Daily Health Policy Report

Tuesday, April 17, 2012

Last updated: Tue, Apr 17

KHN Original Reporting & Guest Opinion

Health Reform

Campaign 2012

Coverage & Access


Health Information Technology

Health Care Marketplace


State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Insuring Your Health: Out-Of-Network Care Is Expensive But A Couple Of New Options Exist

In her latest Kaiser Health News consumer column, Michelle Andrews writes: "Financially, it's always been risky to get health care from a hospital or doctor that's outside your health plan's network. Without the protection of guaranteed rates negotiated by your health plan, you may end up owing much more, including any billed amounts not paid by your plan. Out-of-network cost sharing is usually higher, too" (4/16). Read the column.

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Capsules: Wash. Abortion Coverage Bill Placed On Hold

Now on Kaiser Health News' blog, Christian Torres reports: "A bill that would require insurers to cover abortion services is off the table this year in Washington state. A special session of the Washington legislature ended Wednesday without the Reproductive Parity Act reaching a vote. The bill would require private insurers that provide maternity coverage to also cover abortion" (Torres, 4/16). Check out what else is new on the blog.

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Political Cartoon: 'Encore Presentation'

Kaiser Health News provides a fresh take on health policy developments with "Encore Presentation" by Matt Wuerker.

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


When the mic was hot...
Romney gave insights on his
safety net vision.

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

Feds Cite Two Insurers For Excessive Premium Increases

The insurance companies will be able to charge the higher amount, but they will be required to disclose on websites that reviewers found the rates to be unreasonable and explain why they are still imposing them.

Reuters: U.S. Cites Assurant Unit Over Health Premium Hike
U.S. officials on Monday cited two health insurers for excessive premium increases, under consumer protection rules of President Barack Obama's healthcare reform law that could soon be nullified by the Supreme Court. The Department of Health and Human Services called on Assurant Inc's Time Insurance Co and Bedford Park, Illinois-based United Security Life and Health Insurance Co to either offer rebates to customers in six states or rescind premium hikes ranging up to 24 percent (Morgan, 4/16).

CQ HealthBeat: CMS Announces More Small Health Plans With 'Unreasonable' Proposed Rates
A Centers for Medicare and Medicaid Services official on Monday announced that two insurers in five states have proposed rate hikes that are "unreasonable." The insurers, Time Insurance Company, a unit of Assurant Life, and United Security, will be able to charge the rates, which consist of increases ranging from 12 percent to 22 percent. But they must state on their websites and on the CMS healthcare.gov website that reviewers have found the rates to be unreasonable and explain why they are imposing them anyway. Health and Human Services Secretary Kathleen Sebelius said in a news release that it's time for the companies to "immediately rescind" the rate hikes, "issue refunds to consumers or publicly explain their refusal to do so" (Reichard, 4/16).

Politico Pro: HHS Rate Review Hasn't Hit Big Insurers Yet
HHS dinged another two health insurers Monday for proposing "unreasonable" rate hikes — but the department has yet to reel in a big fish. Time Insurance proposed unreasonable rate hikes in five states, and United Security didn't provide enough data to justify a rate hike in Arizona, CCIIO announced Monday. That comes after months of sporadic HHS announcements about "unreasonable" rate hikes from Trustmark Life, John Alden Life Insurance and Everence — an Indiana-based insurance company that primarily serves the Mennonite community (Millman, 4/16).

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State Insurance Exchange Implementation Faces Challenges

In some places, state-level progress in building the law's insurance exchanges appears to be stalling because of political divisions.

Politico Pro: Maine Punts On Health Care Exchange
For almost a year and a half, the stars seemed aligned for Maine to build its own health insurance exchange. The tea party-affiliated governor, Paul LePage, backed an exchange in a surprise move last summer. An advisory committee he created also supported it. Instead, Republican lawmakers abandoned their efforts to create an exchange, and the state wound up with a stripped-down, 1½-page bill that only addresses the Affordable Care Act's Navigator program — if a state or federal exchange takes root in Maine. LePage signed it over the weekend. And now health care reform supporters are questioning the legitimacy of Maine's new law — because they think it directly conflicts with some of the most important rules about what navigators are supposed to do (Millman, 4/16).

The Associated Press/Denver Post: Colo. GOP Rejects Health Law Passed By Their Own
Colorado Republicans aren't happy with a health care law promoted by some of their own leaders in the state Legislature. In a platform resolution whose results were announced Monday, Republicans at the state GOP convention voted overwhelmingly to seek repeal of the Colorado Health Benefits Exchange... The platform resolution vote does not affect public policy, nor does it reflect the opinion of all Republicans. But the health exchange vote could be another portent of danger for Republican lawmakers who supported it (Wyatt, 4/16).

The Lund Report (an Oregon news service): Insurance Agents to Play Critical Role in Oregon's Insurance Exchange
Up until now, agents have been paid a commission by insurance companies. That will change once the exchange is operational, Kim Wirtz, who's in charge of policy and implementation, told the Health Insurance Exchange Board last week. Insurance agents will be paid by the exchange itself, using a 2.52 percent administrative fee, which equates to about $16 for people who purchase coverage (Waldroupe, 4/16). 

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U.S. Chamber Of Commerce Finds Small Business Owners Wary Of Health Law Regs

The survey finds that the regulations rank at the top of small business owners' concerns. In other news, the National Journal examines the future of accountable care organizations.

Politico Pro: Survey: ACA Regs Worry Small-Business Owners
A new survey by the U.S. Chamber of Commerce finds that health care regulations rank at the top of the list of small business owners' concerns -- even though the Obama administration has been trying to sell the health care reform law as relief for small businesses. In a first quarter small-business outlook study by the Chamber -- which opposes the Affordable Care Act -- 38 percent of small-business executives surveyed said health care related regulations are the most challenging ones that they face. In addition, 73 percent of those surveyed said the health care law is proving an obstacle to hiring more employees for their business (Smith, 4/16).

National Journal: Are ACOs Already Over?
Last week the federal government announced it had signed up 27 hospital and doctor groups to participate as accountable care organizations, one of the health reform law's great cost-saving hopes. The number is well under federal projections from October, which predicted up to 270 groups would sign up to become Medicare accountable care organizations, or ACOs. The ACO program pays bonuses to doctor and hospital groups if they successfully coordinate care and improve health outcomes for certain Medicare patients. The groups can eventually lose money from the federal government if they don't meet those standards (McCarthy, 4/16).

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Rep. Frank Says Obama's Push For Health Law Was 'Mistake'

Rep. Barney Frank, D-Mass., said in a magazine interview that President Obama made a "mistake" pushing for health reform and that he urged Obama to take up financial system reform instead. In the meantime, Rep. Dennis Kucinich said a single-payer health care system is the only "obviously constitutional" health care plan.

National Journal: Barney Frank: Obama Made 'Mistake' With Health Care Push
Rep. Barney Frank, D-Mass., said he advised President Obama against taking up health care reform following a special election in 2010 that changed Democrats' fortunes in the Senate, saying that he should have instead turned his focus to financial reform. Frank referenced former President Bill Clinton and his failed health care plan from the 1990s (Miller, 4/16).

The Hill: Rep. Frank Says He Urged Obama To Back Off Health Care Reform
Rep. Barney Frank (D-Mass.) thought President Obama was making a "mistake" in pressing for health care reform in 2010 and urged the White House to back off after Democrats lost their 60-seat majority in the Senate, the congressman tells New York magazine. "I think we paid a terrible price for health care," Frank told the magazine in a lengthy interview as he prepares to retire at the end of his 16th term. "I would not have pushed it as hard. As a matter of fact, after [Sen.] Scott Brown [R-Mass.] won [in January 2010], I suggested going back. I would have started with financial reform, but certainly not health care" (Pecquet, 4/16).

The Hill: Kucinich: Single-Payer The Only 'Obviously Constitutional' Health Care Plan
Rep. Dennis Kucinich (D-Ohio) is continuing to argue for a single-payer health care system, saying it would not raise the same constitutional questions that have dogged President Obama's health care law. Kucinich on Monday highlighted a recent report that said a single-payer system would save the state of Minnesota nearly $190 billion over 10 years. "Single-payer health care is inevitable in the U.S. and the states are the first to recognize it," Kucinich said in a statement (Baker, 4/16).

In the meantime, a Catholic cardinal said Monday that the U.S. bishops' opposition to mandated coverage of contraception in the health care law isn't politically motivated --

Chicago Tribune: Cardinal Tries to Clarify Bishops' Stance On Health Care Law
Though the church's concern primarily focuses on the Obama administration's proposal to provide contraception coverage to all employees, including those who work for religious groups, George clarified in his talk to the Union League Club of Chicago on Monday that the church's opposition isn't personal or politically motivated (Brachear, 4/16).

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Campaign 2012

Romney Begins Vice Presidential Search And Rep. Ryan Could Be On The Short List

Rep. Paul Ryan, R-Wis., the author of the House GOP budget plan which revamps Medicare, helped Romney in Wisconsin. In other campaign news, Romney renews attack on health law to woo conservative leaders.

The Associated Press: No Shocker In Store: Romney Veep Search Under Way
GOP budget guru Paul Ryan, R-Wis., also came from humble beginnings. Ryan campaigned at Romney's side for several days ahead of Wisconsin's recent Republican primary, a victory that helped push Rick Santorum out of the race. It's unclear whether Ryan's role as face of the Congressional Republican budget plan, which includes a fundamental transformation of Medicare, would present too much political risk (Hunt and Peoples, 4/16).

The Wall Street Journal: Romney Woos Conservative Leaders
Mitt Romney, while ramping up efforts to win swing voters who will play a large role in November's election, has remained personally involved in trying to persuade conservative leaders to back him and help drive Republican turnout this fall. … Mr. Romney has sought to woo tea-party supporters. On Monday evening, he spoke to a tea-party rally in Philadelphia, where he derided Mr. Obama's health-care law and proposal for million-dollar earners to pay a tax rate of at least 30% (O’Connor and Hook, 4/16).

Los Angeles Times: What Would Romney Cut? Overheard Conversation Holds Clues
But there was no question that the typically cautious candidate had gone well beyond his typical stump speech — in which he mentions his support for moving programs like Medicaid to the states, where he says they would be more efficient, and his backing of Rep. Paul D. Ryan's budget plan, which aims to rein in the cost of Medicare while cutting taxes. For the most part, Romney has offered just a few examples of cuts he would favor, such as federal subsidies to Amtrak or the Corporation for Public Broadcasting, which amount to a tiny slice of the budget (Reston and Mehta, 4/17).

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Coverage & Access

Seniors Increasingly Challenged By Cost, Logistics Of Handling Health Care

News organizations are covering how some seniors are moving in with their children or grandchildren -- or using community programs -- to help navigate the world of care.

NPR:  One Roof, Three Generations, Many Decisions
In 1950, U.S. life expectancy was just over age 68. Today, it's nearly 79. In many cases, as people live longer, they are piling up higher medical and personal care costs, while draining the savings that might otherwise have served as an inheritance for younger generations. The price of getting help, such as that provided by long-term-care insurance, has gotten much steeper in recent years (Geewax, 4/17).

HealthyCal: Independence by the Bay: the Community Living Fund
"I don't know how any senior can handle all of this stuff," sighs Mary Anne Humphrey, 68, who suffers from limited mobility due to a spinal cord injury. Humphrey is explaining the endless paperwork, social services, doctor appointments, benefit plans and medications that she juggles as a disabled senior. Fortunately, Humphrey is one of 1,200 San Francisco County residents that have received help over the past five years from a unique Bay Area program that keeps older adults and the disabled living independently: the Community Living Fund (Perry, 4/16). 

Arizona Republic: AARP Campaign Focuses On Government Programs
AARP is gathering small groups in all 50 states to distill a consensus about managing the challenges facing Social Security and Medicare. AARP will leverage the sheer numbers of Americans age 50 and above to "have a say" in how Congress handles the programs. ... About one out of every six Arizonans is collecting Social Security, AARP volunteer Carl Erickson said. About half of those seniors are living on less than $20,000 a year and Social Security makes up about half of that household income (Wright, 4/16).

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Medical Journals Facing Raft Of Ethical, Transparency Challenges

The New York Times, Connecticut Mirror and MedPage Today examine how prominent journals are handling questions about their independence or integrity.

The New York Times: A Sharp Rise In Retractions Prompts Calls For Reform
No one claims that science was ever free of misconduct or bad research. ... But critics like Dr. [Ferric] Fang and Dr. [Arturo] Casadevall argue that science has changed in some worrying ways in recent decades — especially biomedical research, which consumes a larger and larger share of government science spending. In October 2011, for example, the journal Nature reported that published retractions had increased tenfold over the past decade, while the number of published papers had increased by just 44 percent (Zimmer, 4/16).

MedPage Today: Clinical Trial Data Should Be Open for Review
Original clinical study reports, which contain far more detail than published randomized trials, should be made available to independent researchers seeking to verify efficacy and safety claims, a group of Cochrane reviewers argued (Walsh, 4/16).

The Connecticut Mirror: At 200 Years, Fortress Of Medical Research Confronts The Information Age
[I]n recent years, in large part because of the Internet and the national debate over health care reform, cries for transparency in medicine and health care have been getting louder -- and the New England Journal has found itself increasingly on the defensive.Medical journals have been upbraided for what some say is a failure to be open about the increasingly close financial ties between medicine and industry (Satija, 4/17). 

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Health Information Technology

FDA To Regulate Smartphone Medical Applications

Health information technology is a huge market and growing.

Politico: FDA Tangles With Wireless Medical-App Makers
An onslaught of mobile health technology has forced an arranged marriage between smartphone app makers and the Food and Drug Administration -- because someone had to regulate them. There's just one problem: Many of the tech wizards aren't used to FDA supervision. And now, both sides are struggling to figure out how to live with each other (Norman, 4/16).

Bloomberg: EHealth-Led Exchanges Eye $4 Billion Market In Health Law
EHealth Inc. (EHTH) and an array of online insurance brokers are eying a possible $4 billion-a-year market, after the Obama administration’s surprise decision to let them sell government-subsidized coverage under the health overhaul. If the 2010 health care law survives a Supreme Court review, private brokers can offer the plans starting in 2014, via websites that let consumers compare coverage among a variety of plans the way Expedia users weigh costs and benefits among airlines. That may give the brokers access to as many as 22 million uninsured Americans (Nussbaum, 4/16).

The Dallas Morning News: Will Digital Medical Records Improve Care Coordination?
A digital information exchange allowing authorized doctors in North Texas to see a patient’s medical history will soon become a reality. There is plenty of skepticism, however, about whether it will work to lower the cost of care . ... The health information exchange is the first big initiative from an organization of insurers, employers and health care providers in the Dallas area that was created to rein in costs and improve quality (Landers, 4/16).

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Health Care Marketplace

Lawyers Eye Disability Act For Lawsuit Opportunities

The New York Times: Disabilities Act Used By Lawyers In Flood Of Suits
A small cadre of lawyers, some from out of state, are using New York City's age and architectural quirkiness as the foundation for a flood of lawsuits citing violations of the Americans With Disabilities Act. The lawyers are generally not acting on existing complaints from people with disabilities. Instead, they identify local businesses, like bagel shops and delis, that are not in compliance with the law, and then aggressively recruit plaintiffs from advocacy groups for people with disabilities (Secret, 4/16).

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Medical Societies Bracing For Medicare Penalties

Medscape: Medical Societies See 'Imminent Storm' of Medicare Penalties
After earning hundreds of millions of dollars through Medicare incentive programs designed to improve the quality of care and hold down costs, the medical profession now worries about the flip side of bonuses — financial penalties from all angles.Thousands of physicians learned about the first of the penalties earlier this year when they received a letter stating that Medicare would reduce their reimbursement in 2012 by 1% for not electronically prescribing in the first half of 2011 (Lowes, 4/16).

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State Watch

Mississippi Gov. Signs Landmark Anti-Abortion Law

The state's new law could effectively close the state's only clinic. Meanwhile, a law in Idaho designed to limit abortions is being challenged.

The Associated Press: Miss. Gov Signs New Limits On Abortion Providers
Mississippi's already strict abortion laws have become even tighter after Gov. Phil Bryant signed a bill that will place new regulations on the state's only abortion clinic. Effective July 1, the new law says anyone performing abortions in an abortion clinic must be an obstetrician-gynecologist who has admitting privileges at a local hospital. The Republican governor signed the bill Monday (Pettus, 4/16).

Politico: Miss. Governor Signs Abortion Law
Jackson Women's Health Organization in Jackson, Miss., is the only abortion facility in the state, and its owner recently told POLITICO that two of its three physicians do not have the now-required admitting rights. Diane Derzis had predicted that once signed into law, H.B. 1390 could force her clinic to close (Lee, 4/16).

CNN: Mississippi Governor Signs Bill Tightening Restrictions On Abortion Providers
Seven other states require abortion providers to have hospital privileges, but no other state requires that an abortion provider be an OB/GYN, said Elizabeth Nash, state issues manager for the Guttmacher Institute in Washington (4/17).

Los Angeles Times: Mississippi Adopts New Abortion Restrictions
The law is one of several recent state measures championed by antiabortion activists and passed largely by Republican allies. Last week, Arizona Gov. Jan Brewer signed a law that banned most abortions after 20 weeks. In March, Virginia Gov. Bob McDonnell signed a bill requiring women to undergo an ultrasound before having an abortion (Fausset, 4/17).

Earlier, related KHN story: Mississippi Legislature Passes Abortion Clinic Bill (Hess, 4/4)

Kaiser Health News: Capsules: Wash. Abortion Coverage Bill Placed On Hold
A special session of the Washington legislature ended Wednesday without the Reproductive Parity Act reaching a vote. The bill would require private insurers that provide maternity coverage to also cover abortion (Torres, 4/16).

The Associated Press: Idaho Doctor-Lawyer Fights Fetal Pain Abortion Law
Rick Hearn, the lawyer in the center of this fight, represents an Idaho woman challenging her state's abortion laws in an effort to avoid future prosecution. The same Rick Hearn, who also is a physician, is attempting to jump into the case as a plaintiff using his status as a doctor, even though he has never terminated a pregnancy, in an effort to make sure that if the case is successful, it applies broadly enough to get his client off the hook for good. ... More than a half-dozen states, including Arizona and Georgia this month, have recently banned abortion after more than four months of pregnancy (Boone, 4/17).

Meanwhile --

Arizona Republic: Arizona Panel Endorses Change To Contraception Bill
A legislative conference committee made up of House and Senate Democrats and Republicans has amended House Bill 2625 to limit the type of business that can seek an exemption from covering contraception medication in health-care plans. The bill originally applied to any Arizona business or insurance company. Under the amendment, it would only be applied to "religiously affiliated" businesses (Rau, 4/16).

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State Roundup: Minn. Doc Training Money Cut

News outlets report on a variety of health policy issues in Texas, Minnesota, Georgia, Kansas, Massachusetts, Ohio, Florida and Pennsylvania.

The Texas Tribune: Interactive: The Cost Of Texas Vs. The Federal Government
What are Texas' lawsuits against the federal government costing the state? $1.25 million and counting. This interactive breaks down the costs of the 24 lawsuits that Texas Attorney General Greg Abbott has brought against the federal government during his 10 years in office. ... [T]wo recently filed lawsuits, involving the Women's Health Program and the so-called Contraception Rule, are included in the graph but don't show any associated costs. Lawyers and other staff members have not yet filed billing reports for their work (Aaronson, 4/17).

The Dallas Morning News: Texas Health Aims To Transform Care With Healthways Partnership
Texas Health Resources, one of the largest health care providers in North Texas, wants its patients to become active participants in their well-being rather than just consumers of health services. Such collaboration, Texas Health says, will make people healthier and reduce overall health care spending, which now absorbs roughly one-sixth of the nation's gross domestic product. To help accomplish that goal, the Arlington-based health system will announce on Tuesday a 10-year agreement with Healthways that Texas Health says will transform the way it delivers care (Jacobson, 4/17).

Minnesota Public Radio: State Funds For Medical Training In Limbo
State and federal funds pay most of the training costs for doctors. But in reaching a budget deal last summer to resolve the state government shutdown, Gov. Mark Dayton and Republican legislative leaders slashed training funds from about $58 million to about $31 million. Health leaders say it's important to restore the funding because to have enough doctors, Minnesota must ... train its own (Dunbar, 4/16).

Georgia Health News: For Uninsured Georgians, Specialty Care Can Be Hard To Come By
Primary care is cheaper and can be obtained at a retail clinic, a doctor's office, a charity clinic or a community health center. ... Georgia Watch, a consumer advocacy organization, says that for many uninsured Georgia adults, specialty care services are virtually non-existent, because these people usually don't have the cash to pay upfront (Miller, 4/16). 

Kansas Health Institute News: New Policy Aims To Reduce Number Of Kansans In Nursing Homes
The Kansas Department on Aging has put together a list of 800 nursing home residents who officials believe might be able to move to less expensive, less institutional settings. ... Kansas, with its disproportionately elderly population, has a higher percentage of people in full-care nursing homes than all but a handful of other states. KDoA officials have pledged to pay the case manager's employer $2,000 for each Medicaid-funded nursing home resident who is able to move out of the nursing home (Ranney, 4/16). 

Boston Globe: Partners In Talks With Hallmark Health
For obvious reasons, Partners Healthcare System Inc. sat on the sidelines during the early innings of the hospital merger and acquisition binge in Massachusetts. The nonprofit medical giant was already seen as too big and powerful to win state permission to expand another inch by acquisition. The presumptive response from Attorney General Martha Coakley to any such idea could be summed up in three words: No, no, no. But the rules may be changing. Partners is at the center of three potential health care deals that have already been disclosed. Now this: Partners is in talks with Hallmark Health System about yet another possible combination (Syre, 4/17).

Reuters: Molina Protests Ohio Medicaid Contract Loss
Molina Healthcare Inc said on Monday it filed a formal protest of a decision by the state of Ohio not to renew its Medicaid contract. Molina shares plunged 25 percent earlier this month after the state said the company was not among five plans selected to serve Ohio's Medicaid health care program for the poor (Kelly, 4/16).

The Miami Herald/News Service of Florida: Number Of Children On Medicaid Grows In Florida
The number of children covered through Medicaid, Florida Healthy Kids and other state health programs hit two million in March, according to totals released Monday by Florida KidCare. That was the first time the combined enrollment reached that level (4/16).

WBUR's CommonHealth blog: For Decisions On Dying, Today's The Day
Consider: Who do you want responsible for making decisions for you in case you're ill? ... Do you want aggressive treatments to prolong life or palliative care to provide comfort measures, increasing the quality of life in your final days? ... National Healthcare Decisions Day encourages people to fill out an advance directive (Siddiqui, 4/16).

Related, earlier KHN story: Oregon Emphasizes Choices At Life's End (Foden-Vencil, 3/8). 

MSNBC/PhillyBurbs: Bill Would Guarantee That Health Professionals Can Share Fracking Info
A Pennsylvania senator plans to introduce a bill this week that would give doctors explicit permission to share "trade secret" fracking chemicals with patients and others, including the public in the event of a health emergency. In its current form, Sen. Daylin Leach, D-Delaware/Montgomery, believes the law "effectively" bars health care professionals from sharing critical information with patients and leads to "unnecessary confusion" (Ciavaglia, 4/17).

California Healthline: State Wins Case to Cut Adult Day Provider Rates
After four similar cases went against the state in the past few months, the Department of Health Care Services won in court late Friday, when a federal judge refused to issue a preliminary injunction against Medi-Cal cutbacks. The lawsuit, brought by the Adult Day Health Care Association, challenged the department's plan to cut Medi-Cal provider rates by 10 percent (Gorn, 4/17).

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Editorials and Opinions

Viewpoints: White House Makes Its Case On Cutting Medicare But One Critic Isn't Buying The 'Shared Sacrifice'

The New York Times: The White House Argument
These officials say the administration has also made modest but important progress in controlling Medicare spending, the biggest debt driver. The budget raises some Medicare premiums on high-income retirees and increases some deductibles. White House officials say they have taken enormous heat from the left for putting some structural Medicare reforms on the table — cutting benefits, raising eligibility ages and changing cost-of-living adjustments. Republican leaders, they point out, have not done anything that brave (David Brooks, 4/16). 

The Washington Post: A Consensus We Can't Afford
But the terms of the "grand bargain" represented by the Obama-Boehner negotiations or the Simpson-Bowles recommendations are skewed dramatically to the right. The basic outline exchanges cuts in Social Security and Medicare for "tax reform," promising to lower tax rates while closing enough loopholes to raise revenues. That requires erasing the mortgage deduction for middle-class homeowners or ending the employer deduction for providing health care to employees. This notion of "shared sacrifice" is unconscionable, given that working Americans have been sacrificing for years and weren't even invited to the Wall Street bacchanalia that created the mess (Katrina vanden Heuvel, 4/16).

The Wall Street Journal: Defining Disability Down
Fraud, waste and abuse in government will always be popular political targets, especially during an election year. But they are not the root causes of this nation's escalating bankruptcy. … One entitlement program that highlights the progression of this disease is the Social Security Disability Insurance fund. In August 2010 a report from the Government Accountability Office revealed that hundreds of federal employees were receiving millions in fraudulently obtained disability benefits from this fund. Reforms—including matching disability beneficiaries and recipients to federal payroll data—were recommended but according to the Government Accountability Office have not been implemented (Howard Rich, 4/16).

Reuters: Law Or No Law, Some States Adopt US Healthcare Reform
If the Supreme Court overturns President Obama's health care reform law in June, Americans without health coverage may get some relief anyway - especially if they live in Rhode Island, Maryland or Oregon. These states are at the head of the pack in implementing the Affordable Care Act (ACA), and they were working to expand health coverage well before the law was passed. If the ACA is thrown out by the high court, these states - and others supportive of the law's goals - will keep pursuing reforms (Miller, 4/16).

iWatch News: Why The Insurance Industry Needs Obamacare To Stay In Business
Health insurers have known for years that their business practices of excluding growing numbers of Americans from coverage and shifting more and more of the cost of care to policyholders are not sustainable over the long haul. That's why their top priority during the health care reform debate was to make sure whatever bill Congress passed included the much-vilified individual mandate. And it's also why the big insurance companies have been working almost frantically to reinvent themselves lately (Wendell Potter, 4/16).

The Miami Herald: Better Health, Fewer Tests
When nine medical societies announce that at least five common practices in each of their specialties are unnecessary, wasteful or even harmful to patients, everyone should take note. Everyone — patients, doctors, the healthcare industry, insurers and various levels of government. The point the societies are making is not that we should ration medicine but, rather, tailor the care to the individual patient's particular health needs and medical and family history (4/16).

The Washington Post: Which Mitt Will We Get?
It's all over but the shouting — or, in this case, the polite applause: Mitt Romney is going to be the Republican presidential nominee. But which Mitt Romney? Will it be Mitt One or Mitt Two? ... Mitt Two vows to repeal President Obama's Affordable Care Act and denounces the individual health insurance mandate at the core of the legislation. As most Americans know, however, it was Mitt One who pioneered the individual mandate when he was governor of Massachusetts (Eugene Robinson, 4/16).

The New York Times: Vital Signs: Doctor's Stake In Lab Affects Biopsy Rate
Medicare pays for prostate biopsies by the jar, and a jar can contain one or more specimens. Self-referring doctors billed Medicare for an average of 4.3 more jars per biopsy, a difference of almost 72 percent that persisted despite controlling factors (Nicholas Bakalar, 4/16).

Boston Globe: In Fight To Cut Health Costs, Resist Stiffer Regulation For Now
Although it's been over a year since Governor Patrick filed legislation aimed at controlling health care costs, the joint legislative panel working on the issue has yet to make its own proposal. That's not because the Committee on Health Care Financing has dropped the ball. Instead, the delay speaks both to the complexity of health care policy and to the rapid change in the health care sector over the last two years (4/17). 

Archives of Surgery: Making Sense Of Accountable Care Organizations
The ACO concept is a work in progress. Although it is unclear exactly how they will be implemented in the end, ACOs will clearly be part of the landscape in restructuring health care delivery over the next few years. Whether ACOs ultimately become part of the long-term solution to slow the growth of health care spending, the ultimate goal of better coordination and more efficient, patient-centered care is no doubt important. And the success of that principle is vital to the future of our entire health care system (Arthur S. Hong and Dr. Justin B. Dimick, 4/17).

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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.