Daily Health Policy Report

Tuesday, April 10, 2012

Last updated: Tue, Apr 10

KHN Original Reporting & Guest Opinion

Health Reform

Campaign 2012

Health Care Marketplace

Public Health & Education

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Say What? Most Insurance Covers Little Of The Cost Of Hearing Aids

In her latest Kaiser Health News consumer column, Michelle Andrews writes: "Only a quarter of the 35 million U.S. adults who could benefit from hearing aids actually get them, and one of the main reasons is money. A hearing aid typically costs a few thousand dollars, sometimes much more, and most insurance plans don't cover that. Medicare generally doesn't pay anything, though hearing loss is a common concern among its beneficiaries. Faced with a hefty expense, many people decide that hearing what's going on around them is a luxury they can't afford" (Andrews, 4/9). Read the column.

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Capsules: Research Weighs Higher U.S. Costs For Cancer Care; During Tough Times, Hospitals Expand Into Affluent Areas; A Saturation Point For Under-26 Coverage?

Now on Kaiser Health News' blog, Sarah Barr reports on new findings regarding cancer care costs: "Higher U.S. spending for cancer care pays off in almost two years of additional life for American cancer patients on average compared to their European counterparts — a value that offsets the higher costs –according to a study in the April issue of the journal Health Affairs" (Barr, 4/9).

Also on the blog, Jordan Rau reports on where hospitals turn for business during difficult economic times: "Amid the recession, hospitals have been aggressively establishing footholds in affluent areas outside their traditional market boundaries as they fight for the patients with the best insurance, according to a new study" (Rau, 4/9). 

In addition, Christian Torres reports on the findings of a Gallup poll regarding under-26 coverage: "According to a Gallup poll released last week, the uninsured rate among 18- to 25-year-olds has leveled off around 24 percent since early 2011" (Torres, 4/10). Check out what else is on the blog.

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Political Cartoon: 'Easy Rider?'

Kaiser Health News provides a fresh take on health policy developments with "Easy Rider?" by Jimmy Margulies.

Meanwhile, here's today's health policy haiku:


End-of-life issues
No one talks about money
Everyone spends it
-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.

Note: Yesterday's haiku was an anonymous submission. It was inadvertently attributed to a different haiku writer. 

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Health Reform

Study: Health Law Would Add $340 Billion To Nation's Deficit

Although the health overhaul is touted by the Democrats as a means to control health care costs, a study by a Republican member of the board that oversees Medicare financing contends that it will add at least $340 billion to the federal deficit.

The Washington Post: Health-Care Law Will Add $340 Billion To Deficit, New Study Finds
President Obama's landmark health-care initiative, long touted as a means to control costs, will actually add more than $340 billion to the nation's budget woes over the next decade, according to a new study by a Republican member of the board that oversees Medicare financing. The study is set to be released Tuesday by Charles Blahous, a conservative policy analyst whom Obama approved in 2010 as the GOP trustee for Medicare and Social Security (Montgomery, 4/9).

Reuters: Obama Healthcare Law Could Sharply Worsen U.S. Deficits: Study
Obama and the Democrats believe the law will control skyrocketing costs and curtail government "red ink." But Blahous, a former economic adviser in the George W. Bush White House, said in his research that the law is expected to boost net federal spending by more than $1.15 trillion and add between $340 billion and $530 billion to deficits between 2012-21 (Crawley, 4/10).

The Associated Press: Study: Obama's Health Care Law Would Raise Deficit
Reigniting a debate about the bottom line for President Barack Obama's health care law, a leading conservative economist estimates in a study to be released Tuesday that the overhaul will add at least $340 billion to the deficit, not reduce it. Charles Blahous, who serves as public trustee overseeing Medicare and Social Security finances, also suggested that federal accounting practices have obscured the true fiscal impact of the legislation, the fate of which is now in the hands of the Supreme Court (Alonso-Zaldivar, 4/10).

Fox News: Study Claims Obama's Health Care Law Would Raise Deficit
However, the White House said Monday that Blahous' "new math" calculations are false, and that the health care law will reduce the deficit by billions. "Claims that the Medicare savings in the ACA have somehow been “double counted” are without merit," Jeanne Lambrew, the Deputy Assistant to the President for Health Policy said in a release, citing the Center on Budget and Policy Priorities. "Deficit-reduction legislation that includes Medicare provisions has been accounted for in exactly the same way in previous Congresses under both political parties" (4/9).

In other news related to the health law -

Politico Pro: Hospitals Will Try To Stop Cuts If Mandate Falls
In background interviews and in on-the-record statements, hospital lobbyists say they would enlist lawmakers to help them recoup some of the $155 billion in cuts they agreed to if the law fails to deliver on its promise of expanded coverage for all Americans. The major hospital groups ... accepted those cuts during the health reform debate because they believed the legislation would give them more insured customers — enough to make up for the loss. But if the individual mandate gets overturned, their rationale for agreeing to those cuts goes away (DoBias, 4/10).

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Polls And Politics: How The High Court Is Changing Public Health Law Views

Recent polls generally indicate that last month's oral arguments changed public views about the health law, but it is not clear in which direction. There are also surveys and analysis about the law's under-26 coverage provision and whether people think seniors with higher incomes should pay more for Medicare.

Politico Pro: SCOTUS Health Polls Give Conflicting Verdicts
The Supreme Court arguments over the health care law changed some public sentiment over the high court — but polls are getting conflicting answers about which way. The court's approval ratings are up about 13 percentage points since mid-March, according to a poll released Monday by Rasmussen Reports. But a poll released last week by the Pew Research Center for the People & the Press found that more people have a negative impression of the institution. In the Rasmussen poll, 41 percent of likely voters rate the Supreme Court’s performance as "good" or "excellent," up from 28 percent in mid-March (Haberkorn, 4/9).

Kaiser Health News: Capsules: A Saturation Point For Under-26 Coverage?
According to a Gallup poll released last week, the uninsured rate among 18- to 25-year-olds has leveled off around 24 percent since early 2011 (Torres, 4/10). 

Politico Pro: Poll: High-Income Seniors Should Pay More
A new analysis of polling data by the Kaiser Family Foundation finds 54 percent of the public believes senior citizens with higher incomes should pay more for their Medicare coverage. The catch: Only a small minority of the public realizes higher income seniors are paying more already. The analysis, based on Kaiser Health Tracking data collected in February, looks at public opinion on different options for curbing the nation’s health care spending on the entitlement program. Democrats and independents showed the most support for higher charges. Fifty-eight percent of Democrats and 57 percent of independents agreed higher income seniors should be charged more, compared to 46 percent of Republicans (Smith, 4/9).

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Campaign 2012

In Past Campaign, Santorum Played Up Support For Medicare Drug Plan

In 2006, Rick Santorum took a moderate stance on the prescription drug plan -- and cast a vote in the Senate that he has called a mistake in this presidential campaign. Meanwhile, in Maine, a Senate candidate who is running as an independent, is keeping "people guessing" about which political side he would pick.  

The Associated Press: Spin Meter: Santorum Looks Moderate In 2006 Flier
Rick Santorum boasts that his deep conservative values make him a stronger challenger against President Barack Obama this fall than likely GOP nominee Mitt Romney. ... Yet Santorum showed a considerably more moderate face in a campaign brochure from his failed 2006 Senate race in Pennsylvania. ... In the Senate, Santorum was a leading advocate for extending Medicare prescription drug benefits to seniors, a measure that conservative critics criticized as a huge entitlement expansion that would swell the federal budget deficit by hundreds of billions of dollars. As a presidential candidate, he's called that vote a mistake (Miga, 4/10).

The Associated Press: In Senate Race, Maine's King Is Critical Of GOP
Angus King is keeping people guessing whether he would side with Democrats or Republicans as a U.S. senator. But Maine's former two-term governor, running as an independent to succeed retiring Republican Sen. Olympia Snowe, calls the GOP budget plan "a disaster" and the party's position on women's health "a mistake." … King supports Obama's health care overhaul, which is under Supreme Court review, and he supports abortion rights (Peoples, 4/10).

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Health Care Marketplace

U.S. Spends More On Cancer Care, But Gains Time In Return

A new analysis published in Health Affairs found that American cancer patients lived almost two years longer than those in 10 European countries -- leading the researchers to say that the additional expense is worth it.   

Reuters: Is High Spending On Cancer Care 'Worth It'?
With the United States spending more on health care than any other country -- $2.5 trillion, or just over $8,000 per capita, in 2009 -- the question has long been, is it worth it? At least for spending on cancer, a controversial new study answers with an emphatic "yes." Cancer patients in the United States who were diagnosed from 1995 to 1999 lived an average 11.1 years after that, compared with 9.3 years for those in 10 countries in Europe, researchers led by health economist Tomas Philipson of the University of Chicago reported in an analysis published Monday in the journal Health Affairs (Begley, 4/9).

Kaiser Health News: Capsules: Research Weighs Higher U.S. Costs For Cancer Care
Higher U.S. spending for cancer care pays off in almost two years of additional life for American cancer patients on average compared to their European counterparts -- a value that offsets the higher costs --according to a study in the April issue of the journal Health Affairs (Barr, 4/9).

NPR: With Cancer Care, The U.S. Spends More, But Gets More
And what it found is that for most types of solid tumor cancers, particularly breast and prostate cancer, even after considering the higher costs, U.S. patients experienced greater survival gains than patients in Europe. And those costs did grow. Between 1983 and 1999, the period covered by the study, U.S. spending on cancer care grew 49 percent (in 2010 dollars). By comparison, spending in the 10 European countries included in the study grew by 16 percent (Rovner, 4/9).

But treatments decisions aren't simple for physicians or patients --

Politico Pro: Study: Doctors Vary On Costly Cancer Care
In recommending cancer treatments, doctors don't always pay much attention to the price of extending a patient's life -- and sometimes they don't follow their own guidelines. A new Health Affairs study led by Dr. Peter A. Ubel of Duke University examines how oncologists make cost-effective decisions when new drugs on the market, such as Avastin, cost hundreds of thousands of dollars. When asked what would be a reasonable definition of cost per additional year of life for a cancer patient, most doctors indicated that a drug with a ratio of less than $100,000 per year of life is worthwhile. But in a hypothetical scenario in which doctors were given the option of prescribing an expensive new drug of varying cost, oncologists presented with more expensive drugs endorsed them (Smith, 4/9).

WHYY/Marketplace: Gambling On Cancer Treatments
Here's a tough question: If you had cancer, which of these treatments would you choose? Traditional chemotherapy that would guarantee an extra year or two of life but no more. Or an experimental drug that could extend your life by at least four years, but had only a 10 percent shot of working. A study in today's issue of HealthAffairs asked over a hundred patients that question (Warner, 4/9).

In other news --

Boston Globe: 60 Percent Of Cancer Patients Die In A Hospital, Dartmouth Study Finds
Although most Americans say they want to die at home, not hooked up to a hospital ventilator, many doctors still feel compelled to treat even terminal cancer with the most aggressive care. Sixty percent of cancer patients die in a hospital, one-quarter of them in intensive care. And it makes no difference whether patients are treated by doctors at community hospitals, teaching hospitals or specialized cancer care centers, according to a study of Medicare patients released Monday afternoon (Weintraub, 4/9).

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When The Economy Is Tough, Hospitals Woo Well-Insured Patients

A study published in Health Affairs found that during the recession, hospitals have sought to establish themselves in affluent markets.

Kaiser Health News: Capsules: During Tough Times, Hospitals Expand Into Affluent Areas
Amid the recession, hospitals have been aggressively establishing footholds in affluent areas outside their traditional market boundaries as they fight for the patients with the best insurance, according to a new study (Rau, 4/9). 

Modern Healthcare: Hospitals Expand To Reach Well-Insured Patients: Report
Dominant regional hospital systems are using geographic expansion to attract well-insured patients from outside their traditional market areas, according to a report by the Center for Studying Health System Change published in Health Affairs. Researchers studied 12 U.S. health care markets and found that hospitals are expanding their geographic base with one or more of these strategies for building referral bases and gaining additional inpatient admissions: Buying or building full-service hospitals or freestanding emergency departments, buying or establishing physician practices, or developing a regional presence with emergency transport service, according to the report (Robeznieks, 4/9).

In other news -

The New York Times: For The Elderly, Emergency Rooms Of Their Own
Hospitals also have strong financial incentives to focus on the elderly. People over 65 account for 15 percent to 20 percent of emergency room visits, hospital officials say, and that number is expected to grow as the population ages. Under the Affordable Care Act … hospitals' Medicare payments will be tied to scores on patient satisfaction surveys and how frequently patients have to be readmitted to the hospital (Hartocollis, 4/9).

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HHS Proposes To Push Back ICD-10 -- A Billing System Unpopular With Docs

The Department of Health and Human Services announced that it would push back for one year the compliance deadline for doctors to convert to the ICD-10 revision of diagnostic and procedural codes. 

The Wall Street Journal's Health Blog: ICD-10 Likely To Be Pushed Back A Year
It's official – the Obama administration is proposing to push back by a year the deadline for a new medical-coding standard that was originally set to go into effect on October 1, 2013 (Mathews, 4/9).

The Hill: HHS Delays New Billing System Unpopular With Doctors
The Department of Health and Human Services (HHS) on Monday formally delayed new billing rules that doctors have criticized as overly complicated. HHS gave doctors an extra year to begin using a new set of codes when billing insurance companies for their services. The new system, known as ICD-10, adds a slew of new codes to describe specific treatments. For example, there are separate codes for "walked into lamppost, initial encounter" and "walked into lamppost, subsequent encounter" (Baker, 4/9).

Modern Healthcare: HHS Proposes Delaying ICD-10 Deadline To Oct. 1, 2014
A proposed rule from HHS pushes back by one year the compliance deadline for conversion to the International Classification of Diseases 10th Revision of diagnostic and procedural codes to Oct. 1, 2014. The rollback of the ICD-10 deadline was telegraphed by HHS Secretary Kathleen Sebelius in February. ... Also announced Monday, nearly 16 years after passage of the Health Insurance Portability and Accountability Act, HHS has issued a proposed rule pursuant to a HIPAA mandate that all health insurance plans be numerically tagged with a unique health plan identifier (Conn, 4/9).

MedPage Today: HHS Anounces ICD-10 Delay
The Department of Health and Human Services (HHS) has proposed a 1-year delay in its deadline for implementing the new ICD-10 diagnosis coding system. In a fact sheet announcing a proposed rule that sets a deadline of Oct. 1, 2014 to comply with the ICD-10 system, HHS noted that "some provider groups have expressed serious concerns about their ability to meet the October 1, 2013 compliance date." Their concerns were partly based on difficulties with implementing a new standardized health claims form, known as Version 5010, for electronic health transactions. Providers need to implement Version 5010 before they can start using ICD-10 (Frieden, 4/9).

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Public Health & Education

Research Explores Power Of Offering Colon Cancer Screening Options

Researchers find that when given a choice of methods, more people will opt to get screened for colon cancer. Meanwhile, a separate study found that insurance coverage of lung cancer screenings for high-risk patients could prevent -- at a low cost -- thousands of deaths annually.

KQED: Talking About Choices May Encourage Colon Cancer Screening
Although about 50,000 people in the U.S. died from colorectal cancer (CRC) last year, as many as half of those deaths could have been prevented by routine screening. ... The problem is getting people to undergo screening can be a bit of a challenge. ... But now doctors are looking at the psychology of how they talk to patients to figure out what might get the most people to get on board with screening (Menghrajani, 4/9).

NPR: Colon Cancer Screening More Likely When People Are Given A Choice
When given a choice, 69 percent of people get screened for colon cancer within a year, according to a new study. By contrast, just 38 percent of people got a colonoscopy when their doctor recommended that method alone. Compare that with the 67 percent of people who did the fecal blood test when that was the only test recommended. … This new study suggests that by pushing colonoscopies, doctors may be missing out on a chance to get people screened, especially if patients belong to an ethnic or racial minority (Shute, 4/9).

Medscape: Colorectal Cancer Screening: Providing Options For Patients
The current universal recommendation of colonoscopy may actually reduce adherence to colorectal cancer (CRC) screening recommendations, especially among racial/ethnic minorities. Therefore, the CRC screening recommendations should allow for patient preferences, the results of a study suggest (Pullen, 4/9).

MedPage Today: Patients Want Choice Of Colon Cancer Screen
Moreover, the researchers found that the common practice of advocating screening with colonoscopy reduced adherence among racial and ethnic minorities in their study. National guidelines vary in their recommendations for colon cancer screening; some leave the choice of test up to the clinician and patient while others favor colonoscopy (Pal, 4/9).

Meanwhile, new research supports coverage of lung cancer screening -

The Hill: Study Recommends Coverage Of Lung Cancer Screening
Having insurance companies cover lung cancer screenings for high-risk patients could prevent thousands of deaths every year at a low cost, according to a new study the policy journal Health Affairs is calling a "first-of-its-kind actuarial study." The study examined the costs and benefits of providing lung cancer screenings to smokers and long-term former smokers between the ages of 50 and 64. Assuming about 9 million people a year would take advantage of the benefit if it was offered, the model found that the screening would cost insurance companies about $247 per member tested annually — less than $1 per commercially insured member per month (Pecquet, 4/9).

In the background -

The Fiscal Times: Doctors Urge Rationing 45 Common Screening Tests
Last week, physician groups representing nearly half of America’s doctors issued guidelines that would limit Americans' access to allegedly unnecessary medical tests and procedures. The public reaction was noticeable for the one thing that was missing -- a public outcry against rationing. … While the medical societies took on a few hot button issues like the frequency of colonoscopies for older adults, it avoided mammography, which during the debate over health care reform led critics to accuse the U.S. Preventive Services Task Force (USPSTF) of rationing because it recommended against routine mammography in women under 50. Why didn't the latest recommendations generate a similar outcry? The physician groups' recommendations were greeted with enthusiasm by the very same "rationers" that had backed USPST in the mammography dust-up (Goozner, 4/9).

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The Urgency Of Autism: Progress In Combating It, Even As Diagnoses Increase

News outlets examine progress being made in diagnosing autism and understanding its possible causes.

USA Today: Autism Science Is Moving 'Stunningly Fast'
The quest to unravel the mystery -- and get children and families the help they need -- has become more urgent as autism has become more widely diagnosed. The condition now affects one in 88 children, according to a report last month from the Centers for Disease Control and Prevention (Szabo, 4/9).

Healthy Cal: Autism Diagnoses Increase, Especially Among Latinos
More children than ever before are being diagnosed with autism, a developmental disorder that impairs the brain's ability to build communication and social skills, according to a report released last week by the Centers for Disease Control and Prevention. Autism has been detected in about one in 88 children, a 23 percent increase from the CDC’s last count in 2006 and almost double the number of diagnoses found ten years ago. Experts believe better screening and growing public awareness about autism are driving the steady increase in diagnoses. Still, some say too few doctors -- only 40 percent according to a 2008 survey -- are screening for autism, leading to delays in diagnosis and treatment for many children (McKinnon, 4/9).

Healthy Cal: Obesity, Diabetes In Mothers Linked To Developmental Delays
For years, obesity and autism have been on the rise. Now, a new study is providing evidence that maternal metabolic conditions like obesity and diabetes may be linked to developmental delays and autism. Obese mothers are 1.66 times as likely to have a child with autism as normal weight mothers who do not have high blood pressure or diabetes, according to the study conducted by the UC Davis MIND Institute. They are also more than twice as likely to have a child with a second developmental disorder (Craig, 4/9).

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State Watch

States Plot Medicaid Managed Care Changes; Kansas Plan Faces Skepticism

In Ohio, Molina Healthcare loses its Medicaid managed care contract. In Texas, a plan to save money by incorporating Medicaid drug benefits into a managed care program gets pushback. And, Kansas counties weigh in on a plan to shift Medicaid beneficiaries to managed care.

The Wall Street Journal: Molina Loses, Aetna Wins In Ohio Medicaid Decision
A surprise decision by Ohio to shake up the providers of its Medicaid health plan marked a sharp setback for incumbent insurer Molina Healthcare Inc., which lost its contract (Kamp, 4/9).

Bloomberg: Medicaid Insurers Plunge As Ohio Dumps Old Business For New
Ohio's decision to shut out Molina Healthcare Inc. and two other health plans that contract to manage 1.5 million of the state's Medicaid patients sent the shares of the companies plummeting. Molina, based in Long Beach, California, declined the most in almost seven years in intraday trading today while Centene Corp. fell the most in four years and Amerigroup Corp. decreased the most in four months. Ohio is streamlining its Medicaid programs in an effort to save taxpayers $1.5 billion (Armstrong, 4/9).

Texas Tribune: Interactive: Mapping Medicaid Patients' Pharmacy Access
State lawmakers expect to save more than $100 million by including pharmaceutical reimbursements in Medicaid managed care, which was rolled out across the state this year. But pharmacists and small-business owners are crying foul, saying the lowered rates could run independent pharmacists out of business and greatly reduce Medicaid patients' access to medication. The interactive map below shows Medicaid patients' access to pharmacies across the state by comparing the location of pharmacies serving Medicaid patients as of March 2012 to the percentage of the county population enrolled in Medicaid as of August 2011 -- the most current available enrollment data (Aaronson, 4/10).

Kansas Health Institute: Counties Weighing In On KanCare
County officials across Kansas are raising doubts about KanCare, Gov. Sam Brownback’s plan for letting insurance companies manage the state’s $2.8 billion Medicaid program. ... Johnson County is Kansas' most heavily populated county. [Ed Eilert, a Republican member of the Johnson County Commission ] said he expected the commission there soon would pass a resolution urging the governor to "carve out," or exclude from KanCare, the long-term care services Medicaid provides for people with a developmental disability. According to local officials contacted by KHI News Service, at least 20 counties have passed similar resolutions asking the governor to reconsider the reach of KanCare. At least three more are considering a resolution (Ranney and Shields, 4/9).

In other news --

The Lund Report (an Ore. news service): Deschutes County Audit Could Result In Medicaid Payback
An August 2011 audit performed by Accountable Behavioral Health Alliance on Deschutes County Health Services is showing how difficult it is for some organizations to meet the requirements and provide the type of care expected of coordinated care organizations (CCOs). According to the audit, which examined nine patient records and 81 claims in those records, Deschutes County Health Services had nearly a 20 percent error rate. With such a high error rate, Deschutes County could have to pay back some of its Medicaid dollars depending on another audit under way by the Addictions and Mental Health Division (Waldroupe, 4/9).

Georgia Health News: State's Share In WellCare Case: $33 Million
The Tampa-based company runs one of three HMO-like organizations that, as a group, supervise care for more than 1 million Medicaid and PeachCare members in Georgia. The $33 million will be in federal and state funds, with Georgia's net amount being $13 million. Medicaid is jointly financed by the states and federal government. …The alleged manipulation of enrollment of members included targeting low-cost and healthy people, while discouraging, failing to enroll, or disenrolling, undesirable recipients, those considered high-cost and chronically ill, the Olens statement said (Miller, 4/9).

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State Roundup: Md. Legislature Approves Health Enterprise Zones

A selection of health policy stories from California, Utah, Maryland, Florida, Missouri and Georgia.

NPR Shots Blog: Calif.'s Prescription-Drug Monitoring System Feels Pain From Budget Cuts
California has the oldest continuous prescription-drug monitoring program in the U.S. … It used to rely on carbon copies. … The system went online in 1998, and that's when its full power was realized. ... So alarm bells went off among doctors and law enforcement when California Gov. Jerry Brown announced last year that, for budget reasons, he was eliminating the Bureau of Narcotic Enforcement, which had long managed the prescription-drug monitoring program (Varney, 4/10).

The Associated Press: Utah: 750K More Victims In Health Dept Data Breach
An additional 750,000 people had their personal information stolen by hackers, state health officials said Monday after discovering that the thieves downloaded thousands more files of data than authorities initially believed. Officials originally estimated that about 24,000 people had their records stolen after a computer tracked to Eastern Europe infiltrated a server beginning March 30, then changed that number to 182,000 victims. Health officials now believe a total of nearly 900,000 people have had their personal data stolen (Loftin, 4/10).

The Baltimore Sun: Health Enterprise Zone Legislation Passes
A program to improve health care in minority areas and reduce health disparities was approved by the General Assembly over the weekend. The pilot program, which now goes to Gov. Martin O'Malley for his signature, would offer tax breaks and other incentives to local health departments and community groups for their programs in these underserved areas -- labeled as Health Enterprise Zones (Cohn, 4/9).

Earlier, related KHN coverage: Different Takes: Maryland Advances An 'Enterprising' Plan To Eliminate Health Disparities (2/23).

Modern Healthcare: Fla. Heightens Scrutiny Of Public Hospital Deals
Florida Gov. Rick Scott has signed into law a bill that would add more oversight to the sale or lease of public hospitals in the state, and perhaps prompt more merger activity. Among its provisions, the law requires public hospitals to undertake a public evaluation of how they are competing in their respective markets, and evaluate whether a deal might be in their best interest. And while it does not require any hospital to pursue a sale, critics have said it could invite more deal-making in the space (Kutscher, 4/9).

The Miami Herald: Hospitals To Become 'Broward Health'
A plan to change the name of Broward General Medical Center, the county's oldest hospital, and the names of three other public hospitals has physicians and others protesting. Broward General will become Broward Health Medical Center, a change that will roll out this summer as part of an advertising campaign. The three other public hospitals in the Broward Health system will lose the words "medical center" in their titles (Nevins, 4/9).

San Francisco Chronicle: Calif. Suits On Inmate Health Care Likely To Rise
The law firm that successfully sued California in 2001 over the dismal health care in state prisons has filed a similar suit against Fresno County and is eyeing possible action against Riverside County over alleged inadequacies in medical, mental and dental care for inmates -- suits that come as counties begin to house thousands more offenders than they have in the past. The nonprofit Prison Law Office and others are concerned that California's realignment of prisons and jails -- which has inmates serving time in county jails for crimes that in the past would have landed them in prison -- may have simply shifted the state's prison problems to the 58 counties and their jail systems (Lagos, 4/9).

St. Louis Public Radio/Marketplace: Missouri's Low Cigarette Tax Under Fire
The state with the lowest tax on cigarettes? No, not tobacco country -- Virginia or North Carolina. It's Missouri, with a tax of just 17 cents a pack. The national average is a buck and a half. But health advocates are pushing a ballot initiative to increase the levy in Missouri (Altman and Brancaccio, 4/10).

Georgia Health News: Health Worse In Rural Counties, Study Shows
An analysis comparing health statistics for Georgia counties shows a wide gap between rural and urban/suburban areas in the state. The top seven counties in the state in the new health rankings -- Fayette, Forsyth, Oconee, Cherokee, Gwinnett, Cobb and Columbia -- are all in large metropolitan areas in the northern or north-central part of the state. The bottom 10 counties are in rural South or Middle Georgia, according to the rankings, compiled for each state by the University of Wisconsin and the Robert Wood Johnson Foundation and released last week (Miller, 4/9).

California Healthline: Keeping Up With DHCS Lawsuits
The Department of Health Care Services may need an abacus to keep track of all of the lawsuits being levied against it. A ruling is expected as early as today in a lawsuit brought against DHCS by the California Primary Care Association and several other providers. The CPCA hopes a federal judge will grant a temporary restraining order to halt a lower reimbursement rate for adult day health services in the recently launched Community Based Adult Services program. A full hearing on the case is expected in about two weeks, when the CPCA will argue for a preliminary injunction to stop the rate reduction (Gorn, 4/10).

California Healthline: Should California Reconsider Health Care Districts?
Shortly after World War II ended, the California Legislature passed laws allowing counties and communities to create special health care districts to ensure that low-income and underserved Californians have access to hospitals. These districts, most of them built around publicly owned hospitals, could levy taxes and gain access to special financing tools. … Now, with the Affordable Care Act poised to dramatically change the state's health care system, we asked stakeholders and experts if California should be reconsidering health care districts (4/9).

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Editorials and Opinions

Viewpoints: 'Slicing' The Safety Net; GOP Health Law Fight Should Have Targeted Cost-Cutting Panel, Not Mandate

The New York Times: A Rockier Pathway To Work
Last month, the House passed a 2013 budget written by Representative Paul Ryan of Wisconsin that would reduce spending in the category of Education, Training, Employment and Social Services by $16 billion from the previous year, or 22 percent, on top of all the cuts forced by Republicans over several years. The cut in that category is typical of a budget that savages precisely the kind of domestic spending, like job training and Pell grants, needed to help people get off social-safety-net programs, while slicing open the net itself, through big reductions in Medicaid and food stamps (4/9). 

The Washington Post: How Romney Can Solve His Woman Problem
Mitt Romney’s electoral trouble with women — more precisely with college-educated women — is real enough. … The media — ever drawn to simple explanations that reinforce their own cultural expectations — have diagnosed Romney's gender-based electoral weakness as the result of his opposition to the contraceptive mandate. This is both initially plausible and demonstrably false. More than 60 percent of American voters don't even know Romney's position on the mandate. … And when pressed, a majority of women affirm that religious institutions should be exempted from the mandate. … The GOP's main problem is not the contraceptive issue; it is the perception that it has become too ideological on many issues (Michael Gerson, 4/9).

The Wall Street Journal: The Unhappy History Of Running Against The Supreme Court
By scolding the Supreme Court over its 2010 Citizens United decision and cautioning it against declaring ObamaCare unconstitutional, President Obama is ignoring a lesson liberals and progressives should have learned long ago. None has ever succeeded in galvanizing popular opinion against the courts. In American politics, the goal is not to curb the judiciary but to co-opt it (Paul Moreno, 4/9).

Politico: President Obama Wrong To Bully The Supreme Court
Though a former constitutional law professor, the president seems to have forgotten that the Supreme Court is a co-equal branch of government. It is the court’s job to review our laws, to ensure they don't exceed Congress’s limited authority or violate Americans' constitutional rights. It is not unprecedented for the court to declare a law unconstitutional — the justices do it on a fairly regular basis (Rep. Lamar Smith, R-Texas, 4/10).

USA Today: Health Care, Not Coverage
For the next three months, the Supreme Court will mull the constitutionality of the new health care law. At stake is the government's requirement that its citizens buy private health insurance. But whatever the outcome, it's a foregone conclusion that some fundamental change must be instituted in the financing of health care delivery (Carly Fiorina, 4/9).

USA Today: Editorial: Medicare Cost Panel Is Common Sense
A decade from now, what critics like to call ObamaCare will either be the routine way Americans get health coverage or a historical footnote, and the war against it will be largely forgotten, along with its often silly, over-the-top claims about non-existent "death panels," a government "takeover" of health care and — right now — a battle against an obscure Medicare cost-cutting board that critics say would neuter Congress and foist rationing or worse on the nation's elderly (4/9). 

USA Today: Opposing View: IPAB Is Not The Solution
Imagine that your loved one required surgery, yet you were told by the government that the procedure was unnecessary and wouldn't be covered by Medicare. A Medicare program with the Independent Payment Advisory Board (IPAB) crafted by President Obama ensures that this dilemma will become reality for countless seniors (Rep. Phil Gingrey, R-Ga., 4/9).

The Dallas Morning News: GOP’s Picked Wrong Health Fight
The real problem with this law, which I hope Congress and the next administration fix, is finding a reliable way to finance the $900 billion measure. The financing of the system of vouchers and state exchanges largely depends upon an unelected panel of experts cutting Medicare’s growth in spending by $500 billion. That approach should worry us all, even those who favor universal coverage. Congress rarely has shown any appetite to control Medicare spending. ... Even if the unelected panel makes real changes, there’s no guarantee Congress will stick to them (William McKenzie, 4/9).

Politico: 'Obamacare': Fairness v. Justice
Obama has called access to free contraceptives and abortion-inducing drugs for all women a matter of "basic fairness" and a "core principle" that needs to be balanced against the constitutional rights to religious liberty and free speech. To Obama and his allies, the "principle" of free birth control is at least as important as the constitutional right to freedom of religion. ... "Fairness" ... has no place among judges on a court — whose duty is to dispassionately judge a law's constitutionality (Gary Bauer, 4/10).

WBUR: My Dog Gets A Print-Out From His Doctor, Why Don't I?
The vet's electronic health record software makes it easy for the vet and the technician to produce these summaries, so promptly that the payment clerk can routinely hand the printout to us at the end of the visit. The information in the visit summary is significant, actionable, pertinent, timely and specific; in short, it's highly meaningful. … In spreading the use of electronic health records for humans, the powers that be are deciding what constitutes "meaningful use" by doctors of the E.H.R. They're gathering comments from the public until May 7, 2012. We humans are just as deserving as our dogs; we too, should get doctors' orders as clear as our dogs get (Ken Farbstein, 4/9).

WBUR: Filling In The Gaps On Pain Prescriptions
A prominent number quoted in [a New York Times] article -- that, according to the federal Centers for Disease Control and Prevention, 14,800 people died in 2008 in episodes involving these painkillers -- is correct. And that’s 14,800 too many. No doubt about it. But look at what the article failed to say: That, again according to the CDC, half of all those deaths involving prescription painkillers also involved at least one other drug, including benzodiazepines, cocaine and heroin. And that "alcohol is also involved in many overdose deaths." To blame it all on prescription painkillers -- and pain patients and their doctors -- is simply not the full truth (Judy Foreman, 4/9).

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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.