Daily Health Policy Report

Monday, June 1, 2009

Last updated: Mon, Jun 1

Capitol Hill Watch

Health Reform

Administration News

Coverage & Access

Health Care Marketplace


State Watch

Editorials and Opinions

Capitol Hill Watch

Congress Returns From Memorial Day Recess, Focuses On Reform

Congress is returning from its Memorial Day recess Monday with plans to begin examining proposals in earnest for what health care reform in America will look like, The Associated Press reports.

"First up as Congress returns from a weeklong recess: Sen. Edward M. Kennedy, (D-Mass.,) partially sidelined by cancer, is convening his health committee's Democrats on Tuesday to begin weighing his proposals to extend health care to all. Later in the week, the tax-writing Senate Finance Committee meets behind closed doors to work on legislation to achieve the same goal." A spokeswoman for House Majority Leader Steny Hoyer, D-Md., said that during the recess House Democrats held 120 health care events.

Also today, health industry leaders are slated to deliver specific plans to the White House on cost-saving measures to save $2 trillion in costs over 10 years, a pledge they made to President Obama. "The groups of health insurers, doctors, hospitals and others are expected to produce a slate of cost-saving proposals, such as reducing hospital readmission rates, improving coordination of care, focusing on prevention and cutting administrative expenses" (Werner, 6/1). 

As Congress sets to work, Politico reports that "If there was such a thing as a sure bet in the bill, this would be it: the creation of an insurance marketplace, or “exchange,” where individuals and small employers could compare plans side by side, find options with a minimum benefits package and buy coverage. Insurers would be required to take all comers, regardless of pre-existing conditions. Proponents say it would give individuals a place to find affordable insurance that could go with them from job to job." Other options still include instituting taxes on employer-provided health benefits, though unions are opposed to the idea, and it could face other roadblocks as Obama promised not to raise taxes on those earning less than $200,000 annually (Brown, 6/1).

Senate Finance Committee Chairman Sen. Max Baucus, D-Mont., told USA Today that the legislation is coming together. But reform will have to clear several hurdles to happen, including avoiding detours like North Korea's nuclear ambitions, defining roles by lawmakers, the price tag, keeping passage of the bill through budget reconciliation on the table and testing the reform coalition to keep supporting the proposal through hard times (Page, 6/1).

Senate Democrats are pledging not to let President Obama's push for a quick confirmation of his Supreme Court nominee, Sonia Sotomayor, steer health reform off-course, Roll Call reports.

"Democrats noted that the Senators leading the charge to reform health care are not integral to shepherding Sotomayor through the confirmation process — neither Baucus nor Kennedy sit on the Judiciary Committee. Democrats also believe the Republicans will want to avoid the political risk of unnecessarily delaying the confirmation of the Supreme Court’s first Hispanic justice."

"Additionally, several moderate Democratic Senators from conservative-leaning states are skittish, putting them in direct conflict with their liberal counterparts, among them the influential Democratic Conference Vice Chairman Charles Schumer (N.Y.). Schumer is actively pushing a public plan option intended to bridge the partisan divide, but he has yet to find any GOP takers" (Drucker, 6/1).

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Democratic Senators Deny Rift On Plans

"Democratic plans for revamping U.S. healthcare are taking shape, with Sen. Edward Kennedy, D-Mass., soon to announce a proposal which could form the core of the nation's new health system,"  Reuters/The Boston Globe reports. Kennedy, who chairs the Senate Health, Education, Labor and Pensions Committee, is expected to unveil a plan that will "include both a new government program to provide medical coverage for all as well as a mandate that every American acquire some form of health insurance." Sen. Max Baucus, D-Mont., who chairs the Senate Finance Committee, is developing "his own draft bill, which he hopes can win support from Democrats as well as Republicans leery of too great a government role in the new healthcare system."

“How the two draft bills balance out remains to be seen. The two chairmen have told Obama they plan to develop complementary bills. The Finance Committee has sole jurisdiction over financing the overhaul and shares jurisdiction with Kennedy's committee" on other reform issues (Smith, 5/31).

The senators issued a joint press release saying they will work together, but failed to acknowledge the point of contention between them, inclusion of a public health insurance plan that would compete with private insurers. Kennedy favors such a plan, while Baucus — pushing for what he calls a more bipartisan bill — favors a plan that would create such a system only if private insurers fail at bringing down costs, The New York Times reports.

“‘For both of us,’ the statement said, ‘reforming the nation’s health care system to cut cost, improve quality and provide affordable coverage remains the top priority on our two committees. We have worked together closely over many months and will continue to do so. We intend to ensure that our committees report similar and complementary legislation that can be quickly merged into one bill for consideration on the Senate floor before the August recess'" (Pear, 5/31).

The Times reports in a separate story that “Senator Charles E. Schumer of New York, the third-ranking member of the Senate Democratic leadership, said Friday, ‘It’s pretty certain that Senator Kennedy could not support the Baucus plan, and Senator Baucus could not support the Kennedy plan.’ But Mr. Schumer said “it’s possible” that both could support a version he is developing. Under Mr. Schumer’s proposal, any new public plan would have to comply with all the rules and standards that apply to private insurance. A public plan would also have to be self-sustaining, would have to rely on premiums and would not have a pipeline into the federal Treasury" (Pear, 5/31). 

According to Politico, both Baucus and Kennedy have planned to easily meld their bills together before introducing it on the Senate floor, despite differences between them (Brown, 5/30).

Kennedy’s plan would also expand a “health insurance program for children to cover those up to the age 26. It would also require individuals to get health insurance and set a federal standard for Medicaid, the federal program for the poor, to cover people earning up to 150 percent of the poverty level. Kennedy would pay providers participating in the public plan 10 percent more than Medicare reimbursement rates. Families earning up to 500 percent of the poverty level would be eligible for a sliding scale of subsidies to help them buy insurance," Bloomberg reports (Gaouette, 5/30).

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Lawmakers Examining Nonprofit Hospitals' Tax Breaks

Nonprofit hospitals will lobby Congress to keep hands off their charitable status – which grants large tax exemptions, costing the government revenue – as lawmakers plan a health care overhaul, the New York Times reports. The leading senators of the Senate Finance Committee, Max Baucus, D-Mont., and Charles Grassley, R-Iowa, are considering a requirement that hospitals must provide a set amount of free care to benefit from the tax perks.

“A formulaic, one-size-fits-all charity care standard will hamstring hospitals’ efforts to respond to the unique needs of their communities,” according to an American Hospital Association bulletin described in the Times (Pear, 6/1).

An in-depth review by the Boston Globe found that the value of tax breaks to Massachusetts General Hospital and other private nonprofit hospitals "far exceeds the amount the state's leading hospitals spend on free care for the poor and other community benefits," and adds: "What's more, hospital spending on free care is declining because of the state's 2006 healthcare reforms."

Medicine has become big business since hospitals like Mass. General were founded to care for the poor in the 19th century, increasing the value of exemptions. More recently, public programs like the Children's Health Insurance Program and Medicaid have vastly expanded coverage. The ten biggest hospitals in the state benefited from $638 million in tax breaks and state discounts in 2007, but reported only $374 million in "community benefits" provided that year, the Globe found.

"[A]s nonprofit hospitals have been increasingly run like businesses, the successful ones have adopted practices similar to those of for-profit companies, aggressively expanding into the markets of other hospitals and using their clout to charge higher prices for their services," the Globe reports. And, against the backdrop Washington's reform debate, Grassley "believes federal regulations may be needed to ensure that nonprofit hospitals are required to do more charity work than their profit-making peers," the Globe says. In the meantime, Massachusetts officials are eyeing the millions of dollars in lost tax revenue (Allen and Bombardieri, 5/31).

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Health Reform

Prospects For Health Care Reform

In a story that analyzes prospects for major health care reform this year, Kaiser Health News points to cost as the biggest challenge to reform and noting that, "the Democratic proposals could cost $1 trillion to $1.5 trillion over 10 years, and lawmakers are a long way from coming up with the money." The piece, which is posted on the McClatchy Washington Bureau's Web site, raises the question of how forcefully Obama will push for such costly reform and then outlines three major scenarios: "Democrats win big," "crash and burn" and "half-a-loaf or less."

In the first scenario, the House and Senate pass health care legislation before the August break, Congress passes comprehensive health care legislation in late fall and Obama holds a signing ceremony shortly before Christmas. To do so, Democrats would need to remain unified while also picking up some Republican votes and tackling the contentious issue of taxes, dipping into "employer-provided health care benefits, which totaled $226 billion in 2008." Kaiser Health News reports that the result would most likely include "an insurance exchange," a kind of marketplace where individuals and businesses could buy coverage from private carriers or perhaps a new government-run plan. In addition, there would be requirements that all Americans have insurance, and that insurers sell coverage even to people with health problems. Employers would have to cover their workers or chip in something to help pay for the uninsured. Medicaid, the state-federal health program for the poor, would be expanded."

A second scenario could occur if politics and taxes prove insurmountable challenges. In that case, some moderate Democrats, Republican critics and industry officials could insist that universal coverage is unfeasible and that the plan is too expensive, depends too heavily on taxing the middle class and does too little to control spiraling costs. This may also occur if the industry and non-health care interests turn "against the overhaul effort, joining with Republican opponents and pumping cash into negative ads."

Kaiser Health News reports that a more mixed third scenario could also emerge "if determined to send Obama something, Democrats would patch together a scaled-back bill." It notes that, “Such legislation could still involve significant changes, but perhaps extended over a longer period of time, say 15 years, to stretch out the costs" (Appleby and Carey, 6/1).

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This Time Around, Debate Much Different

Insurance companies, "the industry that gets credit for helping to kill the Clinton administration’s health care overhaul 15 years ago," are now "striking a conciliatory tone as it faces the most serious attempt to overhaul the system since that effort collapsed," CQ Politics reports. With low favorability ratings and Democrats in control of the federal government, "insurers know they aren't in a good bargaining position" this time around. They have already offered concessions, including providing "insurance in the individual markets to everyone, without regard to who is sick," and not "charging people who are ill higher rates and cut health care costs." But they've also been ''careful to structure their offers in such a way that appears significant but does not overpromise." An individual mandate for all Americans and an end to health screening for applicants could offer "a win-win outcome, one that will benefit not just patients but potentially the profits of the industry as well." But "perhaps the biggest motivation for insurers to deal now is that they fear what might happen if they don’t" – the "creation of a government-run plan that would be more attractive to the public and siphon off customers" (Adams, 6/1).

In a separate article, CQ Politics reports that the "widely accepted narrative" of a "unified industry unilaterally" killing the Clinton initiative with opposition and the infamous Harry and Louise ads, and then reversing itself "years later to emerge as a savior," leaves out "some of the twists in the debate." Industry groups "came out swinging" against the Clinton plan, but "insurers were never unified in their efforts." In addition to their effective efforts, "divisions among Democrats" were also "a key reason the overhaul failed." Chip Kahn, a "top lobbyist at HIAA during the Clinton administration," told CQ that in 1993-1994, the group would have been "willing to accept" some of the same ideas now being considered, had they "been coupled with an employer mandate" (Adams, 6/1). 

Determined not to be overshadowed this time, public plan proponents are initiating their own $82 million dollar lobbying effort, "billing it as their largest health reform campaign ever," Politico reports. The campaign, backed by "11 progressive groups," is "designed to put public plan opponents on notice that supporters are ready for a fight." It includes funding for "organizing grass-roots supporters and paid advertising, phone banks and direct mail." The coalition also "plans to bring at least 5,000 people to Washington on June 25 to make more than 300 lobbying visits." The coalition includes: Health Care for America Now, the Children’s Defense Fund, MoveOn.org, Americans United for Change, USAction, Campaign for Community Change, Rock the Vote, Campaign for America’s Future, the AFL-CIO, the American Federation of State, County and Municipal Employees, and the Service Employees International Union, according to Politico (Frates, 6/1).

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Administration News

Nancy-Ann DeParle: Congress "Very Much On Track"

Nancy-Ann DeParle, director of the White House Office of Health Reform, predicted in an interview with Kaiser Health News that a comprehensive health care reform bill would reach President Obama by Thanksgiving, and that she hasn’t given “a moment’s thought” to accepting a scaled-back package.

She said the congressional committees with jurisdiction over health care are “all very much on a track to do exactly what the president has asked them to do and to mark up bills that are very similar to the plan he articulated during the campaign.” Asked whether the president would sign a bill that relied mainly on new taxes to pay for an overhaul, she replied, “No.” She added, “I believe the bill will be fully financed, evenly divided between savings in Medicare and Medicaid and some other sources of revenue, such as the ones he’s identified” (Appleby, 6/1).

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Coverage & Access

GM Files For Bankruptcy, Union Health Plan Changes

The United Auto Workers' benefits plan is expected to receive a nearly 20 percent ownership stake in General Motors as a result of the automaker's bankruptcy filing today and proposed restructuring, the Washington Post reports (Whoriskey, 6/1).

The bankruptcy will cause drastic changes in UAW retirees health benefits, Time reports. The GM stock awarded to the VEBA, or Voluntary Employees Benefit Association, is near worthless, and the those who depend on the benefits are uneasy, UAW President Ron Gettelfinger told Time. GM's VEBA has $9.4 billion in assets, only enough for three years of the 377,000 retirees' benefits. "In less than four years, blue-collar retirees have gone from modest co-pay and deductibles to footing 25 percent of the their bill for health. The new UAW contracts also include reductions in benefits: dental and vision coverage will be dropped, effective July 1" (Szczesny, 5/31).

Agreements between GM, the White House and the union have resulted in restructured payment schedule for the benefit plans, Business Week reports. "The union agreed to take 17.5% equity in the new GM, stock warrants for an additional 2.5 % of the company, plus $2.5 billion in cash and $6.5 billion in preferred stock that pays a $585 million annual dividend—all in place of the $20 billion GM had pledged to the UAW to start a Voluntary Employee Benefits Assn., or VEBA" (Welch, 5/31).

Also, bondholders agreed Saturday to take up to a 25 percent stake in GM, clearing the last hurdle to GM's bankruptcy, the Washington Post reported over the weekend.

But as they do so, some bondholders are upset that they've been given less guarantee on their investment than the UAW's VEBA: "The 'Main Street Bondholders,' representing some of those individuals, said the deal unfairly gave the United Auto Workers' retiree health-care trust fund 66 cents on the dollar, while offering bondholders 13 cents on the dollar, assuming the new GM is worth $25 billion. This group of bondholders vowed to fight back using a section of the bankruptcy code, which could give them their own standing" (Marr, 5/31).

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N.J.Hospital Dispute Shows Challenges To Controlling Health Costs

A battle over whether to build a new hospital in northeastern New Jersey illustrates the formidable obstacles confronting President Obama and Congress as they try to mine savings from the $2.5 trillion health care system, Kaiser Health News reported in a story that appeared on washingtonpost.com. Some experts say New Jersey already has plenty of hospitals and a new one will only add to the state’s status as one of the nation's highest health care spenders. But the need to control spending may be trumped by public enthusiasm for a new facility and the competitive drive of its prospective owner (Rau,6/1).

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Health Care Marketplace

With Health Reform Uncertain, Maryland Hospitals Consolidate

"Facing difficult economic times and the uncertainties of national health care reform, some Maryland hospitals are choosing to be swallowed up by larger medical systems, with an unusual string of mergers over the past 16 months and more likely on the way," The Baltimore Sun reports. The consolidations could offer benefits to all those involved. Small hospitals gain "the hope of safe harbor from whatever financial storms are on the horizon, hospital chains "get footholds in new areas, where they can build market share and increase the number of patients they serve," and patients may "gain access to large networks of top-notch doctors, even if the patients live many miles from a major medical institution."

The Sun notes that "In Maryland, where nearly all hospitals are not-for-profit, mergers require no money to change hands. The parent company simply takes over the debts - and assets - of its new affiliate." Smaller hospitals often benefit from extra money for "building and expansion projects" and the "cost savings that come when doing business as a bigger organization." But "not everyone is convinced that mergers are good news for patients." The concern is that the mergers, for example, could "upend" patients' "relationships with their longtime physicians, particularly if the new owner eliminates services at their local hospital." In addition, "local jobs can be lost when redundant services are eliminated in order to save money after institutions merge."

A 2007 survey by the American Hospital Association found that "56 percent of the nearly 5,000 hospitals in the United States were part of systems, large or small" (Desmon, 5/31).

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CMS Rates Nursing Homes

The Wall Street Journal reports that "the federal government is stepping up efforts to improve the quality of nursing-home care and now has an online tool consumers can use in evaluating facilities. The Centers for Medicare and Medicaid Services, or CMS, will begin a pilot program this summer to see if cash incentives to nursing homes can improve the care they provide, especially in areas such as nurse staffing and preventable hospitalizations."

In a separate effort, CMS started the Nursing Home Compare system in December to rank 16,000 nursing facilities based on government inspection results, staffing data and quality measures. The Wall Street Journal reports that "about three million Americans need nursing-home care at some point each year, and the care is often costly. Unlike with most other health-care needs, many elderly and disabled Americans have to pay for nursing homes themselves, either because they earn too much to qualify for Medicaid or they don't qualify for Medicare's coverage." The Journal pointed out that "many seniors are surprised by Medicare's limited coverage for nursing-home care: up to 100 days after a hospitalization of three days or more," noting that "the beneficiary pays nothing during the first 20 days at a nursing home, $133.50 a day after that and the full cost after 100 days." Consumer groups warn people to research facilities because care can vary widely (Zhang, 6/1).

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State Watch

An Examination Of California's Proposed Budget Cuts

The New York Times reports on a series of deep budget cuts to help California, which is some $24 billion in the red, deal with its’ ongoing financial woes.

"In a special election on May 19, voters rejected a batch of measures on increasing taxes, borrowing funds and reapportioning state money that were designed to close a multibillion-dollar budget gap." In response, Gov. Arnold Schwarzenegger has proposed measures to make up the difference. The New York Times reports that, if enacted by the Legislature, such measures "would turn California into a place that in some ways would be unrecognizable in modern America: poor children would have no health insurance, prisoners would be released by the thousands and state parks would be closed. Nearly all of the billions of dollars in cuts the administration has proposed would affect programs for poor Californians, although prisons and schools would take hits, as well."

Schwarzenegger "is threatening to eliminate the Healthy Family Program, the state’s health insurance program that covers over 900,000 children and is financed with state and federal money, as well as the state’s main welfare program, known as Cal-Works, which provides temporary financial assistance to poor families and a caregiver for the severely disabled." The New York Times reports: "Some of the proposed cuts are clearly saber rattling on the governor’s part, but there is a nervous acceptance among lawmakers, advocates for the poor and outside budget experts that the state is out of money and time."

"If lawmakers sign off on closing the health insurance program for children whose families make too much to qualify for Medicaid, California would be the first state in the nation to close the popular program," The New York Times reports about the program known as CHIP . "With the cuts to Medicaid, the state would probably increase its number of uninsured people by nearly 2 million, the California Budget Project says." The New York Times also notes: "The Democratic-controlled Legislature has been uncharacteristically silent on most of the cuts, most likely because lawmakers know that tax increases are not politically palatable, that huge cuts in some form are in the offing no matter what, and that any program they wish to spare will quite likely have advocates among their ranks" (Steinhauer, 5/30).

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N.J. To Consider Enhancing Protections For Medicaid Residents In Assisted Living

The Associated Press/Philadelphia Inquirer reports that "lawmakers this week will consider measures to enhance protections for assisted living residents in New Jersey to ensure they aren't discharged simply because they pay with Medicaid." The legislation comes in response to an investigation that found a Wisconsin-based assisted living firm called Assisted Living Concepts, which has eight facilities in New Jersey and more than 200 nationwide, "wrongly showed New Jersey residents the door once they exhausted their savings and were about to go on Medicaid, despite promises to allow them to stay."

Four Democratic Assembly members sponsored a package of bills to increase protections for seniors in such facilities that will be heard on Thursday. The measures "would urge the state health and senior services commissioner to make Medicaid-eligible residents more financially and administratively attractive to assisted living facilities; make information about assisted living facility services and options more accessible to consumers; and request the health commissioner and consumer affairs division director recommend how to use the state's consumer fraud law to more effectively protect assisted living residents." The AP/Philadelphia Inquirer also noted that "last week, Gov. Jon S. Corzine signed a bill requiring nursing homes and assisted living residences to provide an informational sheet concerning Medicaid eligibility to certain residents" (DeFalco, 5/31).

The Milwaukee Journal Sentinel reported last week that "When Assisted Living Concepts told a resident last year that she would be discharged Jan. 28, the (New Jersey) Department of Health and Senior Services fined the company $1,000 a day, beginning Nov. 10, for violating the terms of a commitment made in 1996. The company subsequently let the resident remain at the center." The Journal Sentinel also said "Laurie Bebo, chief executive of Assisted Living Concepts, did not return calls seeking comment. But in a teleconference with investors this month, she said, 'Obviously, we were pretty disappointed with the public advocate's report, but not surprised that it was completely unbalanced'" (Boulton, 5/28). 

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Connecticut Senate Passes Health Care Pooling, Universal Coverage Bills

Connecticut senators on Saturday passed two health care bills that would both allow municipalities and small businesses to join the state employee health care pool, The Hartford Courant reports.

Gov. M. Jodi Rell, R-Conn., vetoed a similar bill to allow the pooling last year, and Connecticut’s budget director has spoken out against it this year.

The Courant went on to say: "Immediately after the pooling bill passed, the Senate began debating the controversial SustiNet universal health care bill ... Sen. Jonathan Harris, a West Hartford Democrat who summarized the bill on the Senate floor, said the current healthcare system needs to be improved because it is highly expensive. Every year, the current public and private health care systems spend $22 billion to cover the healthcare in Connecticut. The SustiNet plan, he said, will save $1.8 billion." Harris added that the details on the plan will be decided by future General Assemblies. The bill creates task forces on tobacco, obesity and the workforce to make recommendations by 2011 on how health care in those areas should change to save costs.

"The bill calls for an expansion and improvement of electronic medical records 'so we bring that country doctor with the bag from the 19th century into the 20th century,' Harris said. 'SustiNet brings this to the table.'" Republicans say the SustiNet bill will in the end be too costly — up to $1 billion in 2012 alone — and is a step toward European-style social medicine. 

Sen. L. Scott Frantz, R-Conn., offered ideas on how to save money in health care without SustiNet: "If all tobacco use was eliminated, the system could save 40 percent to 60 percent of the entire healthcare bill," Frantz said. "If obesity was eliminated, the system would save another 15 percent to 25 percent" (Keating, 5/31).

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Editorials and Opinions

Post Columns Debate Medical Practice: Data vs. Personality

Dueling Washington Post columns Sunday took opposing views – both critical - of the prevailing style of practice among today's physicians. Harlan Krumholz, a cardiologist and Yale professor, favors data-driven medical decision making, especially by patients. He hopes for a Consumer Reports-type source of detailed information for patients deciding which doctor to hire. Nephrologist Ronald J. Glasser laments the depersonalization of medical practice in an increasingly profit-driven industry.

Glasser points out that 93 percent of medical students graduating this year will end up working at "large clinics, managed-care companies or hospital systems." That trend in medicine has led doctors to abandon "the patient to the work rules of health plans and the professional demands of managed care" and replaced patient-physician relationships with "cookie-cutter best-practice guidelines and rules on prescribing drugs, acceptable lengths of hospital stays and the number of clinic patients a doctor must see per hour" (Glasser, 5/31).

By contrast, Krumholz argues, "For most patients, the decision of where to seek care comes down to a recommendation based on hearsay," rather than reliable information. "The paucity of information about medical performance not only makes it hard for patients to choose care. It also impairs our ability to improve care. If we in the medical profession could measure results, we could weed out bad practices and nurture the good ones" (Krumholz 5/31).

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A Selection Of Viewpoints And Perspectives

A Red State Booster Shot – The Washington Post
Those in the red states still smarting over Barack Obama's election victory can perhaps take solace in this: The Democrats' No. 1 domestic policy initiative, universal health care, is likely to help red America at the expense of blue (Alec MacGillis, 5/31).

Better Health Care: Balancing Better Options - Politico
I have developed a proposal that helps to unlock access to affordable health coverage by requiring insurance companies in every state to offer a low-cost health insurance policy to every person, regardless of his or her health or what job he or she has (Sen. Judd Gregg, 6/1).

The Wisdom Of Mandates – The Boston Globe
For all the fiscal problems the Commonwealth now faces, its three-year-old universal health insurance reform cannot be blamed for driving up state government costs uncontrollably (Editorial, 5/31).

Health Reform's Savings Myth – The Washington Post
The idea is that Congress can add a massive health-care program this year -- covering the uninsured -- and use the same measures that pay for the health reform to fix the broader budget problems. If that sounds too good to be true, there's a reason (Maya MacGuineas, 5/31).

Obama Targets Wrong Tax For Health Reform – The Detroit News
Obama should instead admit that John McCain was right -- we need to fix the inefficient tax treatment of employer-sponsored health insurance (Joseph Antos, 5/30).

Health Reform Would Be Expensive. So Would No Health Reform. – St. Louis Post-Dispatch
A lot of the debate about reforming health care revolves around a false choice — the simplistic idea that transforming the health system would be far more expensive than sticking with the current system. A growing body of scholarly evidence points to the fallacy of that argument (Editorial, 5/31).

A Rogue Industry – The New York Times
It is time to grant the F.D.A. the power to regulate the content and marketing of tobacco products (Editorial, 5/30).



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Stephanie Stapleton

Andrew Villegas

Lisa Gillespie
Shefali Luthra

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.