Daily Health Policy Report

Tuesday, February 5, 2013

Last updated: Tue, Feb 5

KHN Original Reporting & Guest Opinion

Health Reform

Health Spending And Fiscal Battles

Medicare

Health Care Marketplace

Quality

Coverage & Access

Public Health & Education

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Health Law Bars Opting Out Of Maternity Coverage; Long Term Care Insurance Is Guaranteed If Company Goes Out Of Business

Kaiser Health News consumer columnist Michelle Andrews answers readers' questions about maternity coverage requirements in the new health insurance exchanges, long-term-care insurance and switching employer health plans (Andrews, 2/5). Read the column.

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Political Cartoon: 'Butcher Shop?'

Kaiser Health News provides a fresh take on health policy developments with "Butcher Shop?" by Taylor Jones.

Meanwhile, here is today's health policy haiku:

 A RATIONAL APPROACH?

Magical thinking:
Health care bubble will not burst.
What will we mortgage?
-Janice Lynch Schuster  

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

Fifth GOP Governor Backs Medicaid Expansion

Ohio Gov. John Kasich announced Monday that he will push to expand Medicaid to cover more low-income Ohioans, as Health and Human Services Secretary Kathleen Sebelius pledged to fund such expansions longterm. Meanwhile, lawmakers and health providers in Pennsylvania, Oklahoma, California, Texas and Wisconsin continue to debate the expansion, which was made optional by the Supreme Court.

Politico: Kathleen Sebelius: Medicaid Expansion's Not 'Bait And Switch'
In a message targeted at states undecided about expanding Medicaid under the health care law, Department of Health and Human Services Secretary Kathleen Sebelius stressed Monday that the White House won't back away from its promise to fund the expansions, even amid mounting battles over the federal budget. Sebelius said states hesitant to sign up for the Medicaid expansion under the Affordable Care Act shouldn't fear that the federal funding commitment will disappear when states boost their Medicaid rolls (Millman, 2/5).

The Associated Press/Washington Post: Ohio's Republican Governor Backs Medicaid Expansion Under Federal Law To Cover More Poor
Ohio's Republican governor announced Monday he will push for expanding Medicaid under the federal health care law, a move that would give many more poor people access to government care. It also sets up a potential fight among the governor and Republicans who control the state Legislature and are strongly against President Barack Obama's health care law (2/4).

Politico: Kasich's Obamacare Flip Burns Conservatives
Conservative groups wanted to stop the march of Obamacare expansion at ground zero: the states. But one of their best hopes just caved (Nather, 2/4).

The New York Times: Ohio: Governor Will Seek To Cover More Under Medicaid
Gov. John R. Kasich, a Republican, said he would seek to expand the Medicaid program in Ohio to cover several hundred thousand more adults with incomes up to 138 percent of the poverty level. Expanding the program is a central goal of President Obama's health care law, but the Supreme Court ruled last year that it was an option for states, not a requirement (Goodnough, 2/4).

Reuters: Ohio Governor Kasich Backs Medicaid Expansion In Proposed Budget
Ohio's Republican governor on Monday endorsed the expansion of Medicaid under President Barack Obama's healthcare reform law, raising expectations that political opposition to the plan may be starting to thaw among GOP leaders in so-called Red states. Gov. John Kasich, the fifth Republican state governor to support the Medicaid expansion, made his announcement as part of a press briefing on his $63.3 billion 2014-15 budget proposal (Palmer, 2/4).

CQ Healthbeat: Sebelius Praises Kasich Backing Of Medicaid Expansion
Ohio Gov. John R. Kasich on Monday became the fifth Republican governor to announce support for expanding Medicaid, a decision that Health and Human Services Secretary Kathleen Sebelius called “a great step forward.” Kasich’s decision, which was announced in conjunction with the release of his two-year budget proposal, was widely anticipated (Adams and Reichard, 2/4).

The Associated Press: Corbett May Wait On Decision On Medicaid Expansion
[Pennsylvania] Gov. Tom Corbett may not announce whether he will support the expansion of Medicaid under the federal health care law when he delivers his budget address to the Legislature on Tuesday. What to do about Medicaid is a major dilemma for the Republican governor, who as attorney general earlier joined an ultimately unsuccessful multi-state lawsuit to try to throw out President Barack Obama's sweeping 2010 health care law (Levy, 2/4).

The Associated Press: Dems Say Politics Must Be Removed From Medicaid Plan
Democratic leaders in the Oklahoma Legislature said Monday that Gov. Mary Fallin's decision not to expand the state's Medicaid program was politically motivated and that more public awareness is needed among the roughly 200,000 low-income Oklahomans who would benefit from the expansion. Fallin announced in November that Oklahoma would reject the Medicaid expansion allowed under the health care overhaul law, citing the cost to both the state and federal governments (2/5).

Milwaukee Journal Sentinel: Wisconsin Hospital Association Endorses Medicaid Expansion
The Wisconsin Hospital Association has come out in favor of expanding the state's Medicaid program under the Affordable Care Act to include adults now not eligible for coverage. The hospital association said its board of directors last week unanimously supported expanding the program. "There will be much debate on this issue with valid opinions on both sides," Steve Brenton, president of the Wisconsin Hospital Association, said in a statement. "But at the end of the day, in this time of uncertainty, we cannot have fewer people with coverage and more uncompensated care." The U.S. Supreme Court ruling on the law last summer gave states the option of not expanding their Medicaid programs. Gov. Scott Walker, who has not indicated what he may do, is expected to announce his decision this month (Boulton, 2/4).

The Texas Tribune: Trade Associations Lend Support For Medicaid Expansion
Despite the resistance of Gov. Rick Perry and many other Republicans to expanding Medicaid in Texas under the Affordable Care Act, some momentum seems to be building from outside of the Capitol in support of the expansion. Texas’ two largest health care trade associations, the Texas Medical Association and the Texas Hospital Association, have announced support for extending Medicaid coverage to low-income adults (Aaronson, 2/5).

California Healthline: Finance, Health Care Linked In Expansion Effort
State health care and finance officials met for the first time with stakeholders Friday to outline some of the differences between two possible approaches -- state-based or county-based -- to implementing the state's optional Medi-Cal expansion. Many details of the proposed expansion of Medi-Cal are unknown, state officials said Friday because they're waiting for more federal guidance in many areas. One important detail is known: the federal government will fully pay for the expansion benefits for new enrollees for the first three years. Diana Dooley, the state's Secretary of Health and Human Services, said implementing the expansion will be influenced in equal parts by financial and health care considerations (Gorn, 2/4).

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Insurance Exchange 'Navigators,' New Payment Models Claim Roles In Health Law Implementation

The Washington Post reports on the challenges involved in fielding a team of health exchange navigators to help people work through their choices and the process. Meanwhile, MedPage Today reports on comments made by Health and Human Services Secretary Kathleen Sebelius regarding the "obligation" providers have to try new payment models.

The Washington Post: For Insurance Exchanges, States Need 'Navigators' -- And Hiring Them Is A Huge Task
Signing up an estimated 30 million uninsured Americans for coverage under the health care law is shaping up to be, if not a bureaucratic nightmare, at the very least a daunting task. While some people will find registering for health insurance as easy as booking a flight online, vast numbers who are confused by the myriad choices will need to sit down with someone who can walk them through the process (Aizenman, 2/4).

Medpage Today: Sebelius Urges Docs To Adopt New Pay Models
Health care providers have an obligation to try new payment models that can help lower the growth rate of health spending, Health and Human Services Secretary Kathleen Sebelius said Monday. "Far too many health care providers are still content to sit back and let others blaze the trail to a 21st century health care system," Sebelius said at the AcademyHealth National Health Policy Conference here. "My plea to all of you today ... is to help us speed up the rate of change." In the last few years, health care spending has grown at historically slow rates, she pointed out. Meanwhile, efforts to reduce health care-acquired infections, hospital readmissions, and elective early deliveries have shown success. But the change in care delivery and payment models isn't happening fast enough, Sebelius said (Pittman, 2/4).

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Health Spending And Fiscal Battles

GOP Lawmakers At Odds Over Strategies For Spending Cuts, Broader Party Message

Los Angeles Times: As House Returns, GOP Strategies Reflect Soul-Searching
Republicans have little interest in Obama's desire to find more tax revenue to control deficits, and pledge they will fight for deeper spending cuts. Their promise of a 10-year balanced budget … is an ambitious undertaking. Even the budget from Rep. Paul D. Ryan (R-Wis.), with its overhaul of Medicare and other safety net programs, did not balance for almost 20 years. While many Republicans … are primed for this fight as they aim to slash spending to balance budgets, others would like to broaden the party's message. Obama is set to address Democrats in both the House and Senate at their private caucus retreats this week as they consider ways to extract more revenue by closing loopholes. The White House has given little insight into why the president again missed the February deadline for presenting his budget, and Press Secretary Jay Carney declined Monday to say when the blueprint would be ready (Mascaro, 2/4).

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Medicare

Obama Administration Proposes Eliminating 'Obsolete' Medicare Regs

Doing away with the regulations, which it has deemed are "excessively burdensome," would save an estimated $676 million a year, according to the administration. In other news, The Medicare NewsGroup examines the population of people with a permanent disability who also qualify for Medicare.

Reuters: U.S. Proposed Scrapping Some Obsolete Medicare Regulations
The Obama administration on Monday proposed eliminating certain obsolete Medicare regulations, a move it said would save hospitals and other health care providers an estimated $676 million a year, or $3.4 billion over five years. The Department of Health and Human Services described the targeted regulations as unnecessary or excessively burdensome and said their proposed elimination would allow greater efficiency without jeopardizing safety for the Medicare program's elderly and disabled beneficiaries (Morgan, 2/4).

The Medicare NewsGroup: Troubling Trends On Disability As A Back Door Into Medicare
No publicly presented Medicare reform proposal has addressed the growing problem of those younger than age 65 who are finding their way into the program through permanent disability. Those who qualify for Social Security Disability Insurance (SSDI) and who have been disabled for at least two years are automatically enrolled in Medicare, no matter their age. That means a growing number of those under age 65 -- at least five million people -- are qualifying for lifetime benefits, according to a recent tally published in the journal Health Affairs. Policymakers are concerned about the rise in disabled adults because they often require expensive care, putting even more pressure on the health care system (Wasik, 2/4).

Meanwhile, a class-action lawsuit settlement addresses Medicare's therapy plateau --

The New York Times' The New Old Age: Therapy Plateau No Longer Ends Coverage
Congress continued for another year a little-known process that allows exceptions to what Medicare pays for physical, occupational and speech therapy. The Medicare limits before the exceptions are $1,900 for physical and speech therapy this year, and $1,900 for occupational therapy. In addition, the settlement of a class-action lawsuit last month now means that Medicare is prohibited from denying patients coverage for skilled nursing care, home health services or outpatient therapy because they had reached a "plateau," and their conditions were not improving (Jaffe, 2/4).

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Health Care Marketplace

Humana Reports 3.5% Fourth-Quarter Drop In Profits

According the the health insurer, the slip was caused by more expensive claims during this year's flu season and high costs for new and existing Medicare customers.   

The Associated Press/New York Times: A Bad Flu Season Lowers Humana's Profits
The health insurer Humana reported a 3.5 percent drop in its fourth-quarter net income on Monday as it absorbed higher claims payments driven by the flu outbreak, which offset continued growth in its lucrative Medicare Advantage membership (2/4).

The Wall Street Journal: Humana's Profit Slips On Higher Coverage
Humana's profits have declined in recent quarters partly due to high costs for both new and existing customers on Medicare plans. The company -- which is one of the biggest providers of privately run Medicare Advantage health plans for seniors in the U.S. -- has been buying stakes in doctor practices in an effort to push further into providing health services, and not just paying for them (Warner, 2/4).

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Quality

Hospital House Calls: A Way To Cut Costs And Improve Quality?

Meanwhile, a group of experts convened by the National Quality Forum has released its second annual round of recommendations on quality measures to be used in federal health programs.

The Wall Street Journal: Hospitals Try House Calls To Cut Costs, Admissions
To keep patients out of the hospital, health care providers are bringing back revamped versions of a time-honored practice: the house call. In addition to a growing number of doctors treating frail patients at home, insurers and health systems are sending teams of doctors, nurses, physician assistants and pharmacists into homes to monitor patients, administer treatments, ensure medications are being taken properly and assess risks for everything from falling in the shower to family care-giver burnout (Landro, 2/4).

Modern Healthcare: NQF Panel Weighs In On Quality Measures
The Measure Applications Partnership, a group of health care experts convened by the National Quality Forum to provide pre-rulemaking guidance to HHS, has released its second annual round of recommendations on quality measures for use in federal health programs. The MAP reviewed more than 500 measures currently under consideration by HHS for 20 federal programs, according to NQF. One hundred forty-one of those measures were green-lighted for immediate use. The MAP supported the direction of another 166 measures -- including measures of early elective deliveries and shared decisionmaking for neurosurgery patients -- pending more testing or NQF endorsement. The group did not support 165 measures for HHS programs and it also recommended phased removal of 64 measures, such as one for coordination of care for melanoma patients (McKinney, 2/4).

Also in the news, NPR takes a look at how baby boomers are aging --

NPR: Aging Poorly: Another Act Of Baby Boomer Rebellion
Baby boomers have a reputation for being addicted to exercise and obsessed with eating well. But that story didn't jibe with what physician Dana E. King and his colleagues see walking through the door of their family practice every day in Morgantown, W.Va. (Stein, 2/4).

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Coverage & Access

Army Secretary Urges Soldier Mental Health Resilience Training

The step is part of an effort to improve the Army's coordination of mental health programs and to address increasing military suicide rates.

Los Angeles Times: Army Secretary Calls For Mental Health 'Resilience' Training
With suicides in the Army reaching another record in 2012, Army Secretary John McHugh said Monday he is reviewing recommendations from a study of soldier behavioral health evaluations and intends to adopt mental health "resilience" training for all soldiers (Murphy, 2/4).

The Associated Press/Washington Post: Army Secretary Visits Joint Base Lewis-McChord To Review Behavioral Health Evaluations
Army leadership is looking to improve coordination among its mental health programs and other soldier-resilience efforts, acknowledging Monday that a patchwork system of tools is often confusing for both commanders and soldiers. Army Secretary John McHugh said he has asked Army officials to finish a plan for an overhaul in the next couple weeks (2/4).

Reuters: U.S. Army To Build Soldier 'Resilience' To Fight Suicides, Violence
The U.S. Army, grappling with a spike in military suicides, plans to take steps to improve soldiers' resilience to mental health problems to combat such deaths as well as depression, substance abuse, and violent behavior, Army Secretary John McHugh said on Monday. McHugh ordered Army officials to lay out detailed plans by February 15 to boost soldiers' "physical, emotional and psychological resilience," but did not reveal program specifics, such as estimated costs or goals (Myers, 2/4).

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Public Health & Education

Technology Helps Doctor Unlock Clues About Illness's Environmental Causes

The Washington Post: New Technology Helps Doctors Link A Patient's Location To Illness And Treatment
Epidemiologist David Van Sickle spent years studying asthma, but like many researchers of the chronic disease, he was frustrated by the obstacles to determining precise triggers of an individual attack. That frustration gave him an idea for a rescue inhaler topped with a GPS sensor. The invention would map the user’s location every time he took a puff and send that information back to his doctor. Such a device, Van Sickle thought, would give doctors data about when and where attacks occurred, helping them figure out possible environmental causes and allowing them to plan treatment accordingly (MacDonald, 2/4).

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State Watch

Feds Clear Way For Fla. To Enroll Medicaid Recipients Into Private Plans

The waiver approved by HHS means elderly people who need long-term care can be put in programs that will offer services in their homes and help them stay out of nursing homes, the Associated Press reports.

The Associated Press: Fla. Moving Ahead With Medicaid Privatization
Federal health officials gave Florida the green light to enroll long-term care patients into a statewide Medicaid privatization program. But Gov. Rick Scott noted Monday he is awaiting a final signoff from the feds to privatize the program statewide for most of the state's nearly 3 million Medicaid recipients. ... The waiver approved on Friday will allow Florida to enroll patients who require long-term care into managed care programs that will offer services in their home or other community programs to keep them out of nursing homes. Long-term care patients are typically a fragile population with extensive medical needs (Kennedy, 2/4).

Health News Florida: Feds Give OK; Medicaid's Frail Elderly To Enter HMOs
Federal health officials have given Florida permission to enroll elderly, sick Medicaid patients into private managed-care plans, Gov. Rick Scott's office announced on Monday. The three-year waiver of federal Medicaid rules can begin July 1, according to the letter from two officials at the Centers for Medicare and Medicaid Services, part of the federal Department of Health and Human Services (Gentry, 2/5).

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Catholic Hospital Says Its Argument On Fetuses Was 'Morally Wrong'

A Catholic hospital is backtracking on its claim in court that two fetuses that died under its care were not human beings -- saying now that that argument was "morally wrong."

CNN: Catholic Hospital Says It Was 'Morally Wrong' To Argue Fetus Is Not A Person
A Catholic hospital in hot water for claiming in a Colorado court that a fetus is not a person backtracked on Monday, saying it was "morally wrong" to make the argument while defending itself in a wrongful death lawsuit. The flip-flop concerns the case of Lori Stodghill. She was 28 weeks pregnant with twins when she went to the emergency room of St. Thomas More Hospital in Canon City, Colorado, vomiting and short of breath. She went into cardiac arrest in the lobby and died. That was New Year's Day 2006 (2/5).

The Associated Press: By Arguing Fetuses Are Not Legally Persons, Catholic Hospital Wades Into Charged Debate
It was a startling assertion that seemed an about-face from church doctrine: A Catholic hospital arguing in a Colorado court that twin fetuses that died in its care were not, under state law, human beings. When the two-year-old court filing surfaced last month, it triggered an avalanche of criticism -- because the legal argument seemed to plainly clash with the church's centuries-old stance that life begins at conception (Riccardi, 2/4).

Elsewhere, Arkansas lawmakers approved an abortion restrictions bill--

The Associated Press: Arkansas House OKs Abortion Restrictions
The Arkansas House voted Monday to ban abortions after 20 weeks of pregnancy with no exceptions for rape or incest, sending the proposal to a state Senate that approved more stringent restrictions last week. The House also voted to block insurers from covering abortions if they participate in the online marketplace created under the federal health care overhaul (DeMillo, 2/4).

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State Roundup: Calif. 'Healthy Families' Deficit At $100M

A selection of health policy stories from California, Colorado, Texas, Alaska, Delaware, Georgia, Washington state and Oregon.

California Healthline: As Healthy Families Deficit Rises, Tax Pressure Rises With It
The Healthy Families program has run out of money, according to state health officials. The deficit currently stands at almost $100 million and will keep rising every month, according to Janette Casillas, executive director of the Managed Risk Medical Insurance Board, which oversees Healthy Families. Gov. Jerry Brown's administration is pursuing two ideas for refilling the coffers: reinstitution of a recently expired tax on managed care organizations and an appropriation bill if the MCO tax isn't revived (Gorn, 2/4).

Denver Post: University Of Colorado Health Ponders Creating Its Own HMO
Even as it consolidates power over six hospitals, more than 15,000 employees and billions of dollars in revenue -- while rebranding dozens of buildings and services to boost its image -- University of Colorado Health is already preparing for the next revolution. The burgeoning three-state hospital group is contemplating a step into the insurance end of health care and tearing up old delivery methods ahead of an overhaul in federal payments (Booth, 2/5).

The Texas Tribune: Medicaid Fraud Recovery Tops $1 Billion
The Texas attorney general's office is touting a new state record -- $1 billion in Medicaid fraud recoveries over the last 10 years. About $400 million of the state's recoveries were returned to Texas' coffers (White, 2/4).

The Associated Press : Alaska Looks To Get A Handle On Health Care Costs
State officials are looking at ways to lower the growth of Alaska's health care costs, including an alternate retiree plan and developing an employee wellness program. The path the state is on isn't sustainable, Administration Commissioner Becky Hultberg and Health Commissioner Bill Streur told the House Finance Committee on Monday (Bohrer, 2/4).

The Associated Press/Washington Post: Delaware Small Business Advisory Panel Discusses Workers Comp, Health reform, Loan Programs
Workers compensation insurance and health care reform are among the issues being looked at by a panel aimed at helping small businesses in Delaware. The state small business advisory committee was scheduled to meet Tuesday, with a review of a new workers compensation task force topping the agenda (2/5).

Georgia Health News: Small Rural Hospital Closes Doors; More May Follow
The Friday closing of Calhoun Memorial Hospital in the southwest Georgia town of Arlington reflects the financial squeeze that many rural facilities face. A handful of other rural hospitals in the state also may be teetering on the brink, with rising levels of uninsured patients and with Medicaid continuing to pay low rates for services. HomeTown Health, an organization of rural hospitals in Georgia, says a half-dozen facilities could follow Calhoun Memorial’s move and shut down in the coming months. Ironically, news of the nonprofit hospital’s closing came just hours after the state House passed a bill to facilitate renewal of the hospital provider fee. Jimmy Lewis of HomeTown Health said that if the bill had failed and the fee had vanished, more than 20 rural hospitals might have had to close (Miller, 2/4).

The Olympian: In Washington State, Mental Health Funds Sought As Help Falls Short
It's nothing new: horror stories about people whose mental illnesses turned them into killers; a safety net that failed to catch them; and now, politicians in Olympia vowing to do something. "There's suddenly a lot of movement, and it's sad that it's taken a series of catastrophic tragedies to start addressing this, but it's a catalyst," said Larry Thompson, a therapist at Western State Hospital in Lakewood who said he’s more hopeful for change than he has been in years (Schrader, 2/4).

Statesman Journal: Demonstrators Urge Universal Single-Payer Health Care System
Changes are underway to change state and federal health care, but hundreds of Oregonians gathered at a rally Monday said they want lawmakers to move further toward establishing a universal single-payer system. More than 200 people held up protest signs, chanted and even sang at the Capitol’s steps to show their support for such legislation. Instead of paying private health insurance premiums, co-payments and other medical expenses, residents would fund the universal health care plan through a tax based on their ability to pay, according to Health Care for ALL Oregon, a coalition of labor, education and health care organizations that hosted the rally (Wong, 2/4).

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Editorials and Opinions

Viewpoints: Sen. Hatch's Prescription For Safeguarding Entitlements; Medicare Crackdown On CVS Drug Program; JFK's Mental Health Vision Failing

Politico: 5 Entitlement Reforms For Better Fiscal Course
American families are used to working with dollar amounts starting with hundreds and thousands. But the fiscal situation of our country requires us to act in terms of billions and trillions. ... Unfortunately, waiting until the last minute to stop a crisis has become standard operating procedure in Washington. But that isn't how we should be tackling our debt or safeguarding Medicare and Medicaid (Sen. Orrin Hatch, R-Utah, 2/4).

USA Today: Benefit Programs Shouldn't Be Cut: Opposing View
We must reject efforts to cut Social Security and Medicare in the name of debt reduction. A recent national poll shows that most Americans, across party lines, reject benefit cuts in Social Security and Medicare to reduce the deficit. Older Americans paid for their benefits with each paycheck, and they are owed the benefits they paid for (Hank Johnson, 2/4).

USA Today: Automatic Spending Cuts Just Dumb And Dumber: Our View
In a little less than a month, assuming that Congress is not overtaken by a sudden case of sanity, automatic spending cuts totaling $1 trillion over nine years will go into effect. ... The sequestration would take money from the one-third of federal spending that funds core government functions such as national defense, law enforcement and education. That might be OK if it also tackled the real problem: the benefit programs — such as Social Security and Medicare — that account for three-fifths of spending and are exploding in cost. It doesn't (2/4).

The New York Times: A Convenient Morality
Last week, the Obama administration proposed a further tweak to its rules about insurance coverage of contraception, trying to quiet religious organizations' complaints that the edict tramples on their beliefs. Roman Catholic officials have been especially vociferous. Their moral conviction, they insist, cannot be slave to secular convention. Except, that is, when it works to their advantage (Frank Bruni, 2/4).

The Washington Post: Obama's New Contraception Rules Try To Fool Catholics
The Obama administration's latest revision of its contraceptive policy was welcomed by some religious people as a breakthrough, even a "miracle." Upon reflection, it seems less like the parting of the Red Sea than a parlor trick (Michael Gerson, 2/4).

Los Angeles Times: CVS's Medicare Drug Program Causing Headaches For Enrollees
The federal Centers for Medicare and Medicaid Services said in a letter to CVS' SilverScript subsidiary that its inability to process prescriptions correctly "poses a serious threat to the health and safety of Medicare beneficiaries." The federal agency blamed the problems on "widespread data system failures" that have "created disruptions in tens of thousands of Medicare beneficiaries' access to prescription medications" (David Lazarus, 2/5). 

The Wall Street Journal: Fifty Years Of Failing America's Mentally Ill
On Feb. 5, 1963, 50 years ago this week, President John F. Kennedy addressed Congress on "Mental Illness and Mental Retardation." He proposed a new program under which the federal government would fund community mental-health centers, or CMHCs, to take the place of state mental hospitals. As Kennedy envisioned it, "reliance on the cold mercy of custodial isolations will be supplanted by the open warmth of community concern and capability" (E. Fuller Torrey, 2/4). 

The Wall Street Journal: The GOP's ObamaCare Flippers
As D-Day looms for ObamaCare, one big question is how many states will sign up for its Medicaid expansion. The recent and spectacular flip-flop of Arizona Governor Jan Brewer is a case study in the political pressure and fiscal gimmicks designed to get states to succumb. It's also a study in the arcane and perverse ObamaCare incentives that are intended to gather ever more health-care spending under federal control (2/4).

Philadelphia Inquirer: Makes Us Sick
In his budget address Tuesday, Gov. Corbett is expected to highlight plans for corralling the staggering costs of state-employee pension obligations. In many ways, the pensions paid to some workers -- particularly lawmakers -- is a story of privilege and plenty. Lawmakers can collect their full pensions, averaging $35,000 a year, at age 50. (State employees wait until age 60, and theirs average $23,000 a year.) These numbers are important to remember when looking at the flip side: the millions of families in the state who make far less in salaries than state employees make in pensions. That's why we're more interested in whether Corbett will finally decide to expand Medicaid -- a key part of the Affordable Care Act (2/5).

The Hill: Time To Help States Make Lemonade On Issue Of Long-Term Care?
The enactment of the American Taxpayer Relief Act of 2012 averted the so-called fiscal cliff, but it also repealed the Community Living Assistance Services and Supports Act that was intended to create a public mechanism to help people pay for long-term services and supports if they become disabled. ... Meanwhile, the private long-term-care-insurance industry has imploded (Lee Goldberg, 2/4).

Boston Globe: Hospital Fees Shouldn't Apply For Treatments In Doctors' Offices
When health care providers send out confounding medical bills thick with mysterious fees, it's stressful to patients, and it illustrates a troubling lack of transparency within the health care system. Consider the case of local patient Robert Reed, who had three pre-cancerous spots treated with liquid nitrogen at a suburban dermatologist's office last year — and was billed not just for the doctor's visit, but for $1,525 in operating room and hospital charges. Reed's case, profiled in a recent Globe article, isn't unusual. Amid widespread confusion about who's paying whom and for what, it's easy for costs to keep on going up. That's why it's important for medical bills to reflect the true price of the procedure — and avoid any add-ons that seem designed simply to take advantage of arcane insurance rules (2/5).

The New York Times: Feeding A Disease With Fake Drugs
More than eight million people get sick with tuberculosis every year, according to the World Health Organization. In 2011, 1.4 million died from it, making it the world's deadliest infectious disease after AIDS. Thanks to billions of dollars spent on diagnosis and treatment over the past decade, deaths and infections are slowly declining. Yet a disturbing phenomenon has emerged that could not only reverse any gains we've made, but also encourage the spread of a newly resistant form of the disease (Roger Bate, 2/5).

The Wall Street Journal: Those Misleading World Health Rankings
The federally chartered Institute of Medicine issued a comprehensive report last month on the state of American health. Saying that "Other high-income countries outrank the United States on most measures of health," the report concluded that the U.S. "is among the wealthiest nations in the world, but it is far from the healthiest." ... But the institute's report doesn't tell the whole story. Its key measurements aren't directly related to the quality of American health care (Sally C. Pipes, 2/4). 

Health Policy Solutions (a Colo. news service): Diabetes Prevention Program 'A Potent Weapon'
The fallout from the obesity epidemic sweeping Colorado and the nation includes an alarming rise in diabetes. If trends continue, one in three Americans will have type 2 diabetes by 2050, costing the nation trillions in health care and leaving those with diabetes a lifetime of serious health problems. Estimates show that one in three adult Coloradans have pre-diabetes, meaning their blood sugar levels are high, but not high enough to diagnose type 2 diabetes. Without lifestyle changes to improve their health, those with pre-diabetes are likely to develop type 2 diabetes within six years (Dr. Chris Urbina, 2/4).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Ankita Rao
Marissa Evans

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2012 Kaiser Health News. All rights reserved.