Daily Health Policy Report

Wednesday, December 12, 2012

Last updated: Wed, Dec 12

KHN Original Reporting & Guest Opinion

Fiscal Cliff

Health Reform

Health Care Marketplace

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Q & A: Options For Patients Who Get Out-Of-Network Care (Video)

Kaiser Health News consumer columnist Michelle Andrews answers a reader question about handling an out-of-network bill from a provider the patient didn't choose (12/11). Watch the video.

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As Population Diversifies, Rethinking How We Care For Elderly

Reporting for Kaiser Health News, Liz Seegert writes: "The elderly population of the future may not look much like the old people of today. It will be less white and with fewer native English speakers. That means physicians, nurses, social workers and health aides will have to adapt to our increasingly diverse society, according to Peggye Dilworth-Anderson, professor, health policy & management, and interim co-director of the Institute on Aging at the University of North Carolina. She says that not understanding the 'cultural context' of each patient can lead to inappropriate diagnoses and treatment and contribute to health disparities" (Seegert, 12/11). Read the story.

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Capsules: Health Cost Bite To Family Budgets Sinks Deeper

Now on Kaiser Health News' blog, Jay Hancock reports: "Medical costs aren’t just breaking government budgets. The price of commercial health insurance has risen five times faster than family incomes since 2003 even as the financial security it offers has shrunk, says a new Commonwealth Fund report that underscores how medicine is consuming bigger and bigger parts of the private economy" (Hancock, 12/12). Check out what else is on the blog.

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Political Cartoon: 'Ho Ho Ho!'

Kaiser Health News provides a fresh take on health policy developments with "Ho Ho Ho!" by Gary Varvel.

Meanwhile, here is today's health policy haiku:


Adult vision care 
covered by state exchanges?
Keep an 'eye' on it.


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.

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Fiscal Cliff

Fiscal Talks Continue With New Round Of Proposals, Finger-Pointing

With the deadline looming, President Barack Obama and House Speaker John Boener, R-Ohio, traded new fiscal offers but appeared no closer to a deal. Boehner is pushing for more specifics on how Obama would cut safety net programs, while the White House continues to press for tax increases for the wealthy.

Los Angeles Times: Fiscal Talks Hobbled By New Finger-Pointing
Optimism surrounding secretive high-level budget talks faded quickly Tuesday amid a fresh round of partisan finger-pointing, reducing the chances of a resolution to the fiscal standoff by Christmas. House Speaker John A. Boehner (R-Ohio) spoke to President Obama by phone late in the evening after presenting a GOP counteroffer. Republicans, meanwhile, showed further signs of political division. Top members of the party … said the GOP should accept the president's offer to raise tax rates on the top 2% of Americans in exchange for spending cuts. … But Republican negotiators continued to hold out for deeper reductions to Medicare, Medicaid, Social Security and other safety net programs than the president has been willing to accept, contributing to the stalemate that could result in a tax increase for most Americans (Mascaro and Mason, 12/11).

The Washington Post: Obama, Boehner Trade 'Fiscal Cliff' Proposals But Appear No Closer To A Deal
Even as Boehner spokesman Michael Steel announced that a new offer had been delivered to the White House, he complained that Republicans are "still waiting" for Obama to propose serious cuts to popular health and retirement programs that are forecast to swell the national debt in coming decades (Montgomery and Kane, 12/11).

Los Angeles Times: Boehner Pushes Obama For Cuts Related To 'Fiscal Cliff'
Boehner said he remained optimistic after his private meeting over the weekend with Obama at the White House, but took the unusual move of delivering floor comments after both sides had remained mum after their secretive session. "Where are the president's spending cuts?" Boehner said as the chamber opened Tuesday. "When is the president going to get serious?" Boehner has said his party would be willing to consider new tax revenue through an overhaul of the tax code, but in exchange Republicans want steep cuts to Medicare, Medicaid and the Social Security safety net (Mascaro, 12/11).

Politico: John Boehner: Where Are Obama's Cuts?
Speaker John Boehner tried again to shift the fiscal cliff debate from tax rates to spending cuts, saying Tuesday that the White House has yet to "identify what spending cuts the president is willing to make as part of the 'balanced approach' he promised the American people" (Sherman and Kim, 12/12).

The Associated Press/Washington Post: Fiscal Cliff Talks Intensify, But With Little Apparent Progress As End-Of-Year Deadline Looms
Leading lawmakers expressed pessimism that a deal was close, despite increasing angst about a Dec. 31 deadline to stop the expiration of Bush-era tax cuts and separate across-the-board spending cuts that are the result of Washington's failure to complete a deficit-reduction deal last year. … The Boehner camp again said it's up to the White House to proffer additional spending cuts to programs like Medicare. The White House countered that Republicans still need to cave on raising tax rates for the rich (12/12).

USA Today: Obama, Boehner Trade New Fiscal Cliff Offers
In an interview with ABC News, Obama said he believes Republicans will give on their opposition to raising tax rates. "I'm pretty confident that Republicans would not hold middle-class taxes hostage to trying to protect tax cuts for high-income individuals," he said. All of the George W. Bush era tax cuts expire Dec. 31. Democrats want to extend the current rates for all but the top 2%. Meanwhile, Boehner called out the president from the House floor for stalling negotiations because Obama has not proposed enough spending cuts to appease Republicans (Page, 12/12).

Politico: Fiscal Cliff: GOP Makes Another Counteroffer
Obama sent House Republicans a counteroffer to their original proposal Monday that called for $1.4 trillion in new revenue but little movement on entitlement cuts, sources said. Obama’s original revenue proposal was $1.6 trillion. The new GOP offer doesn’t represent major movement — Republicans are still offering $800 billion in revenue, which is $600 billion from the White House’s position. But it’s not clear what else was new in the Boehner offer to the White House (Sherman and Bresnahan, 12/11).

The New York Times: As Fiscal Talks Heat Up, Questions On Whether Boehner Can Get The Votes
On Monday, the president presented a new offer and on Tuesday, Mr. Boehner answered back as he and the president conferred by telephone. That talk came two days after a one-on-one meeting in the Oval Office without staff members present — their first solo meeting since those failed talks toward a "grand bargain" in July 2011. While neither provided details, one person familiar with the White House proposal said Mr. Obama had reduced his call for $1.6 trillion in additional revenues from the wealthy over the first 10 years to $1.4 trillion, still $600 billion higher than the Republicans' position. And another said the president also proposed that the two sides commit to working on overhauling the corporate tax code next year (Calmes and Weisman, 12/11).

In related news -

The Hill: Pelosi: Keep Medicare Age Where It Is
House Minority Leader Nancy Pelosi (D-Calif.) slammed the idea of raising Medicare's eligibility age as part of a year-end deal to reduce the deficit. In an op-ed published Tuesday, the California Democrat criticized the proposal as ineffective and unfair to seniors. "Raising the Medicare age asks the most vulnerable citizens to pay more with little to show for it in terms of long-term deficit reduction or more affordable care, for seniors or anyone else," Pelosi wrote in USA Today...Pelosi's line in the sand is sure to please the Democratic base and AARP, both of which oppose raising the Medicare age. But it could put her at odds with President Obama, who was reportedly open to the idea last summer (Viebeck, 12/11).

CNN (Video): Seniors Warn Congress: Hands Off
Lisa Sylvester reports on intense lobbying by seniors against fiscal cliff tampering with Social Security, Medicare (12/11).

The Medicare NewsGroup: Fact/Fiction: Medicare Will Go Broke Or Bankrupt
The Sound Bite: Politicians continue to claim that Medicare will go “broke” or “bankrupt” in the coming years without Medicare reform. The Facts: This is fiction. Conversations on Medicare going broke or bankrupt center around the funding and expenditures under Medicare Part A (Hospital Insurance), and not around Medicare Part B (Medical Insurance) or Medicare Part D (Prescription Drugs) (Solana, 12/11).

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Liberal Democrats Pledge To Protect Medicaid

Some Democrats argue that cuts to Medicaid, which provides health insurance coverage to low-income Americans, should not be part of the fiscal negotiations.

NPR: Democrats Draw Line On Medicaid Cuts
At least in public, Republicans have been clear that they see the current budget negotiations as a chance to address what they see as the source of Washington's deficit problem: Major entitlement programs. … But if Republicans have drawn a line in the sand insisting that those major programs be put on the table for negotiation, Democrats are drawing a line of their own. They say Medicaid, which serves the health care needs of some 60 million low-income Americans, needs to be taken off the table (Rovner, 12/12).

The Associated Press/Washington Post: Liberal Democrats Say Medicaid Must Not Be Cut As Part Of Bipartisan Bargain On Fiscal Cliff
Liberal Democratic members of Congress are warning President Barack Obama to not cut the Medicaid health care program as part of negotiations with Republicans over avoiding the so-called fiscal cliff (12/11).

Modern Healthcare: Liberal Democrats Rip Proposed Medicaid Cuts
Leading liberals in Congress blasted separate Republican and Democratic proposals to cut Medicaid spending as part of an end-of-the-year deficit deal but remained open to unspecified Medicare cuts. Republican proposals to restructure Medicaid from an open entitlement to a fixed-dollar block grant to states and a Democratic proposal to move it into a per-capita grant drew derision from senior Senate and House Democrats during a Tuesday news conference packed with boisterous healthcare union representatives. "Both of these ideas are bad ideas because they limit the federal government's participation in making sure Medicaid will cover those who are most vulnerable," said Rep. Henry Waxman (D-Calif.). Waxman and other Democrats also criticized a proposal by Republicans to pay for a one-year freeze in Medicare physician pay rates and put off a looming 26.5% cut (Daly, 12/11).

CQ HealthBeat: Democrats Warn Against Medicaid Cuts
Some Democratic senators and congressmen said Tuesday that they would not support a budget-reducing deal that cut Medicaid, even as one leading House Democrat acknowledged that the party will probably have to accept Medicare cuts. "Whatever they're talking about with Medicare, maybe there are some things we can live with," Rep. Henry A. Waxman, D-Calif, said at a Capitol Hill event organized by consumer advocacy and union groups such as the Service Employees International Union and Families USA. "But we cannot live with any cuts in Medicaid" (Adams, 12/11).

The Hill: Liberals: Leave Medicaid Out Of Talks
Republicans have insisted on entitlement cuts in exchange for higher revenues in a deal to avoid the “fiscal cliff,” a combination of tax increases and automatic spending cuts set to take effect at the end of the year. Congressional Democrats oppose almost all cuts to Medicare, Medicaid and Social Security, but they’re taking an especially hard line against Medicaid cuts, including proposals President Obama has supported in the past. “If you want to boil it down to one message: Keep your hands off the Medicaid program,” Rep. Henry Waxman (D-Calif.) said. “We don’t believe in cutting Medicare, either, but whatever they talk about in Medicare, maybe there’s some things we can live with. But we cannot live with any cut to Medicaid” (Baker, 12/11).

Meanwhile -

Los Angeles Times: 'Obamacare,' Fiscal Cliff Leads To Small Business Optimism Plunge
It’s the fiscal cliff’s fault, according to a new report from the National Federation of Independent Business. The threat of major spending cuts and tax hikes in the new year has caused a forward-looking gauge of Main Street sentiment to plummet. The election and the looming implementation of President Obama's health coverage overhaul is also weighing on small business owners, according to the report (Hsu, 12/11).

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Health Reform

States Still Have Time To Build Exchanges, Some Experts Say

Politico Pro reports that some exchange experts aren't buying the argument that states have too little time to set up insurance markets. Meanwhile, Bloomberg reports on the fragmented regulatory landscape that insurers selling products in those new markets will face.

Politico Pro: Experts: States Aren't Out Of Time
Some states say it was tardy, shoddy guidance from the Obama administration that forced them to punt on running a state-based health insurance exchange. But many exchange experts aren't buying it, saying plenty of other states have forged ahead and that those that waited until the 11th hour still could. In fact, one prominent consultant said he could get the exchange basics up and running in 90 days. That's the counterpoint to all the complaints governors and other state officials have had about the details — or lack of them — that they say they've gotten from Obama administration on how the health exchanges will work (Norman, 12/11).

Bloomberg: Insurers Face Jumbled Market With Health Exchange Rules
UnitedHealth Group Inc. (UNH), the biggest U.S. health insurer, will face a fragmented regulatory landscape in 2014 under the first state insurance marketplaces approved as part of the health-care overhaul. Rules for the six state insurance exchanges that won conditional approval from the Obama administration Dec. 10 are split evenly between those with strict criteria for companies that want to participate and states that have opened their exchanges to all comers, a scenario supported by the insurance industry. A high bar for inclusion could limit the number of insurers offering health plans in some states (Wayne, 12/12).

News outlets also report on specific state decisions about running insurance marketplaces -

The Associated Press/Washington Post: Utah Governor Asks Obama To Approve State's Own Health Care Exchange
Utah's Gov. Gary Herbert is asking President Barack Obama to approve a health insurance exchange the state already has in place and declare that it meets the requirements of the federal health overhaul. It’s not clear he will get his wish (12/11).

MPR: Consultant: Public Trust Is Key To Success Of Health Exchange
A communications consultant told a state panel today that building public trust will be key to the success of a new health insurance exchange. The exchange is a central part of the federal health care law. One out of every five Minnesotans is projected to use the online marketplace to research and buy health insurance beginning in 2014. Prior market research found a low level of trust of health plans among the uninsured people the exchange is supposed to help. Todd Rapp of Minneapolis-based Himle told a state exchange task force that advertisements, messages and other information about the exchange must foster trust, engage the public and appear straightforward. "You're not going to successfully bring a million people onto this program in a month, you know that," Rapp said. "What you want people to do is believe in the program, to believe that they have a voice in the program, and to understand and get the answers that they need." The Minnesota exchange is supposed to be ready to begin enrollment in Oct. 2013 (Stawicki, 12/11).

Politico Pro: Idaho Governor Backs State-Run Exchange
Idaho Gov. Butch Otter says he wants his state to set up its own health insurance exchange. Otter, who’s been supportive of a state-based exchange, said it currently seems to be the best way to keep out intervention from the federal government. However, Otter acknowledged that he’ll need legislative support, and he warned that he could change his mind "if circumstances warrant." And the state Legislature has been resistant so far to an exchange, even refusing a $20 million HHS planning grant earlier this year (Millman, 12/11).

Reuters: Idaho Chooses State-Based Insurance Exchange Under "Obamacare"
Idaho Governor Butch Otter reluctantly opted on Tuesday for a state-based health insurance exchange under terms of President Barack Obama's healthcare overhaul, complaining it would do little to cut costs while inflating government. Idaho was one of several Republican-led states that delayed compliance with the Affordable Care Act until after the November 6 presidential election in hopes a victory by Republican candidate Mitt Romney would bring a repeal of the law (Zuckerman, 12/11).

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Analyzing The Medicaid Expansion Balance Sheet

As states contemplate the financial implications of pursuing the health law's Medicaid expansion, the recent Health and Human Services decision to not fund partial expansions continues to draw reactions. 

Politico: HHS: No Partial Funding Of Medicaid Expansion
Supporters of the massive Medicaid expansion under health reform cheered HHS's Monday announcement that states have to do all or nothing — partial expansion isn't an option. But critics said the Republican governors may dig in more, seeing the Department of Health and Human Services offering a dagger, not an olive branch. "Rather than try to engage Republican governors, they decided to ramp up political pressure from provider groups and everyone else and make their lives miserable," said Michael Ramlet, director of health policy at the American Action Forum. "The Obama administration's refusal to grant states more flexibility on Medicaid is as disheartening as it is shortsighted,” the new Republican Governors Association Chairman Bobby Jindal of Louisiana said in a statement (Norman and Cheney, 12/12).

Modern Healthcare: Public Hospitals Plan Lobbying Blitz In States Weighing Medicaid Opt-Out
An advocacy group for public hospitals plans to lobby its members to continue explaining to state leaders the importance of Medicaid expansion under the federal healthcare reform law. HHS clarified in a letter issued Monday that it will cover all costs of expanding Medicaid enrollment, as authorized by the Patient Protection and Affordable Care Act, only in states that undertake an expansion of Medicaid eligibility to 133% of the federal poverty level, or as high as 138% of the federal poverty level. Some state political leaders had asked whether they could partially expand eligibility and still receive the federal funding. The National Association of Public Hospitals and Health Systems, representing many of the safety net hospitals facing some of the biggest effects of state decisions on Medicaid expansion, will urge its members to take up the cause of expansion in their states, said Beth Feldpush, the association's vice president for advocacy and policy (Daly, 12/11).

The Associated Press: Sandoval Supports Medicaid Expansion
Gov. Brian Sandoval said Tuesday that he will support expanding Medicaid eligibility in Nevada as called for under the federal health care law to provide coverage for the state's neediest residents. In an exclusive interview, Sandoval said expanding coverage will add 78,000 residents to the state's Medicaid rolls but will save the state $16 million in mental health programs that otherwise would be paid for out of the state general fund (Chereb, 12/11).

The Associated Press: Nebraska To Lose $44M In Medicaid Money
Nebraska will see an estimated $44 million cut in federal Medicaid funding in its next two-year budget, a loss that will force lawmakers to make up the difference with state dollars when they convene next year. The Nebraska Department of Health and Human Services has requested an additional $18.9 million in state aid for fiscal 2014 and $24.8 million in fiscal 2015 to offset the projected loss in federal matching dollars, according to budget documents obtained by the Associated Press (12/11).

The Associated Press: Cost Of Medicaid Expansion Lawmakers' Main Concern
Cost is the primary concern for Mississippi lawmakers faced with a decision on whether to expand the state Medicaid program with the implementation of the Affordable Care Act. The Clarion-Ledger reports that lawmakers discussed the matter on Monday during a joint committee meeting of the Public Health and Welfare and the Insurance committees (12/11).

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Feds Seek Dismissal Of Contraception Mandate Challenge Filed By Archdiocese Of Atlanta

In related coverage, religious colleges involved in a separate challenge to the birth control mandate will go to court this week to argue their standing to bring a lawsuit.

The Associated Press/Washington Post: Federal Government Seeks Dismissal Of Suit Over Birth Control Requirement In Health Care Law
The federal government has asked a judge to dismiss a lawsuit filed by the Roman Catholic Archdiocese of Atlanta and other religious institutions seeking to overturn a provision in the federal health care law that requires group health plans to provide free birth control (12/11).

McClatchy: Religious Colleges Challenge Health Care Law's Contraception Rule
North Carolina's Belmont Abbey College is trying to resurrect a religious school charge against the Obama administration’s signature health care law. But first, the school and its many allies must prove their time has come. On Friday, in a cutting-edge case, attorneys for Belmont Abbey and Illinois-based Wheaton College will try to convince a key appellate court that their challenge to the law’s contraception coverage mandate is not premature. If the colleges prevail, they will be poised for a head-on religious liberty showdown. ... The oral argument Friday before a three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit will focus on seemingly technical points called "ripeness" and "standing." Both sound more boring than the First Amendment’s guarantee of religious freedom, but both are crucial (Doyle, 12/11).

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Health Care Marketplace

Family Health Insurance Costs Up 62 Percent Since 2003

The total cost of family health insurance, for both employers and employees, hit $15,000 last year, up 62 percent since 2003 -- and worker wages rose only 11 percent in that time, a new Commonwealth Fund report says.

Kaiser Health News: Health Cost Bite To Family Budgets Sinks Deeper
The price of commercial health insurance has risen five times faster than family incomes since 2003 even as the financial security it offers has shrunk, says a new Commonwealth Fund report that underscores how medicine is consuming bigger and bigger parts of the private economy. ... The average total cost of family health insurance -- employer and employees' shares -- hit $15,022 last year, up 62 percent since 2003, while the median family income rose only 11 percent during the same period, the report said. If that trend continues, premiums for family coverage will come close to $25,000 by 2020 (Hancock, 12/12).

Modern Healthcare: Worker's Spending On Health Premiums Surges 74% in 8 Years
The cost of employee health insurance grew faster than income in every state, an analysis of data from 2003 to 2011 shows, and health benefits increasingly failed to protect workers from the cost of getting injured or ill. The analysis of health insurance in the workplace by the health policy foundation the Commonwealth Fund underscored the financial strain on household and business budgets from the country's rising health care costs. Fast-growing premiums outpaced wages, the report said, and have "been consuming resources that employers might otherwise have earmarked for salary or wage increases, for other benefits or for hiring additional workers." A worker, on average, spent $3,962 on family premiums in 2011, an increase of 74 percent from 2003. Meanwhile, the average family premium totaled $15,022, an increase of 62 percent from 2003, the report said. "It's real money," said Cathy Schoen, senior vice president of the Commonwealth Fund (Evans, 12/12).

NBC: Health Insurance: U.S. Paying More For Less, Report Finds
Health insurance premiums have shot up more than 60 percent in the last eight years, and if they keep up at this pace the average family of four will be paying $25,000 a year just for health insurance, according to a report released Wednesday. At the same time, deductibles are also going up for employer-sponsored plans, so workers are paying more and more for less and less, the non-profit Commonwealth Fund said. "Workers are paying more for less financial protection when they get sick," said Commonwealth Fund senior vice president Cathy Schoen, who led the team writing the report (Fox, 12/12).

Meanwhile, Aetna reached a settlement regarding out-of-network providers --

Medscape: $120 Million Aetna Settlement Creates Physician Payday
Thousands of physicians stand to collect some cash from a proposed $120 million settlement that Aetna reached last week with organized medicine, Aetna beneficiaries, and other plaintiffs in a class-action lawsuit over rates paid to out-of-network providers. The pay-out will range from a few hundred dollars to possibly $5000 or more, depending on how physicians choose to participate in the settlement, which awaits approval from a federal district judge in Newark, New Jersey. The plaintiffs in the case, including the American Medical Association (AMA) and 10 state medical societies, accused the giant insurer of systematically underpaying physicians and other clinicians who were out-of-network providers. Such providers are entitled to the lesser of either their billed charges or the "usual, customary, and reasonable" (UCR) fee for the particular service rendered (Lowes, 12/11).

In related coverage --

Kaiser Health News: Q & A: Options For Patients Who Get Out-Of-Network Care (Video)
Kaiser Health News consumer columnist Michelle Andrews answers a reader question about handling an out-of-network bill from a provider the patient didn't choose (12/11).

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State Watch

Texas Governor Calls For Late-Term Abortion Ban

Citing what he called fetal pain, former GOP presidential hopeful Rick Perry urged state lawmakers to ban abortions after 20 weeks of pregnancy. He said his ultimate goal was to eliminate abortions altogether.

Reuters: Texas Governor Seeks Law Banning Late-Term Abortions
Texas Governor Rick Perry called on state lawmakers on Tuesday to pass a bill banning late-term abortions, a controversial prohibition that has been pushed by anti-abortion activists since 2010. Seven states -- Alabama, Idaho, Indiana, Kansas, Louisiana, Nebraska and Oklahoma -- have put laws into effect in the past several years banning late term abortions, based on questionable medical research suggesting that a fetus feels pain starting at 20 weeks of gestation (MacLaggan, 12/11).

Houston Chronicle: Perry Wants To Further Restrict Abortions And Providers
Proclaiming his ultimate goal to eliminate abortion at any stage, Gov. Rick Perry on Tuesday said he would back legislation to ban abortion in Texas after 20 weeks, the point at which he said a fetus can experience pain. He said he also wants lawmakers in the upcoming legislative session to pass a law requiring physicians who perform abortions to have admitting privileges with nearby hospitals, and he wants abortion clinics to be licensed as ambulatory surgical centers. "Over the last decade, Texas has taken extraordinary steps to protect the lives of the unborn, but when 80,000 lives are lost to abortion each year in our state, we know our work is far from over," Perry said, speaking at the Source Pregnancy Center in west Houston (Holley, 12/11).

The Dallas Morning News: Perry Backs New Proposed Abortion Restrictions
Gov. Rick Perry, who has led the charge against abortions, said he will push for new restrictions when the Legislature convenes next month, including one that would outlaw abortions after 20 weeks into a pregnancy. Perry cited laws passed in 10 other states that settled on the 20-week cutoff as the point in development when a fetus might feel pain. Previously, based on the Supreme Court’s Roe vs. Wade decision, elective abortions could be performed up to the time when the fetus was viable – about 28 weeks (Hoppe, 12/11).

In the meantime, Planned Parenthood continues its fight against Texas to remain included in the Women's Health Program there --

The Dallas Morning News: Planned Parenthood Files Two New Lawsuits Against Texas
It’s back to the courts for Planned Parenthood. A Texas Planned Parenthood patient, Marcela “Marcy” Balquinta, filed suit against the state on Tuesday to ensure the provider is not left out of the women’s health program when the state takes it over on Jan. 1. Attorneys for Balquinta and Planned Parenthood, which is involved in the suit, claim Health and Human Services executive director Kyle Janek and the Texas Department of State Health Services do not have the authority to exclude Planned Parenthood from the program (Cardona, 12/11).

And a Mississippi abortion clinic also fights to stay open amid a new law there --

The Wall Street Journal: Abortion Clinic Presses To Stay Open
Mississippi's only abortion clinic says it won't be able to meet a requirement of a new state law that tightens regulations for abortion providers, and has asked a federal judge to prevent state officials from revoking its license (McWhirter, 12/11).

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State Roundup: Health Centers Moving Into Contaminated Tracts

News outlets report on state health news in California, Florida, Massachusetts, New York, Oregon, Pennsylvania, Texas and Wisconsin.

The New York Times: Health Centers Find Opportunity In Brownfields
The community health center rising on a derelict corner here in West Philadelphia never would have broken ground if not for the asbestos inside the building that was demolished to make way for it. Because of the contamination, Spectrum Health Services received a $2 million federal cleanup grant, the first piece of a $14 million construction financing puzzle. ... It will also be the latest in a nationwide trend to replace contaminated tracts in distressed neighborhoods with health centers, in essence taking a potential source of health problems for a community and turning it into a place for health care (Kaysen, 12/11).

WBUR: CommonHealth (Interview): Is Mass. Public Health In Danger?
When Gov. Deval Patrick recently announced a $540 million ... gap in the state budget, every state organization immediately worried about how deeply the ensuing cuts would bite into their funding — none more so than the Department of Public Health. In fact, public health advocates are so concerned about the potential consequences of further cuts that they sent a letter to Gov. Patrick saying that the state's public health infrastructure is already "not meeting basic needs" (12/11).

Houston Chronicle: Judge Worries New Harris Mental Health Court Is In Peril
A Houston judge says one of her colleagues and the newly elected district attorney are working to close Harris County's mental health court less than three months after its official dedication. State District Judge Jan Krocker released a statement saying Belinda Hill, the head administrative judge, has torpedoed $500,000 in funding offered by Pat Lykos, the lame duck district attorney, out of the office's discretionary account. Without the money, Krocker said, the court that took her more than three years to create and oversees will close Jan. 31 (Rogers, 12/11).

The Oregonian: 3,000 Seniors, Disabled Adults Were Victims Of Abuse Last Year, State Report Finds
Nearly 3,000 seniors and adults with disabilities were victims of abuse last year, according to a state report released this week. Adult protective services officials at the state Department of Human Services received more than 28,000 reports of potential abuse last year, of which 4,052 were substantiated. The division received about 1,000 more reports last year than in 2010. Financial exploitation and self-neglect were the two areas of abuse with the most victims, according to the report. Self-neglect refers to the inability of an adult to understand the consequences of his or her actions, perhaps resulting in harm ... to oneself or others (Zheng, 12/11).

Bay Citizen/California Watch: Some Counties Requiring Health Workers To Get Flu Vaccine

In an effort to prevent health care workers from spreading the flu to patients this winter, county health officials are mandating that medical staff around the Bay Area receive vaccinations or wear a surgical mask on the job. Health officials say flu vaccination rates among health care workers are dangerously low – 60 percent of those working in California hospitals received the vaccine in the 2010-11 flu season, according to the most recent data available from the California Department of Public Health (Mieszkowski, 12/12).

The Lund Report: Regence BlueShield Made Serious Multimillion Dollar Accounting Mistakes
Regence BlueShield and its parent company Cambia Health Solutions made sloppy mistakes in their reporting practices, sometimes to the tune of millions of dollars, according to a Lund Report review of the insurer's most recent Washington state financial exam. The examination (by the Washington Office of the Insurance Commissioner) was completed earlier this year and covers the insurer's work through the end of 2010. Regence BlueShield is the Washington subsidiary of Portland-based Cambia, which also owns Regence BlueCross BlueShield of Oregon and Blues plans in Utah and Idaho. ... Officials at both Regence BlueShield and at the Washington Office of the Insurance Commissioner emphasized that the insurer remains solvent and capable of meeting its financial obligations (Sherwood, 12/11).

Milwaukee Journal Sentinel: County Supervisor Calls For State Takeover Of Mental Health Complex
County Supervisor Joe Sanfelippo called for a state takeover of the Milwaukee County Mental Health Complex, saying Tuesday that the county has failed to make good on plans to downsize the psychiatric hospital and treat more of its patients in the community. "After years of studies, warnings and repeated requests to modernize and to reform this vital program, for the County Board to sit back and do absolutely nothing is deplorable," Sanfelippo said. He released a statement calling for state Health Services Secretary Dennis Smith "to step in and take decisive action that will protect and improve the lives of these individuals with mental illness” (Schultze, 12/11).

Health News Florida: State Senate Wants Your 2 Cents
Last week's organizational meeting of the Senate Select Committee on the Patient Protection and Affordable Care Act was a bit rowdy, with anti-"ObamaCare" activists loudly insisting that the legislature "nullify" the federal law. This week, the Senate unveiled a website in which constituents can register their opinions about the law in a quieter way. It also saves Floridians the burden of making the trip (Gentry, 12/11).

California Healthline: Healthy Families Set For January Transition
State health officials have made it clear that the first phase of the Healthy Families transition to Medi-Cal managed care will go on as scheduled, beginning Jan. 1. Children's health advocates say they will do everything to support that effort while still keeping a careful eye on its progress. The first phase of the transition will move about 415,000 children into Medi-Cal -- almost half the 860,000 children enrolled in Healthy Families. The transition is dependent on federal approval by CMS within three weeks (Gorn, 12/12).

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Editorials and Opinions

Viewpoints: Pelosi Says Higher Medicare Age 'Doesn't Work;' Marketplace's Clout Could Lower Seniors' Drug Costs

USA Today: Truth About Medicare Age
(In) the talks to avert the fiscal cliff, the idea of raising the Medicare age is central to the Republican proposal. There's just one critical problem: It doesn't work. It doesn't have public support. It's unfair. And it doesn't lower health expenditures. Such a proposal is a reflection of the broader Republican plan: an assault on the middle class, seniors -- and our future (Rep. Nancy Pelosi, 12/11). 

The New York Times: The 2,000-Year-Old Wonder Drug
The inexorable rise in health care spending, as all of us know, is a problem. But what's truly infuriating, as we watch America's medical bill soar, is that our conversation has focused almost exclusively on how to pay for that care, not on reducing our need for it. In the endless debate about "health care reform," few have zeroed in on the practical actions we should be taking now to make Americans healthier (David B. Angus, 12/11).

Los Angeles Times: When Government Does Things Better Than Private Enterprise
There seems to be a consensus developing that raising (Medicare eligibility) age to 66 or 67, from today's 65, would be a fairly painless way of demonstrating our commitment to fiscal responsibility. You're all living longer, so what's the big deal? — you'll have plenty of time to enjoy the fruits of Medicare, if you're a little more patient. Best of all, the change would save the federal budget $5.7 billion in 2014 alone. ... What's on the other side of the Medicare-age ledger? (Michael Hiltzik, 12/11).

The Washington Post's The Plum Line: Raising Medicare Age Could Leave Hundreds Of Thousands Uninsured
It looks increasingly possible that lawmakers will reach a fiscal cliff deal that includes a hike in the Medicare eligibility age — a concession to those on the right who seem determined to see very deep entitlement cuts, even if they take benefits away from vulnerable seniors. One argument for raising the eligibility age is that seniors who lose benefits can get insurance through Medicaid or the Obamacare exchanges. But a new report to be released later today undercuts that argument — and finds that up to half a million seniors could lose insurance if the eligibility age is raised (Greg Sargent, 12/11). 

Huffington Post: Seniors Shouldn't Have To Pay More To Medicare To Pad Drug Company Profits
People in Washington are talking about raising Medicare costs for some beneficiaries. That's the wrong way to address our budget deficit. Instead we should allow Medicare to use its marketplace clout to negotiate better prices or rebates for prescription drugs. That would produce significant savings. Proposals to raise seniors' costs, including means-testing and raising the eligibility age for Medicare, miss the mark (Ethan Rome, 12/11).

Baltimore Sun: The Other, More Dangerous, Cliffs
The "fiscal cliff" isn't nearly the biggest cliff we face -- if we're talking about dangerous precipices looming on the horizon. Here are three: The child poverty cliff. A staggering number of our children are impoverished. Between 2007 and 2011, the percentage of American school-age children living in poor households grew from 17 percent to 21 percent. Last year, according to the Agriculture Department, nearly 1 in 4 young children lived in a family that had difficulty affording sufficient food at some point in the year. Yet federal programs to help children and lower-income families -- such as food stamps, federal aid for poor school districts, Pell grants, child health care, subsidized lunches, child nutrition, prenatal and postnatal care, Head Start and Medicaid -- are being targeted for cuts by deficit hawks who insist we can no longer afford them (Robert Reich, 12/12).

Des Moines Register: Seeing Health Reform As Economic Tool
(We) are recasting our message to the governor on this issue: Don't expand Medicaid just to help the poor and the mentally ill and the elderly Iowans who need it. Do it to help businesses. Governor (Terry) Branstad may not have thought about Medicaid as an economic development angle. We're not sure who has advised him when he first took a position against expanding Medicaid. ... A recent study by the Kaiser Family Foundation shows that the additional federal money for new Medicaid enrollees will actually save the state money and put more revenue into the bank accounts of Iowa hospitals that frequently are swallowing the cost of treating people who are not uninsured (12/11).

The Denver Post: Alabama Forges Ahead With Research On Benefits, Costs Of Medicaid Expansion
Okay, so not only is Colorado so far behind Alabama in football that we barely play the same game, now it turns out we’re also behind the Sweet Home state in Medicaid research. University of Alabama-Birmingham researchers have carefully tallied uphow many people will join Medicaid under the proposed federal expansion, what it will cost Alabama to administer given the feds’ offer of a 100 percent underwriting, and what the state would get back in new tax money and economic development (Booth, 12/11).

Kansas City Star: Removing Shame From Mental Illness
In the days since Jovan Belcher’s murder-suicide, the tragedy has been framed as a controversy about gun control. What about the issue of getting help before it's too late? I recently returned to Kansas City after living in California for 10 years. In Los Angeles, I was surprised to see how open people were about their mental health. People chatted about how great their therapist was as if they were recommending their favorite restaurant. Friends would debate and discuss their favorite medications for anxiety and depression. In contrast, during my upbringing here, depression and mental illness were rarely discussed. As a child I recall repeatedly going to visit my grandfather in the hospital's locked-down psych ward. I was told he was "sick" or "sad" (Jenni Simcoe, 12/11).

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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.