Daily Health Policy Report

Tuesday, February 4, 2014

Last updated: Tue, Feb 4

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch

Administration News

Public Health & Education

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Insuring Your Health: Advocates Worry That Drug Company Assistance Programs Will Be Banned From Helping Patients With Marketplace Policies

Kaiser Health News consumer columnist Michelle Andrews writes: "People who need expensive drugs to treat serious medical conditions often rely on drug manufacturers’ assistance programs to help afford their medications. But it’s uncertain whether such programs are permitted to aid people who buy health insurance on the marketplaces established by the federal health law. With open enrollment ending in less than two months, federal rules remain unclear, leaving patients, advocates and drug programs in limbo. They're concerned about how recent guidance recommending that third parties refrain from making payments to help patients with cost sharing or premiums may affect these programs" (Andrews, 2/4). Read the column.

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From Ethiopia To West Virginia, Community Health Workers Help Close Access-To-Care Gaps

Kaiser Health News staff writer Ankita Rao, working in collaboration with The Atlantic, reports: “Across the world, countries have started to embrace community health workers as a means of reaching people who don't always have regular access to care through clinics and hospitals. Their titles vary -- India has more than 800,000 "Accredited Social Health Activists" and Malawi employs 11,000 Health Extension Workers -- but the impact seems to be universal. Not only do the workers treat and manage care, they also help curb health care costs by preventing complicated disease and emergency room visits” (Rao, 2/4). Read the story.

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Capsules: New Rule Gives Patients Direct Access To Their Lab Reports

Now on Kaiser Health News' blog, Ankita Rao reports: "Calling your doctor to get lab results might be a thing of the past: a new federal rule will allow patients to have direct access to their completed laboratory reports. The regulation was announced Monday by the Department of Health and Human Services. It amends privacy rules under the Health Insurance Portability and Accountability Act (HIPAA) and the Clinical Laboratory Improvement Amendments of 1988 (CLIA) that required patients to get their lab results from their physician, according to the announcement" (Rao, 2/4). Check out what else is on the blog.

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Political Cartoon: 'Support Coup?'

Kaiser Health News provides a fresh take on health policy developments with "Support Coup?" by Clay Bennett.

And here's today's health policy haiku:


New regulations
cut out the middleman. What's
in it for patients?

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

For People Who Faced Enrollment Issues With Healthcare.gov, Appeals Hearings To Begin Soon

But news outlets report that the computer and phone systems designed to address those appeals have yet to be launched. So far, an estimated 22,000 requests for fixes have been submitted via the mail. Meanwhile, the Centers for Medicare & Medicaid Services issued a statement Monday saying it was reaching out to customers who encountered errors during the signup process to assist them in completing applications without going through a formal appeal.    

Reuters: U.S. Says Healthcare.Gov Enrollment Appeal Hearings To Begin Soon
The Obama administration on Monday said it will soon begin hearings to resolve problems for people who enrolled in health insurance through the Obamacare website healthcare.gov, only to encounter errors including unnecessarily high costs. The U.S. Centers for Medicare and Medicaid Services (CMS), the lead agency responsible for implementing the healthcare reform law, issued a statement saying it was reaching out to consumers with error-ridden enrollments to help them complete applications for coverage without a formal appeal (2/3).

CBS News: 22,000 File Appeals With Obamacare Site, Report Says
Roughly 22,000 Americans have filed requests for the Health and Human Services Department (HHS) to fix errors in their health insurance coverage caused by healthcare.gov glitches, but the computer program to process those 22,000 requests has yet to be built, the Washington Post reports. The appeals were filed by people who say that HealthCare.gov -- the website that serves as the Obamacare portal for 36 states -- failed to correctly calculate the subsidies they’re eligible for, sent them into the wrong insurance program or completely denied them coverage, the Post reported after obtaining internal government data. Those 22,000 appeals were submitted through the mail, since the computer and phone systems for filing appeals have yet to launch (Condon, 2/3).

The Philadelphia Inquirer: 22,000 Insurance Policies Appeals Filed On Healthcare.gov, 0 Resolved
Four months after the launch of HealthCare.gov, Americans are still having a hard time getting answers about the correct coverage they need. Although more than 2 million people have signed up for coverage under Obamacare by now, tens of thousands of Americans have discovered that the federally run exchange site made mistakes when they signed up (2/4).

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Washington's Insurance Exchange Is Winning, Too; N.Y. and Calif. See Strong Obamacare Enrollment Numbers

More than 33 percent of eligible Washington residents have signed up for care on the state's health law online insurance exchange. In New York and California, exchanges see big sign-up numbers. Finally, lawmakers in Florida and Virginia ready plans for insurance exchanges that aren't part of the health law.

The Washington Post’s WonkBlog: Seattle Has A Great Football Team -- And An Awesome Obamacare Exchange, Too
Yes, there is the Super Bowl victory, as well. But you have enough things to read about that -- and not nearly as much coverage of the Washington Health Plan Finder, which is arguably having one of the best open enrollment seasons in the country. Washington, alongside Vermont, leads the nation in percentage of eligible population enrolled in its exchange. According to the Kaiser Family Foundation, 33.1 percent of Washingtonians eligible to sign up for coverage through the exchange have gone ahead and done so (Kliff, 2/3).

The Associated Press/Wall Street Journal: N.Y. Health Exchange Insures Thousands More
The state's new health exchange reports more than 657,000 New Yorkers have completed applications for insurance while nearly 381,000 of them have enrolled for specific coverage (2/4).

The Sacramento Bee: State Health Care Sign-Ups Faster Than Expected
Sacramento-area residents are buying insurance on the state’s new health care exchange much faster than anticipated -- but hundreds of thousands still lack coverage, new figures show. The Affordable Care Act requires most individuals without health insurance to obtain it and provides subsidies to those unable to afford premiums. One way to purchase insurance is through the state’s health care exchange, Covered California. About 27,000 individuals in the four-county region bought insurance on the exchange from October through December 2013, the first three months the exchange was open, new Covered California statistics show. That’s almost as many as the state initially predicted would buy insurance during the entire six-month enrollment period (Reese, 2/4).

Miami Herald: Florida To Launch Discount Health Insurance Exchange
Since 2008, Florida has been promising its residents a state-run health insurance exchange. Republican lawmakers continued to champion the much-delayed program even as they opposed Obamacare and refused to expand Medicaid to help the working poor. Now, officials say they are at last ready to launch Florida Health Choices and hope to reach people who can’t afford insurance on the federal exchange, or just don’t like the president’s plan (Mitchell, 2/3).

The Richmond Times-Dispatch: Senate Panel Backs New Private Insurance Marketplace
Sen. John Watkins, R-Powhatan, has proposed creation of a Virginia marketplace for private health insurance coverage of people who have none now. Marketplace Virginia would be established as a new division of the State Corporation Commission, which through its Bureau of Insurance currently certifies and oversees health plans sold on the new electronic federal marketplace that began operating Jan. 1. The Senate Commerce and Labor Committee approved the proposal, offered Monday as a surprise substitute to Watkins’ proposal to create a state-operated insurance exchange, and sent it to the Finance Committee to review its fiscal impact on the state. Sens. Stephen D. Newman, R-Lynchburg, and Mark D. Obenshain, R-Harrisonburg, voted against the bill (Martz, 2/4).

Problems still plague Minnesota's exchange --

MinnPost: What Will It Take To Fix MNsure’s Call Center? More Tech Fixes, Staff, Money And Time
Hour-long waits … dropped calls … frustrated callers … overwhelmed staff … too many side issues … Since early November, a litany of complaints has dogged MNsure’s call center,  a key resource in helping the public use Minnesota’s health exchange to sign up for insurance. Three months later, MNsure still has not solved many of the major call-center issues -- and now it’s gearing up for a busy last two months of open enrollment (Nord, 2/3).

The Star Tribune: MNsure Scolded For Waiting Too Long To Fix Call Center Problems
A major boost in manpower is still weeks away at MNsure’s overwhelmed call center, which continues to keep customers on hold for 30 minutes or more while the state health exchange tries to regroup from a variety of problems that have slowed enrollment. Call center industry veterans, and one MNsure board member, said the agency should have solved staffing problems at the call center three months ago, when it became obvious the agency had underestimated the number of operators needed to handle the deluge of calls. Some callers have waited as long as two hours to speak with a MNsure representative since the exchange launched on Oct. 1. The industry standard for call centers is 30 seconds (Meitrodt and Crosby, 2/3).

In other state news about the health law -

Georgia Health News: Anger At Obamacare On Display In House
Disastrous. Unaffordable. “An abomination.” These descriptions were part of the anti-Obamacare sentiments heard during a legislative hearing Monday at the Georgia General Assembly. The rhetoric echoed what was heard at town hall meetings in 2010 after Obamacare — officially known as the Affordable Care Act — was passed by Congress. Tea Party and other activists opposed to the federal health law packed a small hearing room to listen to the arguments in favor of House Bill 707, sponsored by Rep. Jason Spencer (R-Woodbine). The bill would prevent state institutions and employees from implementing ACA provisions (Miller, 2/3).

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Sebelius Urges Kansas, Missouri To Expand Medicaid

Health and Human Services Secretary Kathleen Sebelius appeared in Missouri and Kansas to urge officials to accept federal expansion funds, calling it a moral and financial imperative. Meanwhile, a new poll finds support for the expansion in Virginia and news outlets cover developments in Florida and South Carolina.

The Kansas City Star: Sebelius Promotes Obamacare In Kansas City
It is a moral and financial imperative for Missouri and Kansas to expand their Medicaid programs, President Barack Obama’s champion in chief for the Affordable Care Act said this morning in Kansas City. Health and Human Services Secretary Kathleen Sebelius urged state legislators to accept federal Medicaid expansion funds available to Missouri, Kansas and other states that haven’t bought into a key facet of health care reform (Stafford, 2/3).

The Washington Post: Poll Finds Support For Medicaid Expansion In Virginia
A majority of Virginia voters support expanding Medicaid as long as there are federal funds to pay for it, according to a new poll. The Wason Center at Christopher Newport University found that 56 percent of the state’s registered voters back the expansion of the state-federal health program for the poor, but almost the same number — 54 percent — would oppose it if the federal government did not provide the promised funding (Weiner, 2/3).

PBS NewsHour: In A State Without Medicaid Expansion, Uninsured South Carolinians Mind The Gap
After the Supreme Court ruled that states were not obligated to expand their Medicaid programs under the Affordable Care Act, South Carolina was one of the first to opt out. PBS NewsHour’s Mary Jo Brooks reports on the effects for residents who are still uninsured, plus a small alternative program designed to reach some of them (Brooks, 2/3).

Health News Florida: Medicaid Saves 1,100 Lives: Study
More than 1,100 Floridians will die prematurely if the state Legislature continues to refuse to expand Medicaid under the Affordable Care Act. This prediction emerges from a study published on the Health Affairs blog. The analysis considers the implications of three previous data-collection efforts by other groups (Gentry, 2/3).

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New Enroll America Health Law Outreach Targets Young Women With Pets

The pet-themed ads are designed to appeal to these women and convince them to sign up for coverage and raise their awareness about the financial assistance for which they may qualify.   

USA Today: Health Insurance Ads Target Gen Y Women
The campaign by the non-profit advocacy group Enroll America uses pets to reach its audience and launches with less than two months to go before the March 31 deadline for enrollment. Enroll America says about 81 percent of the public doesn't know about the deadline and 69 percent of people don't know that financial help is available to those with incomes below 400 percent of the poverty level (O’Donnell and McElhaney, 2/4).

Fox News: New Obamacare Ads To Use Pets In Push To Enroll Young Women
Enroll America, the advocacy group leading efforts to enroll Americans in Obamacare, is launching a multi-million dollar advertising campaign featuring cats, dogs, birds and other pets in a bid to convince young women to sign up for health coverage, USA Today reported. With less than two months to go before the March 31 deadline to apply for coverage under Obamacare, Enroll America officials tell the newspaper 81 percent of the public is unaware of the deadline and 69 percent don't know that financial aid is available to those earning less than 400 percent of the poverty level. Enroll America President Anne Filipic told USA Today the pet-themed ads are designed to "help break through the clutter." She cited statistics showing that more than 60 percent of American homes have a pet and that most female pet owners would risk their lives for their pets (2/4).

Meanwhile, the Los Angeles Times reports that about a third of college students report being uninsured and say cost is the reason -

Los Angeles Times: 30% Of College Students Report Being Uninsured, Most Citing Cost
About a third of California college students report being uninsured and they said the primary reason was cost, not an aura of invincibility, according to a new survey. The results released Monday are based on a poll of 836 students at three Cal State University campuses last fall in Los Angeles, Fresno and San Jose (Terhune, 2/3).

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Obamacare Deductibles, Not Premiums, Cause Sticker Shock

A PwC study finds that insurance premiums for policies sold in new online insurance marketplaces are comparable to, or lower than, those for employer-based policies. However, the deductibles are higher in many cases. Other stories examine how the White House is pushing delivery system changes, such as the creation of ACOs, and how implementation delays could affect the IRS.

The Fiscal Times: Obamacare Sticker Shock Found In Deductibles, Not Premiums
Despite concerns that Obamacare would cause the price of insurance premiums to skyrocket, a new study found that they are either lower or comparable for similar employer-based policies. However, consumers may still experience sticker shock from Obamacare’s pricey deductibles. According to a report released by PwC’s Health Research Institute, insurance premiums on the new health exchanges are cheaper than those paid by the majority of Americans who have employer-based coverage—partly because of high deductibles (Ehley, 2/3).

MedPage Today: White House To Push ACOs, Other New Models
The Obama administration in 2014 will "double down" on delivery system reform efforts such as the further proliferation of accountable care organizations (ACOs), a White House health policy adviser said Monday (Pittman, 2/3).

Politico Pro: Obamacare Delays Could Challenge IRS Customer Service Role
The Internal Revenue Service could be in a bind if the Obama administration continues to tinker with its signature legislative achievement by delaying Obamacare provisions, a watchdog report released Monday found. The agency is on track with preparing for an expected onslaught of new queries about the law, but the IRS could face “challenges” if any more key provisions are delayed, the audit from the Treasury Inspector General for Tax said. “Changes in the implementation of ACA tax provisions can result in increased demand for customer service assistance resulting in more contacts with the IRS,” the report said (French, 2/3).

ABC News: Avoid These 4 Obamacare Mistakes
Signing up for Affordable Care Act (ACA) insurance coverage may feel a little bit like competing in the Olympics. First, you’ll navigate a slippery slope of data, complete a mountain of paperwork, and finally choose Bronze, Silver, or Gold coverage. You might want to stand on a little box and hum the national anthem when you’re done. To avoid the “agony of defeat,” here are four costly mistakes you’ll want to avoid (Pratini, 2/4).

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Capitol Hill Watch

House GOP Crafts Debt-Limit Strategy -- One Version Involves Repealing A Health Law Provision

The Washington Post reports that some House Republican lawmakers are considering a play that would trade a one-year extension of the debt limit for a repeal of the overhaul's risk corridors. This provision will be the subject of a House Oversight and Government Reform Committee hearing this week.   

The Washington Post: House GOP Finalizes Debt-Limit Playbook
Several House members told The Washington Post on Monday that Republican leaders have narrowed their list of possible debt-limit strategies to two options: trading a one-year extension for approval of the Keystone XL pipeline, or trading a one-year extension for repeal of the Affordable Care Act’s risk corridors (Costa, 2/3).

The Fiscal Times: GOP Strategy On Obamacare: Repair Or Repeal?
Republicans are ramping up their war on Obamacare this week with several new plans to carve away at the president’s health care law. The House Oversight Committee will hold a hearing on Wednesday targeting the law’s "risk corridors" provision, which conservatives have deemed a "bailout" for insurance companies. A few have signaled they may use the provision as leverage in a larger fight over the debt ceiling, which Treasury Secretary Jack Lew warns must be raised by the end of February (Ehley, 2/4).

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GOP Campaigns Against Health Law In Mass., Florida Races

Republican candidates criticize Democratic opponents for their embrace of the health law in a closely contested congressional matchup in Florida and in several races in Massachusetts. Meanwhile, The Washington Post's fact checker awards three Pinocchios to claims by South Carolina Sen. Tim Scott about the impact of the medical device tax on small businesses.

Politico: Alex Sink, David Jolly Spar In Florida Debate
Several exchanges focused on the Obamass newly implemented health care law, which remains unpopular throughout much of the country. Jolly portrayed Sink as a steadfast supporter of Obamacare and challenged her to explain what she does not like about it. Sink said she wanted to keep the law intact, saying that she had come across people who are thrilled with it. But she said she was unhappy with the law's implementation and disagreed with several of its planks, including its tax on medical devices. "I could go on and on with the things that need to be fixed," she said (Isenstadt, 2/3).

Los Angeles Times: Republican Congressional Candidate Hits Obamacare In Florida Debate
The Republican hoping to preserve his party's hold on a closely contested, vacant congressional seat in Florida took less than a minute in a debate Monday to hit what he hopes will be the winning theme. His Democratic opponent, Alex Sink, wants to "further the agenda of President Obama," Republican David Jolly said in his opening statement. At his earliest opportunity, Jolly returned to the idea, saying he favored repealing the president's healthcare law (Lauter, 2/3).

Politico: Massachusetts Republicans See 2014 Opportunity In Obamacare Flaws
Massachusetts may have inspired Obamacare, but state Republicans see its flaws giving them an opening with voters in November. The state's transition from its own health reform law to federal reform — from Romneycare to Obamacare — has been a mess. Massachusetts's first-in-the-nation exchange had to be revamped to meet Obamacare requirements, but it melted down, threatening coverage for hundreds of thousands of people. Officials are relying on costly workarounds so people don't lose insurance altogether, and there's no timetable for a permanent fix (Cheney, 2/3).

The Washington Post’s Fact Checker: Sen. Scott's Claim That The Medical Device Tax Will Cost Small Businesses $29 Billion 
[Sen. Tim Scott, R-S.C.], in decrying the impact of the Affordable Care Act, made some startling claims about the taxes in the law. First, he said that the medical device tax takes $29 billion from "the pockets of small business owners." Then, he said the law also "takes another $800 billion out of the pockets of small business owners." Greg Blair, press secretary for Scott, said that regarding the $800 billion, Scott meant to say this was "taken out of the pockets of small business owners and families." We don't like to play gotcha at The Fact Checker, especially when someone is speaking on live television, but we will note that he emphasized the impact on small business. We have previously highlighted that research from the Joint Committee on Taxation that only 3 percent of small businesses are affected by higher marginal rates on families making more than $250,000 a year (Kessler, 2/4).

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Administration News

New Rule Allows Patients Direct Access To Lab Results

The Obama administration released new regulations Monday that would allow patients to get test results without going through their doctor first. The rules are part of an effort to empower patients and give them more control over their health care.

The Washington Post: New Rule Allows Patients To Get Test Results Directly From Labs, Without Doctors' Clearance
Patients may obtain their test results directly from the laboratory that produced them, without having to go through their doctors first, under regulations announced Monday by the Obama administration. The rule is part of a broader effort by the administration to give Americans more control over their health care. It supersedes state law and will have particular significance in 13 states that forbid labs from releasing test results directly to patients (Somashekhar, 2/3).

USA Today: Patients May Now Get Lab Results Without A Doctor’s Help
Patients or their representatives may now see their medical test results directly from the laboratory, rather than having to request them from a doctor's office, according to a new rule announced Monday. "Information like lab results can empower patients to track their health progress, make decisions with their health care professionals and adhere to important treatment plans," Health and Human Services Secretary Kathleen Sebelius said (Kennedy, 2/3).

Kaiser Health News: New Rule Gives Patients Direct Access To Their Lab Reports
But HHS said the rule helps ensure patients have full access to their health information and can be proactive in their choices for care. The rule also notes that studies have found “physician practices failed to inform patients of abnormal test results about seven percent of the time, resulting in a substantial number of patients not being informed by their providers of clinically significant tests results" (Rao, 2/4).

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Public Health & Education

FDA Targets Teens In New Anti-Smoking Campaign

The $115 million multimedia effort, which includes ads highlighting yellow teeth and wrinkled skin to show the costs of smoking are not just financial, is scheduled to be unveiled Tuesday.  

The Washington Post: New FDA Anti-Smoking Campaign Eyes Teens Risk Of Becoming 'Replacement Customers'
The graphic TV ad is part of a first-of-its-kind national anti-smoking campaign spearheaded by the Food and Drug Administration and targeted at young people ages 12 to 17. The effort, being publicly unveiled Tuesday, aims to show teens that the cost of smoking is not just financial. FDA Commissioner Margaret A. Hamburg, in an interview with a small group of reporters Monday, said the campaign is designed to speak to the estimated 10 million young people who are considering trying cigarettes or who may be experimenting with them already (Cha, 2/4). 

The Associated Press/Washington Post: FDA Launching Anti-Smoking Campaign Aimed At Youth
The Food and Drug Administration is using ads that depict yellow teeth and wrinkled skin to show the nation’s at-risk youth the costs associated with cigarette smoking. The federal agency said Tuesday it is launching a $115 million multimedia education campaign called “The Real Cost” that’s aimed at stopping teenagers from smoking and encouraging them to quit (2/4).

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State Watch

State Highlights: Va. Lawmakers Disagree On Emergency Mental Health Custody

A selection of health policy stories from Washington state, Virginia, Wisconsin, West Virginia and Florida.

The Seattle Times: Some Mental-Health Officials Oppose Commitment Bill
The proposal, numbered 2725 in the House and 6513 in the Senate, would create a new appeal process for when county officials decline to order an involuntary commitment. In those situations, immediate family members could ask a Superior Court judge about the case (Rosenthal, 2/3).

The Richmond Times-Dispatch: Senate, House Split On Duration Of Emergency Custody
A gap is widening between the Senate and House of Delegates over how long to hold someone involuntarily for a psychiatric evaluation to determine if the person poses a threat to self or others and, if so, find an appropriate psychiatric bed. A Senate Finance subcommittee on Monday endorsed a 24-hour limit on emergency custody orders, which now can last no longer than six hours, while a House committee approved a two-hour extension to no more than eight hours. But senators also are attracted to a third option — a 12-hour time limit, as recommended by a gubernatorial task force studying gaps in Virginia’s mental health system (Martz, 2/4).

The Milwaukee Journal Sentinel: Lawmakers Pledge Quick Action On Milwaukee County Mental Health System
Lawmakers are promising quick action on a bill to curb political influence over Milwaukee County's mental health system by putting medical professionals in charge of directing care. The bill, unveiled Monday, would strip all authority from the County Board and establish a mental health board of 13 people, mostly doctors and people with experience in the mental health system. The members, who would not be paid, would be appointed by the governor to make policy decisions about mental health care (Kissinger and Schultze, 2/3).

Kaiser Health News: From Ethiopia To West Virginia, Community Health Workers Help Close Access-To-Care Gaps
Across the world, countries have started to embrace community health workers as a means of reaching people who don't always have regular access to care through clinics and hospitals. Their titles vary -- India has more than 800,000 "Accredited Social Health Activists" and Malawi employs 11,000 Health Extension Workers -- but the impact seems to be universal. Not only do the workers treat and manage care, they also help curb health care costs by preventing complicated disease and emergency room visits (Rao, 2/4).

Health News Florida: Prestige Wins Medicaid Contracts
With a billion dollars riding on the contested decision, Florida's Agency for Health Care Administration says it will award its Medicaid managed-care contract for Miami-Dade and Monroe counties to Prestige Health Choice. The final order, signed by AHCA Secretary Liz Dudek on Friday, rejects a recommendation from an administrative law judge who held hearings in the case in November (Gentry, 2/3).

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Editorials and Opinions

Viewpoints: Drop In Abortion Rates May Have Something To Do With Better Contraception; GOP Health Law Alternative 'Designed To Fail'

The New York Times: What's Behind The Declining Abortion Rate?
A new study released on Monday finds that the abortion rate among American women declined to its lowest level in more than three decades in 2011. ... Notably, though, the decline in abortions from 2008 to 2011 was mirrored by a decline in pregnancy rates that the researchers say may reflect stricter adherence to birth control methods during recession, and the growing use, especially among younger women, of reliable long-term contraceptives, like the intrauterine device, or IUD. IUDs are 45 times more effective than oral contraceptives and 90 times more effective than male condoms in preventing pregnancy. But they are also more expensive, making them unaffordable for many women. This fact might help explain the significantly higher rates of abortion among the poor. The cost issue underscores the importance of the Affordable Care Act’s contraception mandate (Dorothy J. Samuels, 2/3). 

Los Angeles Times: Defining The Rights Of The Religious In America
Two decades ago, Congress overwhelmingly approved and President Clinton enthusiastically signed the Religious Freedom Restoration Act. But now that the 1993 law is being used to challenge the Obama administration's requirement that employer health plans include contraceptive services, some supporters of the law are having second thoughts, and several organizations want the Supreme Court to declare it unconstitutional. That would be a mistake (2/4).

Los Angeles Times: How The GOP's Obamacare Alternative Is Designed To Fail
Evidently fed up with accusations that their "repeal and replace" plan for Obamacare has consisted of a whole lot of "repeal" and not even a tiny bit of "replace," Senate Republicans last week unveiled an actual, detailed healthcare reform proposal. The Patient Choice, Affordability, Responsibility, and Empowerment Act ("CARE") bears the names of Sens. Richard Burr (N.C.), Tom Coburn (Okla.) and Orrin Hatch (Utah). It preserves some of the things people like about the Affordable Care Act--insurance for those with pre-existing conditions, for example--but does so in a way that's guaranteed to fail most of those affected. Among other things, it eliminates minimum coverage standards written into the ACA, including items like maternity coverage, which will inevitably make insurance more expensive for women relative to men (Michael Hiltzik, 2/3). 

The New York Times: Firearms' Toll Among The Young
The world at large heard instantly about the school massacre in Newtown, Conn., where 20 youngsters were murdered in 2012 in a terrifying spree of gunfire. Far less noticed but no less horrific is the unending toll from the more routine bursts of gunfire that each day send an average of 20 American children and adolescents to hospitals, many of them for long-term treatment (2/3).

The Washington Post: Philip Seymour Hoffman's Death Shows That We're Losing This Drug War
Oscar-winning actor Philip Seymour Hoffman is yet another victim of the war on drugs. Prohibition is not working. It is time to try something new. ... We do know that this need to get high is beyond some people’s control. Our drug policy of prohibition and interdiction makes it difficult and dangerous for people like Hoffman to get high, but not impossible — and it makes these tragic overdose deaths more common than they have to be (Eugene Robinson, 2/3).

The Wall Street Journal: How To Win The Super Bowl Against Cancer
This should concern us greatly on Tuesday's World Cancer Day and beyond. Ratings may have the best of intentions—to promote the development of effective treatments and to control the costs of cancer care—but there are much better ways to achieve both goals. In more and more countries, ratings of medicines have become part of the already lengthy process that stands between new treatments and the patients who might be helped. Some ratings take the form of medical-benefit or innovation scales that try to predict the contributions of new medicines to health outcomes, often by comparing new and existing treatments (John C. Lechleiter, 2/3). 

The New York Times: Don't Ask Your Doctor About 'Low T'
But "low T," as the condition has been labeled, isn't nearly as common as the drug ads for prescription testosterone would have you believe. Pharmaceutical companies have seized on the decline in testosterone levels as pathological and applicable to every man. They aim to convince men that common effects of aging like slowing down a bit and feeling less sexual actually constitute a new disease, and that they need a prescription to cure it. This is a seductive message for many men, who just want to feel better than they do, and want to give it a shot, literally. The problem is that prescription testosterone doesn't just give your T level a boost: it may also increase your risk of heart attack (John La Puma, 2/3).

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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.