All seven California affiliates of the organization, the Susan G. Komen for the Cure foundation, released a statement saying they opposed its decision (Preston and Harris, 2/2).
NPR: As Komen Defends Itself, Planned Parenthood Rakes In Substitute Funds
Leaders of the breast-cancer charity Susan G. Komen for the Cure tried in vain Thursday to contain the controversy stemming from its decision to end its grants to Planned Parenthood. But it's becoming clearer that Planned Parenthood has the upper hand in the battle (Rovner, 2/2).
The Atlanta Journal Constitution: Komen Withdrawl Of Funds Leaves Handel In Spotlight
Praise and scorn rained down on Karen Handel Thursday, as both foes and supporters of abortion rights credited the former Georgia secretary of state for the Susan G. Komen Foundation’s rift with Planned Parenthood. Those in the pro-life camp lauded Handel, who joined Komen last year as its vice president for public policy, for withdrawing funding for Planned Parenthood's breast cancer screening programs. Pro-choice supporters targeted the former Georgia GOP gubernatorial candidate with their ire -- often expressed as sarcastic thank-yous after Planned Parenthood announced that the dust-up had brought in a one-day flood of more than $650,000 in donations (Leslie, 2/2).
The Dallas Morning News: CEO Defends Decision As Backlash Grows Over Komen Move To Cut Planned Parenthood Funding
Facing mounting backlash, Susan G. Komen for the Cure responded Thursday to critics who accused the nation's top breast-cancer fundraiser of caving to anti-abortion pressures when it cut Planned Parenthood's funding. "It's a mischaracterization of our goals, our mission and everything we do," said Nancy Brinker, founder and chief executive officer of the Dallas-based foundation. Anti-abortion groups have taken credit for Komen's decision, saying they lobbied for seven years to stop Planned Parenthood's funding (Jacobson and Farwell, 2/2).
The Wall Street Journal: Nonprofits' Backers Mobilize
One of the nation's leading breast-cancer charities grappled Thursday with the fallout from its decision to cut funding for Planned Parenthood affiliates. Opponents of the move organized online pressure against Susan G. Komen for the Cure and some of its corporate sponsors. But the charity said it had seen a jump in donations since the decision became public Tuesday. Meantime, Planned Parenthood supporters, including New York City Mayor Michael Bloomberg, announced donations to the women's health group (Mathews, Radnofsky and West, 2/3).
McClatchy: Komen Official Defends Decision To Cut Funding To Planned Parenthood
As backlash grew against the decision by Susan G. Komen for the Cure foundation to cease awarding grants to Planned Parenthood, Komen officials went public, after two days of silence, to try to manage the uproar. In a Thursday conference call with the media, Komen founder and chief executive Nancy Brinker said the decision to end 16 of 19 grants to Planned Parenthood affiliates was because of policy changes intended to improve how grantees are selected. The decision had nothing to do with Planned Parenthood's position as an abortion provider, she said (Roan, 2/2).
Reuters: Bloomberg Pledges $250,000 To Planned Parenthood
Billionaire New York City Mayor Michael Bloomberg pledged on Thursday to give $250,000 of his own money to the Planned Parenthood Federation of America after breast cancer charity Susan G. Komen for the Cure withdrew funding for the group. ... "Politics have no place in health care. Breast cancer screening saves lives and hundreds of thousands of women rely on Planned Parenthood for access to care," Bloomberg said in a statement (2/2).
Bloomberg: Komen Says Criticism Unfounded As Planned Parenthood Replaces Lost Funding
Susan G. Komen for the Cure sought to blunt criticism of its decision to end much of its breast-cancer funding for Planned Parenthood clinics while the health network rode a wave of appeals to replace the money. Planned Parenthood Federation of American received $400,000 from 6,000 donors as of Feb. 1. More pledges were made yesterday though the group didn't have an updated amount, said Shawn Rhea, an organization spokeswoman (Lopatto and Edney, 2/3).
The Philadelphia Inquirer: Komen Foundation Needs Cure For Backlash Over Planned Parenthood Cutoff
The Susan G. Komen foundation, a behemoth in breast cancer philanthropy and creator of the immensely successful Race for the Cure brand, is battling a public-relations debacle. Within hours of Tuesday's news that Komen would stop giving grants to Planned Parenthood for breast health services, donations began pouring in to the family planning organization while pink-ribbon crusaders vowed to cut Komen off…. Two dozen Democratic U.S. senators, led by New Jersey's Frank Lautenberg, on Thursday sent a letter urging Komen to reconsider, saying "it would be tragic if any woman . . . lost access to these potentially lifesaving services because of a politically motivated attack" (McCullough, 2/3).
The Fiscal Times: Planned Parenthood Funders Strike Back At Komen
High-profile policymakers, advocates, and breast cancer survivors who once sported pink ribbons will do so no more. Outraged by the decision of The Susan G. Komen for the Cure Foundation to yank funds from Planned Parenthood, many supporters are closing their wallets to the breast cancer treatment and research group and funneling money instead to Planned Parenthood. As an indication of the intensity of feeling, donors contributed $650,000 to Planned Parenthood over the last 24 hours – providing almost enough to replace the lost Komen funding for one year, Planned Parenthood officials said on Thursday (Hirsch, 2/2).
This Story: Email | Print | Link to | Top
In California, seven Komen groups ask the national breast cancer group to reverse its funding decision. Others report concerns about community support for future money-raising activities.
San Francisco Chronicle: Komen Affiliates Blast Cuts To Planned Parenthood
The California affiliates of Susan G. Komen for the Cure on Thursday denounced the decision by the breast cancer charity's national headquarters to cut breast-screening grants to Planned Parenthood and vowed to keep those services operating. Calling the action by the national organization a misstep, the California group vowed to change the policy and do "whatever it takes to do what is right" for the health of the state's women. "The seven California Affiliates of Susan G. Komen for the Cure are strongly opposed to Komen National's new grant-making policy," the groups said in a message to California's congressional delegation. "We are currently working with our national organization to change the policy" (Colliver, 2/3).
Los Angeles Times: Susan G. Komen For The Cure Founder Defends Planned Parenthood Decision
California affiliates released a statement saying they were strongly opposed to the new policy and were working with national headquarters to resolve it. … Other Komen affiliates posted statements on their Facebook pages, including postings critical of Komen's move … or supportive of Komen (Roan, 2/2).
Houston Chronicle: Houston Affiliates Respond To The Komen, Planned Parenthood Uproar
After 21 years and more than $25 million in grants, Susan G. Komen for the Cure Houston has never awarded money to Planned Parenthood Gulf Coast because the health organization has not applied for a grant. That means — except for the local reaction to a national decision that affiliates didn't see coming — it's business as usual in Houston, said Betsy Kamin, president of the local Komen board. "The affiliates were not made aware of it in advance, so it was somewhat shocking to us," said Kamin, who added that the local group anticipates backlash, including the loss of financial and community support. "It would be an absolute tragedy for the women we serve to not get funded by the granting process because our local grants are impacted by the decision from national" (George, 2/2).
The Baltimore Sun: Debate Over Komen's Planned Parenthood Decision Grows In Maryland, Nation
The inaugural Susan B. Komen breast cancer race scheduled for Ocean City in April was meant to be a feel-good event promoting a noble cause — and a way to boost tourism during the resort town's off-season. Now uncertainty surrounds it and other Komen events in Maryland and beyond, as fallout continues from the national organization's recent decision to pull funding from Planned Parenthood (Walker, 2/2).
St. Louis Beacon: Progressive Legislative Caucus Blasts Komen Decision
Thirty-four members of the Missouri General Assembly's bipartisan Progressive Caucus have formally asked the national Susan G. Komen for the Cure foundation "to reconsider their decision to cut cancer-screening funding to Planned Parenthood." The group has signed letters sent to the foundation and to its chief executive, Nancy Brinker (Mannies, 2/3).
(St. Paul) Pioneer Press: Komen Controversy Sparks Support For Planned Parenthood Twin Cities Chapter
The Twin Cities chapter of Planned Parenthood did not receive money from the Susan G. Komen for the Cure foundation for its breast cancer screening program, a spokeswoman said Thursday. Even so, the chapter's administrative offices in St. Paul and Minneapolis are being flooded with calls of support, spokeswoman Jennifer Aulwes said. The local chapter's website traffic Thursday was 70 percent higher than the daily average over the past six months, Aulwes said. (Snowbeck, 2/2).
Milwaukee Journal Sentinel: Reaction Swirls Around State's Planned Parenthood, Komen Groups
Wisconsin Planned Parenthood officials say a decision by Susan G. Komen for the Cure to cut funding to its national organization will not affect state breast cancer prevention programs. They have operated without Komen money for several years, said Tanya Atkinson, executive director of Planned Parenthood Advocates of Wisconsin. Officials with Komen's southeast Wisconsin affiliate, meanwhile, said they hope the decision by their national organization to cut funding to Planned Parenthood Federation of America will not affect their popular annual run/walk fundraiser, which raised more than $1 million last year (Fauber, 2/2).
This Story: Email | Print | Link to | Top
The National Business Group On Health is advocating this position as a way to reduce flu risk for health care workers and patients.
Modern Healthcare: Group Pushes Health Worker Flu Vaccinations
A national employer health care group joined several provider advocacy groups in urging hospitals to require their employees to obtain annual influenza vaccinations. The National Business Group on Health, a not-for-profit group representing the health policy interests of some of the largest U.S. employers, urged seasonal flu requirements for hospital workers as a way to reduce risks for health care workers and patients (Daly, 2/2).
Kaiser Health News: Capsules: Taking Another Shot At The Flu Vaccine
Despite nearly 20 years of recommendations that health workers get flu shots, the most recent data from the Centers for Disease Control and Prevention show that less than 64 percent of them do. Consumer and business groups met in Washington Thursday to show their support for a recommendation from the National Business Group on Health (NBGH) that hospitals require all health care workers to be vaccinated annually against the flu (Kulkarni, 2/2).
This Story: Email | Print | Link to | Top
Administration News
House Speaker John Boehner, R- Ohio, called the birth control order unconstitutional while a senior White House official acknowledged during a conference call with reporters that there has been "a fair amount of interest and some confusion" about the policy.
The Associated Press: Boehner: Feds Should Back Off Birth Control Order
The Obama administration scrambled Thursday to contain a growing election-year outcry over its decision that church-affiliated employers must cover birth control regardless of their religious principles. House Speaker John Boehner, a Catholic, called the requirement unconstitutional while White House spokesman Jay Carney said it is part of a reasoned policy to promote women's health and does not encourage abortion (Alonso-Zaldivar, 2/2).
CQ HealthBeat: White House Explains Contraceptive Rule As Criticism Continues
White House officials Thursday defended their decision to require hospitals and colleges with religious affiliations to provide free contraceptive care to employees. Earlier in the day, House Speaker John A. Boehner called the regulation unconstitutional. A senior Obama administration official in a conference call with reporters said there has been "a fair amount of interest and some confusion" following the Jan. 20 announcement, which has drawn outrage among leaders of the Catholic Church. The call was not intended to break any new ground on policy, officials said, but rather to further explain the decision. But it also demonstrated that the hubbub clearly is being heard (Norman, 2/2).
The Associated Press/Washington Post: White House, Religious Groups In Fight Over Doctrine, Religious Freedom And Contraception
The Obama administration's decision requiring church-affiliated employers to cover birth control was bound to cause an uproar among Roman Catholics and members of other faiths, no matter their beliefs on contraception. The regulation, finalized a week ago, raises a complex and sensitive legal question: Which institutions qualify as religious and can be exempt from the mandate? (2/3).
CNN: Contraceptive Coverage Controversy
The White House is pushing back on criticism of its decision requiring church-affiliated employers to provide no-cost contraceptive coverage including birth control as part of their health care plans. "This decision was made after very careful consideration of the legal and policy points and we believe it strikes the appropriate balance between respecting religious beliefs and approving access to services," a senior administration official told reporters on a conference call Thursday afternoon. That was a direct response to comments made by House Speaker John Boehner, who insisted the provision in the new health care law "violates our Constitution" (Lothian, 2/2).
This Story: Email | Print | Link to | Top
Health Care Marketplace
The Wall Street Journal: Study: Hospitals Overpay For Devices
Some hospitals pay thousands of dollars more than others for big-ticket medical devices such as defibrillators and hip replacements, and a portion of the higher costs could be passed on to the federal Medicare program, a new government report says (Weaver, 2/3).
This Story: Email | Print | Link to | Top
State Watch
Officials in Providence, R.I., and Iowa propose changes in health benefits. New York City Mayor Michael Bloomberg says he'll use health care reserve fund dollars to make up a shortfall.
The New York Times: Mayor Of Providence Seeks Urgent Steps In City's Financial Crisis
Mayor Angel Taveras, a Democrat, outlined plans to reduce pensions for retired municipal workers and vowed to appeal a recent state court ruling preventing the city from forcing its retirees to switch to the federal Medicare health insurance program when they turned 65. He also called for bigger contributions from major tax-exempt universities and hospitals in Providence (Bidgood and Goodnough, 2/2).
The Associated Press/Washington Post: Mayor Says Providence Could Face Bankruptcy Without Retiree Benefit Cuts, Nonprofit Payments
Mayor Angel Taveras painted a bleak picture Thursday of the city's finances, saying Providence faces "devastation" and could go bankrupt if retiree benefits aren't cut and tax-exempt institutions like Brown University don't pay more in lieu of taxes. Taveras said he cut a projected $110 million deficit for the current fiscal year to less than $30 million but that the city is on track to run out of money by June. He said taxpayers and city workers have already sacrificed — taxes and fees have gone up, several schools were closed and there are 200 fewer people on the city's payroll compared to a year ago — and he called on retirees and nonprofit hospitals and universities to do the same (2/2).
Des Moines Register: State Workers Should Pay $2,400 A Year In Health Premiums, Republicans Say
Iowa's state employees would pay $2,400 a year in health care premiums under a budget proposal released today by House and Senate Republicans. The proposal, however, has little chance of being enacted for the upcoming fiscal year because of legal limitations between the state and union employees, Republicans conceded. ... Most state employees – including lawmakers and their families – pay no health care premium (Clayworth, 2/2).
The New York Times: As Fiscal Cloud Lifts, Mayor Offers A Budget Free Of Tax Increases Or Broad Layoffs
Mr. Bloomberg said costs that the city could not control, like those of pensions, health care, Medicaid and debt service, would increase by $2 billion, or 7.5 percent. But he said he would balance the budget in part by drawing on money from a health care reserve fund and money expected from the sale of new taxi medallions. City expenditures would shrink by $437 million (Chen, 2/2).
This Story: Email | Print | Link to | Top
Medicaid coverage is making news in Kansas, Connecticut and Colorado.
McClatchy/The Kansas City Star: Kansas' Largest Insurer Declines Participation In Brownback's Medicaid Reform
The state of Kansas' largest insurance company has decided it doesn't want to participate in Gov. Sam Brownback's plan to move Medicaid patients into privatized managed-care programs. In a letter addressed "Dear provider," Angie Strecker, director of institutional relations for Blue Cross Blue Shield of Kansas, said the insurer "has decided not to submit a proposal to the state to be a Medicaid contractor" (Lefler, 2/2).
The CT Mirror: Advocates Challenge DSS Denial Of 'Habilitation' Services For Children
When she was younger, Natalia Caraballo used some words and sign language to communicate. But around her 2nd birthday, Natalia, who has Down syndrome and autism, stopped speaking and started making less eye contact with those around her. Her parents hoped to continue the intensive therapy Natalia, now 4, had received through an early intervention program. But their insurance, HUSKY, the state's Medicaid program, denied coverage for the services, known as applied behavioral analysis, saying that the services were for "habilitation" purposes, not rehabilitation. … Child and patient advocates say it's a misinterpretation of federal law that could have damaging implications for poor children born with disabilities and prove costly to taxpayers (Levin Becker, 2/2).
Kansas Health Institute: Dental Association Says New Program Will Increase Access In Rural Areas
The Kansas Dental Association is launching a new effort to address a shortage of dentists in some rural parts of the state. Association officials hope to recruit three dentists by May to participate in a student-loan repayment program that would provide each of them $50,000 to practice in localities designated as "dental deserts" by the Kansas Department of Health and Environment's Bureau of Oral Health. Those selected would be required to remain in the program for three to four years and agree to devote at least 35 percent of their practices to serving low-income and Medicaid patients. Currently, only about 25 percent of Kansas dentists accept Medicaid patients (McLean, 2/2).
The Associated Press/Denver Post: Colorado May Revive Circumcision Funding
Circumcisions for Colorado boys could again be covered by Medicaid, a year after circumcisions were eliminated to save money. A Senate committee voted 6-3 Thursday to restore circumcisions as a covered medical procedure for Medicaid recipients. If approved, the change would cost Colorado some $230,000 a year (2/2).
Health Policy Solutions: Senate Committee Votes To Restore Medicaid Funds For Circumcision
Despite the spirited testimony of seven opponents to routine circumcision, the Senate Health and Human Services Committee Thursday voted 6 to 3 to restore Medicaid funding for the procedure. A change in the long bill, the budget document developed by the Joint Budget Committee, dropped funding for the procedure last year, making Colorado one of 18 states to defund circumcision under Medicaid (Carman, 2/2).
This Story: Email | Print | Link to | Top
A selection of state health policy news from around the U.S.
Health News Florida: Hospitals Dodge Budget Cuts
Spending cuts to health programs will be less than half as much as forecast in the Senate budget, that chamber’s health-spending chief announced today. Now, the Senate Subcommittee on Health and Human Services Appropriations will have to cut only $390 million from current spending levels, rather than the more-draconian $850 million that had originally been assigned, said Sen. Joe Negron, chair of the panel. … Negron said hospitals and nursing homes' Medicaid pay rates may be touched only lightly, if at all. Instead, Negron said, he intends to eliminate behavioral-health programs that are not performing up to expectations (Gentry, 2/2).
Arizona Republic: Southwest Valley Hospitals Expand To Keep Up With Patient Demand
An increasing number of patients are prompting health care leaders in the southwest Valley to expand and build medical clinics in underserved areas despite the economic doldrums. Goodyear's two hospitals plan to significantly increase their operations while eventually providing more jobs (Yantis, 2/2).
McClatchy/The State (Columbia, S.C.): S.C. Senate Panel OKs End Of Abortion Coverage For Rape, Incest Victims
The South Carolina state insurance plan — which covers state employees, and teachers and local government workers who opt to join — would not pay for abortions in cases of rape or incest if a state Senate panel has its way. The proposed change, if it becomes law, would mean the state would only pay for abortions if the life of the mother is in danger. It is a departure from the federal Hyde Amendment, which for 30 years has set the standard for limiting government funding of abortions to cases of rape, incest and to save the life of the mother (Beam, 2/2).
The Associated Press/Boston Globe: Vt. House Approves Redesign For Mental Health
The Vermont House approved a sweeping overhaul of the state's mental health system yesterday, a move set in motion when Tropical Storm Irene flooded the government complex in Waterbury that included the Vermont State Hospital. The measure was approved 124 to 3 after key sponsors said it would alleviate the crisis created when the Waterbury facility closed and other hospitals not equipped or staffed to do so were forced to try to care for the most acutely mentally ill Vermonters. Sponsors said the bill will help build a better system of care in the long run (Gram, 2/3).
CBS/Associated Press: Vt. Employers Offer Range Of Views On Health Care
Vermont employers offered a range of views Wednesday to lawmakers on the future of the state's health care reform, but most of those testifying at a public hearing appeared to favor a go-slow approach. The House Health Care and Senate Health and Welfare committees took testimony Wednesday evening at a public hearing attended by about 80 people. Vermont last year passed legislation outlining a plan to move the state first to the health care marketplace — or "exchange" — called for under the federal health reform last passed two years ago, and then beyond that to something approaching a single-payer, government-backed plan by 2017 (2/2).
Boston Globe: Dueling Letters On $275 Million Medicare Windfall For Mass. Hospitals
A group of state hospital associations from around the country last month asked the Obama administration to take a closer look at a provision of the Affordable Care Act that will land Massachusetts hospitals an extra $275 million or more in yearly Medicare reimbursements. The letter prompted Senator John Kerry and others in the Massachusetts congressional delegation to respond Tuesday, calling claims that the elected officials have manipulated the Medicare budget "completely false" (Conaboy, 2/2).
Boston Globe: Donor Registry Settles With AG
UMass Memorial Health Care, which hired models in short skirts to lure potential bone marrow donors and then charged insurers high fees to test samples, will pay $520,000 as part of an agreement with Attorney General Martha Coakley's office. The attorney general, who filed a complaint and final judgment in Suffolk Superior Court today, said in a written statement that the Caitlin Raymond International Registry and UMass Memorial Health Ventures, Inc. — subsidiaries of the hospital network — jointly engaged in improper marketing by paying fashion models to recruit potential donors at malls, festivals, and sports venues including Foxboro Stadium (Kowalczyk, 2/2).
WBUR: UMass Memorial Settles Over Donor Recruitment Practices
UMass Memorial Health Care, and a bone marrow registry it operates, are paying more than $500,000 to settle state investigations into some of the methods used to recruit bone marrow donors. UMass Memorial denies breaking any laws but says it takes responsibility for bad judgement used in efforts to add more potential donors to the registry. The attorney general's complaint says UMass Memorial used models and other "inducements" in donor recruitment drives, failed to disclose total costs associated with registering as a donor, and charged health insurers unreasonable rates during marrow testing (2/2).
The Associated Press: Mass.: Bone Marrow Donor Recruiting Cases Settled
A bone marrow registry and medical laboratory company that used fashion models wearing high heels and short skirts to recruit potential donors will pay the states of Massachusetts and New Hampshire $770,000 for engaging in an improper marketing practice, officials in both states said Thursday. The Caitlin Raymond International Registry and UMass Memorial Health Ventures Inc. paid models to help recruit potential registrants during donor drives at malls, festivals and sporting ventures, including Gillette Stadium and the Mall of New Hampshire (Lavoie, 2/2).
San Francisco Chronicle: Daly City Hospital Fined $100K For Patient Death
State regulators fined a Daly City hospital $100,000 after a patient in a vegetative state suffocated when a nurse failed to remove a cap on her breathing tube. Seton Medical Center must pay the maximum fine allowed by law for what the California Department of Public Health called inadequate medical care. The hospital said it would appeal the decision. The 81-year-old woman suffered a stroke in 2009 and depended on a breathing tube to stay alive, according to a state report (Kane, 2/3).
The Seattle Times: Consolidate Health Care System? Bill Splits School-Worker Unions
A bill working its way through the legislature has triggered something of a bizarro world in Olympia, with liberals lambasting a government takeover of health care and two of the state's most powerful unions fighting each other. The proposal seems mild enough, although complex: Senate Bill 6442 would repeal the current K-12 employee health-care system, in which each of the state's 295 school districts separately negotiate private insurance plans with individual unions. Instead, insurance for all would be controlled by a state board. Supporters say the consolidation would save money and enable the system to more fairly serve all by making it easier for school support personnel such as janitors, lunchroom workers and bus drivers to add dependents to their plans. But opponents contend costs would actually rise because the government would be less efficient than the private sector (Rosenthal, 2/2).
Kansas Health Institute: Selling Doctors On Rural Communities
Recruiting doctors to live and work in rural America is a chronic problem. Most health centers try to attract workers with big salaries, a home on a golf course or other cushy perks. Not so in Ashland, Kan., population 855, where the CEO of a tiny hospital is building a reverse recruitment model based on remote access and problems commonly found in third-world countries. Benjamin Anderson, Ashland Health Center's CEO, has created what he calls mission-focused medicine, offering up to eight weeks off for missionary work. He’s found that a doctor who is willing to sleep on a cot in the Amazon or treat earthquake victims in Haiti is ready to serve in rural Kansas (Lowe, 2/2).
Lund Report: Insurance Exchange's Request to Pursue Its Own Health Coverage Met With Skepticism
An unexpectedly heated debate transpired in the House Health Care Committee yesterday over whether the Oregon Health Insurance Exchange's 11 staff members should be able to seek their own health care coverage rather than be covered by the Public Employees' Benefit Board (PEBB), which provides benefits to state employees (Waldroupe, 2/2).
Lund Report: Medical Liability Reform Appears Likely to Come Before 2013 Legislative Session
Despite pressure by Republicans to include tort reform in legislation that will transform Oregon's health care system during the February legislative session under way, that issue will have to wait until 2013, predicted Sen. Alan Bates (D-Medford). ... Legislators are expected to approve an implementation plan this month that will lead to the creation of coordinated care organizations that will integrate physical, mental and dental care and lower costs by reducing hospital admissions and focusing on prevention (Lund-Muzikant, 2/2).
This Story: Email | Print | Link to | Top
Health Policy Research
Every week, KHN reporter Shefali S. Kulkarni compiles a selection of recently-released health policy studies and briefs.
Journal Of The American Medical Association: Association Of Emergency Department Length Of Stay With Safety-Net Status -- This study compares ER performance at safety-net hospitals (those with a disproportionate share of Medicaid and uninsured patients) to non-safety net hospitals to see if proposed pay-for-performance measures could have a negative impact. Researchers examined whether patients were admitted to the hospital within eight hours of showing up in the ER or if they were be discharged, transferred or moved to observation within four hours of coming to the ER. Using national hospital data, researchers found "compliance with proposed ER length-of-stay measures for admitted, discharged, transferred, and observed patients to not differ between safety-net and non-safety-net hospitals" (Fee et. al., 2/1).
Government Accountability Office: CMS Should Improve The Accuracy Of Risk Score Adjustments For Diagnostic Coding Practices – This GAO report – requested by four Democratic congressmen – examines how the Centers for Medicare and Medicaid Services "pays plans in Medicare Advantage (MA)—the private plan alternative to Medicare fee-for-service (FFS)—a predetermined amount per beneficiary adjusted for health status. To make this adjustment, CMS calculates a risk score, a relative measure of expected health care costs, for each beneficiary. ... Policymakers raised concerns that differences in diagnostic coding between MA plans and Medicare FFS could lead to inappropriately high MA risk scores and payments to MA plans." GAO found that "before CMS's adjustment, 2010 MA beneficiary risk scores were at least 4.8 percent and perhaps as much as 7.1 percent higher than they likely would have been if the same beneficiaries had been continuously enrolled in [fee-for-service plans]," and recommends that CMS use more updated beneficiary data when calculating their risk score adjustment (1/12).
Institute of Medicine: Living Well With Chronic Illness: A Call For Public Action -- This major report examines the overwhelming prevalence of chronic disease in the U.S. The authors recommend "that a variety of illnesses be selected for public health action based on a planning process that emphasizes the inclusion of chronic illnesses with cross-cutting clinical, functional and social implications that impact the individuals who live with them," and also write: "Given the economic burden of chronic diseases to the United States, the CDC should support expanded use of new and emerging economic methods, such as cost-effectiveness techniques, in making policy decisions that promote living well with chronic illness" (Bell et. al., 1/31).
Journal Of Health Services Research: The Effectiveness Of Implementing An Electronic Health Record On Diabetes Care Outcomes -- Researchers analyzed data on patients who were 40 years or older and had at least two diabetes-related visits within a year to a primary care physician. The patients who visited doctors who had adopted an electronic medical record system (which reminded them of recommended care procedures) had significantly more improvements in blood pressure readings, were less likely to smoke and more likely to take aspirin to prevent heart disease than patients of doctors without EHRs. However, the study did not show any improvements in those patients’ blood sugar or cholesterol levels. (Herrin et al., 1/17).
The Kaiser Family Foundation: A Guide To The Supreme Court’s Review Of The 2010 Health Care Reform Law -- This issue brief looks at the background and issues surrounding two major provisions of the federal health law that are at the heart of the case that the Supreme Court will hear in March: the individual mandate to purchase health insurance or pay a fine and the expansion of the Medicaid program to cover "all people under age 65 with household incomes at or below 133%" of the federal poverty level. The brief reviews the Anti-Injunction Act and the Commerce Clause as they might apply to the decisions of the court (Musumeci, 2/1).
Related resource page from KHN: The Supreme Court Decides: Health Law At The High Court
This Story: Email | Print | Link to | Top
Editorials and Opinions
The New York Times: A Painful Betrayal
With its roster of corporate sponsors and the pink ribbons that lend a halo to almost any kind of product you can think of, the Susan G. Komen for the Cure foundation has a longstanding reputation as a staunch protector of women's health. That reputation suffered a grievous, perhaps mortal, wound this week from the news that Komen, the world's largest breast cancer organization, decided to betray that mission (2/2).
Los Angeles Times: Komen's Untimely 'Cure'
The Komen decision will probably prompt more attacks on Planned Parenthood, which has long provided low-cost medical care to women in need. If Komen loses a significant portion of its donor base, funding for breast cancer research and treatment will be affected, and for a long time Komen's name will be connected more with ugly politics than with pink ribbons. In the end, it's women in need of medical care who stand to lose the most (2/3).
Philadelphia Daily News: Komen Foundation Acts Poorly In Defunding Planned Parenthood
Parent Parenthood has been under fierce attack by ultra-conservatives for years now, with outrageous allegations which have been proved false repeatedly but which have gained astonishing traction because the news media failed to do their job and many supposed defenders of women's rights were timid in the face of the onslaught. … Within hours of the decision -- made in December and revealed Wednesday -- Komen's rationale was exposed as bogus and its credibility seriously damaged (2/3).
Chicago Sun-Times: Komen Stumbles Into Middle Of Abortion Flap
The Susan G. Komen for the Cure foundation sure blundered into this one. … The decision to cut off funding for breast cancer screening for poor women at Planned Parenthood health centers has split loyal Komen supporters into two camps, splintering a powerful and effective organization that has done tremendous good for more than three decades. For the sake of women suffering from breast cancer, we urge Komen to do all it can to repair the damage, including reinstating these life-saving grant dollars (2/3).
Boston Globe: In Rejecting Planned Parenthood, Komen Should Explain Its Motives
When the Susan G. Komen foundation, the well-known breast cancer advocacy group, announced this week that it would stop funding breast cancer screenings at Planned Parenthood, the news quickly reverberated through abortion-rights and anti-abortion circles. The political motivations seemed clear: Komen has been under increasing pressure from anti-abortion groups to sever its relationship with Planned Parenthood, the nation’s largest provider of abortions. The foundation’s head of public policy ran for governor of Georgia in 2010 on an antiabortion platform (2/3).
The New York Times: Romney Isn't Concerned
Also, given this whopper about how safety-net programs actually work, how credible was Mr. Romney’s assertion … that if the safety net needs a repair, "I'll fix it"? Now, the truth is that the safety net does need repair. It provides a lot of help to the poor, but not enough. Medicaid, for example, provides essential health care to millions of unlucky citizens, children especially, but many people still fall through the cracks: among Americans with annual incomes under $25,000, more than a quarter — 28.7 percent — don't have any kind of health insurance. And, no, they can't make up for that lack of coverage by going to emergency rooms. … So we do need to strengthen our safety net. Mr. Romney, however, wants to make the safety net weaker instead (Paul Krugman, 2/2).
The Washington Post: Why The Poor Should Concern Romney
The problem with Mitt Romney’s latest boneheaded statement — "I'm not concerned about the very poor" — isn't the ammunition that it gives political opponents eager to yank the Republican candidate's words out of context. The deeper problem is that Romney's remarks betray a trio of fundamental misunderstandings: of the nature and scope of poverty in America; the state of the social safety net; and the impact of his own proposals on protections for the poorest Americans (Ruth Marcus, 2/2).
Chicago Tribune: A Matter Of Faith
There are sound financial and health reasons for insurers to provide contraceptive coverage, and many policies do. A woman is more likely to receive prenatal care and less likely to seek an abortion if she has planned her pregnancy. But the Roman Catholic Church is morally opposed to contraception, teaching that "each and every marital act must of necessity retain its intrinsic relationship to the procreation of human life" (2/3).
The Washington Examiner: President Obama Versus Religious Liberty
The Obama administration is at it again. They are now using Obamacare to impose a secular vision on Americans who believe that they should not have their religious freedom taken away. On January 20, 2012, the Obama administration affirmed a rule that would force Roman Catholic hospitals, charities, and universities to purchase health insurance for their employees that includes coverage for contraception, abortifacients, and sterilization, in violation of their religious principles. This is wrong (Mitt Romney, 2/3).
The Wall Street Journal: A Battle The President Can't Win
But the big political news of the week isn't Mr. Romney's gaffe, or even his victory in Florida. The big story took place in Washington. That's where a bomb went off that not many in the political class heard, or understood. But President Obama just may have lost the election. The president signed off on a Health and Human Services ruling that says under ObamaCare Catholic Institutions—including its charities, hospitals and schools—will be required by law, for the first time ever, to provide and pay for insurance coverage that includes contraceptives, abortion-inducing drugs and sterilization procedures. If they do not, they will face ruinous fines in the millions of dollars. Or they can always go out of business. In other words, the Catholic Church was told this week that its institutions can't be Catholic anymore (Peggy Noonan, 2/3).
The Washington Post: With Abortion Measure, Republican 'Mini-Mayors' Are At It Again
Congressional interference in District business is nothing new — witness the ban on the District using its own tax dollars to pay for abortions for low-income women and the periodic attempts to eliminate needle exchange programs or overturn local gun control. But this measure (to prohibit abortions after the 20th week after fertilization) is particularly offensive in that its backers defend it as a way to prevent the unborn from feeling terrible pain. "It would address the pain and suffering of children who have done nothing wrong," (Rep. Trent) Franks said this week (2/2).
USA Today: Editorial: Disability Claims Swelling In Recession
Certain things can cause someone to become disabled — a chronic illness, for example, or an accident. One thing that should not cause people to be categorized as disabled is a recession (2/2).
USA Today: Opposing View: Disability Benefits Remain A Vital Lifeline
Social Security Disability Insurance remains a vital lifeline for citizens who once held full-time jobs but have become too ill or injured to work. It is a time-honored expression of our nation's commitment to help care for those who must stop working due to illness or injury (Charles Martin, 2/2).
Medscape: Tired Of Being A Doctor? Choices For Opting Out Of Medicine
While the road into medicine is clearly marked, the trail leading out is tougher to discern. There are plenty of opportunities, experts say, but identifying them -- and selecting the right path -- may challenge career-changing doctors to develop some new skills. In 2010, 24% of the 2400 physicians responding to a Physician's Foundation survey said they plan to drop out of clinical practice in the next 1 to 3 years by switching jobs. Of those, half said they plan to find a nonclinical job within healthcare, while the other half plan to leave healthcare entirely (Shelly Reese, 2/2).
Denver Post: No Longer A Hidden Health Crisis
In 2003, a report was published that outlined Colorado's fragmented and underfunded systems for delivering mental health care. At the time, many were shocked to learn that one in five Coloradans needed mental health treatment, but only one-third of them received it. Flash forward nine years, and improvements have been made — including incremental increases in funding, collaboration and the availability of integrated behavioral health services in primary care settings . But there is still a lot of work to do (Don Mares and Carl Clark, 2/3).
Boston Globe: Cities Shouldn't Set Own Rates
The stubborn dispute between insurers and the state's private ambulance companies has gone on for far too long. It needs to be solved, but a solution will require credible information about the real cost of the emergency service those companies provide. Last fall, in an attempt to bridge the divide over how much insurers should pay out-of-network ambulance companies for emergency trips, Governor Patrick proposed that the health plans pay either the rate they would give in-network companies or 300 percent of the Medicare rate, whichever is less (2/3).
This Story: Email | Print | Link to | Top
Health Policy Haiku
Here is today's health policy haiku:
SEEING A SHADOW
Moth entranced with flame
Groundhog Day get it right now
Reactivate CLASS*
-Dr. Joanne Lynn
*The Daily Report detailed the news coverage of this week's House vote to repeal the CLASS Act.
If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.
This Story: Email | Print | Link to | Top