Daily Health Policy Report

Tuesday, May 15, 2012

Last updated: Tue, May 15

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch

Campaign 2012

Coverage & Access

Public Health & Education


State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Many Businesses Offer Health Benefits To Same-Sex Couples Ahead Of Laws

Kaiser Health News staff writer Julie Appleby reports: "President Obama's pronouncement last week in favor of same-sex marriage has no legal effect on employers' decisions on whether to offer benefits to workers' domestic partners, but some advocates believe it could reinforce a decade-long trend toward coverage" (Appleby, 5/14). Read the story.

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Insuring Your Health: Some States Mandate Better Coverage Of Oral Cancer Drugs

In her latest Kaiser Health News consumer column, Michelle Andrews writes: “Health plans, however, have been slow to adjust to the change. People who get traditional IV chemotherapy on an outpatient basis often pay a flat co-payment that covers the drug as well as the cost of administering it. Annual out-of-pocket costs are also typically capped” (Andrews, 5/14). Read the column.

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Capsules: How Much Do The Nation's Pre-Eminent Hospitals Cost Medicare?

Now on Kaiser Health News' blog, Jordan Rau reports: "Can you cut health care spending without undermining the quality of care? It's a major concern as Medicare prepares to prod hospitals to provide medical care more efficiently by giving bonuses to those whose patients cost less and taking money away from places that send the government higher bills" (Rau, 5/14). Check out what else is on the blog.

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Political Cartoon: 'E.O.B?'

Kaiser Health News provides a fresh take on health policy developments with "E.O.B?" by Roy Delgado.

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


For health exchanges,
does the name really matter?
Some people think so.

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

Insurers Have $1 Trillion Riding On The Health Law's Future

According to a Bloomberg Government study, much of this new revenue would result from the health law's Medicaid expansion and subsidies to help people purchase health insurance, and it all is contingent on the Supreme Court upholding the law.  

Bloomberg: Insurers Face $1 Trillion Revenue At Stake In Health Law
Health insurers will gain $1 trillion in new revenue over the next eight years under the 2010 health care law, assuming it's upheld by the Supreme Court, according to a Bloomberg Government study. The amount is equal to about one-half percent of the nation's estimated gross domestic product from 2013 to 2020, and insurers led by UnitedHealth Group Inc. (UNH) would keep about $174 billion -- $22 billion a year -- for profit and administrative costs. The money comes from U.S. subsidies to people purchasing insurance beginning in 2014 and an expansion of Medicaid, the government's health program for the poor (Wayne, 5/14).

In related news, Sen. Patrick Leahy, D-Vt., said Monday he remains hopful that the high court will find that the health overhaul is constitutional --

The Hill: Sen. Leahy Hopeful That John Roberts Will Vote To Uphold Health Law
Senate Judiciary Committee Chairman Patrick Leahy (D-Vt.) on Monday said he believes Supreme Court Chief Justice John Roberts might vote to uphold President Obama's health care law. Before the court heard oral arguments in the health care case, Roberts was mentioned frequently as a possible swing vote. His aggressive questioning during the three days of oral arguments seemed to quash most of that speculation, but Leahy said he remains hopeful (Baker, 5/14).

CNN: Leahy Urges High Court To 'Do The Right Thing' Keep Health Care Law
A leading senator is urging the Supreme Court to "do the right thing" and uphold the constitutionality of the sweeping health care reform law championed by President Barack Obama and congressional Democrats. In a floor speech Monday, Sen. Patrick Leahy, D-Vermont and chairman of the Senate Judiciary Committee, directly addressed Chief Justice John Roberts, urging him in a sharply partisan tone to keep the law, passed in 2010, in place (Mears, 5/15).

Also in the news, children's health advocates express concerns about Medicaid eligibility --

CQ HealthBeat: Kids' Advocates Worry About How State Exchanges Will Determine Medicaid Eligibility
Advocates for children's health warn that low-income families might slip through the cracks in the new state health benefits exchange system, according to a letter advocacy groups submitted in response to provisions in an exchange rule issued earlier this year. In the rule, "many provisions would potentially undermine the ACA's [Affordable Care Act] clear intent to establish a simple, unified pathway to health coverage for consumers," wrote the groups, including the American Academy of Pediatrics. One major element of the rule would let state exchanges opt out of making final determinations on public program eligibility, they said (Norman, 5/14).

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Capitol Hill Watch

Health Programs At Risk In Gathering Budgetary Storm

Deep spending cuts, scheduled as part of last year's debt accord, are forcing lawmakers from across the political spectrum to consider difficult positions. Medicare and Medicaid will likely be on the table.

The Washington Post: Taxmageddon Sparks Rising Anxiety
The halls of the U.S. Capitol are already teeming with people warning of disaster if lawmakers fail to defuse a New Year's budget bomb scheduled to raise taxes for every American taxpayer and slash spending at the Pentagon and most other federal agencies. Last week, hospital executives came to complain about big scheduled cuts in Medicare payments. Next month, university presidents plan to raise the alarm about big scheduled cuts in federal research grants. And the chief executives of Lockheed Martin and other aerospace giants last Wednesday passed out digital countdown clocks ticking off the seconds until "over 1 million American jobs" will be lost to big scheduled cuts in defense (Montgomery and Helderman, 5/15).

The Washington Post: Boehner Sees Battle Over Debt Limit As 'Action-Forcing Event'
Republicans alarmed by the depth of cuts on tap for the Pentagon are scrambling to replace them, but Democrats say they will only agree to undo the defense cuts in exchange for higher taxes on the wealthy. Boehner's remarks suggest that Republicans believe they have leverage, too, and that they are willing to resist a needed increase in the debt limit unless Democrats agree to far-reaching changes to federal health programs such as Medicare and Medicaid (Montgomery, 5/15).

In other Capitol Hill news --

Politico: Bernie Sanders Floats Plan To Make HIV Drugs Less Costly
Why do American patients pay tens of thousands of dollars each year for HIV drugs that cost just hundreds in Africa? Drugmakers wave their patent rights in developing countries as part of the President's Emergency Fund for AIDS Relief. But the higher cost of brand-name drugs in the United States makes it difficult for many HIV patients to stay on drug regimens that can cost as much as $30,000 a year (Feder, 5/14).

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Campaign 2012

Romney, Obama Medicare Plans Trigger Analysis

The New York Times analyzes the specifics of the Medicare plans advanced by GOP presidential hopeful Mitt Romney and President Barack Obama. Meanwhile, Sen. Ben Nelson, D-Fla., is facing attack ads associated with his vote on the health law.  

The New York Times: Romney Medicare Plan Draws A Stark Contrast
President Obama and Mitt Romney agree on one thing about Medicare: the differences between them are huge. Each man says his opponent's policies would end Medicare as it now exists, undermining the rock-solid guarantee of health care for older Americans (Pear, 5/15).

The Hill: Sen. Nelson Asks TV Stations To Pull Ads Attacking Him For Backing Health Care Law
Sen. Bill Nelson (D-Fla.) is asking Florida TV stations to pull an ad that attacks him for supporting President Obama's health care overhaul. Nelson is facing a tough reelection fight this fall -- he's one of three potentially vulnerable Senate Democrats targeted in the latest round of ads from the U.S. Chamber of Commerce. The ads sharply criticize Obama's health care law -- and the Senate Democrats who voted for it (Baker, 5/14).

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Coverage & Access

Business Trend To Offer Health Benefits To Same-Sex Couples Leaves Feds Behind

Although President Barack Obama's pronouncement last week in favor of legalizing same-sex marriage does not reverse current federal policy which denies health benefits to domestic partners, some advocates hope it will be a "morale boost."  And many employers already offer such benefits to attract and retain top workers.

Kaiser Health News: Many Businesses Offer Health Benefits To Same-Sex Couples Ahead Of Laws
President Obama's pronouncement last week in favor of same-sex marriage has no legal effect on employers' decisions on whether to offer benefits to workers' domestic partners, but some advocates believe it could reinforce a decade-long trend toward coverage (Appleby, 5/14). 

Politico: Gay Marriage Is One Thing, Benefits Another
President Barack Obama's endorsement of same-sex marriage may have given the marriage equality movement a big morale boost. But it won't, on its own, give gay couples equality when it comes to health insurance. The Defense of Marriage Act, which forbids the federal government from recognizing any marriage not between a man and a woman, has hog-tied federal agencies when it comes to liberalizing gay Americans' access to federal government benefits, from collecting their spouse’s Social Security benefits to marriage-related tax breaks (Norman, 5/14).

And in Rhode Island -

The Associated Press: Gov.: RI Recognizing Out-Of-State Gay Marriages
Rhode Island's governor on Monday declared that the state will recognize same-sex marriages performed elsewhere, giving gay couples the same rights as heterosexual ones when it comes to health insurance and a slew of other benefits. The order signed by Gov. Lincoln Chafee in a Statehouse ceremony directs state agencies to recognize marriages performed out of state as legal and treat same-sex married couples the same as heterosexual ones (Niedowski, 5/14).

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Public Health & Education

HHS Announcing Finalized Alzheimer's Plan

The plan, which includes an emphasis on research, sets 2025 as the target date for finding effective treatments for this disease.  

National Journal: HHS Announces New Alzheimer's Plan Tuesday
Health and Human Services Kathleen Sebelius releases the administration's plan for fighting Alzheimer's disease later on Tuesday at the National Institutes of Health. Aging experts have been warning that the U.S. faces an epidemic of Alzheimer's as the giant Baby Boom generation hits the senior years. A team led by Denis Evans at Rush-Presbyterian–St Luke's Medical  in Chicago projected in 2003 that by 2050, more than 13 million Americans will have the incurable brain disease, compared to about 5 million now (Fox, 5/14).

The Associated Press: Clock Ticking With New Plan To Fight Alzheimer's
The Obama administration is adopting a landmark national strategy to fight Alzheimer's disease, with an ambitious goal of finding some effective treatments by 2025. For families suffering today, the first National Alzheimer's Plan offers some help too. Starting Tuesday, families can turn to a one-stop website, www.alzheimers.gov, for easy-to-understand information about where to get help. Doctors also will get a chance to receive training on how to better care for people with Alzheimer's (Neergaard, 5/15).

Reuters: U.S. Launches Ambitious Alzheimer's Plan With Research Push
The U.S. government launched an ambitious push to develop new treatments for Alzheimer's on Tuesday with a first prevention study of high-risk patients and tests on an insulin nasal spray that has shown promise in earlier studies. The trials, funded by grants of $16 million and $7.9 million respectively, are part of a national Alzheimer's plan, a sweeping effort to find an effective way to prevent or treat Alzheimer's by 2025 and improve the care of those already afflicted with the brain-wasting disease (Steenhuysen, 5/15).

CQ HealthBeat: Collins Sees Opening to Accelerate Progress Against Alzheimer's
National Institutes of Health Director Francis Collins kicked off a two-day scientific conference on Alzheimer's disease Monday by saying he sees great promise in recent efforts to counter the mind-destroying condition. "We might be able to accelerate progress in a way that offers real hope to those individuals who are affected," he told researchers at the NIH Bethesda campus for the meeting (Reichard, 5/14).

CBS (Video): Promising Alzheimer's Research Delayed By Shortage Of Volunteer Patients
In Bethesda, Md. Monday, the National Institutes of Health began hosting a two-day summit on the fight against Alzheimer's disease. More than 5 million Americans have the disease, a number expected to triple by 2050. And researchers trying to defeat the disease are facing an unexpected hurdle, as CBS News correspondent Wyatt Andrews reports. ... "The problem is finding volunteers to join the studies," Turner said. "Patients." This one study of 750 patients is 250 patients short. Nationally, the shortfall is in the thousands, with almost every clinical trial related to Alzheimer's needing more volunteers (Andrews, 5/14).

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Heritage: Stop Subsidies For 'Multimillionaire Seniors' To Shore Up Medicare Program

A report by the conservative Heritage Foundation recommends making wealthier Medicare beneficiaries pay more to help get the program's "fiscal house in order." Also in the news, The Wall Street Journal reports that a judge who considers cases related to the Social Security Disability Insurance Program -- one of the federal governments most rapidly growing entitlement programs -- was placed on paid leave while complaints about his demeanor are probed. 

National Journal: Conservatives Want Multimillionaire Seniors Off Medicare Handouts
Multimillionaire seniors are getting too much in government subsidies for their Medicare coverage, according to a report from the conservative Heritage Foundation. J.D. Foster, a senior economics fellow at Heritage, says making wealthier seniors pay more in Medicare premiums is just the reform the program needs to get its fiscal house in order. Using the Medicare Trustee's report, Foster calculated that taxpayers spend an extra $4,897 per Medicare beneficiary above what is collected in Medicare-specific taxes and premiums. Eliminating that subsidy, Foster says, "and Medicare's shortfall disappears now and forever" (McCarthy, 5/14).

The Wall Street Journal: Another Disability Judge Placed On Leave
The judges have wide discretion in how to decide cases, with Mr. Krafsur awarding benefits in virtually every case that crosses his desk. In the fiscal year that began Oct. 1, Mr. Krafsur awarded benefits in 338 of the 339 decisions he has reached. … The Social Security Disability Insurance program is one of the government's most rapidly growing entitlement programs, and it is projected to pay more than $130 billion in benefits to close to 11 million people in 2012. Those collecting benefits receive monthly payments from the government, and they also qualify for early Medicare benefits (Paletta, 5/14).

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State Watch

Calif. Gov. Brown's Revised Budget Includes Substantial Medi-Cal Cuts

The ballooning budget deficit in California might mean hospitals and nursing homes will get less state money.

Reuters: California Targets Health, Public Workers To Fix Budget Hole
California Governor Jerry Brown on Monday unveiled a revised state budget plan that calls for new cuts to healthcare for the poor and elderly and reduced work hours for state employees as part of an effort to close a $15.7 billion budget gap (Christie, 5/14).

The Associated Press: California Gov. Jerry Brown Urges Austere Cuts, Tax Hikes To Tackle Reemerging Deficit
Brown said California's sputtering economic recovery is putting a heavier-than-expected drag on state tax revenue. The state has been blocked from making cuts to Medi-Cal and In-Home Supportive Services in court and by federal requirements. The revised budget deficit is $6.5 billion more than the $9.2 billion gap Brown anticipated in January (5/15).

Sacramento Bee: Optimistic Projections Led To Dramatic Surge In California Budget Deficit
[T]he state budget deficit had grown by a remarkable 70 percent since January, but fiscal experts said the economy had little to do with it. They instead blamed a bad marriage of volatile capital gains and political intransigence that led state leaders last year to count on a huge upswing in revenues that never materialized. At the same time, corporate tax changes from 2009 appear to have cost California more than state officials ever realized (Yamamura, 5/15).

San Jose Mercury News: Gov. Jerry Brown Slashes Programs For The Poor, Threatens To Do The Same To Schools
Brown also proposed cuts to hospitals and nursing homes to reduce Medi-Cal costs ... reducing state workers' pay by 5 percent through contract renegotiations; and using assets that used to belong to local redevelopment agencies (Harmon, Richman, Noguchi and de Sa, 5/14).

KQED: Brown's New Budget Cuts Would Hit Health Programs
Many of Governor Brown’s previous attempts to cut back on health care spending in the Golden State have been stymied by lawsuits or federal agencies that deemed the cuts too severe (Varney, 5/14). 

KQED's State of Health blog: Governor's New Budget Slices -- Again -- Into Health Care
In a conference call with reporters today, Secretary of Health and Human Services Diana Dooley said the cuts to her agency were inevitable. "The problem we have and always have in health and human services is this is where most of the spending is. The spending is in education and health and human services to a very large degree, and the only place you can cut back are the places where you are spending" (Aliferis, 5/14). 

California Healthline: May Budget Revise Hits Health Care Hard
Those proposals include: Reducing supplemental payments to private hospitals, along with elimination of public hospital grants and stopping increases to managed care plans for some supplemental public hospital payments. Taking back the 2.4 percent rate increase to nursing homes (Gorn, 5/15).

California Watch: Advocates Fear Patient Care Will Suffer Under State Budget Cuts
The revised budget poses a new set of challenges to care providers and patient advocates. Last week, groups representing doctors, nurses and nursing home residents decried a comparatively minor budget change that would have cut the mandate for hospital and nursing home inspectors to perform unannounced inspections to monitor compliance with state laws (Jewett, 5/15). 

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Minn. Hospital Workers Weigh Strike

Unionized workers at eight Twin Cities hospitals -- including nursing assistants, food service employees and other support staff -- are taking a vote on whether to strike over management's contract offer.

(St. Paul) Pioneer Press: Twin Cities Hospital Workers Voting Whether To Strike 
As unionized hospital workers started voting Monday, May 14 on whether to authorize a two- to five-day strike, medical centers in the Twin Cities issued a statement saying they would receive a minimum 10-day notice before any such strike might occur. …  Hospitals said they are seeking "reasonable changes to the current contract to be good stewards of our limited resources." They also are seeking flexibility "to adapt to an ever-changing health care world," the medical centers said.  But in a statement issued Monday, a union official said the changes would mean that workers who agreed to a wage freeze three years ago now would be asked to "survive on even less” (Snowbeck, 5/14).

Minneapolis Star Tribune: Workers At 8 Twin Cities Hospitals Take Strike Vote
Nursing assistants, food service workers and support staff at eight Twin Cities hospitals are voting this week on whether to authorize a two- to five-day strike. … Tee McClenty, the union's chief negotiator, said the members are upset by concession demands from the hospitals that could increase their individual health insurance costs by thousands of dollars. She also said the two sides are far apart on wages (Lerner, 5/14).

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Okla. Judge Strikes Down Law That Restricted Drug-Induced Abortion

The court said the new law did not meet the state constitution's guarantee of "the fundamental rights of women to privacy and bodily integrity," the Tulsa World reports.

Politico Pro: Oklahoma Restrictions On Medical Abortion Struck Down
An Oklahoma judge struck down a state law Monday that effectively banned medically preferred methods for inducing abortions and pharmaceutical treatment of ectopic pregnancies. The ruling came in a case filed by the Center for Reproductive Rights that challenged state law that restricted off-label use of drugs for these purposes. Scientific researchers now believe there are off-label drug combinations that are more safe and effective than those currently listed on the label for the abortion-inducing drug RU-486 (Feder, 5/14).

Tulsa World: Oklahoma Court Finds HB1970 Abortion Law Unconstitutional
An Oklahoma County District Court has tossed out at a 2011 law that put restrictions on drugs used to induce abortions. The court found that House Bill 1970 is "an unconstitutional law in violation of the fundamental rights of women to privacy and bodily integrity," guaranteed by the Oklahoma Constitution, according to an order issued Friday (Hoberock, 5/15).

In related news -

NPR: Should Parents Be Able To Sue For 'Wrongful Birth'?
Several states, including Kansas and New Jersey, are debating so-called "wrongful birth" laws that would prevent parents from suing a doctor who fails to warn them about fetal problems. Abortion rights activists say the laws give doctors the right to withhold information so women don't have abortions (Lohr, 5/15).

The Kansas City Star: Kansas Governor Signs Another Abortion Bill
Gov. Sam Brownback has signed a bill into law that would allow pharmacists to refuse to provide drugs they believe might cause an abortion. Called the Heath Care Rights of Conscience Act, the new law would bar anyone from being required to prescribe or administer a drug they "reasonably believe" might result in the termination of a pregnancy. Critics believe the law will open the door for a pharmacist to refuse a request for something like the "morning-after" pill, which the Mayo Clinic says can prevent or delay ovulation, block fertilization or keep a fertilized egg from implanting in the uterus (Cooper, 5/14). 

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State Roundup: Undocumented Immigrant Health Care Showdown In D.C.

A selection of health policy news from across the country.

The Washington Post: Gray, Catania Face Off Over Health Funding
Mayor Vincent C. Gray is heading for a final showdown Tuesday with D.C. Council member David A. Catania over city funding for a health insurance program that pays for hospital care for thousands of undocumented immigrants (Craig, 5/14).

The Wall Street Journal: Espada Guilty Of Stealing Clinic's Funds
Former state Sen. Pedro Espada Jr., the flamboyant Bronx politician who claimed one of New York's most powerful offices only to quickly fall from power, was convicted Monday on federal charges of theft from a health clinic he founded (El-Ghobashy, 5/14).

The Kansas City Star: Brownback Signs Bill To Help Fill Kansas Dentist Shortage
Gov. Sam Brownback has signed into law a bill that's intended to help the state cope with a dentist shortage but critics say doesn't go far enough. Brownback signed a law the expands the ability of dental hygienists to deal with tooth decay to help deal with the fact that 93 Kansas counties don't have enough dentists to serve their residents and 13 others don't even have a dentist. The bill is a much scaled down approach compared to another proposal that would have created a midlevel provider called a registered dental therapist who could perform some of the duties now handled by dentists, including filling cavities and pulling teeth (Cooper, 5/14).

Modern Healthcare: 100 Ky. Hospitals Sign On For Safety Program
The Kentucky Hospital Association said it has reached nearly an 80 percent participation rate in a nationwide program to reduce adverse events and readmissions. A total of 100 hospitals in the state have signed on to the Partnership for Patients campaign, according to a news release . About 2,000 hospitals in 33 states are participating in the initiative, which HHS launched in April 2011 (Kutcher, 5/14).

Sacramento Bee: Q&A: Insurance Commissioner Dave Jones On Health Care Reform
Since he took office early last year, state Insurance Commissioner Dave Jones has made health care reform his top priority. Now he's backing a ballot measure -- the Insurance Rate Public Justification and Accountability Act -- that would give him the power to block health insurance rate increases he deems excessive. He spoke to The Bee recently about the initiative and President Barack Obama's health care reform act under review by the U.S. Supreme Court (Garza, 5/14).

The Connecticut Mirror: Report: Babies, 18-year-olds Still Wrongly Losing Medicaid Coverage 
One-year-olds and 18-year-olds are still wrongly losing Medicaid coverage because of administrative glitches and confusing notices, despite pledges from Department of Social Services officials to address the issues, according to the researchers who identified the problems. ... [Mary Alice Lee and Sharon Langer], who are senior fellows at Connecticut Voices for Children, reported this month that babies turning 1 and teens turning 18 were in 2010 twice as likely as other children to lose coverage in HUSKY, the Medicaid program (Levin Becker, 5/14). 

The Texas Tribune: On the Records: Expanded Nursing Could Boost Economy 
Giving advanced practice registered nurses in Texas an expanded role in health care through legislative changes next year could increase the state’s economic output by $8 billion annually and create nearly 100,000 permanent jobs, according to a report by economist Ray Perryman released Monday. ... Perryman prepared the report for Texas Team Advancing Health Through Nursing, a nursing advocacy organization, of which he is a member (Aaronson and Park, 5/14). 

Minnesota Public Radio: Aging Population Leads Minn. Nurses Back To School 
Nursing schools have historically trained nurses to work at the bedside, in hospitals. But the rapidly aging population means more nurses are delivering care to patients outside of traditional hospital settings. Students are looking beyond two-year-nursing programs to learn more about physical therapy, treatment management and psychological care while pursuing a bachelor's degree (Baier, 5/14). 

The Associated Press: RI Considers 'Homeless Bill of Rights'
The bill would specifically prohibit law enforcement, health care workers, potential landlords or employers from treating homeless people unfairly because of their housing status. The measure's sponsor, Sen. John Tassoni, said most Americans probably aren't aware of the daily discrimination faced by homeless people (Klepper, 5/14).

The Dallas Morning News: New Report Sees Signs Of Progress At Parkland Hospital
Parkland Memorial Hospital made "measurable progress" in March toward a massive reorganization aimed at protecting patients, according to the initial compliance report issued by safety monitors. The report cautions that its scope is limited -- it covers only a few days of preliminary work by Parkland to address more than 400 mandates outlined in a federally imposed action plan. Still, this is the monitors’ first upbeat assessment since issuing three scathing reports in February (Moffeit, 5/14).

The Associated Press/Chicago Sun-Times: Quinn: Pension, Medicaid Reform A Rescue Operation
Gov. Pat Quinn appealed Monday to an influential group of business leaders in Chicago to add their weight to his push to reform Illinois' debt-laden Medicaid and public pension systems, describing the plan as both a tough sacrifice and an urgent "rescue operation" for future generations. With barely two weeks left in the legislative session, the Democratic governor has gone on the offensive and turned to unlikely allies in the business community to pressure lawmakers to pass his proposals. On the other side, unions and advocates for the poor say the reforms will hurt the most vulnerable. …To rein in Medicaid costs, Quinn has proposed cutting services for the poor and disabled and cutting payments to doctors and hospitals. To keep from having to cut further, he proposes essentially doubling the tax on a pack of cigarettes (Keyser, 5/14).

Kansas Health Institute News: New Kind Of Kansas Health Insurance Company In The Works 
For many, the term co-op evokes images of grain elevators ... or maybe where local-food devotees go to get a weekly helping of fresh produce. But a group at work in Wichita has a different vision. They are working to develop a member-owned co-op that would provide thousands of Kansans with health insurance. And they want the coverage to be different from plans offered by traditional carriers (McLean, 5/14). 

The Lund Report: Oregon's Health CO-OPs and Insurance Exchange Expect to Collaborate 
Anticipating future collaboration, representatives of Oregon's two developing healthcare CO-OPs gave a presentation to the state health insurance exchange's board last week. "They asked us to come and be part of a presentation on co-ops, to learn more about them and their role," said Cory Streisinger, who chairs the board of Community Care of Oregon, a healthcare CO-OP getting off the ground in Oregon after receiving $57 million in grants and loans from the Center for Medicare and Medicaid (Waldroupe, 5/14).

WBUR's CommonHealth blog: Health Reform 2012: Hello, How Much Will My Care Cost? 
Not exactly how things work now, is it? But as the Massachusetts legislature works toward the next, cost-cutting phase of health reform, both the House and the Senate proposals envision a toll-free number and online information for patients who want a sense in advance of how much their care is about to cost. I asked Dr. Neel Shah, founder and executive director of the Boston nonprofit Costs of Care, what he thought of the legislative proposals (Goldberg, 5/14). 

New Orleans Times-Picayune: Health, Higher-Ed Officials Warn Of Dire Consequences Of House Cuts 
Health programs including hospice care, a behavioral health hospital and services for the disabled are on the chopping block, and higher education is anticipating hundreds of millions of dollars in cuts ... The cuts come after a group of 51 state representatives succeeded Friday in removing one-time money for recurring expenses from next year's budget (Adelson, 5/14). 

The Lund Report (an Oregon news service): Oregon's Missed Opportunity for Tobacco Prevention; Master Settlement Agreement Monies Spent Elsewhere
Tobacco costs Oregonians at least $2.4 billion a year in direct and indirect costs related to smoking and tobacco use. That's over $13 per pack of cigarettes sold. ... Despite these staggering estimates, only 3 cents of the $1.18 tax per pack of cigarettes in Oregon goes toward tobacco reduction efforts (Scharer, 5/15). 

Colorado Public Radio: Shop And Compare For Healthcare
[I]n healthcare, different people pay different prices for the exact same procedures, depending on whether they’re insured, or which insurer they have. And in general, none of those prices are public. But there’s a project afoot in Colorado to change that, to create a new database of who does what procedures, how much they’re charging and whether they’re any good at it (Whitney, 5/14).

Alaska Public Radio: New Management Style Allows Health Organization To Improve Care
A Native health care organization in Anchorage is transforming the way it does business with the Toyota management system.  Chugachmiut delivers health care and social services to seven Alaska Native villages around Prince William Sound. Executive director Patrick Anderson says the Toyota Lean management style has helped the organization free up resources to spend on improving care (Feidt, 5/14).

North Carolina Health News: Legislators Return to a Variety of Health Care Issues In the General Assembly
This week, the General Assembly reconvenes for the ‘short’ session ... Below is a list of health-related committees and sub-committees, and what initiatives they will be sending to the larger legislative body later this week. Hospital regulation revisions ... Pharmaceutical Liability ... Children’s Health  (Hoban, 5/15).

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Editorials and Opinions

Viewpoints: Calif. Health, Welfare Programs Struggle Under Budget Cuts; Protecting Children From Diabetes Threat

Sacramento Bee: Gov. Jerry Brown, Lawmakers Have A Month To Get California Budget Right
Gov. Jerry Brown and the Democratic-controlled Legislature passed a budget last year that was built on a rickety foundation of false hopes. If that wasn't apparent at the time, it is now that the budget deficit has ballooned to $15.7 billion, up from Brown's $9.2 billion estimate from only four months ago. ... Brown offered several solutions on Monday. Health and welfare programs for the poor would bear 30 percent of the cuts, including $880 million from the main welfare program, CalWORKs, through a variety of reductions (5/15).

The Wall Street Journal: Jerry Brown Vs. Chris Christie
On public-employee unions, Mr. Brown can talk a good game—at Monday's press conference, he announced a 5% pay cut for state workers, and he has proposed pension reform. Yet for all his pull with unions (the last time he was governor, he gave California's public-sector unions collective-bargaining rights), Gov. Brown, a Democrat, has not been able to accomplish what Republican Gov. Christie has: persuade a Democratic legislature to require government workers to kick in more for their health care and pensions (William McGurn, 5/15). 

Forbes: Not That the Obama Administration Has Noticed, But Drugs Are Expensive to Develop
Obamacare will hit pharmaceutical firms with more than $20 billion in new taxes over the next ten years. Some firms may conclude that they can't shoulder both a hefty tax bill and the risk of a multimillion-dollar research failure. That would be tragic news not just for patients waiting for cures but for the American economy, which benefits tremendously from the massive sums that pharmaceutical companies sink into research and development (Sally Pipes, 5/14).

Houston Chronicle: Protect Those Most Vulnerable To Diabetes
They used to call it adult-onset diabetes, because it only occurred in adults. Most often caused by obesity, it is now at record levels, affecting almost 26 million Americans …. And now, even more troubling news: A new study, published by the New England Journal of Medicine, shows the disease progresses faster and is tougher to treat in children; one major finding was that a standard medication successful for adults often fails with younger patients…. We can't afford to ignore this latest threat to our young and vulnerable (5/14).

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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.