Daily Health Policy Report

Wednesday, February 29, 2012

Last updated: Wed, Feb 29

KHN Original Reporting & Guest Opinion

Capitol Hill Watch

Health Care Fraud & Abuse

Health Reform

Campaign 2012


Health Care Marketplace

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Health On The Hill: House Republicans Pound Sebelius On Health Law

Kaiser Health News staff writer Mary Agnes Carey talks with Jackie Judd about HHS Secretary Kathleen Sebelius' appearance before the House Ways and Means Committee. She defended the health care law and the president's fiscal 2013 budget request. The hearing had all the hallmarks of a partisan political event (2/28). Read the transcript or listen to the interview.

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Medicare Spends Less Than Private Insurers On Knee Replacements

Kaiser Health News staff writer Julie Appleby reports: "The federal government spends 14 percent less than private insurers for knee replacement surgery and its related costs, even though Medicare patients are older and twice as likely to be readmitted to the hospital, a research paper released this week shows" (Appleby, 2/28). Read the story.

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Capsules: Maine's Top Court Backs State Authority To Limit Health Plan’s Profits; Wash. Senate Nears Vote To Require Abortion Coverage; More Americans Head To The ER For Dental Emergencies

Now on Kaiser Health News' blog, Julie Appleby reports: "In a case closely watched by the insurance industry, Maine’s top court Tuesday upheld state regulators' authority to hold down rate increases sought by Anthem Health Plans of Maine. In its ruling, the Supreme Judicial Court said that Maine's insurance superintendent had 'properly balanced the competing interests' in arriving at an approved rate increase of 5.2 percent" (Appleby, 2/28).

Christian Torres reports that the Wash. state senate is nearing a vote to require abortion coverage: "While lawmakers in Washington clash over birth control, lawmakers in Washington state are close to passing a first-of-its-kind law that would require insurers to cover abortion services" (Torres, 2/28).

Also on the blog, Shefali S. Kulkarni writes: "Americans who turn up in the emergency room to get dental care aren't lost, they're probably just running out of options. According to a new report from the Pew Center on the States, more than 800,000 visits to the ER in 2009 were for toothaches and other avoidable dental ailments" (Kulkarni, 2/28). Check out what else is on the blog.

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In Victory And Defeat, Romney And Santorum Bash Health Law (Video Clips)

In this Kaiser Health News video, GOP presidential candidates Mitt Romney and Rick Santorum struck out against the health care law in their speeches after the polls closed. Watch the video or read the transcript.

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Political Cartoon: 'Conundrum'

Kaiser Health News provides a fresh take on health policy developments with "Conundrum" By Chip Bok.

Meanwhile, here's today's haiku:


Cure for nausea
Caused by old JFK speech
Try birth control pill

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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Capitol Hill Watch

Senate Vote On Contraception Policy Set For Thursday

With the political stakes high, lawmakers are expected to vote Thursday on a Republican measure to let employers opt out of covering any health treatment they find morally objectionable.

The New York Times: Senate Nears Showdown On Contraception Policy
The Senate on Tuesday headed toward a showdown over President Obama's policy requiring health insurance coverage of contraceptives for women, even as Republicans appeared to be divided over the wisdom of pressing for a vote any time soon (Pear, 2/28).

The Wall Street Journal: Senate Set To Vote On Contraception
The heated battle over insurance coverage for contraception is shifting to Capitol Hill, with the Senate due to vote Thursday on a measure to let employers opt out of covering any health treatment they find morally objectionable (Bendavid, 2/29).

National Journal: Senate Voting On Contraception Amendment On Thursday
The Senate will vote on a controversial contraception amendment Thursday, Senate Majority Leader Harry Reid, D-Nev., said Tuesday. The amendment from Sen. Roy Blunt, R-Mo., would exempt employers from covering any health care service they find immoral. Blunt pushed his amendment after political opposition erupted to an Obama administration decision to require even religiously affiliated employers to offer health insurance that covers contraceptives free of charge. Blunt's amendment is widely expected to fail (McCarthy, 2/28).

The Hill: Parties Clash Over Scope Of Blunt Amendment
Senate Democrats said Tuesday that up to 20 million women could lose access to healthcare services under an amendment from Sen. Roy Blunt (R-Mo.), but Republicans argue that the proposal would change very little about the healthcare system. Blunt’s amendment, which could see a vote in the Senate this week, would let employers opt out of federal benefit mandates that violate their religious or moral beliefs (Baker, 2/28).

Politico: Roy Blunt: The New Culture Warrior
Blunt is pushing legislation to undo — and then some — President Barack Obama’s mandate that employers provide coverage for contraceptives. The gambit, his most audacious in his 13 months in the Senate, is sure to bolster his standing with the social conservative wing of the party. But there’s worry even within his own party that his proposal goes too far and could unleash a voter backlash in a year the GOP hopes to wrest control of the White House and Senate from Democrats (Wong, 2/28).

Los Angeles Times: Republicans Keep Up Birth Control Battle
Dissatisfied with the Obama administration's compromise on contraceptive coverage, congressional Republicans are fighting to do away with the requirement that insurers provide free birth control — a strategy that might rally their conservative base but risks alienating sought-after independent voters in this election year (Mascaro, 2/28).

In related news, Politico examines what it calls the "or else" in the Obama administration's rule -

Politico: Contraception Rule Could Lead To $100 Fines, Hill Report Says
So what, exactly, is the "or else" in the Obama administration's contraception coverage mandate? House Republicans asked the Congressional Research Service to look into it, and now they're blasting out the answer they got. According to the research service, insurers and employers that do not comply with the contraception coverage rule could face federal fines of $100 per day per employee (Feder, 2/28).

Meanwhile, in the House -

National Journal: House Judiciary Hearing Takes On Contraception Mandate
The House Judiciary Committee is the latest to hold a hearing on the contentious debate about an Obama administration mandate that religiously affiliated organizations, like all other employers, cover contraception in their employees' health plans. Apparently responding to the public-relations misstep of a previous House committee, which invited an all-male panel to testify on the same question, the Tuesday hearing on "Executive Overreach: The HHS Mandate Versus Religious Liberty," included three women on its witness list. Two of the women testifying opposed the mandate. One woman, who chaired the Institute of Medicine panel that recommended the coverage requirement, defended it (Sanger-Katz, 2/28).

And, in related news -

Politico: Kathleen Sebelius: Rule Coming Soon On Contraception Coverage
HHS Secretary Kathleen Sebelius says the Obama administration plans to issue a rule "in the near future" on its compromise plan on contraception coverage and is meeting with insurers, clergy and health leaders to get feedback on how to make it work (Nocera, 2/28).

Modern Healthcare: Contraception Policy Is Unfinished Business
Talk of HHS' controversial mandate requiring employers to include contraceptive services in their employee health plans has quieted down, but HHS Secretary Kathleen Sebelius indicated Tuesday that the administration is continuing the conversation. ... “We've begun outreach,” Sebelius told Modern Healthcare after her remarks about essential health benefits at the National Forum on Health Care, an event hosted by the American Cancer Society's Cancer Action Network (Zigmond, 2/28).

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Sebelius Testifies Before House Ways And Means Committee

The Health and Human Services secretary said the administration was vetting candidates for the the Independent Payment Advisory Board and defended President Barack Obama's 2013 budget.

Kaiser Health News: Health On The Hill: House Republicans Pound Sebelius On Health Law
Mary Agnes Carey talks with Jackie Judd about HHS Secretary Kathleen Sebelius' appearance before the House Ways and Means Committee. Sebelius defended the health care law and the president's fiscal 2013 budget request. The hearing had all the hallmarks of a partisan political event (2/28). Read the transcript or listen to the interview.

CQ HealthBeat: Administration Vetting IPAB Candidates, Though Panel Likely Won’t Make Recommendations Until 2018
The Obama administration is slowly vetting candidates to serve on the controversial Independent Payment Advisory Board that House Republicans plan to soon vote to repeal, Health and Human Services Secretary Kathleen Sebelius told Ways and Means Committee members on Tuesday. "Active discussions are under way about those possible candidates," Sebelius said. "Vetting those folks is not an easy task because this must be a full-time job" (Adams, 2/28).

There's more about IPAB -

Politico Pro: House Panel Aims To Repeal IPAB
Congressional Republicans plan to start votes on Wednesday to repeal the health care reform law’s Independent Payment Advisory Board, potentially culminating in a bipartisan House floor vote shortly before the Supreme Court’s oral arguments next month. The Energy and Commerce Health Subcommittee is slated to mark up repeal legislation Wednesday, and Ways and Means Health Subcommittee plans to go next week. A House floor vote could come the week of March 19, according to congressional aides and bill sponsor Rep. Phil Roe (R-Tenn.). Already it has 209 Republican and 17 Democratic co-sponsors (Haberkorn and Dobias, 2/29).

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Snowe - The Lone GOP Health Law Vote - Opts To Not Seek Re-Election

Sen. Olympia Snowe, R-Maine, cited the polarized climate of Congress and Washington as a key reason she will leave the Senate. Her departure renews Democrats' hope of winning this GOP seat.

The Associated Press: Maine GOP Sen. Snowe Won't Seek Re-election
With centrists becoming few and far between, Republican Sen. Olympia Snowe cited the increasingly polarized climate of Washington in abandoning the U.S. Senate after three terms, giving Democrats new hope of winning the longtime GOP-held seat. ... She was the only Republican who voted for a version of President Barack Obama's health care overhaul, joining Democrats and casting a vote for the plan in the Senate Finance Committee (Sharp, 2/29).

Boston Globe: Olympia Snowe Shocks GOP With Decision Not To Run
Olympia Snowe, a moderate Republican senator from Maine known for her ability to work across party lines on key issues affecting New England and the nation, stunned her colleagues yesterday by announcing she will not seek reelection this fall. ... During the lengthy debate over President Obama's bid to overhaul the nation's health care system, Snowe was the only Republican senator to vote for the legislation at any point; she supported the Finance Committee's version of the bill in 2009, though she did not vote for the final version (Jan and Bender, 2/28).

CQ HealthBeat: Snowe Departure Marks Exit Of Lone GOP Vote For Health Care Overhaul
The decision announced late Tuesday by Sen. Olympia Snowe that she won't run for re-election this fall marks the departure of the lone Republican in the Senate who voted for any version of the health care overhaul legislation that ultimately became law in 2010. Snowe was sympathetic to the aims of health care overhaul architects to expand coverage of the uninsured. In general she was a vote Democrats could hope to obtain for some of their proposals if they were willing to negotiate extensively and to make some adjustments. But after voting for the version of the overhaul approved by the Senate Finance Committee, she refused to vote for the overhaul on final passage (Reichard, 2/28).

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Health Care Fraud & Abuse

Texas Doctor Charged In $375 Million Medicare Scam

Federal authorities charged the Dallas-area physician and five owners of home health-care agencies with a scheme that included registering homeless people for home health care services they never received.

The Wall Street Journal: Doctor Accused Of Big Medicare Scam
Federal agents on Tuesday arrested a Dallas-area doctor accused of bilking Medicare of $350 million over a five-year period, in what the government called the largest Medicare fraud scheme by dollar value linked to a single physician. According to documents filed by the Justice Department in Dallas federal court, 54-year-old Dr. Jacques Roy carried out the fraud with the help of his office manager and home health-care agencies (Zimmerman and Radnofsky, 2/29).

The Washington Post: Texas Doctor Charged in $375 Million Health-Care Scam, The Largest Of Its Kind
A Texas doctor and five owners of home health-care agencies were arrested Tuesday on charges that they fraudulently billed Medicare and Medicaid nearly $375 million in what authorities described as the largest case of its kind (Horwitz, 2/28).

Los Angeles Times: $375-Million Medicare Fraud: Dallas Doctor Accused In Record Case
Federal law enforcement officials announced what they called the largest healthcare fraud case in the nation's history, indicting a Dallas-area physician for allegedly bilking Medicare for nearly $375 million in billings for nonexistent home healthcare services. Top Justice Department officials, working for several years to stem a rampant rise in healthcare fraud around the country, also revealed Tuesday that 78 home health agencies that were working with the physician, Dr. Jacques Roy, will be suspended from the Medicare program for up to 18 months (Serrano, 2/28).

The New York Times: Seven Charged In Health Care Fraud
The federal authorities in Dallas arrested a Texas doctor and six others Tuesday in a home health care scheme that the authorities said cheated the government out of nearly $375 million in Medicare and Medicaid fees. It was so brazen, they said, that it involved registering homeless people for home health care services they never received (Thomas, 2/28).

NPR: Texas Doctor Indicted In Record Medicare Fraud Case
A massive Medicare and Medicaid fraud scheme has been shut down by federal authorities. One doctor in Texas, Jacques Roy, was allegedly responsible for nearly $375 million in fraudulent billing (Goodwyn, 2/29).

The Texas Tribune: Texans Accused of $375 Million Health Care Fraud
Only Medicare patients who are home bound qualify for home health services. Officials with CMS said home health agencies are under intense scrutiny when they enroll, because their services are expensive (Aaronson, 2/28). 

Bloomberg: Texas Health-Care Services Accused By U.S. Of $374 Million In Phony Bills
Seven people in Texas billed U.S. government health programs for $374 million in services that weren't provided or necessary in the largest at-home health-care fraud scheme, according to the Justice Department.  A doctor, the office manager of his practice and five owners of at-home health agencies were arrested yesterday on charges related to their participation in the fraud, the department said in a statement. In court papers, the U.S. described door-to-door efforts to recruit thousands of patients who didn't need services, a boiler room where falsified documents were signed and overseas bank accounts (Stern, 2/29).

The Dallas Morning News: Rockwall Doctor Who Owns DeSoto Medical Firm Among 7 Accused In Bilking Medicare, Medicaid For $375 Million
A Rockwall doctor's brazenness in allegedly charging the government for fake services, along with regulators’ newfound ability to analyze bills faster, helped dismantle the nation's largest home health care fraud ever orchestrated by a single physician, prosecutors said Tuesday. The doctor and six associates were charged with recruiting fake patients among Dallas' homeless population and elsewhere, then falsifying records that earned the defendants $375 million over a five-year period, authorities said(Drahan, 2/28). 

The Associated Press: 7 Accused Of Bilking $375M From Medicare, Medicaid
A Texas doctor has been charged with running a massive health fraud care scheme with thousands of fraudulent patients and intermediaries allegedly offering cash, food stamps or free groceries, to bilk Medicare and Medicaid of nearly $375 million. A federal indictment unsealed Tuesday charges Jacques Roy, a doctor who owned Medistat Group Associates in DeSoto, Texas, and six others in an alleged scheme to bill Medicare for home health services that were not properly billed, not medically necessary or not done (Lozano and Merchant, 2/28).

The Hill: Obama Administration Credits Health Reform Law For Record-Setting $375M Fraud Bust
The Obama administration announced Tuesday that federal law enforcement officials have arrested a Texas doctor and the owners of five home health agencies on charges they defrauded Medicare and Medicaid by a record-setting $375 million over five years. The administration credits a joint initiative created in 2009 between the departments of Justice and Health and Human Services for the indictment (Pecquet, 2/28).

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Health Reform

Dept. Of Justice Lawyers Strategize On How To Win Key SCOTUS Votes

Media outlets report on this and other health law implementation developments, including news about health exchanges and the measure's pre-existing condition insurance plan.

Politico: Who's Health Care's Key SCOTUS Vote?
Administration lawyers have peppered their briefs with citations to opinions written by Anthony Kennedy and Antonin Scalia, they've seized on the arguments made by one of Scalia's most beloved former clerks and their allies in legal circles have talked up how a decision upholding the Affordable Care Act would play into John Roberts's legacy as chief justice (Haberkorn, 2/28).

HealthyCal: Language Will Be Barrier To Health Coverage, Study Says
More than 100,000 Californians could miss out on the benefits of federal health reform because language barriers would keep them from buying insurance in a new online health insurance exchange, according to a new study by the California Pan-Ethnic Health Network, the UCLA Center for Health Policy Research, and the UC Berkeley Center for Labor Research and Education (2/29). 

The Lund Report: Tribal Concerns In Health Exchange Spotlight
Even though the financial future of the Oregon Health Insurance Exchange suffered a setback by going back to committee during this short legislative session, both tribal and exchange leaders expect nothing will change in terms of the guaranteed insurance funding and basic administrative structure. ... [Northwest Portland Area Indian Health Board] will be looking into ways that the exchange could permit tribes, tribal organizations and urban Indian organizations to pay premiums on federally-certified health (Rendleman, 2/28). 

Georgia Health News: Plan Covering Pre-Existing Conditions Not A Perfect Remedy
After Joe Sellers was diagnosed with leukemia, he was able to get decent health insurance for his wife and children, but not for himself. Joe Sellers sees himself as a square peg fitting into a round hole of health insurance. ... he looked into the government's Pre-Existing Condition Insurance Plan, designed for people, like himself, with health problems. But Sellers had insurance — albeit threadbare –- and thus did not qualify (Miller, 2/28). 

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States Should Consider Highest-Cost Patients When Developing Essential Benefits Package

That recommendation comes from a report issued Tuesday by the IMS Institute for Healthcare Informatics, which concluded that those under age 65 have very different health spending habits than Medicare beneficiaries. Meanwhile, experts offer advice to states regarding development of essential benefits packages.

Los Angeles Times: States Should Study Spending Before Picking Benefits, Report Says
California and other states should consider the medical care used by the highest-cost patients who battle cancer and other chronic conditions when setting essential benefits under federal reform, according to a study. The report issued Tuesday by the IMS Institute for Healthcare Informatics found that the under-65 population, which will be affected the most by the federal healthcare overhaul, has very different medical spending patterns than Medicare beneficiaries that policymakers should take into account as they prepare to extend coverage to millions of the uninsured (Terhune, 2/28).

Modern Healthcare: Experts Suggest Priorities For Essential Benefits
Ensuring transparency in benefit design and paying close attention to benefit administration should be among the top priorities of healthcare advocates working on the development of essential health benefits packages, a panel of experts said in Washington. Essential health benefits were the topic of discussion at the National Forum on the Future of Healthcare, an event hosted by the American Cancer Society's Cancer Action Network (Zigmond, 2/28).

CQ HealthBeat: State Insurance Commissioners: Essential Benefits May Be More Uniform Over Time
Two state insurance commissioners Tuesday said despite the latitude the Obama administration is giving states in developing initial essential health benefits, they expect eventually the packages will be more uniform throughout the country. Kansas Commissioner of Insurance Sandy Praeger and Rhode Island Health Insurance Commissioner Christopher Koller praised the administration for giving states flexibility in prescribing benefits for individual and small group plans that will be sold through health insurance exchanges. Department of Health and Human Services officials have said that in 2016 they will re-evaluate the process for putting together the benefits packages (Norman, 2/28).

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Detailing Efforts To Implement The Health Law - An Insider's View

St. Louis Beacon: Q&A with Obama's Accompanist On The Affordable Care Act
After leaving ACA's Office of Consumer Information and Insurance Oversight this year, [Jay] Angoff has remained a senior adviser to Health and Human Services Secretary Kathleen Sebelius. ... Q: How did politics make it difficult for you to implement ACA? Angoff: The hard part had nothing to do with politics. The toughest thing was meeting the statutory deadlines. Within 90 days after the law was passed on March 23, 2010, we had to establish high risk (insurance) pools in each of the 50 states (Joiner, 2/28). 

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Campaign 2012

Romney Wins Michigan, Arizona; Rivals Press Health Policy Barbs

In exit polls, some GOP voters said they were concerned about Republican presidential hopeful Mitt Romney's health care policies. Rivals Rick Santorum and Newt Gingrich offered parallels between the federal health law and the measure Romney signed while governor of Massachusetts.

The Washington Post: Michigan Voters Reveal Romney's Strengths And Weaknesses
But about 14 percent of voters said that abortion was their top concern — a larger proportion than in any of the other states that have held primaries. Of those voters, 77 percent backed Santorum, who has made social issues a centerpiece of his campaign. … Still, Spaniola said, his support of Romney was tenuous because of the health-care overhaul he backed in Massachusetts. "You have to send someone to Washington who knows how to run an economy, and Mitt's the guy. But I hope he does what he says. I'm worried about him with this health-care stuff. It's scary" (Somashekhar and Henderson, 2/28).

Kaiser Health News has video clips of the health policy references that were included in speeches last night by Mitt Romney and Rick Santorum.

Los Angeles Times: Santorum Puts Positive Spin On Second-Place Finish In Michigan Primary
Drawing cheers, Santorum pledged to repeal Obama's signature healthcare law, describing it as a broad and dangerous takeover of Americans' liberty. ... In his sole mention of Romney by name, Santorum linked the healthcare plan the former Massachusetts governor crafted while leading that state with Obama's federal plan, saying Americans needed "not Romneycare or Obamacare but a program that's based upon you, called 'Youcare,' because that's what we believe in America." Santorum, while calling for reducing federal debt and deficits, called for transferring all entitlement programs to the states, a statement that presumably would include programs such as Social Security, Medicaid and Medicare (Mehta, 2/28).

The Washington Post: Santorum's Scrappy Rhetoric A Campaign Staple
Santorum focused almost exclusively in his election-night remarks on promises to cut government spending, repeal Democratic health-care reform and revive the manufacturing sector. And for the first time, he stressed the role in his life of working women, including his mother, whom he said made more money than his father, a rarity in her generation (Helderman, 2/28).

The New York Times' The Caucus Blog: Santorum Pivots Ahead To Ohio
Mr. Obama, he said, had trampled on religious freedom through the administration's ruling that church-run institutions must offer contraception in health plans, even if it violates their beliefs. …. From an attack on the president, he pivoted to one on Mitt Romney, saying that because Mr. Romney's health care plan in Massachusetts was a model for Mr. Obama's plan, he would not be a credible opponent to Mr. Obama in the general election. "Here's the problem, folks," Mr. Santorum said. "We need to have a candidate who can take President Obama on in this biggest issue of the day, of government control of our lives" (Gabriel, 2/28).

The Fiscal Times: Taxes to Abortion: Where Romney and Santorum Stand
Romney plans to cut $500 billion in spending from the federal budget by 2016 by eliminating or reducing numerous government programs including Obama's health care reforms ... Starting in 2022, he would let seniors choose between the current Medicare fee-for-service model and receiving a stipend to buy private insurance. ... Santorum wants to cut federal spending by $5 trillion over five years by capping government spending at 18 percent of Gross Domestic Product. He would do that by... repealing the health care reform law, and converting Medicare from a government-run program to a privately operated program, while providing seniors with small subsidies or payments in order to purchase services (Pianin and Hirsch, 2/28). 

The Associated Press: Gingrich Targeting 'Super Tuesday' States
At an earlier rally in Rome, Ga., Gingrich made more pointed remarks about Romney, calling him a moderate "pro-choice, pro-gun control, pro-tax increase governor" who would hurt the party's chances against Obama. "I don't believe a moderate can beat President Obama. We tried a moderate in 1996, we lost badly. We tried a moderate in 2008, we lost badly," Gingrich said. Referring to separate health plans backed by both men, Gingrich said: "I don't think there is enough difference between Romneycare and Obamacare to have a debate. I think it would be silly" (Thomas, 2/28).

Meanwhile, thoughts from a well-known Romney policy advisor -

Modern Healthcare: Leavitt Sees Use For Reform Law
A senior healthcare adviser to Mitt Romney said a Republican HHS secretary could use the 2010 federal healthcare law to improve the nation's healthcare. Mike Leavitt, the former secretary of HHS under President George W. Bush and current Romney adviser, said the federal government's historic $15 trillion debt will drive "hard" changes in healthcare system to reduce its costs. Those changes, including moving across healthcare from a fee-for-service model to outcomes based payment, may be facilitated by the Patient Protection and Affordable Care Act. Romney has repeatedly urged repeal and replacement of the law (Daly, 2/28).

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Medicare Actuary Issues Cautions About Current Efforts To 'Cure' Spiralling Costs

CQ HealthBeat: Medicare Actuary Says Premium Support, Current Cost-Cutting, Won't Cure Medicare
Medicare's actuary warned Tuesday that controlling cost growth is the primary challenge to the entitlement program's financial stability, but that neither the premium support system sought by Republicans nor cost-cutting measures pushed by the administration provide all the answers. Richard S. Foster, chief actuary for the Centers for Medicare and Medicaid Services, testified alongside Social Security Actuary Stephen C. Goss during a House Budget Committee hearing on strengthening the finances of the two entitlement programs (Ethridge, 2/28).

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Health Care Marketplace

Kodak Seeks To End Health Coverage For Medicare-Eligible Retirees

The Associated Press/Washington Post: Troubled Kodak Moves To Drop Health Coverage For Medicare-Eligible, Post 1991-Retirees
Eastman Kodak Co., looking to whittle expenses as it reorganizes under bankruptcy protection, wants to end health care benefits for about 16,000 retirees who are over age 65 and thus eligible for Medicare (2/28).

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State Watch

UnitedHealth Acquisitions Draw Scrutiny

UnitedHealth Group's acquisition of a Calif. physician group and two Florida health plans are making news, and Maine's top court sides with regulators' authority to reject one Anthem's rate increases there.

The Wall Street Journal: Insurer Battles Physician Group
A clash between health insurer Blue Shield of California and a doctor group that sold its operations to UnitedHealth Group Inc. highlights emerging tensions as lines blur between health insurers and medical providers (Mathews, 2/29).

Reuters: UnitedHealth To Buy Two Florida Health Plans
UnitedHealth Group Inc plans to buy two Florida health plans to increase its U.S. market-leading position in providing Medicare plans for the elderly. Health insurers have been striking deals to boost their Medicare operations as the baby boom generation born after World War II becomes eligible for the government program, swelling its ranks. UnitedHealth's acquisitions fortify its strong position in Florida, where about 10 percent of all Medicare beneficiaries live, according to Goldman Sachs analyst Matthew Borsch (Krauskopf, 2/28).

The Miami Herald: UnitedHealthcare Buys Preferred Care, Medical HMOs
UnitedHealthcare, the giant nationwide insurer, is making a major move in South Florida by announcing Tuesday it has agreed to purchase two Miami-Dade based Medicare and Medicaid insurance plans that have more than 100,000 members and eight clinics. ... Preferred Care Partners has 55,000 Medicare members in its health maintenance organization in South and Central Florida and another 5,000 members in its Medicaid HMO (Dorschner, 2/28).

Kaiser Health News: Maine's Top Court Backs State Authority To Limit Health Plan's Profits
In a case closely watched by the insurance industry, Maine's top court Tuesday upheld state regulators' authority to hold down rate increases sought by Anthem Health Plans of Maine. In its ruling, the Supreme Judicial Court said that Maine's insurance superintendent had 'properly balanced the competing interests' in arriving at an approved rate increase of 5.2 percent (Appleby, 2/28).

In Massachusetts, two hospitals are proposing a merger —

Modern Healthcare: Hospital Moves Forward On Mass. General Deal
Cooley Dickinson Hospital, a 142-bed hospital in Northampton, Mass., took the first step toward a merger with Massachusetts General Hospital. After a three-year process involving seven potential partners, the Cooley Dickinson board of trustees voted Monday to move forward with an affiliation agreement with Boston-based Massachusetts General Hospital, a 907-bed hospital that is part of the Partners HealthCare System, according to a news release (Lee, 2/28).

Boston Globe: Northampton Hospital, MGH To Pursue Merger
Trustees at Cooley Dickinson Hospital in Northampton have voted to negotiate a merger with Massachusetts General Hospital, an alliance that would extend the reach of Mass. General and its powerful parent, Partners HealthCare, beyond Eastern Massachusetts. The deal could send more Cooley Dickinson patients to Boston to receive treatment for cancer, heart disease, and other conditions, boosting Mass. General traffic at a time when it is under pressure from lower-cost competitors (Weisman, 2/29).

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Va. Lawmakers Approve Scaled-Back Abortion Ultrasound Bill

Lawmakers in Virginia have passed a scaled-back version of a contentious ultrasound proposal that would force women to get a "non-invasive" ultrasound before having an abortion.

The Washington Post: Virginia Senate Approves Contentious Ultrasound Bill
The Virginia Senate narrowly approved Tuesday a modified version of a contentious proposal that would require women to get an external ultrasound before an abortion (Kumar, 2/28).

Battles also rage in Texas over a similar sonogram law already being enforced —

The Fort Worth Star Telegram: Texas Sonogram Law Has Some Patients Unhappy
Women seeking abortions at Whole Woman's Health in south Fort Worth often arrive upset or angry about Texas's new sonogram law, which began being fully enforced three weeks ago, a health center official says. Some are unhappy about the requirement that the physician verbally describes the fetus during a sonogram. But it's the hardship of having to schedule two appointments — one for the sonogram and another for the surgery no fewer than 24 hours later — that draws the most consistent ire (Branch, 2/29).

The Texas Tribune: Texas Lawmakers Split On Saving Women's Health Program
Two of the Legislature's top public health leaders are defending Republican lawmakers' pledge to end the entire Women's Health Program rather than allow Planned Parenthood to participate. ... "I guess we all need to see what it looks like when we don't have it, and then we may need to regroup at that point," said state Rep. Lois Kolkhorst (Tan, 2/28). 

In the meantime, lawmakers in California and Pennsylvania are also considering abortion legislation, albeit in very different proposals —

Los Angeles Times: California Bill Would Let Non-Doctors Do Some Abortions To Expand Access
A state lawmaker is proposing to allow nurse practitioners, physician assistants and nurse midwives to perform routine abortions in the first trimester of pregnancy as a way of expanding access to the procedure across California (Riccardi, 2/29).

The Philadelphia Inquirer: Pa. House Proposes Preabortion Ultrasound
Pennsylvania could be the next battleground in the fight over whether a woman seeking an abortion must have an ultrasound exam and, if so, whether it involves inserting a probe into her vagina. … The furor has not daunted Pennsylvania Rep. Kathy Rapp (R., Warren), lead sponsor of House Bill 1077, which mandates a preabortion ultrasound test. … Rapp said she believed her bill, called the Women's Right to Know Act, would require "the ultrasounds on the belly. Any doctor who wanted to proceed to transvaginal ultrasound would have to have a good reason." But the language of the bill suggests otherwise (McCullough, 3/29).

And in Colorado, the contraception coverage mandate has split advocates and the state's attorney general — 

Health Policy Solutions (a Colorado news service): Birth Control Battle Escalates
The battle over contraception has escalated in Colorado with Planned Parenthood officials calling out Colorado's Attorney General for opposing federal birth control mandates. Attorney General John Suthers signed a letter this month along with 11 other attorneys general demanding a reversal of the U.S. Department of Health and Human Services' new requirement that health plans offer birth control coverage. ... Planned Parenthood Votes Colorado, the political arm of Planned Parenthood of the Rocky Mountains, quickly took aim at Suthers (Kerwin McCrimmon, 2/28). 

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State Roundup: N.J. Localities' Coverage Costs; Pa. Cuts Raise Ire

A selection of health policy stories from Massachusetts, New Jersey, Texas, Minnesota, California, Wisconsin and Oregon.

WBUR's CommonHealth blog: Deval Patrick On Mass. Health Reform, Cancer And Cost-Cutting
[At a speech to the American Cancer Society, Gov. Deval Patrick] says that Massachusetts health reform has led to significant improvements in cancer screening. ... Patrick also calculates that current health care cost control efforts are enabling the state to "avoid nearly a billion dollars in cost increases in this fiscal year and another several hundred million more next year" (Goldberg, 2/28). 

The Wall Street Journal: Report: NJ Municipalities Overpay For Health Insurance
The New Jersey state comptroller said Tuesday that local and county governments are wasting more than $100 million a year by enrolling employees in private health-insurance plans — some of them politically connected — instead of the state health plan (Haddon, 2/28).

The Associated Press/Houston Chronicle: Corbett's Welfare Cuts Draw Anger From Democrats
State Democratic senators angrily challenged Gov. Tom Corbett's top public welfare official Tuesday over the administration's moves to stop the growth of spending on a wide range of social safety-net programs despite rising demand and health care costs. Among the Corbett administration's proposals are eliminating cash payments to poor adults, cutting 20 percent from aid for county-run social service programs, raising fees or co-payments for people to use certain services and cutting reimbursements by 4 percent to hospitals and nursing homes that care for the poor (Levy, 2/28).

Minnesota Public Radio: State Facility For The Mentally Ill Risks Losing Over Turmoil
David Proffitt, the administrator of the state's largest facility for the mentally ill and dangerous, began his new job in August 2011 with a vow to improve patient care and reduce the use of restraints and seclusion. ... The use of restraints has more than doubled since Proffitt arrived. Employees describe a chaotic work environment made worse by confusing policies and a lack of adequate training (Baran, 2/28).

Minnesota Public Radio: Data: Violence, Restraints Common At Minnesota Security Hospital
Data provided by the Department of Human Services offer a glimpse into the tense and sometimes violent world of the Minnesota Security Hospital, a state-run facility that provides treatment to nearly 400 adults deemed mentally ill and dangerous by the judicial system (Baran, 2/28). 

(St. Paul) Pioneer Press: Minnesota House Committee Advances Bill Seeking Independent Audits Of Nonprofit HMOs
Just a few weeks after learning of a federal investigation of the state's Medicaid program, a state House committee on Tuesday passed a bill to require annual independent financial audits for nonprofit HMOs that manage the care for most of the state's Medicaid beneficiaries. In addition to audits, the bill introduced by Rep. Steve Gottwalt, R-St. Cloud, would require that health plans give the state detailed data about the health care services provided to beneficiaries. It also would prohibit the actuarial firm that advises the state in evaluating health plans from also providing services to the HMOs (Snowbeck, 2/28).

Minneapolis Star Tribune: Nurses Take Staffing Fight To Legislature
The Minnesota Nurses Association, which made "safe staffing" its rallying cry during a one-day strike in 2010, is calling for legislation to set a limit on how many patients may be assigned to hospital nurses. At a press conference in St. Paul Tuesday, union leaders accused hospital officials of breaking promises made after the strike to work with nurses to address staffing questions. They also said they collected nearly 1,000 reports in the last half of 2011 from nurses who said patients were endangered by inadequate staffing levels (Lerner, 2/28).

California Healthline: Concerns Raised Over Adult Day Health Care Transition, Assessments
Corinne Jan doesn't quite know what to say to some of her patients at the Hong Fook Mental Health Center in Oakland. Many of them are frail, elderly, monolingual in Cambodian, Mandarin or Thai and have been receiving Adult Day Health Care services. ADHC will be eliminated on Mar. 31 as a Medi-Cal benefit and replaced with a new program, Community-Based Adult Services. ... the Department of Health Care Services has made a slew of mistakes in assessing eligibility for CBAS -- getting names wrong, having duplications on their lists and even sending contradictory notices to patients. (Gorn, 2/28). 

Milwaukee Journal Sentinel: Medical School In Wausau Not Feasible, Health System Decides
Aspirus, a health system based in north-central Wisconsin, has determined that partnering with other regional health systems to start a medical school in Wausau is not feasible. The health system and the Wisconsin College of Osteopathic Medicine announced in November that they were studying the possibility of starting a medical school that would focus on students interested in primary care. Aspirus, based in Wausau, had proposed owning the medical school - projected to cost $75 million - with other regional health systems (Boulton, 2/28).

Sacramento Bee: Steinberg Wants Immediate Action To Improve Sacramento County's Child Dental Program
The political back-and-forth over Sacramento County's failing Denti-Cal program is heating up. Senate President Pro-Tem Darrell Steinberg, D-Sacramento, has called on the state's Medi-Cal chief to take immediate action to improve dental care for more than 110,000 Sacramento County children. In a letter to Toby Douglas, director of the Department of Health Care Services, Steinberg said Sacramento County kids can't wait for the department to draw up new contracts with dental plans before they get better care (Bazar, 2/29).

The Lund Report: Workgroup Recommends Oregon Health Plan Use Doulas
A workgroup charged with studying how doulas could be incorporated into the Oregon Health Plan told legislators earlier this week that doing so could help improve birth outcomes, particularly in minority communities. ... Doulas are birth coaches who provide emotional support to a mother during pregnancy, birth and immediately after giving birth (Waldroupe, 2/29). 

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Editorials and Opinions

Viewpoints: 'Romney's Rebound,' Va. Lawmakers' Ultrasound Vote, Kennedys Not Sole Interpreters Of Senator's Legacy

The Wall Street Journal: Romney's Rebound
But Mr. Romney also improved his case for his own candidacy, stressing a reform agenda as much as his business biography. In the final days in particular, he pressed his new plan for a 20 percent across-the-board income tax cut, as well as Medicare reform. He stressed his ability to revive the economy, which remains the dominant issue even among conservatives, despite the prominence of social issues in the last week (2/28). 

The Wall Street Journal: Conservatives And The Mandate
ObamaCare's individual mandate, it turns out, is no more popular with the public than it is with the GOP hopefuls. A USA Today poll this week finds that 72 percent of voters believe the mandate to be unconstitutional. Only fools and angels, then, might tread forth to defend a now-embarrassing history of conservative support for the unpopular mandate (2/28).

The New York Times: The Loyal Opposition: Virginia Lawmakers Vote Against Women's Rights
The Virginia State Legislature has decided not to force pregnant women to undergo vaginal penetration in a medical office before they exercise their Supreme Court-sanctioned right to an abortion. I suppose this is a victory of sorts (Andrew Rosenthal, 2/28).

The New York Times: Women's Health Care At Risk
A wave of mergers between Roman Catholic and secular hospitals is threatening to deprive women in many areas of the country of ready access to important reproductive services. Catholic hospitals that merge or form partnerships with secular hospitals often try to impose religious restrictions against abortions, contraception and sterilization on the whole system (2/28).

The Dallas Morning News: The Politics Of Contraception
The governor drew no distinction between family planning and abortion, which again is part of the national strategy aimed at Planned Parenthood. Though obvious, it is worth noting in this context that contraception is the primary safeguard against abortions. When you deny it, particularly to poor women, the consequences are obvious….At some level, this becomes a debate over whether women, particularly poor women, should have the right to contraception. Is that really where we want to go? (2/29).

Boston Globe: Kennedy Family Isn't Only Interpreter Of Senator's Legacy
Kennedy’s words were open to interpretation: When he referred to "conscience protection," was he referring only to abortion? Or would he also extend "conscience protection" to church-affiliated institutions that oppose insurance coverage for contraception? While Kennedy family members have every right to express an opinion about how the late senator’s principle might be applied, so do others — including U.S. Senator Scott Brown (2/29).

The Philadelphia Inquirer: Corbett’s Budget Will Set Back Pa.’s Patient Safety Efforts
Earlier this month, Gov. Corbett submitted Pennsylvania’s 2012-2013 proposed budget. As expected, reductions in spending were suggested due to our slow economic recovery along with a worthy desire to maintain a balanced budget in our state. However, I believe the governor’s proposed budget clearly misses the mark when it comes to public safety and welfare by proposing to merge the Pennsylvania Patient Safety Authority (PSA) with the Pennsylvania Department of Health (DOH) (Michael Cohen, 2/28).

Des Moines Register: Iowa View: GOP House Budget Would Trim Hospitals' Funding
The high cost of health care and the increase in the costs of health care insurance is hitting a crisis point. The Iowa Senate Democrats have acknowledged this problem and have been working to facilitate changes that would reform the health care delivery system and mitigate cost concerns for years. Hospitals, like all health care providers, are striving to move beyond the current system for provision of health care services (Iowa State Sen. Jack Hatch, 2/29).

Des Moines Register: Board's Charges Are Sign Of Progress
In 2009, a Des Moines Register investigation found the Iowa Board of Nursing Home Administrators rarely issued sanctions against administrators. The board — comprised mostly of those inside the nursing home profession — did not review state inspection reports detailing problems in the facilities. Now, for the first time in 10 years, the licensing board has charged two nursing home administrators with negligence for resident-care issues... This certainly is a sign of progress (2/29).

Market Watch: Canadian National Health Care's Big Benefit
Before "Obamacare" passed, it was Canada’s single-payer national health care system that was often under attack — in the U.S., that is. Even though Canadians treasure their health-care system despite its flaws, Americans were told for years — actually, lied to — that Canadians were being denied urgent care and had to flee to the U.S. to get it. They didn't, and they don't. As a Montreal friend assured me the other day, "If you need help, you’ll get right in. For some other things, you may have to wait a bit" (Bill Mann, 2/28).

Kansas City Star: Medical Care From U.S. Veteran's Point Of View
Complaints are heard, from time to time, about the medical support afforded our country’s veterans. Often the issue is the distance some must travel to get care — a particular problem for those living far from a VA hospital. I remember a time a decade or so ago when the Kansas City VA Medical Center was a target of complaints about everything from cleanliness to treatment outcomes — carping I thought largely unjustified. There's been nothing in my 15-year-or-longer experience there to support such criticism. My most recent visit to the center was typical (C.W. Gusewelle, 2/29).

Houston Chronicle: Merger Of Pharmacy Benefit Managers Would Cost Consumers
That's why we have joined others in the pharmacy community and have called on Congress and the Federal Trade Commission (FTC) to reject the Express Scripts-Medco merger. Patients deserve the right to choose their pharmacy and whether or not they wish to opt-in to mail-order programs. When it comes to health care in America, the rule of the day should be that consumers know best (Dorinda Martin, 2/28).

The Seattle Times: Support State Bill To Fight Medicare/Medicaid Fraud
Sometimes you have to make great sacrifices to help others and I believe those good deeds should be rewarded. Receiving some of the retrieved money gives people incentive to do the right thing and expose fraud. Washington must pass SB 5978. It protects whistle-blowers, taxpayers and Medicaid/Medicare patients. It's a true win-win we can all support (Jim Alderson, 2/28).

The Seattle Times: Judge Leighton's Plan B  Ruling Makes Constitutional Sense
No doubt a druggist who refuses to sell Plan B may infuriate a woman. Her anger is probably less about the inconvenience of finding another store and more about the implied censure of behavior she feels is none of the druggist's damn business. But the Constitution offers no guarantees against a druggist's disapproval — or of "access" to health care, whatever that means. It does guarantee the druggist's free exercise of religion (Bruce Ramsey, 2/28).

The (Ore.) Statesman Journal: Another View: Health Care, Education In The Oregon Legislature
If Republicans in the Oregon Legislature are serious about creating jobs and helping the state's many unemployed workers, they will stop blocking Gov. John Kitzhaber's landmark health care and public education reforms. GOP lawmakers are rightly concerned about employment in a state with an 8.9 percent jobless rate and 176,000 unemployed workers. They've introduced several bills aimed at creating jobs and boosting the economy, and they're holding on to the health care and education bills in an effort to force Democrats to support the GOP proposals (2/28).

Forbes: President Obama's Dangerous New Medical Board
The IPAB is one of the most egregious parts of ObamaCare because it puts rationing of care on auto pilot. A House subcommittee, chaired by Rep. Joe Pitts (R-PA), is expected to vote today on a bill that would repeal the IPAB entirely. The Ways and Means Committee also will vote, and then it will go to the full House of Representatives for a vote, likely next month. After that, the legislation faces an uncertain fate in the Senate, where Sen. John Cornyn (R-TX) just introduced an IPAB repeal bill. Opposition to the IPAB crosses party lines. Rep. Frank Pallone (D-NJ), the top Democrat on the Energy and Commerce Health Subcommittee that will consider the bill today, has said he has no interest in defending the board: "I've never supported it, and I would certainly be in favor of abolishing it" (Grace-Marie Turner, 2/28).

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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.