Daily Health Policy Report

Tuesday, February 12, 2013

Last updated: Tue, Feb 12

KHN Original Reporting & Guest Opinion

Administration News

Health Spending And Fiscal Battles

Health Care Fraud & Abuse

Health Reform

Health Care Marketplace

Veterans Health Care

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Insuring Your Health: Observation Units Can Improve Care But May Be Costly For Patients

In her latest Kaiser Health News consumer column, Michelle Andrews writes: "There's a growing recognition by clinicians that some patients who arrive at the emergency department can benefit if they’re kept under observation for up to a day so that staff can run more tests and monitor their progress to see if their condition is improving or deteriorating" (Andrews, 2/12). Read the column.

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Capsules: Study: One-Third Of Individual Plans Exceed Law's Out-Of-Pocket Cap

Now on Kaiser Health News' blog, Julie Appleby writes: "Consumers who buy their own health insurance will see the total amount they could pay out of pocket for medical care capped starting next year, but some will likely pay higher premiums as a result" (Appleby, 2/11). Check out what else is on the blog.

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Political Cartoon: 'The Condition His Condition Is In?'

Kaiser Health News provides a fresh take on health policy developments with "The Condition His Condition Is In?" by Nate Beeler.

Meanwhile, here is today's health policy haiku:


State of the union?
Tied to baby boomers... and
all about health costs.

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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Administration News

Setting The Scene: Economy, Sequestration At Heart Of Obama's Address

His State Of The Union comments will likely highlight the different partisan views on how these automatic spending cuts, set to kick in March 1, could be minimized. Republicans continue to press for changes in entitlement programs, such as Medicare.

The Wall Street Journal: Obama Address To Focus On Economy, Social Issues
Mr. Obama will also address a series of automatic spending cuts set to kick in March 1—the so-called sequester—which could threaten economic growth, national—security preparation and the jobs of thousands of federal employees. Mr. Obama has called on Congress to pass a temporary measure of spending reductions and new taxes to replace the across-the-board cuts. Republicans have said they don't want to consider new taxes, and want Mr. Obama and Democrats instead to make significant changes to entitlement programs including Social Security and Medicare to reduce their mounting costs, something they are reluctant to do (Favole, 2/12).

MedPage Today: State Of The Union: Light On Health
Tuesday night's State of the Union Address likely will focus heavily on jobs and the economy with few direct mentions of healthcare, the White House and health policy insiders hinted Monday. Bob Doherty, senior vice president of government affairs at the American College of Physicians (ACP) here, told MedPage Today Monday that Obama may allude to health care objectives indirectly and generally at the most. But Doherty said he doesn't expect any direct mentions of health care. White House Press Secretary Jay Carney told reporters during Monday's briefing with members of the media that President Obama will outline a plan to create jobs (Pittman, 2/11).

Marketplace: Since Last State Of Union, Jobs Came From Health, Education
Perhaps every successful politician promises employment. But looking back at the president's first term, where have the jobs actually come from? Over the course of the last four years, the U.S. lost 4 million jobs, then created more than 5 million. Net gain: 1.2 million. The education and healthcare fields created many of those. Why? We're getting older and trying to get wiser. But it also may be hard to replace workers in those fields with technology (Tong, 2/11).

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Health Spending And Fiscal Battles

Obama Opposes Raising Medicare's Eligibility Age To Reduce Spending

According to White House spokesman Jay Carney, the president does not believe this is the right policy to take, although he is open to discussing other entitlement program changes.

The Associated Press/Washington Post: White House: Obama Opposes Higher Age For Medicare In Any Budget Talks
The White House says President Barack Obama opposes raising the eligibility age for Medicare, an idea he once was willing to consider in budget negotiations with House Speaker John Boehner. White House press secretary Jay Carney on Monday said Obama "has made clear that we don't believe that that's the right policy to take" (2/11).

Reuters: Obama Rules Out Raising Medicare Eligibility Age To Cut Spending
Republicans in Congress, who have focused on cutting spending, have said they want to see the eligibility age raised to 67 from the current age of 65, but many Democrats have opposed the idea vehemently (Rampton, 2/11).

Fox News: White House Says 'No' To Raising Medicare Eligibility Age
The White House said definitively Monday it will not agree to increasing the eligibility age for Medicare as part of a deficit-reduction deal with congressional Republicans. Press Secretary Jay Carney suggested President Obama is willing to consider cuts to the entitlement program to reduce the deficit but said "no" to the White House increasing the minimum age. ... He said the president made clear last year in proposals -- from which House Speaker John Boehner "walked away" -- that he was open to entitlement reform options but not to changing the Medicare age (2/11).

Meanwhile, on the topic of the scheduled budget cuts, or sequestration, and who might feel a particular pinch --

California Healthline: Sequestration Would Hurt Rural Health Providers, Study Shows
Rural health care providers heard bleak predictions about the potential effects of sequestration at the National Rural Health Association's 24th annual Rural Health Policy Institute last week. If Medicare reimbursement is reduced by 2 percent as specified in the sequestration process due to start in three weeks, 63 rural hospitals will no longer be profitable and 482 rural health care jobs will be lost nationally, according to estimates by iVantage Health Analytics. California's rural hospitals won't be as hard-hit as those in the Midwest and South, according to the research, but all health care providers who treat Medicare beneficiaries will feel the pinch at some level, said Gregory Wolf of iVantage (Lauer, 2/11).

And, in the background --

The New York Times: Slower Growth Of Health Costs Eases U.S. Deficit
A sharp and surprisingly persistent slowdown in the growth of health care costs is helping to narrow the federal deficit, leaving budget experts trying to figure out whether the trend will last and how much the slower growth could help alleviate the country's long-term fiscal problems (Lowrey, 2/11).

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Health Care Fraud & Abuse

Government Recovers Billions In Health Fraud Crackdown

The Obama administration announced Monday that it recovered a record $4.2 billion last year from medical providers who cheated Medicare and other government health programs.

Los Angeles Times: Government Says It Recovers Billions In Health Fraud Crackdown
The federal government recovered a record $4.2 billion in the last fiscal year from medical providers and others who fraudulently billed government healthcare programs such as Medicare, the Obama administration announced Monday (Levey, 2/11).

USA Today: Feds Recovered $4.2 Billion From Anti-Fraud Efforts
Health and Human Services Secretary Kathleen Sebelius said for every dollar spent on fraud and abuse in the past three years, the government brought $7.90 back in through lawsuits and fines. The 2010 health care law created one agency and expanded another to fight health care fraud, resulting in nine Medicare Fraud Strike Force Teams that sprouted up in areas particularly prone to Medicare fraud -- such as Texas and Florida (Kennedy, 2/12).

Reuters: U.S. Recovers $4.2 Billion From Healthcare Fraud Probes: Report
The Obama administration said on Monday that its efforts to combat fraud in the Medicare and Medicaid healthcare programs were paying off as the government recovered a record $4.2 billion in fiscal 2012 from individuals and companies trying to cheat the system (Kelly, 2/12).

Philadelphia Inquirer: Health-Care Fraud Cases Yield $4.2 Billion
In an era when pharmaceutical executives - like their brethren in banking - are under fire for paying fines too often instead of going to prison to settle allegations of wrongdoing, health care fraud investigations returned $4.2 billion to the nation's coffers last year, the U.S. government said Monday. For every $1 spent on investigations, the government got back $7.90 over the last three years, which is $2.50 higher than the rolling three-year average since the Health Care Fraud and Abuse Control Program began in 1997, according to a joint report released by the Department of Justice and Department of Health and Human Services. Settlements produced nearly $4.1 billion in 2011(Sell, 2/12).

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Health Reform

Final Word On Essential Health Benefits Expected Soon

CQ Healthbeat reports the Office of Management and Budget is reviewing several health law implementation rules including this one, which will determine the types of coverage available to consumers. Meanwhile, a study examines how the health law's caps on out-of-pocket costs will affect consumers next year.

CQ Healthbeat: Final Essential Health Benefits Rule Expected Out Soon
As Office of Management and Budget reviewers do the final check on three significant health rules, lobbyists are anxiously waiting to see whether these regulations will emerge changed, particularly a proposal that outlines the essential health benefits that plans must offer in 2014. Any revisions to the essential health benefit requirements, which were proposed on Nov. 26, 2012, could made a significant difference in the breadth of coverage and affordability of insurance for consumers (Adams, 2/11).

Kaiser Health News: Capsules: Study: One-Third Of Individual Plans Exceed Law's Out-Of-Pocket Cap
Consumers who buy their own health insurance will see the total amount they could pay out of pocket for medical care capped starting next year, but some will likely pay higher premiums as a result (Appleby, 2/11).

Also in the news, reports from the states on Medicaid expansion and health exchanges --

The Associated Press: Fla. Senators To Discuss Medicaid Expansion
Health advocates and hospital executives warned Florida lawmakers on Monday that if they do not expand Medicaid, it will create a coverage gap for those who earn too little to qualify for tax credits to buy insurance from the online exchange but too much to qualify for Medicaid. The decision would also keep Florida from receiving billions of federal dollars to help pay for those health costs while heaping greater burdens on hospitals treating the uninsured (Kennedy, 2/11).

The Associated Press: Medicaid, Exchange Answers Elude W. Va. Lawmakers
Gov. Earl Ray Tomblin has yet to decide whether to open the Medicaid program to more lower-income residents, or how individuals and small businesses will seek coverage through the federal health care overhaul, administration officials told legislators Monday. Several lawmakers questioned whether the Legislature should instead take the lead after seeking updates from Nancy Atkins, head of the agency that oversees Medicaid, and Jeremiah Samples, who's become in the in-house expert on the federal law for the state Insurance Commission (2/12).

The Associated Press: Minnesota House Approves Medicaid Expansion
More than 35,000 low-income Minnesota residents moved closer Monday to becoming eligible for a subsidized health insurance program, part of a state buy-in to the controversial new federal health care law. The Democratic-led state House voted 71-56 to approve an expansion of the state's Medical Assistance program and take advantage of a federal promise to send billions to cover the full cost of the new enrollees for a few years (Bakst, 2/11).

The Associated Press: Doctors, Nurses Ask NC Lawmakers To Grow Medicaid
Several physicians and nurses said Monday the North Carolina General Assembly's choice to cover more uninsured people through Medicaid should be a no-brainer because it will create jobs, save state money and make people healthier. The medical professional spoke at a Legislative Building news conference a day before a House committee takes up a bill to prevent North Carolina from expanding Medicaid under the federal health care overhaul (Robertson, 2/11).

The Texas Tribune: Dallas County To Urge Lawmakers To Expand Medicaid
Dallas County officials will adopt a resolution on Tuesday urging Texas legislators to extend Medicaid benefits to impoverished adults under the Affordable Care Act. And advocates for Medicaid expansion hope the major urban county's decision will spur other counties to adopt similar measures and pressure lawmakers into taking action (Aaronson, 2/12).

And Virginia reduces the hours of part-time workers to avoid triggering a provision of the health law requiring coverage --

The Associated Press: Virginia Struggles With Federal Health Insurance Requirement Regarding Part-Time Workers
State agencies are reducing part-time employees’ hours until officials figure out how to comply with federal health insurance requirements regarding those who work more than 30 hours each week. Gov. Bob McDonnell ordered agencies to cut back part-time employees to no more than 29 hours each week to avoid triggering a provision in the Affordable Care Act that requires health insurance coverage be provided to those who work more hours (2/11).

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Health Care Marketplace

Hospitals Reluctant To Provide Estimates Of Hip Replacement Costs, Study Finds

Researchers called 20 top orthopedic hospitals and two hospitals from every state and DC. Of the orthopedic centers, nine provided an estimate of hospital costs and doctor fees. Only 10 of the other 102 hospitals offered that information.

NPR: Need A Price For A Hip Replacement? Good Luck With That
Researchers from Iowa called 20 top-rated orthopedic hospitals across the country using a script based on Grandma's predicament. They asked for the lowest price (everything included) for a total hip replacement. The researchers also asked two other hospitals in each state and Washington, D.C., for good measure. Getting an answer wasn't easy. Of the top 20 hospitals, only 9, or 45 percent, provided a bundled price that included fees for both the doctors and the facilities. ... The researchers were able to get a bundled price estimate from only 10, or about 10 percent, of the other 102 hospitals they queried (Hensley, 2/11).

Los Angeles Times: What Will A New Hip Cost? Few Hospitals Quote A Price, Study Finds
Pricing information remains difficult to obtain from medical providers and the figures that are quoted vary widely despite government efforts to make the process more consumer friendly, according to a study published Monday in the Journal of the American Medical Assn. for Internal Medicine (Terhune, 2/11).

Politico: Report: Hip Replacement Cost Hard To Pin Down
In the study, researchers requested the lowest "bundled price" for a total hip replacement from two hospitals … in every state and Washington, plus from 20 top-ranked orthopedic hospitals nationwide. The researchers contacted the hospitals up to five times each, telling the hospitals they were asking on behalf of their otherwise healthy 62-year-old grandmother, who didn't have insurance but was prepared to pay out of pocket for the hip replacement. They were trying to find out the total cost — hospital bills plus physician fees. They discovered that a simple dollar amount wasn't so easy to find out with one — or even five — phone calls (Smith, 2/12).

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H&R Block Says Tax Time Is Opportunity For Health Insurance Planning

The tax preparer is offering customers advice and estimates about what their insurance costs might be once changes kick in in 2014.

Los Angeles Times: Tax Help Comes With Health Insurance Advice
Derrick Bean filed his income taxes at an H&R Block office in Los Angeles this month, and the 26-year-old left with something unexpected: a price quote on federally subsidized health insurance. Using the information from his 2012 return, a tax advisor told the actor and waiter that he would qualify for significant government help and pay only about $65 a month in premiums under the federal healthcare law. If he skips coverage, H&R Block warned him, he faces a $95 tax penalty next year and $356 the following year (Terhune, 2/11).

Earlier KHN Coverage: Not Too Early To Plan For Health Taxes, H&R Block Says (Hancock, 1/14).

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Veterans Health Care

VA Adding Mental Health Staff - Including Doctors, Nurses And Counselors

The Associated Press: VA Adds 1,000 Mental Health Professionals To Staff
The Veterans Affairs Department said Monday it has added more than 1,000 mental health professionals and 200 support staff over the past eight months to meet the needs of returning veterans, but still has more to do to meet the requirements of an executive order issued by President Barack Obama. The VA needs to add about 550 more doctors, nurses and counselors by June 30 to comply with the executive order (Freking, 2/11).

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State Watch

State Medicaid Drug Selection Panels' Conflict-Of-Interest Policies Vary Widely

State policies to ensure drug selection in Medicaid programs is free from outside influence vary widely, according to a new study.

MedPage Today: Medicaid Drug Panel Conflict Policies Vary Widely
There's little consistency among conflict-of-interest (COI) policies for state Medicaid drug selection committees, researchers found. Researchers could obtain such policies for only 27 states, and the principles governing these documents varied greatly, according to Nicole Yvonne Nguyen, PharmD, and Lisa Bero, PhD, of the University of California San Francisco. While two-thirds mandated disclosure of conflicts, for instance, fewer than half set monetary cutoffs for reporting, or required that disclosures be publicly available, they wrote online in JAMA Internal Medicine (Fiore, 2/11).

Modern Healthcare: Conflict Policies Vary For Medicaid Drug Panels: Study
The authors recommend that a model policy should be developed and made available to states, a step they said would be likely to increase transparency. More states have started to move to managed-care plans, which often subcontract drug selection decisions to pharmacy benefit managers, as a result of the healthcare reform law and ongoing financial pressures, according to a separate commentary also published today (Lee, 2/11).

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State Roundup: Ga. Officials End Medicaid Electronic Eligibility System Talks

A selection of health policy news from Arizona, Georgia, Florida, Kansas, Minnesota and California.

Reuters: Judge Overturns Arizona Law Barring Planned Parenthood Funding
A federal judge has overturned an Arizona law that sought to block funding through the state for Planned Parenthood's health care clinics because the group also performs abortions. U.S. District Court Judge Neil Wake ruled that the controversial measure signed into law last May by Arizona Governor Jan Brewer, a Republican, unlawfully robs individuals on Medicaid of the ability to choose health care services (Schwartz, 2/11).

Arizona Republic: Judge Sides With Planned Parenthood In Suit Vs. Arizona
A U.S. District Court judge has ruled that a 2012 Arizona law restricting funding to abortion providers is unconstitutional, in a case that is headed for the 9th Circuit Court of Appeals. Judge Neil Wake issued an order Friday in the Planned Parenthood lawsuit challenging House Bill 2800, which prohibits any health care provider that performs abortions from getting Medicaid funding, even for non-abortion related care. Wake had already issued a temporary order, preventing the law from going into effect as scheduled in August. Wake ruled the law violates the federal Medicaid Act, which allows eligible individuals to seek medical care from "any institution, agency, community pharmacy, or person, qualified to perform the service" (Rau, 2/11).

Georgia Health News: Talks Break Down On Mega-Contract For Medicaid
State officials have halted negotiations on a multimillion-dollar contract for a new electronic eligibility system for Medicaid and other health programs. The state canceled its request for proposal (RFP) last week after months of negotiating with the highest-scored vendor, which industry officials identified as Deloitte. Now seemingly back at Square One, the Department of Community Health says it will do much of the work to set up a new eligibility process on its own (Miller, 2/11).

The Associated Press: Florida Enhances Program For Disabled Children
Florida health officials said Monday they will assign care coordinators to about 1,600 children with disabilities amid allegations from federal health officials that the state was cutting in-home services and essentially forcing kids into adult nursing homes. An individual care coordinator will work with no more than 40 disabled children at a time who are receiving in-home nursing services and ensure they have continued access to those services (Kennedy, 2/11).

Kansas Health Institute: KanCare Pilot Project Launched But Opposition To DD "Carve-In" Persists
After months of advisory committee haggling over what it should look like, state officials say they are ready to launch the pilot program that will pave the way for including long-term services for the developmentally disabled in the new KanCare program. Now, all they need to start the pilot are participants (Shields, 2/11).

Kansas Health Institute: Bill Introduced To Prohibit Health Departments From Seeking Accreditation
A bill to prohibit county health departments from seeking accreditation has been introduced by Sen. Michael O'Donnell, a Wichita Republican. At least 12 Kansas health departments have been working for months on becoming nationally accredited and it wasn't immediately clear why O'Donnell, a freshman, would seek to slow or impede the process (Cauthon, 2/11).

Georgia Health News: 'Pill Mill' Ban Clears House Committee
A bill intended to crack down on "pill mills" in Georgia passed a key House committee unanimously Monday, after stirring testimony from a northwest Georgia coroner and a suburban Atlanta police chief. House Bill 178 would put pain management clinics under the regulation of Georgia's medical board, which would issue licenses to their operators. And after June 30, any new pain clinic would have to be physician-owned -- a requirement similar to other states' laws (Miller, 2/11).

Journal Sentinel/Minneapolis Star Tribune: Community Paramedics Aim To Cut Emergencies
As a paramedic, Peter Carlson is used to racing to people's homes. But on his way to see 86-year-old Erika Bruvelis recently, he stopped for coffee and parked outside her Minneapolis house for several minutes -- reluctant to arrive too early. In this case, no one had called 911, and with any luck, no one would go to the hospital. Carlson, 28, is one in the first wave of "community paramedics" in Minnesota and the nation. Instead of responding to emergencies, his job is to try to prevent them. Since October, Carlson has been paying house calls on dozens of patients as part of an innovative program to keep the frail and elderly out of the emergency room. Depending on what they need, he might do a blood test, call Meals on Wheels or help arrange for a wheelchair ramp. Over Christmas, he even baked cookies for one of his patients (Lerner, 2/11).

Arizona Republic: Arizona Democrats Unveil Budget Similar To Brewer's
House Democrats on Monday unveiled a $9 billion state budget that has striking parallels to Republican Gov. Jan Brewer's proposal, but adds more spending for education, school safety and social-welfare programs. It’s the second year in a row Democrats have compiled a detailed spending plan for the state in their bid to get a seat at the negotiating table when Republicans, who hold the majority at the Legislature, meet with Brewer to reach a consensus on the budget. … The Democrats estimate the state could gain an extra $109 million next year by, among other things, ending the sales-tax exemption on warranties and country-club and health-club memberships, and by dropping the school-tuition tax credit, which diverts state income tax to private-school tuition. The Democrats, like Brewer, back full expansion of the state's Medicaid program (Pitzl, 2/11).

California Healthline: Preventive Dentistry Plan Shows Results
The dental outreach plan for the 860,000 California children in the Healthy Families program has shown strong results, including across-the-board improvement in health plans' prevention efforts, according to officials from the Managed Risk Medical Insurance Board, which oversees the program. "Every one of our health plans showed improvement in terms of prevention," said Janette Casillas, MRMIB's executive director. "That means improvement in the number of oral exams, and in prevention efforts such as using sealant."

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Editorials and Opinions

Viewpoints: Entitlement Spending 'Hurts The Young;' State Uncertainty On Medicaid; Dr. Carson's Remedy For Health Care

The New York Times: Carpe Diem Nation
Federal spending is the most obvious example. The federal government is a machine that takes money from future earners and spends it on health care for retirees. Entitlement spending hurts the young in two ways. It squeezes government investment programs that boost future growth. Second, the young will have to pay the money back. To cover current obligations, according to the International Monetary Fund, young people will have to pay 35 percent more taxes and receive 35 percent fewer benefits (David Brooks, 2/11). 

Des Moines Register: Uncertainty Over Medicaid Is Real
Critics accused President Barack Obama of creating "uncertainty" that discouraged job creation and hindered economic recovery. Yet when health care spending comprises about 20 percent of this country's gross domestic product, governors who say they will not expand Medicaid in 2014 are the uncertainty culprits. They are making it difficult for businesses, state government and residents to plan for the future. Gov. Terry Branstad continues to oppose insuring thousands of low-income Iowans under the health reform law (2/12).

Kansas City Star: Medicaid Study Must Not Be The Last Word
A new study calculates that a broad expansion of Medicaid eligibility would cost Kansas an additional $1.1 billion over 10 years, more than double the anticipated increase if the state maintains its current low eligibility threshold. That's a hard-to-swallow commitment for a governor and legislators who are viscerally averse to most government spending and all aspects of "Obamacare." But the findings from the Aon Hewitt consulting firm can't be considered in isolation. Leaders have a responsibility to seek a complete and accurate picture of what a Medicaid expansion, as called for in the federal Affordable Care Act, would mean for the state (2/11).

Los Angeles Times: A Message To Obama, Served Cold
In an earlier era, Dr. Benjamin Carson's speech before the National Prayer Breakfast last week would have been a really big deal rather than mere fodder for a brief squall on Twitter and cable news. … Carson's idea for healthcare reform is even more Washingtonian. Instead of the technocratic behemoth of Obamacare, empower the individual. "When a person is born, give him a birth certificate, an electronic medical record and a health savings account to which money can be contributed — pretax — from the time you're born till the time you die. If you die, you can pass it on to your family members ... and there's nobody talking about death panels." The beauty of Carson's argument exceeds its simplicity, particularly as even economist Paul Krugman now concedes that something like death panels are inevitable if we stay on our current path (Jonah Goldberg, 2/12).

The Oregonian: Oregon Should Emphasize Detection And Treatment Of Mental Illness In Young People
It would not be unreasonable to argue that if we eliminated obesity and mental illness, just about everything would improve: Medical and social service costs would plummet, people would stay in school and lead productive lives, the prison population would decline by up to one third, government agencies would no longer need to compete for more and more funding to meet the needs of more and more medically and emotionally hobbled citizens. Heck, we might even find a path forward in the post-Newtown gun debate. But it would be unrealistic, if not unreasonable, to assume that Oregonians could find the discipline and money required to tackle obesity and mental illness and to eliminate their threat to prosperity and government. But that's what they are -- a threat -- when you put a meter on them (2/11).

The Washington Post: George W. Bush's Words That Saved Millions
Even among the few, odd, nerdy children who want to be speechwriters when they grow up (I was one), none dream of writing a State of the Union address. These tend to be long and shapeless affairs, lumpy with random policy, carried along by strained applause lines. … There are a few exceptions: Lyndon Johnson announcing a War on Poverty; Bill Clinton, as a scandal unfolded, undismayed in the lion's den. And then there were these sentences in the 2003 address 10 years ago: "Tonight I propose the Emergency Plan for AIDS Relief," said President George W. Bush, "a work of mercy beyond all current international efforts to help the people of Africa. This comprehensive plan will prevent 7 million new AIDS infections, treat at least 2 million people with life-extending drugs and provide humane care for millions of people suffering from AIDS and for children orphaned by AIDS" (Michael Gerson, 2/11).

Boston Globe: Time To Expand The Family Medical Leave Act
As we gear up for tonight's State of the Union Address — in which the president is expected to be combative, and Republicans are expected to reject every syllable he utters — here's a fact worth chewing on: Two decades ago, the Family Medical Leave Act passed with bipartisan support. Yes, there was some opposition to the modest idea behind the bill: that workers should be able to recover from major illnesses, help ill relatives, or care for new babies without fear of losing their jobs. Groups like the US Chamber of Commerce and the National Association of Realtors firmly predicted that American business would grind to a screeching halt. But within the halls of Congress 20 years ago last week, common sense prevailed, for reasons that actually go to the heart of conservatism (Joanna Weiss, 2/12).

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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.