Daily Health Policy Report

Tuesday, April 29, 2014

Last updated: Tue, Apr 29

KHN Original Reporting & Guest Opinion

Health Reform

Women's Health

Capitol Hill Watch

Health Care Marketplace

Medicare

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Insuring Your Health: Emanuel: Although 'Not A Perfect Law,' ACA Is Protecting Patients

Kaiser Health News consumer columnist Michelle Andrews writes: “In his new book, 'Reinventing American Health Care,' Ezekiel Emanuel offers some surprising predictions about where health care is going in the next decade and beyond, including forecasting the end of health insurance companies as we know them. Along the way, readers will learn more about what's actually in the Affordable Care Act and its tortuous political path to passage. There's health care trivia too, including the fact that compulsory health insurance dates back to 1790, when ship owners had to buy medical insurance for their seamen. Who knew?” (Andrews, 4/29). Read the interview.

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Capsules: Public Overwhelmingly Supports Law’s Contraceptive Mandate, Poll Finds

Now on Kaiser Health News’ blog, Mary Agnes Carey writes: “By a nearly two-to-one margin, the public supports the health law’s requirement that private health plans cover prescription birth control without cost-sharing, according to a poll released Tuesday. The provision, which is at the heart of a case being weighed by the Supreme Court, was endorsed 61 to 32 percent and was most popular among women, younger adults, Democrats and independents, according to the Kaiser Family Foundation’s monthly tracking poll (Carey, 4/29). Check out what else is on the blog.

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Political Cartoon: 'Guess Again?'

Kaiser Health News provides a fresh take on health policy developments with "Guess Again?" by Dave Coverly.

Here's today's health policy haiku: 

HEALTHCARE.GOV AND ITS WORK AROUNDS

Sure -- the sign up part
is working. But what about
what's under the hood?
-Anonymous 

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

Post-ABC News Poll: Half Of Americans Say Health Law Working Worse Than Expected

Meanwhile, a Kaiser Family Foundation poll concludes that there is a disconnect between people's perception of the health law's enrollment and the actual sign up total. In addition, Fox News reports on a Bankrate survey finding people don't appear to mind paying added fees if those costs increase workers' access to health insurance.

The Washington Post: Post-ABC News Poll Shows Democrats At Risk In November As Obama’s Approval Rating Falls
The Affordable Care Act is expected to be a major issue in the midterm elections. Obama recently urged Democrats to defend the law energetically, particularly after the administration announced that 8 million people signed up for it during the initial enrollment period. Republicans are confident that opposition to the new law will energize their supporters. The Post-ABC poll found that 44 percent say they support the law while 48 percent say they oppose it, which is about where it was at the end of last year and in January. Half of all Americans also say they think implementation is worse than expected (Balz and Craighill, 4/28).

Politico: Poll: Obama Dips, GOP Congress Up
According to a new Washington Post-ABC News poll, Obama’s approval rating stands at 41 percent, the lowest mark of his presidency in the Post-ABC polls. The survey reports that just 34 percent of Americans approve of Obama’s handling of the situation in Russia and Ukraine and 37 percent approve of his handling of the implementation of the Affordable Care Act. The poll comes as the president and both parties gear up for what should be contentious midterm elections. Just 8 percent of voters believe their health care costs have decreased because of the changes in the law, whereas 47 percent think their health care costs have gone up (Topaz, 4/29).

The Hill: Democrats At Risk As Obama's Approval Rating Drops, Poll Finds
Two-thirds say the United States is on the wrong track. The poll also found 37 percent approves of the president's job handling ObamaCare, but nearly 60 percent disapprove. Despite the low ObamaCare rating, 43 percent say Democrats do a better job handling healthcare issues. Forty-one percent say Democrats also do a better handling the economy while 38 percent say Republicans do, the poll found (Shabad, 4/29).

Fox News: Survey: Americans Fine With Added ObamaCare Fees
Many companies have reported they will have to raise prices on their goods and services to be complaint with the Affordable Care Act, but a new survey finds consumers don’t mind the higher price tags if they help provide workers access to insurance. A report from Bankrate.com finds nearly two-thirds of Americans (68%) are okay with a business adding a nominal surcharge of 25 cents to each bill in order to help pay for employees’ health insurance. Support for an insurance surcharge is highest among 18-to-29 year olds at 64%. On the other end, 39% of those ages 65 and up are OK with the additional charge (Rogers, 4/28).

Politico Pro: Poll Finds Disconnect Between Public Perception, ACA Sign-Up Total
A majority of Americans remain underwhelmed by the rollout of the Affordable Care Act despite the final surge in its first enrollment season, according to the latest monthly tracking poll by the Kaiser Family Foundation. However, most people do back the government on one contentious element of the law: They support the contraception coverage mandate and do not believe for-profit companies should be granted a religious waiver, the poll found. The public’s current view of the law is striking given the Obama administration’s celebration earlier this month that 8 million Americans had signed up for coverage, far exceeding its target (Wheaton, 4/29).

Kaiser Health News: Capsules: Public Overwhelmingly Supports Law’s Contraceptive Mandate, Poll Finds
By a nearly two-to-one margin, the public supports the health law’s requirement that private health plans cover prescription birth control without cost-sharing, according to a poll released Tuesday. The provision, which is at the heart of a case being weighed by the Supreme Court, was endorsed 61 to 32 percent and was most popular among women, younger adults, Democrats and independents, according to the Kaiser Family Foundation’s monthly tracking poll (Carey, 4/29). 

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Administration Looking For New Companies To Run Health Marketplace

Federal officials lay out specifications for companies who will take over the website as they seek to make sure the sign-up effort does not run into repeat problems during next fall's enrollment season.

The New York Times: Administration Begins Search For New Contractors To Run Health Care Site
The Obama administration has begun a wide-ranging search for companies to run the online federal health insurance exchange, seeking new talent to prevent a repeat of problems that immobilized the website last fall. In laying out specifications for the project, the administration also provided insight into the next phase of development of the insurance marketplace, which is expected to handle a significant increase in enrollment over the next several years (Pear, 4/29).

At the same time, hospitals are asking the government for more information -

The Hill:  Hospitals Push HHS On O-Care Subsidies Via Charity
The American Hospital Association (AHA) is asking the Obama administration to clearly state its support for charities subsidizing medical expenses for low-income people on ObamaCare's exchanges. In a letter Monday, the AHA and the Catholic Health Association (CHA) urged the Department of Health and Human Services (HHS) to confirm that they do not discourage the subsidies by hospital-based foundations and other charitable groups (Viebeck, 4/28).

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Washington State Requires Insurers To Spell Out Networks

The insurance commissioner issued controversial rules mandating that insurers explain referral and authorization practices to consumers. Meanwhile, a study details how nearly half the plans available through federal and state exchanges didn't list what drugs patients had access to on their websites and Politico Pro questions whether more states will join the federal exchange.

The Seattle Times:  Insurance Chief OKs Rule For Health-Plan Networks
Despite criticism from both insurers and hospitals, [Washington] Insurance Commissioner Mike Kreidler adopted a new rule Monday that spells out what health insurers must do to make sure their networks of hospitals and doctors can provide covered benefits to patients. For patients, the general thrust of the rule, which affects plans offered for coverage in 2015, is “no surprises.” It requires insurers to spell out how their benefit arrangements affect patients’ pocketbooks, clearly explain referral and authorization practices, tell policyholders whether emergency-room doctors in an in-network hospital’s emergency room are also in-network, and update directories of in-network providers monthly (Ostrom, 4/28).

The Hill:  Study: Details On Drug Coverage Missing From Obamacare Websites
Nearly half of plans available through Obamacare’s state and federal insurance exchanges didn’t list what drugs patients had access to or made that information difficult to find on their websites, according to a new survey. The study, conducted by Avalere Health, analyzed consumer experience on healthcare.gov in five states and another 12 state-run insurance exchanges. In 38 percent of cases, plans did not include a drug formulary, a list of covered medications. In another 11 percent of cases, the list of covered drugs was “difficult” or “very difficult” for consumers to find (Al-Faruque, 4/28).

Politico Pro: Exchange Flops Forcing Hard State Decisions -- Hold Or Fold?
Oregon just became the first state to bail on its Obamacare exchange, scrapping its broken enrollment website and letting the federal government take over. But it may not be the last. A half-dozen other states that tried to run their own exchanges this year suffered expensive, embarrassing flops that have raised the prospects of a federal takeover. Although the national narrative has focused largely on the turnaround of healthcare.gov -- the federal exchange used by 36 states -- these failures threaten to overshadow progress in some of the most pro-Obamacare territory in the country (Cheney, 4/28).

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Missouri Gov. Makes Last-Ditch Medicaid Expansion Effort

Gov. Jay Nixon, a Democrat, proposed using the federal money to pay a portion of the private insurance costs for businesses with fewer than 150 employees, but the idea was quickly shot down by Republican legislators officials. Meanwhile, Kansas health providers said their state's decision not to expand the program is denying care to thousands and costing hospitals millions.

The Associated Press:  Nixon Adds New Wrinkle To  Medicaid Expansion Plan
The Democratic governor on Monday outlined an initiative dubbed “Missouri Health Works” that would use federal money to pay a portion of the private health insurance costs for businesses with fewer than 150 employees. The state aid would be available for people earning less than 138 percent of the poverty level, which is about $27,000 a year for a family of three. But the plan faced immediate criticism in the Republican-led Legislature, which has repeatedly rejected plans to expand Medicaid eligibility under the terms of President Barack Obama’s health care law (Lieb, 4/28).

Kansas Health Institute:  Decision To Pass On Medicaid Expansion Costing State, Health Leaders Say
The decision by Gov. Sam Brownback and Republican legislative leaders not to expand Medicaid is denying care to thousands and costing Kansas hospitals millions of dollars, participants in a panel discussion said on Monday. Randy Peterson, president and chief executive of Stormont-Vail HealthCare in Topeka, said that hospitals agreed to reductions in reimbursement rates for Medicare and other federal programs in exchange for increasing the number of Americans with private or Medicaid coverage. Negotiators assumed the increase in coverage would more than offset the reductions (McLean, 4/28).

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Women's Health

Federal Appeals Panel Weighs Mississippi Abortion Law

Elsewhere, Google has agreed to remove advertisements for "crisis pregnancy centers," which opponents say discourage people from having abortions.

The New York Times: Echoes Of Past May Not Carry As Court Weighs 2nd Abortion Law
For the second time this year, a federal appeals panel here heard arguments about the constitutionality of a new state law governing abortion. But despite much in common between the two laws — one in Texas, and the other, the subject of Monday’s hearing, in Mississippi — their effects would differ substantially, raising the possibility that the same court weighing similar laws might arrive at different conclusions (Robertson, 4/28).

The Hill: Google Removes Advertisements For ‘Crisis Pregnancy Centers’ 
Bowing to pressure from abortion-rights groups, Google is removing advertisements from its site for “crisis pregnancy centers” that discourage people from having abortions. NARAL Pro-Choice America had pushed for Google to take down the ads, arguing they violated the Web giant’s advertising policy (Hattem, 4/28).

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Capitol Hill Watch

Biden Swings At Ryan Budget, House GOP Hits Back

Vice President Joe Biden warned that the plan drafted by House Budget Committee Chairman Paul Ryan, R-Wis., would hurt Medicare and Medicaid, while a Republican spokesman criticized Biden for his support of a blueprint that leaves the health law in place.  

The Hill: Biden Leads Attack On Ryan Budget
Vice President Joe Biden on Monday hammered the budget offered by House Budget Committee Chairman Paul Ryan (R-Wisc.), the opening volley in what Democrats say will be a sustained focus on the GOP proposal ahead of the 2014 midterms. ... the vice president couched accusations that Republicans have "adopted an orthodoxy that devalued paychecks" in folksy wisdom from his father and nods to the impact the GOP budget would have on "grandmas" in nursing homes. Biden warned that proposed reforms to Medicare and Medicaid would impact the sick and elderly, while accusing Republicans of wanting to slash education and infrastructure (Sink, 4/28).  

The Wall Street Journal's Washington Wire: Biden, Republicans Trade Election-Year Budget Barbs
Speaking at an event at the George Washington University, Mr. Biden walked the audience through what he deemed the most egregious elements of the budget proposal, crafted earlier in April by Wisconsin Rep. Paul Ryan. He listed tax cuts for wealthy Americans, the elimination of seniors' Medicare guarantee and steep cuts to domestic programs. Matt Gorman, a spokesman for House Republicans' campaign arm, targeted Democrats' budget proposal. "Vice President Biden sure has no qualms about supporting a budget that leaves Obamacare in place, raises taxes, and never, ever balances," he said in a written statement (Ballhaus, 4/28).

Meanwhile, here are some health-related proposals gaining lawmakers' attention -

CQ HealthBeat:  Lawmakers Press To Renew Autism Programs
Lawmakers from both parties are working on legislation that would renew autism research and screening programs before they expire at the end of the fiscal year, with some advocates pressing for expanded services for adults with the condition. Congress faces a time crunch negotiating and passing a bill to reauthorize the 2006 Combating Autism Act (PL 109-416) before Sept. 30, when sunset language would make key initiatives disappear (Attias, 4/28).

CQ HealthBeat:  House Readies For Encore Of Expatriate Health Bill
Legislation that would exempt medical plans for Americans living abroad from the health law's mandates is headed back to the House floor Tuesday after it failed to garner enough votes to pass under an expedited procedure before the spring recess. The bill's authors negotiated changes in response to concerns raised during the last floor debate. The language was posted Friday as an amendment on the House Rules Committee website (Attias, 4/28).

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Health Care Marketplace

Pfizer Proposing $99 Billion Acquisition of British Competitor AstraZeneca

But news outlets note that the deal, which would allow Pfizer to escape the U.S. corporate tax rate, could be difficult to pull off. AstraZeneca says it rebuffed the American drug maker's advances earlier.

The New York Times’ Dealbook: Pfizer Proposes A Marriage With AstraZeneca, Easing Taxes In A Move To Britain
On Monday, Pfizer proposed a $99 billion acquisition of its British rival AstraZeneca that would allow it to reincorporate in Britain. Doing so would allow Pfizer to escape the United States corporate tax rate and tap into a mountain of cash trapped overseas, saving it billions of dollars each year and making the company more competitive with other global drug makers. A deal — which would be the biggest in the drug industry in more than a decade — may ultimately not be done. AstraZeneca said on Monday that it had rebuffed Pfizer, after first turning down the company in January. Nonetheless, the pursuit by Pfizer, founded in a redbrick building in Brooklyn in 1849, has made it clear that the company wishes to effectively renounce its United States citizenship (Gelles and de la Merced, 4/28).

NPR: Tax Breaks Could Be Biggest Prize In Pfizer Deal For AstraZeneca
Pfizer finally fessed up and told the world that it wants to buy British drugmaker AstraZeneca. It wasn't a very well-kept secret. The New York-based drugmaker confirmed publicly that it approached AstraZeneca in January about getting together. AstraZeneca, based in London, rebuffed the New Yorkers (Hensley, 4/28).

The Wall Street Journal: Pfizer Sees Tax Savings From AstraZeneca Deal
Pfizer Inc.'s nearly $100 billion offer to buy British rival AstraZeneca, if accepted, would allow the pharmaceutical giant to move its official headquarters overseas, saving the company that started 165 years ago on a Brooklyn, N.Y., street corner billions in taxes over the next decade. Company executives were outspoken about how their attempted takeover of AstraZeneca, which was confirmed early Monday, would help Pfizer slash its tax bill, saving $1 billion or more each year by one estimate (Hoffman, 4/28).

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Medicare

Panel: Medicare's 'Quality' Metrics Penalize Hospitals Serving Poor Areas

Federal pay-for-performance programs should take into account patients' income, race and other factors when deciding how to reward or penalize hospitals, the panel's recommendations say.

Modern Healthcare:  NQF Urges Medicare Performance Measures That Reflect Demographics 
The CMS should change current policy that may unfairly penalize providers who serve primarily low-income patients, the National Quality Forum says in a recent report. The NQF recommends including patient income, race and other factors in using quality measurements to assess provider performance and what providers are paid (Dickson, 4/28).

The Fiscal Times: If You Don’t Take Your Meds, Should Your MD Be Punished?
Federal policies intended to improve the quality of health care may unfairly penalize hospitals that serve low-income people -- shifting money away from doctors at these facilities and further widening the disparity between the rich and poor. That is the concern of a panel of 26 experts commissioned by the Obama administration that is calling for a sweeping overhaul to federal pay-for-performance initiatives. Medicare and a growing number of private insurance companies are paying providers based on their performance as measured by patient outcomes. The whole idea is to reward quality care and get away from the old fee-for-service model However, the expert panel, created by the National Quality Forum, said in a draft report first obtained by The New York Times that the current approach is severely flawed because it does not take into account the socioeconomic status of patients at each hospital (Ehley, 4/28).

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State Watch

State Highlights: Mixed Reaction To New Telehealth Guideline

A selection of health policy stories from California, Connecticut, Georgia, Florida and Kansas.

Modern Healthcare:  Newly Approved Telehealth Guideline Causes A Stir 
The Federation of State Medical Boards approved a model telehealth policy this weekend that's made some providers of these services happy and others, well, not so much, because of its emphasis on using video rather than audio technology for a first patient visit (Conn, 4/28).

Los Angeles Times: State To Provide $75 Million In Mental Health Grants
State Treasurer Bill Lockyer has announced the approval of $75.3 million in grants that aim to stabilize residents with severe mental illness before they land in jails or hospitals. The grants will go to 28 counties for new or expanded services. They will add 827 residential mental health beds and crisis "stabilization" beds, and pay for more than three dozen vehicles and five dozen staff members for mobile support teams, which often accompany local law enforcement to defuse tense situations and direct those in need to care. More than half of the funding -- $40.9 million -- will go to Los Angeles County, which plans 16 new residential crisis care facilities, each with room for 16 adult residents, including those who are also struggling with substance abuse (Romney, 4/28). 

The CT Mirror: The Basics: How The Nurse Practitioner Bill Could Change Health Care
The state House has given final approval to a controversial bill that would give nurse practitioners more independence, a measure that both supporters and opponents say could have a major effect on health care in Connecticut. Gov. Dannel P. Malloy, whose administration proposed the measure, is expected to sign it. The proposal would allow nurse practitioners to practice independent of doctors after they’ve worked for at least three years in collaboration with a physician (Becker, 4/28).

Georgia Health News: South Behind Other Regions In Health, Report Says
Southerners have high rates of chronic disease such as diabetes and are more likely to be uninsured than people in other regions, a newly released report says. And nearly one-quarter of Southerners report they do not have a usual source of health care. That’s significantly higher than for adults in the Midwest and Northeast, though it’s similar to the rate for residents in the West. The Kaiser Foundation “issue brief” was prepared for a March meeting of health care stakeholders from the South and around the nation, held at the Satcher Health Leadership Institute at the Morehouse School of Medicine in Atlanta (Miller, 4/28).

The California Health Report: ACA Offers Critical Support For Foster Kids
Behind the first wave of pain came fear. It wasn’t just the agony of a shattered pelvis that terrified Jimmy Dion as he lay in the street that day last December. It was having no insurance. A driver had cut him off, and he’d swerved to miss her, but his handlebar caught in the wheel well of a truck. … And on the day of the accident, Dion had just turned 23, well past the age limit on the Medi-Cal health insurance that California extends to most youths who become wards of the state (Richard, 4/28).

The Miami Herald:  Compromise Elusive On HCA Trauma Centers
The Florida Senate approved its version of the trauma center legislation on Monday with a 33-3 vote. In addition to clearing the way for trauma centers at Regional Medical Center Bayonet Point, Blake Medical Center and Ocala Regional Medical Center to remain open, the measure creates a one-year $15,000 cap on trauma activation fees, a one-year moratorium on new trauma centers and creates an advisory committee to make recommendations for approving new trauma centers. The fee cap, moratorium and advisory committee were added after a Tampa Bay Times investigation revealed hospitals across the state were charging huge admission fees to trauma patients, and the highest charges were at HCA facilities (Mitchell, 4/28).

The Miami Herald:  South Florida Memory Centers Focus On Improving Early Alzheimer’s Symptoms
For a disease called “epidemic” by the Florida Department of Elder Affairs, that leaves much of the support in Miami-Dade County to memory centers and two state-designated memory disorder clinics -- the Wien Center and University of Miami’s Memory Disorders Center at the Miller School of Medicine. Memory centers offer free cognitive workups that can reveal reasons for memory changes other than Alzheimer’s, from benign tumors to small strokes or depression (Borns, 4/28).

Kansas Health Institute:  KanCare Companies Lost Money In First Year
The state’s three prime KanCare contractors each lost money in their first year managing health care for the 380,000 Kansas Medicaid enrollees, but received cash infusions from their parent companies that allowed them to meet their contract obligations and stay solvent. That’s according to information included in the draft of the first annual report on KanCare submitted by state officials to the federal Centers for Medicare and Medicaid Services. The draft report was made public Friday afternoon as Gov. Sam Brownback was in Lenexa for a press conference describing his plan to reduce the waiting list for in-home Medicaid services using money from “KanCare dividends” the state has reaped (Shields, 4/28).

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Editorials and Opinions

Viewpoints: New Poll Points Out Inconsistencies Among Health Law's Opponents; Protecting Vets; Calif. Restaurant Nutrition Info Missing

Bloomberg: Would You Pay A Quarter For Someone Else's Insurance?
The case against the Affordable Care Act rests on the premise that the free market can better provide health insurance to the nation's 54 million uninsured than a government program can. But what does it mean if many of the same people who oppose Obamacare also object to the cost of covering more people through the market? A telephone survey by Bankrate.com asked 3,496 people how they would react if a business tacked on an extra 25 cents to every bill to help cover the cost of health insurance for its employees. Among Democrats, 70 percent said they would approve. ... When Republicans were presented with the 25 cents idea, however, a plurality -- 35 percent -- said they would respond by taking their business elsewhere. ... So a significant portion of Republicans don't think the government should pay for people's health insurance, but they are not willing to pay even a small amount more so that those people can get covered through their employer (Christopher Flavelle, 4/28).

Los Angeles Times: Found: The Lamest Anti-Obamacare Column Of All (Thus Far)
As we've recently observed, conservative opponents of the Affordable Care Act have pulled out the stops to paint the law as an unmitigated disaster--notwithstanding its documented gains in health insurance coverage for millions of Americans nationwide. But we think we've found the dopiest entry in this competitive field. Tip your hat to Michael F. Cannon of the libertarian Cato Institute, who wins the prize with a piece entitled "ACA Exchanges at risk." ... Its theme is that Obamacare "creates so many incentives for enrollees to drop their coverage" that this year's enrollment numbers can't be sustained. The piece goes even further, stating that people are financially better off if they drop their coverage and "wait until they get sick to re-enroll" (Michael Hiltzik, 4/28).

The Wall Street Journal: A Doctor's Declaration Of Independence
In my 23 years as a practicing physician, I've learned that the only thing that matters is the doctor-patient relationship. How we interact and treat our patients is the practice of medicine. I acknowledge that there is a problem with the rising cost of health care, but there is also a problem when the individual physician in the trenches does not have a voice in the debate and is being told what to do and how to do it (Daniel F. Craviotto Jr., 4/28).

The Wall Street Journal: Pfizer's Tax Takeover
U.S. pharmaceutical giant Pfizer Inc. wants to buy AstraZeneca, and not just for its pipeline of cancer drugs. Acquiring the British company would also give Pfizer shareholders welcome relief from a U.S. corporate tax rate that is among the world's highest. Instead of paying punitive rates to return its money to the U.S., Pfizer figures it can get a better return paying $100 billion or so to buy a foreign company (4/28). 

The Baltimore Sun: Protecting Our Protectors
In an era when private companies use big data to predict our shopping habits, it is possible and necessary to use data collation and analysis to improve care for veterans. Better data sharing by states would allow the Department of Veterans Affairs (VA) to focus resources in locations with the greatest need, target those most at risk and help tailor care to fit the community ... Other goals that even our diametrically opposed political parties should be able to agree on include appointing a national director on suicide prevention, increasing mental health eligibility for combat veterans from 5 to 15 years and filling the 1,000 mental health care jobs unfilled at the VA (Garrett Berntsen, 4/28). 

The New York Times’ Upshot: How Congress Is Actually Holding Down Medicare Spending
It's a rare health policy wonk who has a good word to say about Medicare's Sustainable Growth Rate formula. That's the formula created by Congress to govern the amount that Medicare pays to physicians for various treatments. It is supposed to adjust payments to meet an overall spending target tied to economic growth. But it hardly ever works out this way. ... However, from another point of view, the formula — as flawed as it is — has helped keep Medicare spending lower than it might otherwise have been (Austin Frakt, 4/28). 

Los Angeles Times: Restaurants Skip Required Nutrition Info; Officials Choose Not To Care
Only five years ago, California enacted a pioneering law that required restaurants to put nutritional information on menus. For the first time, consumers were empowered to make informed decisions about what they ate. So it seems crazy that it's even a question: Does the law still exist? If you ask state Sen. Alex Padilla (D-Pacoima), the author of the menu-labeling law, the answer is yes (David Lazarus, 4/28). 

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Marissa Evans
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.