Daily Health Policy Report

Tuesday, February 25, 2014

Last updated: Tue, Feb 25

KHN Original Reporting & Guest Opinion

Health Reform

Health Care Marketplace

Capitol Hill Watch

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

New ACA Insurance Causes Headaches In Some Doctors' Offices

Kaiser Health News staff writer Jenny Gold, working in collaboration with NPR, reports: “Sheila Lawless is the office manager at a small rheumatology practice in Wichita Falls, Texas, about two hours outside of Dallas. She makes sure everything in the office runs smoothly – scheduling patients, collecting payments, keeping the lights on. Recently she added another duty--incorporating the trickle of patients with insurance plans purchased on the new Affordable Care Act exchanges. Open enrollment doesn’t end until March 31, but people who have already bought Obamacare plans are beginning to use them. ‘We had a spattering in January—maybe once a week. But I think we’re averaging two to three a day now,’ says Lawless. That doesn’t sound like many new customers, but it’s presented a major challenge: verifying that these patients have insurance” (Gold, 2/25). Read the story.

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Insuring Your Health: Readers Ask About Whether Some Practices By Doctors, Insurers Are Acceptable

Kaiser Health News consumer columnist Michelle Andrews writes: "This week, I answer readers' questions about the limits of acceptable practice on and off the exchanges" (2/25). Read her responses.

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Capsules: Rep. John Dingell, Long-Time Champion Of Health Legislation, Will Not Seek Re-Election; Arkansas Medicaid Fight All About The Math, Governor Says

Now on Kaiser Health News’ blog, Mary Agnes Caret writes about Rep. John Dingell’s big announcement: "Another health care legend is retiring on Capitol Hill. Rep. John D. Dingell, a Michigan Democrat who was a key player in many health care battles in Congress, including enactment of the 2010 health care law and his push for a 'Patient's Bill of Rights' in the late 1990s and early 2000s, said Monday he will retire at the end of his current term" (Carey, 2/24). 

Also on Capsules, Phil Galewitz reports on Arkansas Gov. Mike Beebe and his states' Medicaid expansion plan: "Arkansas Gov. Mike Beebe says his strategy to win over state lawmakers skeptical about continuing the state’s Medicaid expansion is to show them the money. ‘It’s arithmetic, it’s not even math,’ Beebe said Monday at a media briefing sponsored by Kaiser Health News and Health Affairs. The Democratic governor said if the Arkansas legislature opts against going forward with the expansion, it would leave an $86 million hole in the state budget, and cost the state’s hospitals and employers tens of millions of dollars" (Galewitz, 2/24). Check out what else is on the blog.

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Political Cartoon: 'Look Up In The Sky?'

Kaiser Health News provides a fresh take on health policy developments with "Look Up In The Sky?" by Nate Beeler.

And here's today's health policy haiku:


 Dingell is leaving.
It's a changing of the guard.
Which one will be next?

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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Health Reform

Report: 11 Million Workers Could See Higher Costs

Nearly two-thirds of small businesses will see their health insurance premiums increase under the ACA, according to a new Centers for Medicare & Medicaid Services report. Democrats counter that the report ignores subsidies for premiums.

The Wall Street Journal: Rising Premiums May Hit Small Firms
A federal actuarial report predicts that 65 percent of small businesses will see their health-insurance premiums increase under part of the Affordable Care Act. The report, from the Centers for Medicare and Medicaid Services Office of the Actuary, is the latest piece of bad news for the president's signature domestic achievement. While the law was designed to curb rising health costs, some consumers have seen their premiums or other out-of-pocket costs increase this year, or had their plans canceled altogether (Corbett Dooren, 2/24).

CNN: Republicans Pounce On Obamacare Report; Democrats Cry Foul
Republicans are seizing on a new report in which the Obama administration itself concludes that the President's signature health care law would raise premiums for roughly two-thirds of small companies. But Democrats point out that Republicans designed and ordered the report, which they say ignores billions of dollars in subsidies that will decrease those premiums (Desjardins, 2/24).

The Associated Press/Washington Post: Premiums May Rise For 11 Million Workers: Report
The estimate is far from certain, partly because many small businesses renewed their policies in 2013. Renewing before the end of the year allowed them to avoid higher premiums that went into effect Jan. 1, when coverage was required to conform to the law (2/24).

Fox News: Obamacare May Increase Premiums For 11 Million Workers, Report Says
Republicans renewed their fight against Obamacare on Monday in response to a new report in which the Centers for Medicare & Medicaid Services concludes that 11 million small business employees may see their premiums rise under the law.  The report, released Friday, says the higher rates are partly due to the health law's requirement that premiums can no longer be based on a person's age. That has sent premiums higher for younger workers, and lower for older ones (2/25).

Politico Pro: Small-Business Health Premiums May Rise, Report Says
A new report by the Obama administration estimates that health insurance premiums of 11 million small-business employees will tick up under the federal health care law, handing Republicans another potent talking point about how Obamacare is inflicting damage on workers. The report also found that premiums are expected to fall for the other 6 million small-business employees and that the impact on premiums in large employer health plans will be "negligible." The report examining the law's key market reform rules was mandated by the Budget Control Act and was quietly released late Friday, about two years late, Republicans noted (Norman, 2/24).

Meanwhile, larger companies are reporting effects of the law.

The Wall Street Journal: Health Law Already Has Impact On Bottom Lines
The Affordable Care Act's impact on the bottom line is starting to ripple across corporate America. More than 80 public companies told investors the new health care rules were, or could be, a financial boost or drag on their quarterly earnings, though they were often uncertain of the magnitude, according to a Wall Street Journal search of earnings-call transcripts for the most recent quarter provided by FactSet (Knox, 2/24).

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For Governors, Medicaid Expansion Issues Create Interesting Political Dynamics

Some Republican governors are seeking political cover as they pursue a version of the expansion, while some Democratic state executives want more backup from the White House. Meanwhile, news outlets also provide updates on developments in Virginia and Arkansas. 

The Washington Post: Republicans Seek Political Cover To Accept Medicaid Expansion Money
In the bitterly partisan debate over the Affordable Care Act, few House members criticized the proposed legislation as harshly or as often as then-Rep. Mike Pence. But now, nearly four years after the measure passed on a party-line vote, Pence, now Indiana’s governor, is asking the federal government for ACA money to expand a program that provides coverage to low-income Hoosiers. But he wants to do it outside the confines of the health-care law (Wilson, 2/25).

Politico: Pro-Medicaid GOP Governors Well Placed For Reelection
Conservative activists threatened revenge for Republican governors who boosted Obamacare. Now it looks like they were mostly blowing smoke. Around the country, Republicans who defied the base and embraced Obamacare’s massive expansion of Medicaid are better positioned for reelection than those who did not. None has garnered a serious primary challenge so far, and even Democrats have struggled to field strong contenders to take them on (Cheney and Hohmann, 2/25).

Politico: Democratic Governors: Obama Needs To Sell Obamacare
With the battle over Obamacare moving from Washington to the states and a deluge of ads battering the law on TV, Democratic governors delivered a message to President Barack Obama this week: We need help.
Four years out from passage of the Affordable Care Act, it’s state executives in Obama’s party who may be bearing the heaviest load when it comes to making the law work and selling it to voters. They’ve grappled with their own glitch-ridden enrollment sites and fought their own legislatures over Medicaid expansion (Burns, Cheney and Dovere, 2/25).

The Washington Post: In Va., Fight Over Medicaid Expansion Continues
Gov. Terry McAuliffe hit the road to sell Medicaid expansion Monday, touring a Northern Virginia hospital to make the human and business case for insuring more poor and working people — and to pressure House Republicans who have pledged to block the effort (Laris and Vozzella, 2/24).

The Associated Press/Washington Post: Business Groups Clash On Va. Medicaid Expansion
The Virginia Chamber of Commerce and state business leaders renewed their call Monday for Republican House lawmakers to accept billions in federal Medicaid funds, saying it would be a boost for the state’s economy (2/24). 

The Richmond Times-Dispatch: Va. Chamber Backs Private Health Care Option; House Leaders, NFIB Oppose Expansion
Virginia’s biggest business organization has embraced a private option plan for extending health coverage to hundreds of thousands of uninsured Virginians by using federal money intended for expanding the state’s Medicaid program. But opponents led by House Speaker William J. Howell, R-Stafford, answered immediately with a news conference that featured the National Federation of Independent Business, a national organization that led the legal fight against the federal health care law and has about 5,500 business members in Virginia. The Virginia Chamber of Commerce presented an 11-point proposal Monday that builds on the Marketplace Virginia plan included in the Senate budget as it hurtles on a collision course with a House of Delegates resolutely opposed to any form of Medicaid expansion (Martz, 2/24).

The Wall Street Journal’s Washington Wire: Arkansas Governor Again Prods Legislature to Fund Medicaid Program
Arkansas Gov. Mike Beebe said he hoped the possibility of “severe and draconian cuts” to state services will spur state lawmakers to fund a program that buys private health insurance for residents who newly qualify for Medicaid (Corbett Dooren, 2/24). 

Kaiser Health News: Capsules: Arkansas Medicaid Fight All About The Math, Governor Says
Arkansas Gov. Mike Beebe says his strategy to win over state lawmakers skeptical about continuing the state’s Medicaid expansion is to show them the money. "It’s arithmetic, it’s not even math," Beebe said Monday at a media briefing sponsored by Kaiser Health News and Health Affairs. The Democratic governor said if the Arkansas legislature opts against going forward with the expansion, it would leave an $86 million hole in the state budget, and cost the state’s hospitals and employers tens of millions of dollars (Galewitz, 2/24).

The Fiscal Times: The Battle To Expand Medicaid In Arkansas
Last fall, Arkansas became the first state to adopt the so-called “private option”— an alternative to Obamacare’s Medicaid expansion that allows low-income people to buy health insurance on the private exchange instead of going onto the federal program. Now with the midterm elections looming and pressure on the president’s health care law ramping up, the country’s first model for the private option could be in jeopardy. The program’s fate is now in the hands of the Arkansas House of Representatives, which will vote for the fifth time to approve the $915 million in federal funding needed to continue financing the alternative to Medicaid expansion (Ehley, 2/25).  

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After Five Days, Covered California Website Restarts; Md. Fires Exchange Contractor

Also in the news, the latest developments regarding the online insurance marketplaces in Connecticut, Oregon, Minnesota and California.

Los Angeles Times: California Website For Obamacare Back Up After 5-Day Outage
California's enrollment website for Obamacare coverage was restored Monday after a five-day outage due to software problems. The online troubles frustrated many consumers, enrollment counselors and insurance agents who wanted to use the Covered California website. The state had been signing up more than 7,000 people per day, on average, in February. The online enrollment system went down late Wednesday and the state continued to work on it throughout the weekend (Terhune and Karlamangla, 2/24). 

The Washington Post: Maryland Fires Contractor That Built Troubled Health Insurance Exchange
The Maryland Health Benefit Exchange voted late Sunday to terminate its $193 million contract with Noridian Healthcare Solutions. Columbia-based Optum/QSSI, which the state hired in December to help repair the flawed exchange, will become the prime contractor, and Noridian will assist with the transition (Flaherty and Johnson, 2/24).

The Baltimore Sun: State Terminates Contracts With Health Exchange Firm
Maryland has terminated its contracts with the company hired to build and operate the state’s online health exchange, which has been riddled with problems since its launch in October. The board overseeing the exchange voted Sunday night to sever ties with Noridian Healthcare Solutions, and the state reserves the right to take the company to court for damages, officials said Monday (Cox and Dance, 2/24).

The New York Times: Connecticut Plans to Market Health Exchange Expertise
Connecticut has been so successful in getting people to sign up for health insurance through its online marketplace that it is setting up a consulting business to help other states build and operate websites where people can compare and buy private insurance policies. And the Obama administration has encouraged the effort, in the hope that more states will run their own exchanges in 2015 or 2016 (Pear, 2/24). 

The Oregonian: Manager Who Oversaw Cover Oregon Health Insurance Exchange Project Blasted State Managers For 'Misinformation'
Carolyn Lawson, the state information-technology official who was asked to resign over problems with the health insurance exchange in December, has declined to comment publicly ever since. Privately, though, she has plenty to say, judging by an e-mail obtained under Oregon Public Records Law. On Jan. 19 Lawson complained to state managers that she has been unfairly criticized by Oregon Health Authority leadership even though she kept her boss, Bruce Goldberg, fully informed. Lawson did as she was told, she said – such as publicly parroting inaccurate OHA talking points, and writing a scripted letter of resignation that portrayed her departure as voluntary (Budnick, 2/24).

Minnesota Public Radio: MNsure, Other Exchanges Near Enrollment Deadline
MNsure, along with other state health insurance exchanges, continue to struggle to overcome bad reviews and technical delays. MNsure recently axed the Paul Bunyan and Babe the Blue Ox ads and is now spending $266,000 on new television ads like this one to encourage enrollment. The open enrollment period ends at the end of March (2/24).

The Star Tribune: Minnesota Poll: Party Split Felt Over MNsure, Health Reform
Minnesotans remain divided along party lines over the federal health law and whether the state should keep its troubled online insurance exchange, MNsure. Half of Minnesotans think their health care situation will be the same or better under the new law, according to the latest Star Tribune Minnesota Poll. About one in five said their situation will improve. But 46 percent of those polled believe their health situation will be worse under the law (Crosby, 2/25).

The California Health Report: Latino Participation In Covered California Lags; Monterey Region Agencies Boost Outreach
Magnolia Zarraga hadn’t had health coverage since graduating from Alisal High School in 1996. Between the lapse in coverage and her pre-existing conditions, she was quoted $900 per month for private insurance. “That wasn’t doable,” she says. Last month, she enrolled in a subsidized “silver” plan for $230 per month through Covered California, the state’s health-care marketplace under the federal Affordable Care Act (ACA). Although she found the process fairly easy, Zarraga, a Salinas-based immigration attorney, sees the need for more outreach to the Latino community, particularly those with language or accessibility barriers (Abraham , 2/24).

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Who's Exempt From The Individual Mandate, And How Will The IRS Enforce It?

CQ HealthBeat examines who's exempt and how IRS enforcement of the mandate will shake out.

CQ HealthBeat: IRS Enforcement Of ‘Individual Mandate’ May Be Light
One of the most debated parts of the health care law is the requirement that most Americans buy insurance starting this year. … But it’s not clear that the IRS will deploy much in the way of resources to aggressively search for individuals who don’t get coverage this first year (Adams, 2/24).

CQ HealthBeat: Many Categories Exempt From Individual Mandate
The Obama administration and Congress exempted many Americans from the health insurance law’s individual mandate. Those people who are either not required to have coverage or are automatically considered to have met the requirement include: Members of a religious sect that is recognized as conscientiously opposed to accepting any insurance benefits (Adams, 2/24).

Elsewhere, the enrollment push continues in California and some doctors' offices are finding long wait times -- on the phone with insurance companies --

Los Angeles Times: L.A. Community Colleges Urge Students To Sign Up For Obamacare
Danielle Alberts fell and broke her right ankle in three places in 2012. Alberts, who earns about $9,000 a year, went to the hospital and was charged nearly $4,000 for a shot and some pain medication. Alberts did not have health insurance. She refused a cast because it would have cost $500 more and she didn't have the money from her jobs as a security guard and caregiver. The ankle healed poorly, leaving her with a limp, and she wears a brace to keep the swelling down (Song, 2/24).

Kaiser Health News: New ACA Insurance Causes Headaches In Some Doctors' Offices
Sheila Lawless is the office manager at a small rheumatology practice in Wichita Falls, Texas, about two hours outside of Dallas. She makes sure everything in the office runs smoothly -- scheduling patients, collecting payments, keeping the lights on. Recently she added another duty -- incorporating the trickle of patients with insurance plans purchased on the new Affordable Care Act exchanges. Open enrollment doesn’t end until March 31, but people who have already bought Obamacare plans are beginning to use them. ‘We had a spattering in January -- maybe once a week. But I think we’re averaging two to three a day now,’ says Lawless. That doesn’t sound like many new customers, but it’s presented a major challenge: verifying that these patients have insurance (Gold, 2/25).

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Health Law Attack Ads Under The Microscope

As congressional races heat up, political ads related to the health law move into the realm of fact-checking and demands for proof.  

The Washington Post’s The Fact Checker: An Attack Ad Against Obamacare, Featuring A Man On Medicare
An irritated reader who lives in Michigan wrote The Fact Checker about this ad, which seeks to bolster Rep. Justin Amash (R-Mich.) as a fighter against the Affordable Care Act, a.k.a. Obamacare. The reader asked how such as an elderly-looking gentleman could be on the Affordable Care Act. Instead, the reader surmised, the man must be on Medicare, which is actually a single-payer government-run health care system (Kessler, 2/25).

Fox News: Cancer Patient Defends Obamacare Criticism After Dem Goes After Ad
A Michigan cancer patient is fighting back after her critical claims about Obamacare were called into question by a Democratic congressman, who went so far as to threaten Michigan television stations running her ad.  Julie Boonstra, who was diagnosed five years ago with leukemia, was featured in an ad last week by the conservative Americans for Prosperity. In it, she said her insurance plan was canceled because of the Affordable Care Act, and claimed her out-of-pocket costs are now "so high it's unaffordable." The target of that ad, Michigan Rep. Gary Peters, subsequently had his campaign lawyers write to Michigan TV stations, effectively warning that their FCC licenses could be at risk unless they demanded more proof from AFP (2/24).

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Health Care Marketplace

Health Stocks Rise As Worries Ease About Medicare Advantage Payment Rate Cuts

Shares of Humana, UnitedHealth, Aetna and others went up Monday as estimates of the 2015 payment rate reduction estimates appeared to land closer to 4 percent than to the initial expectations around 7 percent or even deeper.

The Wall Street Journal: Health Insurers Rally As Fears Over Medicare Cuts Ease
Shares of Humana Inc. and other U.S. health insurers rose Monday as the proposed Medicare reimbursement cuts for 2015 weren't as bad as had been feared. The Centers for Medicare and Medicaid Services issued its proposal late Friday for the rates it will pay health plans in 2015. Cuts had been expected, with some set to phase in automatically under the federal health-care law. Humana, in a filing Monday to the Securities and Exchange Commission, said it expected CMS' proposal to cut Medicare Advantage funding for 2015 by 3.5% to 4%. Humana previously had said it expected a decline of 6% to 7% (Stynes and Mathews, 2/24).

Reuters: U.S. Insurers Say Proposed Medicare Cuts Less Than Feared
U.S. health insurers including Humana Inc said on Monday that the government's proposed cuts to privately run Medicare programs appear to represent a funding decline of around 4 percent, less than the possible cuts of 7 percent or deeper that analysts had been expecting. Shares of most insurers rose on Monday, with Humana leading the pack, up 9.2 percent at $112.29 on the New York Stock Exchange in early afternoon. Shares of UnitedHealth Group Inc were up 2.8 percent at $75.91 and Aetna Inc was up 2.6 percent at $72.24 (Humer, 2/24).

Meanwhile, Tenet reports on the latest quarter -

The Wall Street Journal: Tenet Healthcare Swings To A Loss
The broader hospital sector has been consolidating as the industry is poised for major changes related to the U.S. health-care overhaul. Tenet last year completed its acquisition of Vanguard Health Systems Inc., a move that aims to broaden its geographic reach. Hospitals also continue to face a slowdown in patient traffic that has been viewed as tied—at least partly—to the recession and its aftermath. In the latest quarter, Tenet reported adjusted admissions fell 0.5%, as inpatient admissions fell 2.3% (Prior, 2/24). 

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Capitol Hill Watch

Rep. John Dingell Announces Retirement

The Michigan Democrat, who was often at the center of health care debates as he sought universal health care benefits, says he will not seek a 30th term in Congress.

The Associated Press: Dingell, Longest-Serving Congressman, To Retire
The Michigan Democrat, who was elected to his late father's seat in 1955 and has held it ever since, announced his decision while addressing a chamber of commerce in Southgate, near Detroit. Afterward, he told reporters that he will not run for a 30th full term because he could not have lived up to his own standards (Karoub and Eggert, 2/24).

Politico: The ‘Babe Ruth’ Of Legislators
Congress is losing a lot of policy heavyweights this year, but there’s only one whose career spans from the creation of Medicare to the passage of the Affordable Care Act. In his nearly six decades in Congress, John Dingell has played a central role in more issues than most ordinary lawmakers ever get to touch — everything from health care to energy, environmental laws, food safety and telecommunications policy, and an aggressive oversight approach that cut across even more issues that affect Americans daily. ... And Dingell is the Democrat who introduced a universal health care bill in every new session of Congress, keeping the cause alive until the passage of President Barack Obama's signature legislative achievement in 2010. He rallied Democrats to keep going, urging them not to let another health care reform effort end in failure. And at the signing ceremony, it was Dingell who sat next to Obama, grinning broadly as his cause became the law of the land (Nather, 2/24).

The New York Times: John Dingell To Retire After Nearly 60 Years In House
No member of the House has served as long as Representative John D. Dingell, Democrat of Michigan. So it resonated when Mr. Dingell announced on Monday that he would not seek re-election to a seat he has held since the Eisenhower administration in part because the institution he once revered had become "obnoxious," driven by acrimony and marked by lack of productivity (Hulse and Parker, 2/24). 

Los Angeles Times: John Dingell, Dean Of The House, Plans To Retire
During his long House career Dingell was a champion for Democratic priorities, foremost among them universal health care. At the start of each new Congress Dingell would introduce a bill to establish a universal healthcare system; he was at President Obama's side when he signed the Affordable Care Act into law in 2010 (Memoli, 2/24).

The Wall Street Journal: Michigan Rep. John Dingell To Retire
In his 58 years in Congress, Mr. Dingell has been known for his fierce protection of Michigan's auto industry, putting him at odds with the Democratic caucus's commitment to tougher antipollution standards. But he championed liberal policies elsewhere. He had a hand in some of Congress's landmark legislative efforts, including Medicare, the 1990 Clean Air Act, the Affordable Care Act, and the 1964 Voting Rights Act -- which he said in June was the "single most important vote I cast" (Ballhaus and Peterson, 2/24). 

The Washington Post: In John Dingell’s Departure, A Changing Of The Guard And The End Of An Old Style Of Power
Yet on other issues, Dingell is an ardently old-style liberal. His most cherished cause was expanding health care coverage, which came to fruition with the passage of the Affordable Care Act (Tumulty and Kane, 2/24). 

Kaiser Health News: Capsules: Rep. John Dingell, Long-Time Champion Of Health Legislation, Will Not Seek Re-Election
Another health care legend is retiring on Capitol Hill. Rep. John D. Dingell, a Michigan Democrat who was a key player in many health care battles in Congress, including enactment of the 2010 health care law and his push for a "Patient's Bill of Rights" in the late 1990s and early 2000s, said Monday he will retire at the end of his current term (Carey, 2/24).

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Senate To Consider Massive Bill To Revamp Veterans' Benefits

The legislation would expand health, education and other benefits for vets and would cost $21 billion over 10 years.

The Associated Press: Vets Benefits Bill Should Win Initial Senate Vote
A sprawling Democratic bill expanding health, education and other benefits for veterans seems ready to clear an initial hurdle in the Senate. Yet the election-year measure faces an uncertain fate as Republicans try to make it smaller and find ways to pay for it. The legislation, which sponsor Sen. Bernie Sanders, I-Vt., says would cost $21 billion over the coming decade, could confront GOP lawmakers with an uncomfortable campaign-season test over curbing spending for the nation’s 22 million veterans and their families (Fram, 2/25). 

Politico Pro: Senate To Debate Veterans' Health Care Bill
A massive veterans bill the Senate will consider this week would greatly increase their access to health care, through more than two dozen new facilities across the country, greater rehabilitation for men and women who have returned from deployments with traumatic brain injuries and other services. The omnibus legislation would be the largest package of veterans' benefits passed in decades. Veterans groups are championing the multibillion-dollar bill not only because of its focus on expanded medical and dental care but also its array of provisions aimed at helping veterans obtain education and find jobs (Cunningham, 2/24).

Meanwhile, the budget request for the Defense Department next year also calls for some health benefit cuts for active duty military.

The Washington Post: Pentagon Budget Would Cut Military Health Benefits And Commissary Funds
The Pentagon's 2015 budget proposal would raise health-care costs for certain members of the military community and drastically trim subsidies for the commissaries that provide discounted groceries to troops and their families (Hicks, 2/24). 

The Washington Post: Little Uniformity In Military Health Care
A new series of critical reports highlights the need to speed up unification of the military services' separate approaches to health care, which is one of the fastest-growing budget items but still lacks common standards for dealing with some medical issues (Pincus, 2/24). 

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State Watch

State Highlights: Calif. Malpractice Bill; Conn. Braces For Mental Health Cuts

A selection of health policy stories from California, Connecticut, Florida and Arizona.

Los Angeles Times: New Bill Brings Medical Malpractice Fight To The Legislature
Seeking to avert a costly initiative battle, state Senate President Pro Tem Darrell Steinberg (D-Sacramento) has introduced a bill to serve as a vehicle for a legislative compromise on California's medical malpractice law. The measure is brief: just one sentence stating the Legislature's intention to "bring interested parties together to develop a legislative solution to issues surrounding medical malpractice injury compensation" (Mason, 2/24). 

The CT Mirror: CT Mental Health Clinics Brace For State Cuts Tied To Obamacare
While Gov. Dannel P. Malloy has touted a proposal to increase spending on mental health services, agencies that run mental health and substance abuse clinics are bracing for more than $10 million in cuts to state grants starting July 1. And they say the cuts could mean treating fewer people at a time when demand for care is growing. The Malloy administration proposed cutting the money last year as part of its two-year budget, arguing that the state funding would no longer be necessary because most uninsured Connecticut residents would gain new coverage options Jan. 1 as part of the federal health law. That means the agencies that provide services would be able to bill their newly insured clients’ coverage, the thinking goes (Becker, 2/25).

Health News Florida: Senate Pres.: No On Nurses’ Bill
Don Gaetz, president of the Florida Senate, could present a formidable obstacle to passage of a bill that would increase the powers and independence of nurse practitioners. News Service of Florida, which interviewed Gaetz last Friday, reported he opposes a House bill that would give advanced-practice nurses more authority, including prescribing of controlled substances (Gentry, 2/24).

The Arizona Republic: Medicare IDs Erroneously Published
Banner Health printed Medicare recipients’ identification numbers, which often are identical to their Social Security numbers, on the address labels of more than 50,000 issues of its magazine mailed in Arizona late last week. The 16-page quarterly magazine, titled Smart & Healthy, began arriving in mailboxes in Maricopa and Pinal counties on Monday, alarming residents who spotted their personal information displayed on the magazines. Each recipient’s personal information was printed above the person’s name and address on labels that were affixed to the winter 2014 edition of the magazine (Giblin, 2/24).

The San Francisco Chronicle: Walgreens, UCSF To Help Manage Prescriptions
UCSF and pharmacy chain Walgreens are launching a joint effort to help patients smoothly, safely and accurately fill their prescriptions, the two will announce Tuesday. The most visible aspect of the partnership will take place in a renovated, 1,200-square-foot section of a Walgreens across the street from UCSF Medical Center in San Francisco, where pharmacists from both the university and the pharmacy chain will help customers side by side. In addition, UCSF and Walgreens will seek to reduce medication errors by sharing electronic patient records with primary care doctors (Lee, 2/24).

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Editorials and Opinions

Viewpoints: Finding A Plan For 'Tinkering With DNA'; Fact-Checking Claims Of ACA Losses; Pediatricians' Fears Of Retail Clinics

Los Angeles Times: When Tinkering With Our DNA, Researchers Should Take It Slow
The manipulation of human genes could lead to profound advances in our ability to cure or prevent terrible diseases. But in some cases, it might also mean introducing genetic material that could be passed from one generation to the next, changing the human gene pool in a manner that could inadvertently harm peoples' health. Such "inheritable" DNA is a hotly debated issue among bioethicists, and one that an advisory committee of the Food and Drug Administration will review Tuesday and Wednesday as it considers whether human trials should be allowed for a new therapy that could prevent a rare but devastating inherited disorder (2/25).

The New York Times: Genetically Modified Babies
An advisory committee of the Food and Drug Administration is set to begin two days of meetings tomorrow to consider radical biological procedures that, if successful, would produce genetically modified human beings. This is a dangerous step. These techniques would change every cell in the bodies of children born as a result of their use, and these alterations would be passed down to future generations (Marcy Darnovsky, 2/23). 

Los Angeles Times: Who Really Cost Mrs. Blackwood Her Cancer Medicine?
Stephen J. Blackwood is utterly, unalterably convinced that his mother has lost access to her cancer medicine because of Obamacare. That's the theme of his passionate op-ed in today's Wall Street Journal. The piece currently tops the most-read list over at the Journal website and has shot around conservative websites with the speed of a measles virus in an unvaccinated population. Since we recently expressed perplexity about how easy it is to debunk most (if not all) Obamacare horror stories being retailed by Republicans and other critics of the Affordable Care Act, it's only fair to take a look at this one (Michael Hiltzik, 2/24). 

The Virginian-Pilot: The Fierce Urgency Of Now
As both a practicing physician and a policymaker, my support for Medicaid expansion is no secret. It is a simple fact that one's quality of life significantly improves with access to affordable health care. Imagine your child had a fever of 105 and was not able to be seen by a provider, or that you had to decide between paying rent and refilling a life-saving prescription. Hundreds of thousands of working Virginians make these choices on a daily basis (Va. Lt. Gov. Ralph Northam, 2/25).

Los Angeles Times: Want An America That Works? Innovate, Don't Regulate.
Down with stakeholders. The American Academy of Pediatrics has come out against affordable healthcare for kids. Retail medical clinics — at drugstores, Wal-Marts, etc. — are cropping up across the nation, thanks in part to the expected longer waiting times and out-of-pocket expenses stemming from Obamacare. And the pediatricians don't like it. "While retail clinics may be more convenient and less costly, the AAP said they are detrimental to the concept of a 'medical home,' where patients have a personal physician who knows them well and coordinates all their care," reported the Wall Street Journal. You say "medical home," I say locked-in customers. Tomayto-tomahto (Jonah Goldberg, 2/24).

Los Angeles Times: The Rights Of The Unvaccinated Child: The Legal View
In light of what's starting to look like a surge of measles cases spread by unvaccinated carriers, Hastings Law professor Dorit Rubinstein Reiss offers some welcome insights into the legal rights of unvaccinated children (Michael Hiltzik, 2/24). 

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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.