Daily Health Policy Report

Wednesday, February 27, 2013

Last updated: Wed, Feb 27

KHN Original Reporting & Guest Opinion

Health Reform

Health Spending And Fiscal Battles

Capitol Hill Watch


Public Health & Education

Health Care Marketplace

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Health On The Hill: House Panel Examines Nuts & Bolts Of Changing Traditional Medicare

Kaiser Health News staff writer Mary Agnes Carey and Jackie Judd discuss a Tuesday Capitol Hill hearing during which House Ways and Means Subcommittee on Health, chaired by Rep. Kevin Brady, began examining options for cost savings in traditional Medicare (2/26). Read the transcript or listen to the audio.

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Capsules: Americans Uncomfortable Around Mentally Ill Despite Acknowledging Discrimination; Ways & Means Chairman Hopes To Move Medicare 'Doc Fix' Plan

Now on Kaiser Health News' blog, Jordan Rau reports on a new poll exploring public views on mental illness: "The public has a contradictory view of mental illness, according to a new poll. While most Americans believe people with such ailments are the victims of prejudice and discrimination, a substantial portion of the public say they have qualms about working in the same place or having their children attend a school where someone with a 'serious' mental illness is employed" (Rau, 2/27).

In addition, Mary Agnes Carey reports on developments related to Medicare's 'doc fix': "The chairman of the House Ways and Means Committee made clear Tuesday that finding a solution to the vexing issue of setting Medicare physician payment rates is on his to-do list this year, and he got some tepid support from a key Democrat" (Carey, 2/27). Check out what else is on the blog.

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Political Cartoon: 'Passing On The Left?'

Kaiser Health News provides a fresh take on health policy developments with "Passing On The Left?" by Jeff Parker.

Meanwhile, here is today's health policy haiku:


Camp says SGR
on his to-do list -- but where
to find the money?

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

N.J.'s Christie Joins Ranks Of GOP Govs To Opt To Expand Medicaid

The decision by Gov. Chris Christie would provide health insurance to an estimated 104,000 of the poorest 1.3 million uninsured residents of the state. With this move, Christie follows other Republican governors who were staunch opponents of the health law, including Ohio's John Kasich and Florida's Rick Scott.

The New York Times: Christie Says He'll Take U.S. Money To Expand Medicaid
The expansion, which the governor described in his annual budget address to the Legislature, would provide health insurance to 104,000 of the poorest 1.3 million residents currently living without it, though some groups say the number could be higher. Mr. Christie emphasized that it was a financial decision, not a philosophical shift; if New Jersey did not take the money, he said, the federal government would give it to other states (Zernike, 2/26).

Politico: Chris Christie Takes Obamacare Medicaid Expansion
New Jersey Gov. Chris Christie threw his support behind Medicaid expansion under the president’s health care law Tuesday, becoming the eighth GOP governor to buck his party and align himself with President Barack Obama on the issue…Medicaid expansion starting next year would extend coverage to an estimated 300,000 uninsured New Jersey residents. The federal government fully funds the expansion for three years, after which the state contribution gradually rises to 10 percent (Cheney, 2/26).

Politico: Chris Christie's Obamacare Move Risky For 2016 Election
New Jersey Republican Gov. Chris Christie's reversal on accepting the Obamacare Medicaid expansion was a political no-brainer for a politician running for re-election in a blue state this year. But the move has uncertain implications for Christie as a potential 2016 contender who is already taking darts from some conservatives over his bona fides (Haberman and Nather, 2/26).

The Associated Press: Christie's $32.9B NJ Budget Expands Medicaid
New Jersey Gov. Chris Christie proposed a $32.9 billion budget Tuesday that allows more poor residents to enroll in Medicaid and increases public school aid but defers property tax rebates for three months to cover a projected budget shortfall. Christie, a possible Republican presidential contender in 2016 who is seeking a second term as governor in November, touted the budget as a blueprint that seeks fiscal stability without forgetting about the state's most vulnerable residents. The Democratic-led Legislature must approve the plan (Santi, 2/26).

The Washington Post's WonkBlog: Report: Chris Christie Will Support Obamacare's Medicaid Expansion
Taken together, these eight states will extend Obamacare's coverage expansion to 3.2 million Americans, according to this analysis from the Urban Institute. They will take in a cumulative $90 billion in federal funds to do so. The quick succession of governors to come out in favor of this part of the Affordable Care Act suggests that, when it comes to the Medicaid expansion, the lure of federal dollars may trump anti-Obamacare politics (Kliff, 2/26).

Philadelphia Inquirer: Christie Bucks GOP, Accepts Medicaid Funds
Despite his opposition to President Obama's health-care overhaul, Gov. Christie said Tuesday that New Jersey would take money from the Affordable Care Act to extend Medicaid coverage to tens of thousands of low-income individuals. In accepting the expansion, Christie, who is up for reelection this year, joined seven other Republican governors in bucking a GOP trend aimed at countering a key element of what is known as Obamacare. Fourteen Republican governors, including Gov. Corbett, have rejected expanding Medicaid in their states. Overall, 24 states and the District of Columbia have signed on to the expansion. Christie announced his acceptance in an address to the Legislature outlining a $32.9 billion budget for the fiscal year beginning July 1 (Gambardello, 2/27).

CNN: Christie Johns GOP Governors In Accepting Obama's Medicaid Expansion
The expansion of Medicaid included in President Barack Obama's sweeping health care law was accepted by an eighth Republican governor Tuesday, despite the GOP's fierce opposition to the law as a whole. New Jersey Gov. Chris Christie, explaining he was aiming to put "people first," announced his support for the expansion of Medicaid as he outlined his budget in front of the New Jersey state legislature. He becomes the eighth GOP governor to sign on to the plan, which has also been rejected by some high-profile state chief executives still at odds with the politically charged law known as Obamacare. Many Republicans view parts of the bill, including its individual requirement to obtain health insurance, as government overreach (2/26).  

Also, Politico offers a big-picture look at how opposition to the law is changing --

Politico: The Repeal Obamacare Chorus Quiets
Washington's repeal-Obamacare crowd is feeling a little lonely these days, abandoned by an increasing number of Republicans who have bowed to the political reality that the law isn’t going anywhere anytime soon (Haberkorn and Allen, 2/27).

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Other Governors Pressured For And Against Medicaid Expansion

In North Carolina, lawmakers passed legislation barring the state from expanding the program for the poor, while in Pennsylvania, Kansas and West Virginia, supporters are pressing the economic and political advantages of the health law provision made optional by the Supreme Court.

The Associated Press: NC Lawmakers Vote To Bar Medicaid Expansion
North Carolina lawmakers approved a bill Tuesday barring the state from expanding Medicaid under the federal health care overhaul. Gov. Pat McCrory, a Republican, has indicated he'll sign the GOP-backed bill when it reaches his desk (Biesecker, 2/26).

The Associated Press: Pa. Democrats Build Medicaid Pressure On Corbett
Pressure on Gov. Tom Corbett grew Tuesday to accept the federal government's offer to fund the lion's share of a massive Medicaid expansion now that Pennsylvania is virtually surrounded by states that are getting in line, including states run by Corbett's fellow Republican governors. Democrats seized on New Jersey Gov. Chris Christie's decision to embrace the Medicaid expansion as an opportunity to paint Corbett and Pennsylvania as increasingly isolated from a growing group of states that will accept billions of federal health care dollars to help hospitals and doctors care for millions of uninsured people (Levy, 2/26).

Kansas Health Institute: Hospital Association Poll Shows Most Kansans Support Medicaid Expansion
A majority of Kansans support expanding Medicaid to help low-income people gain health coverage, according to a poll done in December for the Kansas Hospital Association and released this week. According to the survey results, 60 percent of the state's residents would support expanding Medicaid to include persons earning up to 138 percent of the federal poverty level – $15,420. Expansion was opposed by 24 percent of those surveyed and 16 percent said they weren’t sure (McLean, 2/26).

The Associated Press: Groups Say Expanded Medicaid Will Add W.Va. Jobs
Expanding Medicaid will do more than provide coverage to 100,000 West Virginians, supporters of the federal health care overhaul argued Tuesday: It would also create 6,200 jobs while spreading $664 million through the state’s economy by 2016. The advocacy group Families USA hired Regional Economic Model Inc. to develop the estimates, and presented the findings with West Virginians For Affordable Health Care at a state Capitol press conference (Messina, 2/27).

The Associated Press: Branstad Calls DC Meeting On Medicaid 'Cordial'
Gov. Terry Branstad said Tuesday that he had a "cordial" recent meeting with the U.S. health secretary about his decision not to expand Medicaid in Iowa and will soon give the federal government his full proposal that aims to instead extend another program set to expire later this year. The Republican governor said he pressed Health and Human Services Secretary Kathleen Sebelius at their meeting Friday in Washington for a federal waiver to continue IowaCare, which provides limited health benefits to some 70,000 low-income adults in the state using state and federal funding (Lucey, 2/26).

Meanwhile, on state-based exchanges -

The Associated Press: Bill Would Lift Gag On Discussing N.H. Health Care Exchange
New Hampshire's new Democratic House majority is considering reversing a law banning the state from operating its own health care exchange under President Barack Obama's health care overhaul law. The House Commerce and Consumer Affairs Committee held a hearing Tuesday on a bill that would reverse a Republican-passed law that prohibits the state from operating a health exchange (Love, 2/26).

California Healthline: Bridge Plan Approved By Exchange Board
California's Health Benefit Exchange board yesterday approved a plan to seamlessly allow the lowest-income Medi-Cal managed care beneficiaries to choose a health plan offered by the exchange, now known as Covered California. The idea is to allow movement between Medi-Cal and Covered California when beneficiaries' circumstances change, so more people can stay insured without disruption. The exchange plans to launch the program in April 2014. Up to 840,000 Californians could be eligible for it, according to David Panush, director of government relations for Covered California (Gorn, 2/27).

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Health Spending And Fiscal Battles

Sequester Scare Touches Issues Related To Medicare, Medicaid Spending

The $85 billion in scheduled spending cuts to defense and discretionary accounts are scheduled to kick in Friday, and movement toward a last-ditch strategy has not been evident.

Los Angeles Times: Boehner: Time For Senate To Get To Work And Stop Sequester
The $85 billion in cuts were designed as a last-ditch strategy to bring both sides to the negotiating table on a broad deficit-reduction plan. But without an agreement, the cuts, also known as the sequester, are poised to take effect. Up to 13% from defense and 9% from other domestic accounts will be cut in the remaining seven months of the fiscal year, vacuuming about 750,000 jobs from the economy. Social Security and the Medicaid health program for poor and elderly Americans are spared, and cuts to Medicare are capped (Mascaro, 2/26).

The New York Times: Austerity Kills Government Jobs As Cuts To Budgets Loom
But this time is different. Growth has remained sluggish and millions remain unemployed even as the federal government, riven by partisan differences, has largely turned its attention to deficit reduction. Mr. Bernanke, like many critics of sequestration, said the government could not ignore the need to reduce its annual deficits and curtail the growth of its debt. But he said short-term cuts would worsen those problems by slowing the economy. Moreover, sequestration mostly spares Medicare and Medicaid, the health care programs that are the primary reason federal spending is projected to increase. Congress and the administration, he said, should "introduce these cuts more gradually and compensate with larger and more sustained cuts in the future" (Appelbaum, 2/26).

In related news, specific states and health industry stakeholders brace for impact --

Medpage Today: Docs Brace For $11 Billion Hit From Sequester
Medicare providers stand to absorb $11 billion of the $85 billion in federal spending cuts that start Friday and last for the rest of the fiscal year unless Congress takes 11th-hour action. Under the impending sequester, Medicare payments to providers will be cut by 2 percent, and most nondefense programs will be slashed by roughly 8 percent starting Friday. The across-the-board method to limit federal spending has been criticized and deemed harmful by both political parties and nearly all interest groups. But with little agreement on what to replace the spending cuts with, it's growing more likely they will actually take effect (Pittman, 2/26).

CQ Healthbeat: Device Industry Pushes To Prevent Sequester Tax
Device company leaders are worried about the effect sequestration would have on the Food and Drug Administration's ability to train new personnel, industry officials said Tuesday. But industry officials say they are optimistic that Congress will change a statutory quirk that prevents the agency from spending the increased user fee revenue authorized in a measure lawmakers passed in 2012. If Congress does act, that would free up some money the FDA could use for such activities as training new workers (Adams, 2/26).

Wichita Eagle: Kansas Could Lose Millions With Sequestration Cuts
Kansas will lose at least $79 million in funding for the state’s military bases and face about $10.8 million in cuts to education this year if Congress and the president can't reach agreement to head off automatic budget cuts scheduled to begin Friday, according to a new White House report. Those and other Kansas-specific cuts — part of the national sequestration debate — are detailed in a state-by-state report released by the White House Sunday evening. … Public health — Kansas would not receive more than $1 million in grants, including $610,000 for substance abuse, prevention and treatment; $273,000 to prepare for responses to threats such as infectious disease outbreaks, bioterrorism, nuclear or chemical accidents; $85,000 for childhood vaccinations; and $65,000 for HIV testing (Lefler, 2/26).

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Capitol Hill Watch

House Ways And Means Committee Chair Says 'Doc Fix' Is On His To-Do List

And a Tuesday hearing of the House Ways and Means health subcommittee focused on options for finding cost savings in the traditional Medicare program.

Kaiser Health News: Capsules: Ways & Means Chairman Hopes To Move Medicare 'Doc Fix' Plan
The chairman of the House Ways and Means Committee made clear Tuesday that finding a solution to the vexing issue of setting Medicare physician payment rates is on his to-do list this year, and he got some tepid support from a key Democrat. Rep. Dave Camp, R-Mich., said that the effort could be helped by a recent reassessment of how much it would cost (Carey, 2/27).

Kaiser Health News: Health On The Hill: House Panel Examines Nuts & Bolts Of Changing Traditional Medicare
Kaiser Health News staff writer Mary Agnes Carey and Jackie Judd discuss a Tuesday Capitol Hill hearing during which House Ways and Means Subcommittee on Health, chaired by Rep. Kevin Brady, began examining options for cost savings in traditional Medicare (2/26).

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Medicaid Physician Pay Boost Stalled By Delay In Federal Regs

Modern Healthcare: Medicaid Physician Pay Boost Stalled
No states appear to have implemented a temporary Medicaid physician pay boost more than eight weeks after it was supposed to have gone into effect, according to provider groups tracking the issue. The highly anticipated move boosting 2013-14 pay for Medicaid primary-care services provided by physicians to Medicare payment levels was required to go into effect Jan. 1, according to provisions of the Patient Protection and Affordable Care Act. But delayed federal rules implementing the pay hike have pushed back the logistical process that will provide the funds to those physicians. “It's going very, very slow but states are not doing the things they need to do,” said Neil Kirschner, a senior associate for the American College of Physicians (Daly, 2/26).

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Public Health & Education

Poll: Americans Have Mixed Feelings About People With Mental Illness

In related news, a new study found that spending on mental health care has increased over the past five years.    

Kaiser Health News: Capsules: Americans Uncomfortable Around Mentally Ill Despite Acknowledging Discrimination
The public has a contradictory view of mental illness, according to a new poll. While most Americans believe people with such ailments are the victims of prejudice and discrimination, a substantial portion of the public say they have qualms about working in the same place or having their children attend a school where someone with a "serious" mental illness is employed (Rau, 2/27).

Modern Healthcare: Mental Health Spending Rises Following Parity Rules, Report Says
Hospital stays for mental illness or substance abuse increased as hospital visits for other medical care declined the first year insurers were required to treat behavioral health as any other medical condition, a new report found. However it's unclear to what degree the new rules, the economy, changing health benefits or less stigma associated with mental illness contributed to the demand. The results, an analysis of five years of mental health and substance abuse spending by four giant insurers, found hospitalization for mental illness increased 5.9% in 2011 from the prior year. Substance abuse hospital stays increased 19.5% in the same period (Evans, 2/27).

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Health Care Marketplace

Efforts to Copy Biotech Drugs Face Delays, Obstacles

The Wall Street Journal: Biotech Drugs Still Won't Copy
Much anticipated knockoff versions of costly biotech medicines are facing delays and obstacles that could cost patients and health systems billions in missed savings (Weaver, Whalen and Rockoff, 2/26).

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State Watch

Proposals To Transform Medicaid Spur Enthusiasm, Worries

Oregon Gov. John Kitzhaber pushes his state's model for "reinventing" Medicaid with coordinated care organizations, while a proposed expansion of Medicaid managed care in Texas sparks worries about care for the disabled.

Politico: Oregon Governor touts New Medicaid Model
Oregon Gov. John Kitzhaber used the just-completed National Governors Association winter meeting to try to get his colleagues to think not just about cutting or expanding Medicaid -- but about reinventing it (Martin and Kenen, 2/27).

The Texas Tribune: Senate Panel Discusses Reforms To Curb Medicaid Costs
During four hours of public testimony on Senate Bill 7 on Tuesday, disability rights stakeholders aired concerns on the bill's proposals to redesign Medicaid and acute care services to contain costs. … SB 7 aims to curb costs by expanding managed care services, establishing pilot programs to try capping costs and to monitor services more efficiently (Aaronson, 2/26).

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Arkansas Governor Vetoes Bill Banning Abortion After 20 Weeks

The move by the Democratic governor sets up an override fight with a Republican legislature that wants the ban to apply except in cases of rape, incest or if the mother's life is in danger.

The Associated Press/Washington Post: Ark. Governor Vetoes Bill Banning Most Abortions At 20 Weeks, Citing Constitutional Concerns
Democratic Gov. Mike Beebe on Tuesday vetoed a ban on most abortions in Arkansas at 20 weeks into a pregnancy, setting up an override fight with a Republican-controlled Legislature that has been pushing for more restrictions on the procedure (2/26).

Reuters: Arkansas Governor Vetoes Bill Banning Abortions At 20 Weeks
Democratic Governor Mike Beebe on Tuesday vetoed a bill to ban most abortions in Arkansas at 20 weeks into pregnancy, though state lawmakers can override his decision with a simple majority vote. The measure, which had been approved by an 80 to 10 vote in the state House and by a 25 to 7 vote in the state Senate, would provide exceptions only in cases of rape, incest or to save a mother's life (Parker, 2/26).

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State Roundup: Health Care Industry Calls Drug Testing Bill In N.H. 'Vague'

A selection of health policy stories from New Hampshire, Oregon, Kansas and California.

The Associated Press: Health Industry: NH Drug Testing Bill Too Vague
Representatives from the health care industry said Tuesday they have a vested interest in stopping employees from stealing controlled substances but a bill being considered by New Hampshire lawmakers to drug test their workers is too vague. The proposal is part of the legislative response to a recent scandal at Exeter Hospital, where an employee allegedly stole drugs and replaced them with Hepatitis C infected syringes later used on patients (True, 2/26).

Lund Report: Ore. House Bill 2522 Spells Out CCO Role For Chiropractors
The organization representing chiropractors is pushing a bill that would require coordinated care organizations to consider them equal to medical doctors, but quickly ran into opposition. … HB 2522 is opposed by CCOs, and the organization representing osteopathic physicians. "A bill of this nature undermines the original CCO legislation," said Ruth Bauman, chairwoman of the board of Willamette Valley Community Health, the CCO serving Medicaid clients in the Salem area. ... Legislation passed in 2012 created coordinated care organizations to integrate physical, mental and dental care for people on the Oregon Health Plan. The organizations are set up at the local level through collaboration among doctors, hospitals, mental health agencies, county commissioners, patient advocates and other health care professionals (Gray, 2/26).

Kansas Health Institute: Kansas Prescription Drug Monitoring Program Gets Boost
Kansas is one of at least two states set to receive free software needed to run its prescription drug monitoring program as part of a pilot project by the National Association of Boards of Pharmacy. According to state officials, that will translate to annual savings of about $120,000 in license and connectivity fees currently paid to run the Kansas Tracking and Reporting of Controlled Substances system (K-TRACS), which doctors and pharmacists use to check on possible prescription drug abuse by their patients (Cauthon, 2/26).

HealthyCal: Traveling Clinic Treats Kids Who Can't Afford Dental Care
While celebrities and golf professionals gathered at Pebble Beach as part of the AT&T Pro Am in February, a group of teenagers gathered under a tent in a rainy parking lot at the Twin Creeks Golf Course in Salinas to await appointments at a mobile clinic. Christina's Smile Children’s Dental Clinic has been following the PGA tour for 20 years, stopping in nearby communities to offer free dental services to low-income, uninsured children from ages 6 to 15 (Flores, 2/27).

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Editorials and Opinions

Viewpoints: Former Sen. Gramm Criticizes Obama On Budget Cuts; Debate On Revamping Medicare Needs Less Heat, More Deliberation

The Wall Street Journal: Obama And The Sequester Scare
While history shows that a divided government can enact significant spending cuts as an alternative to sequesters, that doesn't appear to be the path Mr. Obama intends to follow. Instead of protecting civilian defense workers, the president will continue to force the Pentagon to buy biofuels at $27 per gallon to promote his green agenda. Instead of protecting children from cuts in nutrition programs, the president will continue to allow $2.7 billion of fraud and mismanagement he has identified in the food-stamp program. Instead of protecting Medicare from a 2% cut, the president will ignore $62 billion in annual waste that his administration has identified in Medicare and Medicaid (Phil Gramm, 2/26).

The Washington Post: A Political DUI
We have a political system that is the equivalent of a drunk driver. The primary culprits are the House Republicans. They are so intoxicated with their own ideology that they are ready to drive the nation's car off the road. ... In my analogy, (President Obama) should take the steering wheel firmly in hand and drive the car toward the destination where most maps show we need to be heading: namely, a balanced program of cuts in Social Security and Medicare and modest increases in revenue (David Ignatius, 2/26).

Politico: Entitlement Reform Key To U.S. Future
As the sequester blame game hits fever pitch this week, Republicans' stance on taxes is simply indefensible, falling hundreds of billions short of even their own prior positions. But as Democrats, we also share a large portion of responsibility for the coming cuts to domestic discretionary spending, as the party has decided in both action and rhetoric that meaningful fixes to the major entitlement programs of Medicare, Medicaid and Social Security are off-limits (Jon Cowan and Jim Kessler, 2/26).

The New York Times: Economic Scene: Medicare Needs Fixing, But Not Right Now
What's the rush? For all the white-knuckled wrangling over spending cuts set to start on Friday, the fundamental partisan argument over how to fix the government's finances is not about the immediate future. It is about the much longer term: how will the nation pay for the care of older Americans as the vast baby boom generation retires? Will the government keep Medicare spending in check by asking older Americans to shoulder more costs? Should we raise taxes instead? It might not be a good idea to try to resolve these questions quite so urgently (Eduardo Porter, 2/26).

Los Angeles Times: Deficit Hawks' 'Generational Theft' Argument Is A Sham
The core idea the term expresses is that we're spending so much more on our seniors than our children that future generations are being cheated. An important corollary is that the government debt we incur today will come slamming down upon the shoulders of our children and grandchildren. … So here's the truth about the "generational theft" theme: It's wrong on the numbers and wrong on the implications (Michael Hiltzik, 2/27).

The New York Times: Economix: In Massachusetts We Trust
From a labor-market perspective, the Affordable Care Act has little in common with the 2006 health reform law implemented in Massachusetts. Some employers are complaining about the $2,000 per-employee-per-year penalty they will pay beginning next year when the main provisions of the Affordable Care Act go into effect. The Congressional Budget Office also warned about the astonishing increase in marginal tax rates that middle-income Americans will experience, because the additional income earned by a family will be considered by the Internal Revenue Service as available for additional health insurance payments (Casey Mulligan, 2/27). 

Los Angeles Times: In Medicine, One Dose Doesn't Fit All
For several reasons, older patients are far more likely to experience adverse drug reactions. For one thing, on average they take a larger number of drugs than younger people, which increases the likelihood that two or more will interact in a harmful way. Also, clearance by the kidneys and liver — the two most important routes for the elimination of drugs — is reduced. As people age, these organs get less blood flow, and there is diminished activity of the hepatic enzymes that metabolize drugs (Dr. Henry I. Miller, 2/27). 

The Medicare NewsGroup: Patient Engagement: A New Frontier In Health Reform
While patient-centered care is still in its infancy and represents what would be a culture shock to the fee-for-service system if introduced too quickly, it has great potential for improving the overall quality of care. … Much more research must be done on patient engagement, but it may very well become an essential element in the tandem goal of improving health care while lowering cost (John Wasik, 2/26).

Georgia Health News: Georgia's Unhealthy Regions Are Whole State's Responsibility
The recent closing of Calhoun Memorial Hospital in tiny Arlington, Ga., comes not just as another body blow to health and health care in impoverished areas of rural Georgia — but as a dagger to the heart of hopes for any kind of economic development or improvement. It also adds more weight to an anchor that already holds down the entire state's economy. As it happens, news of the Calhoun Memorial closing came as the Partner Up! for Public Health campaign was finalizing research and analysis on health and economic disparities in Georgia — research that had documented that Calhoun County was part of a cluster of counties in southwest Georgia that constitutes the least healthy region of the state (Charles Hayslett, 2/26). 

San Francisco Chronicle: Health Insurance Rate Increases Threaten Seniors
Something isn't working in the long-term-care insurance industry. The California Public Employees' Retirement System, which runs the country's second-largest long-term-care plan, just announced a remarkable 85 percent rate increase for most of its policyholders starting in 2015. John Hancock Life Insurance Co. increased rates on some California policies by 40 percent late last year. CNA Financial Corp. is seeking a 45 percent increase on some of its California policyholders right now. California is no anomaly, either -- most of the 8 million Americans who hold long-term-care policies have seen staggering rate increases in recent years (2/25).

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Andrew Villegas

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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.