Daily Health Policy Report

Wednesday, May 16, 2012

Last updated: Wed, May 16

KHN Original Reporting & Guest Opinion

Capitol Hill Watch

Campaign 2012

Coverage & Access

Health Reform

Administration News

Health Care Marketplace

Health Information Technology


State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Attention Health Care Shoppers: Colorado's Price List For Procedures

Colorado Public Radio's Eric Whitney, working in partnership with Kaiser Health News and NPR, reports: "Shopping for the best price for a given health care need is nearly impossible. Unlike shopping for other big ticket items, there's no place to compare prices. Providers often can't, or won't, quote a price for a given procedure - different people are charged different rates based on what kind of coverage they have, or whether they have coverage at all" (Whitney, 5/16). Read the story.

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Capsules: Obama Administration: A Plan To Prevent Alzheimer's By 2025

Now on Kaiser Health News' blog, Christian Torres reports: "The Obama administration is moving forward with an ambitious, fast-moving agenda to improve the treatment of Alzheimer's disease and unlock a method to prevent it by 2025. The final draft of the plan, released today, also sets up a wide-ranging effort to improve the care that Alzheimer’s patients receive and support families" (Torres, 5/15). Check out what else is on the blog.

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Political Cartoon: 'Continuing Commencement?'

Kaiser Health News provides a fresh take on health policy developments with "Continuing Commencement?" by Chip Bok.

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


Please "do the right thing,"
says senator to justice...
It's only "proper."

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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Capitol Hill Watch

Republicans Set Up Election-Year Showdown On Budget

As the Senate prepares to vote today on four separate budget plans -- all of which will likely be rejected -- House Speaker John Boehner, R-Ohio, says he will use the next go-round over the debt limit to force Democrats to make deeper cuts to federal health and safety-net programs, including Medicare.

The New York Times: Republicans Pledge New Standoff On Debt Limit
But Republicans have not been able to unify around an alternative. Instead, they will bring forward four different budgets for the 2013 fiscal year, which begins Oct. 1 — with a budget passed by House Republicans viewed as the most liberal of the lot. One by Senator Rand Paul of Kentucky would eliminate the Departments of Education, Commerce and Energy; cut the National Park Service by 30 percent and NASA by a quarter; and end Medicare in 2014. Senator Mike Lee of Utah proposes a budget that would raise the retirement age to 68, cut the size of government in half over 25 years, and end the payroll tax as well as all taxes on savings and investment and replace them with a 25 percent flat tax (Weisman, 5/15).

Politico: Moderate Dems Frustrated By No Budget
The Democratic-led Senate on Wednesday is expected to reject all four GOP budget plans, including the contentious House-passed proposal authored by Rep. Paul Ryan (R-Wisc.). A fifth budget, offered by Republicans and based on President Barack Obama 2013 spending blueprint, also will likely fall short of the 50 votes needed to pass, dealing the White House an embarrassing election-year blow. But Democratic leaders have defiantly refused to lay out their own vision for how to deal with federal debt and spending, arguing that last summer’s debt-ceiling deal essentially serves as an actual budget (Wong, 5/15).

The Washington Post: Boehner Threatens Another Debt-Ceiling Fight
Boehner, meanwhile, made it clear that he is ready to use the debt limit as a cudgel to force Democrats to compromise, particularly on a strategy for restraining spending on Medicare and other federal health programs, which are the biggest drivers of future borrowing (Montgomery, 5/15).

The Wall Street Journal: Boehner Draws Line In Sand On Debt
Tuesday's salvos were the latest in the election-year debate over the size and scope of the federal government. Democrats have called for a mix of tax increases and spending cuts to reduce the deficit and Republicans have called for spending cuts and overhauls of entitlement programs like Medicare (Paletta, 5/15).

The Wall Street Journal's Washington Wire: Clinton To Obama: Talk About Cuts
Former U.S. President Bill Clinton said Tuesday that President Barack Obama should spend more time talking to the American people about his budget proposals to launch a national dialogue about the crucial issues. The "president should talk more about the Medicare cuts he has proposed” and the “defense cuts he has proposed," Mr. Clinton said. … "He is at least trying to honor the deal he made with Republicans, and I think he should talk more about it and I think they should talk more about it," he said during remarks at a "fiscal summit" held in Washington by the Peter G. Peterson Foundation (Paletta, 5/15).

The Associated Press/Washington Post: After Last Year's Budget Failures, Lawmakers Gather For Annual Deficit Pep Talk
Boehner made the top headline at this year's summit by declaring that when it comes time for Congress to raise the nation's borrowing cap he will again insist on spending cuts and budget reforms exceeding the amount of the debt increase to offset it. He also promised a vote on renewing trillions of dollars in tax cuts passed during the Bush administration, prompting a predictable response from top House Democrat Nancy Pelosi of California (5/16).

Modern Healthcare: Medicare, Medicaid Overhaul Deal Unlikely, Lawmakers Say
Congress is unlikely to reach a "grand bargain" to overhaul Medicare and Medicaid during the post-election lame duck session, according to two congressional budget leaders. In successive appearances Tuesday at a deficit-reduction summit sponsored by the Peter G. Peterson Foundation, Reps. Paul Ryan (R-Wis.), chairman of the Budget Committee, and Chris Van Hollen (D-Md.), the panel's ranking member, agreed that any deal to enact long-term changes to the federal healthcare programs is more likely in 2013 (Daly, 5/15).

NPR's Planet Money blog: 50 Years Of Government Spending, In 1 Graph
Medicaid, Medicare and other health services are the huge gainers here. Together, they make up a quarter of government spending. Fifty years ago Medicare and Medicaid didn't even exist, and federal spending on other health-related services made up a tiny sliver of the whole (Vo, 5/14).

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Campaign 2012

Romney Takes On Debt Issues During Campaign Stop

Meanwhile, the Obama campaign released a new Web video focusing on the president's record on women's health issues. 

The Des Moines Register/USA Today: Romney Discuses Debt During Iowa Stop
Romney's ideas for cutting the $15.67 trillion national debt -- don't raise taxes, reform entitlement programs, limit spending -- were met with strong applause from the crowd of more than 300 people. An additional 100 people stood in an overflow area. On his first trip to Iowa since the caucuses when he was initially declared the winner, Romney didn't offer new proposals, but the way he framed his argument was fresh and probably telegraphs a strategy to chip away at Obama's credibility on his pledge to cut the deficit in half (Jacobs, 5/15).

Boston Globe: Romney Says Obama Sees Free Enterprise As A Villain
With analogies stretching from pioneering homesteaders to sophisticated cellphones, Mitt Romney cast President Obama as an enemy of capitalism while calling himself the defender of fiscal responsibility Tuesday at Drake University... Romney vowed again to repeal Obama’s health care law and said he would reform Medicare and Social Security, without delving into specific strategies (Borchers, 5/16).

The Associated Press: Romney Pins 'Prairie Fire Of Debt' On Obama
In Des Moines, Romney described Obama's approach as that of an "old-school liberal" who ballooned the debt he pledged to curb, and broke with the budget-cutting record of the previous Democratic administration of President Bill Clinton. Romney argued that Obama inflated the deficit with programs such as the 2009 economic stimulus and 2010 health care measure after promising to cut it sharply during his first presidential campaign (Beaumont, 5/15).

The Associated Press: Fact Check: Romney Oversimplifies Debt 'Inferno'
Nowhere in Tuesday's speech was there a new idea of how Romney would accomplish the promised deficit reduction. He spoke generally of reforming Social Security and Medicare, eliminating duplicative government programs, and transferring some functions to the states or the private sector, adding that he would "streamline everything that's left." The closest he has come to laying out a specific spending plan has been in his endorsement of the budget blueprint passed this year by House Republicans, which also fails to produce his promised deficit reductions (Woodward and Raum, 5/16).

The Hill: Obama Campaign Focuses On Women's Health In Latest Web Video
The Obama campaign released a new Web video Tuesday highlighting President Obama's record on women's health issues. The video comes just a day after Obama gave the commencement address at the all-female Barnard College and taped an appearance for "The View." The battle for female voters this year is fierce, and Democrats consistently harness healthcare issues to make their pitch. The latest Web ad quotes Obama saying during the 2008 campaign that "change is a president who will stand up for choice (Baker, 5/15).

And news on the Minnesota Senate race -

Minnesota Public Radio: Hegseth Seeks Medicare, Social Security Overhauls
Delegates to the state Republican convention will endorse a candidate for U.S. Senate later this week. ... Today, Army National Guard Capt. Pete Hegseth explains what he would do to reduce the nation's red ink. ... Hegseth applauds Wisconsin's Republican Rep. Paul Ryan for budget proposals which, among other things, would give senior citizens grants to buy health insurance rather than cover all their health care through the current single-payer Medicare system (Zdechlik, 5/16).

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Coverage & Access

For Same-Sex Couples, Medicare, Federal Health Programs Problematic

These couples still face hurdles created by the Defense of Marriage Act.

Reuters: Gay Couples Can't Bank Obama's Blessings Yet
Same-sex couples also face financial trouble with their healthcare when they are seniors. Eligibility for Medicare is based on the number of quarters in which you have paid payroll taxes into the system. At age 65, anyone with a work history of at least 40 quarters can enroll for Medicare Part A (hospitalization) without paying a premium. ... You can also enroll without paying a premium if a spouse qualifies. But [the Defense of Marriage Act] means that a legally married LGBT same-sex spouse lacking those 40 quarters must take the other route into Medicare -- buying into the system by paying a hefty Part A premium out of pocket. This year, the monthly Part A premium is $451 for those with less than 30 quarters in the system (Miller 5/15).

CQ HealthBeat: Benefits For Federal Workers' Domestic Partners Addressed In Senate Bill
A week after President Obama announced his support for same-sex marriage, a Senate panel will on Wednesday take up legislation that would extend benefits to the domestic partners of federal employees. Homeland Security and Governmental Affairs Chairman Joseph I. Lieberman, I-Conn., wasted no time in pushing his panel to mark up the bill he has introduced in each of the last four Congresses. The bill has never advanced to the full Senate, though the panel did approve it in 2009 (5/15).

Related KHN coverage: Many Businesses Offer Health Benefits To Same-Sex Couples Ahead Of Laws (Appleby, 5/14).

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Health Reform

U.S. Bishops Make Official Their Opposition To Birth Control Mandate

The Catholic bishops said that, without quick congressional action, their organization will sue the Obama administration for requiring insurance plans to provide birth control to women without a co-pay. 

The Associated Press: Bishops Reject Softened Birth Control Rule
U.S. Roman Catholic bishops are rejecting the Obama administration's plan to accommodate faith groups that object to the birth control mandate. The bishops said in a statement Tuesday to Health and Human Services that the prospective new rules don't do enough to protect religious liberty (5/15).

National Journal: Bishops Make Birth Control Opposition Official (Again)
U.S. Catholic bishops made official their opposition to a health reform law rule requiring birth control coverage on Tuesday. The is "unjust and unlawful," the bishops said in comments on the proposed regulation to Health and Human Services. The Obama administration's "accommodation" for religious employers, requiring insurance companies to pay for the birth control coverage, doesn't help, the bishops said (McCarthy, 5/15).

The Hill: Catholic Bishops Threaten Lawsuit Over Administration's Birth Control Mandate
The Catholic Church's U.S. hierarchy warned Tuesday that without quick action by Congress, it will sue the Obama administration for mandating that insurance plans provide birth control to women without a co-pay. "[F]orcing individual and institutional stakeholders to sponsor and subsidize an otherwise widely available product over their religious and moral objections serves no legitimate, let alone compelling, government interest," lawyers for the U.S. Conference of Catholic Bishops wrote in a letter to federal regulators (Viebeck, 5/15).

Politico Pro: Bishops File Complaints On Contraception Rule
The U.S. Conference of Catholic Bishops on Tuesday officially urged the Obama administration to change its policy of requiring many employers to provide insurance coverage of contraceptives. The bishops, in formal comments filed with HHS, reiterated many of their issues with the policy, saying it still requires employers, whether religious or not, to cover contraceptives. The bishops also say they're uncomfortable with the government for the first time defining what is or is not a "religious employer" (Haberkorn, 5/15).

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Contraception Coverage Rule Ripples Through College Campuses

A fight over allowing HHS Secretary Kathleen Sebelius -- a key player in creating a mandate to force student health plans to cover contraception -- to speak at Georgetown's graduation continues. In the meantime, a Catholic university in Ohio is ending its student health insurance plan instead of complying with the mandate.

The Washington Post: Washington’s Catholic Archbishop, Georgetown President Spar Over Graduation Invitation To Kathleen Sebelius
Since Sebelius was announced earlier this month as one of the speakers for this week’s Georgetown graduation ceremonies, about 27,000 people have signed a petition, circulated by a conservative Catholic think tank, urging the university to withdraw the invitation. Sebelius was a key architect of the 2010 health care law, and she authored the requirement that employers, including most religious ones, provide their employees with contraception coverage (Boorstein, 5/15).

Reuters: Catholic College Drops Health Plan Over Contraception Mandate
A small Catholic college in Ohio said Tuesday it was dropping health insurance coverage for students rather than comply with a federal mandate that the plan provide free birth control. The Franciscan University of Steubenville "will not participate in a plan that requires us to violate the consistent teachings of the Catholic Church on the sacredness of human life," according to a bulletin to students posted on the university's website (Simon, 5/15).

Fox News: Catholic University Drops Student Health Insurance, Cites ObamaCare
A Catholic university in Ohio said Tuesday it is being forced to end a student health insurance program over the Obama administration's contraception mandate and costs associated with other provisions of the health care overhaul. Franciscan University in Steubenville, Ohio, said it has so far excluded contraceptive services and products from its health insurance policy for students and will not participate in a plan that "requires us to violate the consistent teachings of the Catholic Church on the sacredness of human life" (5/16).

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Health Law's Health Coverage Expansions Pose Logistical Challenges

Politico reports on how immigration status will play into this effort, and McClatchy notes the strain that will be felt by the physician workforce as a result of the across-the-board push to increase access to care.

Politico: Immigration Status Is A Health Policy Challenge
The Obama administration's drive to cut down on America's uninsured is about to get multilingual. Come 2014, when core provisions of the Affordable Care Act kick in, millions of legal immigrants will have new options for gaining health coverage. And like U.S. citizens, most will be subject to the individual mandate, under which they will be required to get coverage to avoid a penalty (Cheney, 5/16).

McClatchy: Not Enough Doctors
The Supreme Court's ruling on the Patient Protection and Affordable Care Act, expected in June, will determine the future for countless Americans. Health care reform debates have elevated the plight of millions of uninsured Americans to the national consciousness. However, the physician workforce that would be needed to care for millions of newly insured people deserves equal attention. There is a growing shortage of primary care physicians in the United States, and it has been forecast for decades. The American Association of Medical Colleges projects a shortage of 124,000 physicians by 2020, 37 percent of them primary care doctors. This growing shortage predates the coming squeeze due to the Affordable Care Act (Johnson, 5/15).

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Administration News

HHS Launches Health System Management Project

This new online tool will enable consumers to search a variety of federal health care data sets to monitor how the health system is performing.

Modern Healthcare: HHS Launches Health Data Comparison Tool
A new online tool will allow public searches of disparate federal healthcare data sets in one place. HHS launched the Health System Measurement Project on Tuesday to allow simplified tracking of healthcare trends in access to care, cost and affordability, disease prevention and health information technology, according to a news release (Daly, 5/15).

CQ HealthBeat: New HHS Tool Tracks Health System Performance Online
A new Web-based tool is bringing together data sets from across the federal government in one place so Americans can monitor and measure how the nation's health care system is performing, Health and Human Services Secretary Kathleen Sebelius said Tuesday in launching the new site. Known as the Health System Measurement Project, it will allow policy makers, health care providers and the public to develop consistent data-driven views of changes in critical U.S. health system indicators, HHS officials said (Gramlich, 5/15).

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Health Care Marketplace

For A Family Of 4, Health Care Costs Can Top $20,000

A study by the benefits consultant group Milliman notes the average annual health care costs for a family of four are $20,728 -- a 7 percent increase from last year. 

Los Angeles Times: Average Annual Health Care Cost For A Family Tops $20,000
Health care or a Hyundai? The average cost of health care for a family of four this year has increased nearly 7 percent to $20,728 annually, according to a new study by benefits consultant Milliman, or similar to the cost of a mid-size sedan (Terhune, 5/15).

Milwaukee Journal Sentinel: Health Care Costs For Family Of 4 Top $20,000
There's a good chance that health care costs for the typical family of four now are higher than their annual mortgage payment. Health care costs are projected to reach $20,728 this year for a family of four insured through the most common health plan offered by employers, according to the annual Milliman Medical Index. The index includes the cost of health insurance and out-of-pocket costs, such as deductibles and co-pays (Boulton, 5/16).

CQ HealthBeat: Study Says Health Costs For Family of Four Now Top $20,000 For The First Time
Health care costs for a family of four covered by an employer-sponsored preferred provider organization will average $20,728 in health care costs in 2012, according to an estimate released on Tuesday by the Milliman consulting firm. The total represents sums paid both the by the employer and the employee (Reichard, 5/15).

Also in the news, new data from the Centers for Disease Control and Prevention details the health of the American population, with a focus on socioeconomic status.  

CNN: New Data On The Health Of These United States
The Centers for Disease Control and Prevention released their annual health report for 2011 on Wednesday. The report contains more than 150 data tables on the U.S. population's well-being, with a special focus on socioeconomic status (Wilson, 5/16).

The Atlanta Journal-Constitution: Americans Living Longer, But Obesity Rising
The CDC today released its annual state of the union's health, and there's good news and bad. We're living longer. But we're also gaining more weight. Teen pregnancies are at a record low. But fewer people can afford necessary prescription drugs and medical care. The 583-page federally mandated report, titled "Health, United States 2011," also compares how well -- or how poorly -- we fare today with how we were doing over the past decade or so (McMillen, 5/16).

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Accretive Seeks Advice From Top Health Care Policymakers

Accretive Health, subject of a recent report critical of its billing practices, will convene a panel of top policymakers on collection standards in the industry, it said Tuesday.

(St. Paul) Pioneer Press: Accretive Health Asks Daschle, Shalala For Advice On Collecting Health Bills
The Chicago-based company that was subject of a scathing report in April from Minnesota Attorney General Lori Swanson is convening national policy leaders to set standards for how hospitals should inform patients about the money they owe for health care. In a news release issued Tuesday, May 15, Accretive Health Inc. said the discussion will be led by Michael Leavitt -- a former governor of Utah and secretary of Health and Human Services during the George W. Bush administration -- and will include input from former Sen. Tom Daschle, D-S.D., and other national policy leaders. Accretive Health said it hopes the group will work with an independent nonprofit organization to develop national standards for how hospitals and health care providers should talk with patients about expected charges and their access to charity care (Snowbeck, 5/15).

Modern Healthcare: Accretive Launching Collection-Standards Panel
Accretive Health, the billing and collection company that is under scrutiny after a highly critical report by Minnesota's attorney general, said it would launch and fund a panel to set patient collection standards. Accretive named Mike Leavitt, former HHS secretary and founder of a healthcare consulting company, to chair the panel, according to a news release (Evans, 5/15).

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Health Information Technology

The Top Cloud-Based EHRs; 'Meaningful Use' Compliance Slow

Health IT's future, and who's doing it best right now, make news as the national coordinator for health IT and former CMS head Donald Berwick weigh in on "meaningful use" compliance by clinicians across the country.

Boston Globe: Dr. Farzad Mostashari: 5 Things Government Can Do To Improve Health Technology
What is the government’s role in developing new technology? Some would say to stay out of the way. Dr. Farzad Mostashari, the national coordinator for health information technology, said that’s overly cynical. But, Mostashari said in an interview, government is no longer the major producer of innovative products and services that it once was, creating things for military purposes or space exploration that work their way into the consumer market (Conaboy, 5/15).

Medscape: Top 10 Cloud-Based EHRs
CureMD ranks as the number-one vendor of electronic health record (EHR) programs accessed online solely with a Web browser, according to a new study by research firm KLAS. Close behind in second place is Practice Fusion, which has the only free system on the market. Athenahealth and Medical Informatics Engineering tied for third place in the comparison of these inexpensive, easily implemented systems and their vendors. ... KLAS interviewed roughly 300 health care providers who use SaaS EHRs and found that one issue separating the good from the bad is system response time (Lowes, 5/15).

MedPage Today: 'Meaningful Use' Compliance Slow
The medical system is undeniably morphing into a more electronic one, but many clinicians are still not ready for it, according to current and former government officials. Although more than 30,000 clinicians qualified for bonus payments for using electronic health records in 2011, many others are unaware of how to prove they're meaningful users of the technology, wrote Donald Berwick, MD, former administrator of the Centers for Medicare and Medicaid Services, and current National Coordinator for Health IT, Farzad Mostashari, MD, along with several others, in a special article in the May 14th issue of Archives of Internal Medicine (Walker, 5/15).

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VA Hospital Incident Adds To Questions About Nurse Skills

ProPublica: Patient Died at New York VA Hospital After Alarm Was Ignored
Registered nurses at a Manhattan Veterans Affairs hospital failed to notice a patient had become disconnected from a cardiac monitor until after his heart had stopped and he could not be revived, according to a report Monday from the VA inspector general. ...  Only half of 29 VA facilities surveyed by the inspector general in a recent report had adequately documented that their nurses had skills to perform their duties  (Ornstein and Weber, 5/15). 

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State Watch

Mass. Gov. Patrick: Cut Health Care Costs, Allow Government A Role

Patrick said he is confident the commonwealth can slow the growth of health care costs, although he did not endorse either of two proposals before the legislature. He also defended the effort to provide universal health care.

Boston Globe: Patrick Pushes Health Care Cost Controls
Governor Deval Patrick said Tuesday he is confident that health care cost increases can be slowed to no more than the annual growth of the Massachusetts economy without harming the hospitals and doctors that make up the state's dominant industry. Speaking to the Greater Boston Chamber of Commerce, Patrick did not explicitly put his support behind either of the two cost-containment bills being debated in the Legislature. However, he said he probably would not support anything that allows health spending to continue to grow more quickly than the gross state product, a measure of economic activity (Johnson and Conaboy, 5/16).

Boston Globe: Patrick Defends Universal Care, Urges Cost Control
Speaking to both state and national audiences, Governor Deval Patrick today defended the idea of government promoting near universal health care, even as he called on lawmakers, health care providers, and the business community to work jointly on controlling its cost. The twin targets reflected his role both as leader of the state and a top surrogate speaker for President Obama. The Democratic president is defending his federal health care overhaul from criticism by Mitt Romney, the presumptive Republican presidential nominee who enacted the state's health care reforms when he preceded Patrick as Massachusetts governor (Johnson, 5/15).

WBUR's CommonHealth blog: Patrick To Business: Cut Health Care Costs Aggressively, Let Government Play A Role 
For the first time since lawmakers in the Massachusetts House and Senate unveiled separate plans to cut health care costs, Gov. Deval Patrick is weighing in. At a Greater Boston Chamber of Commerce breakfast this morning, Patrick told business leaders that the state should set aggressive spending targets, let government play a role in keeping insurance premiums down, and not necessarily create an entirely new agency to oversee the new reforms (Zimmerman, 5/15).

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Workers OK Strike At 8 Minneapolis-St. Paul Hospitals Over Contract Dispute

About 91 percent of 3,500 workers at eight Minnesota hospitals have authorized a strike after the latest contract kerfuffle with officials, though they haven't said if that strike will occur.

(St. Paul) Pioneer Press: Twin Cities Health Care Workers Authorize Strike Affecting 8 Hospitals
Unionized health care workers have voted to authorize a strike against hospitals operated by five health systems in the Twin Cities, but the tally doesn't necessarily mean a strike will occur. About 91 percent of 3,500 members of the Service Employees International Union Healthcare Minnesota voted in favor of the strike during two days of voting this week, according to a union news release Tuesday, May 15. "The vote speaks for itself," Tee McClenty, executive vice president of SEIU Healthcare Minnesota, said in the news release (Snowbeck, 5/15).

Minneapolis Star Tribune:  Workers Authorize Strike At 8 Twin Cities Hospitals 
Workers at eight Twin Cities hospitals could be off their jobs later this month in a temporary strike over a new contract. A measure authorizing a two- to five-day strike by the union representing 3,500 nursing assistants, technicians and support staff was supported by 91 percent of those voting on Monday and Tuesday. The Service Employees International Union Healthcare Minnesota represents workers at Bethesda, Fairview Riverside, Fairview Southdale, Methodist, St. John's, North Memorial and Children Hospitals in Minneapolis and Children's Hospital in St. Paul. The union is required to give 10 days' notice before striking (5/15).

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State Roundup: La. Panel Kills Health Exchange Plan

News outlets report on a variety of state health policy issues in California, Colorado, Kansas, Louisiana, Massachusetts, Pennsylvania, North Carolina, Oregon and Utah.

New Orleans Times-Picayune: Louisiana Senate Panel Sinks Plan To Set Up Health Insurance Exchange
[W]ith a decisive 8-1 vote late Tuesday evening, the Louisiana Senate Finance Committee buried a bill that would have set up a body of elected and appointed officials to craft the exchanges that are an anchor of President Barack Obama's health insurance overhaul. With the death of Senate Bill 744, Louisiana remains one of a handful of states that have refused to set up their own exchanges, with Gov. Bobby Jindal punting the job back to federal government that he accuses of taking over the American health care system (Barrow, 5/15). 

Reuters/Chicago Tribune: In Abortion Move, Kansas Pharmacists Can Refuse Some Prescriptions
The Republican governor of Kansas has signed a law allowing pharmacists to refuse to fill prescriptions for drugs they believe may induce abortions, a move opponents said could hinder some women's access to birth control. Governor Sam Brownback's office said on Tuesday that the bill "gives more legal protection to Kansas health care providers who refuse to participate in abortions" based on their conscience (Murphy, 5/15).

Kansas Health Institute News: New Law Extends Legal Protections For Refusal Of Abortion-Related Care
Current law already prohibits forcing health care providers to participate in abortions and protects from lawsuits those who refuse to participate. SB 62 extends that liability protection to all medical care facilities, administrators and governing boards. ... Brownback also signed House Bill 2631, which will allow dental hygienists with a Level III Extended Care Permit to provide more types of care to underserved patients. Procedures allowed under the new permit include certain types of temporary fillings, smoothing chipped teeth, adjusting dentures and applying local anesthetics (5/15). 

The Associated Press/Washington Post: Utah Technology Director Resigns In Wake Of Data Theft At State Health Department
Utah’s chief technology officer has resigned following the theft of hundreds of thousands of online medical records from state computers by unknown hackers (5/15).

Kaiser Health News: Attention Health Care Shoppers: Colorado's Price List For Procedures
Shopping for the best price for a given health care need is nearly impossible. Unlike shopping for other big ticket items, there's no place to compare prices. Providers often can't, or won't, quote a price for a given procedure -- different people are charged different rates based on what kind of coverage they have, or whether they have coverage at all (Whitney, 5/16). 

Boston Globe: Mass. Health Insurers' Earnings Fall Off
After registering sharply higher earnings in 2011, the state's nonprofit health insurers posted falling operating income -- and in two cases, operating losses -- for the first quarter of this year as they handled more medical claims. The early months of the year typically bring more claims. People delay elective procedures until after the holidays and insurance companies have to make payments for supplemental Medicare policies until members meet their deductibles and government funding kicks in. But another factor affected health insurers' finances in the first quarter of 2012: mounting pressure to hold down premiums (Weisman, 5/15).

Fox News: I'm Paying For What?! Mandated Health Insurance Benefits
Ten states require health insurance plans to cover antipsychotic drugs. Nine states say health plans must cover bone marrow transplants. Clinical trials for cancer patients are required benefits in 29 states. Those are just a few examples of state health insurance mandates. As of Dec. 31, 2011, states had enacted 2,262 such laws, according to the "Health Insurance Mandates in the States 2011" report by the Council for Affordable Health Insurance (CAHI) in Washington, D.C. (Marquand, 5/15).

KQED: Cash-Only Practices: Better For Patients Or Just Better for Doctors?
Some primary care doctors around the Bay Area are converting to cash-only practices, rather than taking insurance payments. Doctors who choose this model are leaving some of their patients behind. ... [Dr. Samir Qamar:] "We don' think primary care needs insurance. I think it's ridiculous to pay $500 a month to be treated for a sinus infection every spring. Insurance should be saved for the catastrophes" (Menghrajani, 5/15). 

The Philadelphia Inquirer:  Court To Hear Appeal Of Pa.'s Risperdal Lawsuit
Johnson & Johnson's courtroom fights over Risperdal resume in Philadelphia on Wednesday, when Commonwealth Court judges are scheduled to hear an appeal of decisions to dismiss Pennsylvania's 2008 lawsuit that alleged the company fraudulently profited from sales of the antipsychotic drug through the Medicaid program. While Pennsylvania's case did go to trial in Philadelphia, it did not get far. In 2010, a Philadelphia judge threw out the lawsuit, which sought to show that J&J had tricked the state into paying millions more for the drug than it should have (Sell, 5/16).

California Healthline: Senate Committee Rejects Care Changes
Hearings on the latest round of cuts -- including $2.5 billion in reductions to health care programs in California -- are scheduled to start today ... At last Thursday's Senate subcommittee hearing, government officials proposed several ways to cut back on nursing home regulation. ... The "special fund efficiencies" included elimination of the periodic survey that identifies nursing home deficiencies, and to repeal the 45-day deadline for investigating adverse events at hospitals (Gorn, 5/16).

California Watch: Calif. Schools Employing Fewer Nurses, Librarians
California is issuing fewer credentials for public school service positions. ... School nurse credentials saw the biggest drops, with just 209 issued in 2010-11 – a 26.4 percent decline from 2006-07. At the same time, the number of school nurses employed in public schools fell by 13.3 percent to 2,474 (Lin, 5/16).

North Carolina Health News: NC Faces Potentially Massive Legal Settlement Over Housing For Mentally Ill
Close to a year of negotiations between the state Department of Health and Human Services and the US Department of Justice over North Carolina's practice of housing people with mental health problems in adult care homes could mean the state is on the hook for tens, or even hundreds of millions of dollars. ... The situation dates back to 2010, when Disability Rights North Carolina wrote to the US Department of Justice, complaining about the state' use of adult care homes to house thousands of people with mental health disabilities (Hoban, 5/16).

The Lund Report (an Oregon news service): Customers Of LifeWise Health Plan And Health Net May Expect Rebates
In Oregon, customers from two for-profit insurance companies – LifeWise Health Plan and Health Net of Oregon – are likely to benefit from these [medical loss ratio] rebates, based on financial information filed with the Oregon Insurance Division. At the end of 2011, the medical-loss ratio for LifeWise was 78.3 percent overall compared to Health Net's average of 78.79 percent (Lund-Muzikant, 5/15). 

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Editorials and Opinions

Viewpoints: Sen. Alexander Proposes A Medicaid-School Funding Swap; Doctors' Voices Missing In Abortion Debates

The Wall Street Journal: Time For A Medicaid-Education Grand Swap
When I was governor of Tennessee in the early 1980s, I traveled to meet with President Ronald Reagan in the Oval Office and offer that Grand Swap: Medicaid for K-12 education. The federal government would take over 100% of Medicaid, the federal health-care program mainly for low-income Americans, and states would assume all responsibility for the nation's 100,000 public schools. Reagan liked the idea, but it went nowhere (Sen. Lamar Alexander, R-Tenn., 5/15).

USA Today: Where Are The Doctors?
But there is now an unprecedented and sweeping legal assault on women's reproductive rights. New legislation is being introduced, and sometimes passed, in state after state that would roll back access to abortion and contraception, mainly by intruding on the relationship between doctor and patient (Marcia Angell and Michael Greene, 5/15).

Los Angeles Times: It's Time To Serve Up Some Big Incentives To Curb Obesity
To combat the alarming obesity rate, the Institute of Medicine says the U.S. needs to overhaul everything from farm policies to zoning laws. Clearly, doing nothing isn't an option. At the risk of being criticized (and I know I will be) for advocating draconian measures, I think it's time that food and drink received the same level of regulatory oversight as tobacco and alcohol (David Lazarus, 5/14).

The New York Times: When Competitive Bidding Hurts Patients
Last month, the Obama administration announced that the Centers for Medicare and Medicaid Services would make much greater use of competitive bidding to buy medical equipment for Medicare patients. Because of Medicare's size and position in the health care market, it is likely that this policy will be quickly adopted by Medicaid and private insurers. On the face of it, competitive bidding sounds like a very good idea. ... But as a doctor working with patients on the ground, I have doubts (Dr. Dennis Rosen, 5/15).

Los Angeles Times: Brown's Bloody Budget
Gov. Jerry Brown's May budget revision leaves blood all over the Capitol walls. The era when California governors could make their cuts with a scalpel ended before Brown took office, so he does his trimming with a chain saw. The results are cuts in Medi-Cal payments to hospitals and nursing homes, cuts to those who care for the disabled, cuts to state courts and cuts in hours and pay for state employees. So far schools have been largely spared from this grisly exercise, but that will probably change in November if voters fail to approve a tax-hike initiative (5/15).

Boston Globe: On Health Care, State Doesn't Know Best
Which brings us to the "Health Care Quality Improvement and Cost Reduction Act of 2012," a 178-page bill introduced in the Massachusetts House this month amid jaunty predictions of cheaper insurance premiums for Bay State families and tens of billions of dollars in medical savings over the next 15 years. An even longer bill — 235 pages — has been introduced in the state Senate. These bills aren't written in Latin and they don't impose the death penalty, but their core principle is not much different from Diocletian's: The state knows best (Jeff Jacoby, 5/16). 

The Philadelphia Inquirer: Health Care Losing To Politics
Burnishing his political credentials among the Republican right wing may be the only logical explanation for Gov. Christie's blocking the creation of state health-insurance exchanges, which would aid not only the 1.3 million New Jerseyans without coverage, but also small businesses and people who don't have enough medical insurance. Choosing politics over policy, Christie has caved to party extremists who were calling the exchanges "Christiecare." The term served as a loosely veiled threat to a potential running mate for presumptive GOP presidential nominee Mitt Romney (5/16).

The Philadelphia Inquirer: Medicare Cheaters Are Soaking The Taxpayers
The bottom line is that Medicare and taxpayers are frequently charged for products and services that were never delivered. Stuck in the middle are elderly people who are intimidated into giving up personal information or enticed by deals that are too good to be true. If you or a loved one is covered by Medicare or Medicaid, you can prevent fraud by safeguarding personal beneficiary information just as you would your credit card information. A stolen Medicare number is like a stolen credit card number, except taxpayers are stuck with the fraudulent charges (Rebecca Nurick, 5/16).

Politico: In Budget Debate, 'Past Is Prologue'
[House Republicans are] pretending that the debt-limit crisis they brought about last August, and the subsequent bipartisan deal that kept us from going over the precipice, just never happened. But history matters. The bipartisan Budget Control Act that Republicans agreed to in the wake of their manufactured crisis is now the law of the land. In addition to nearly $1 trillion in budget cuts, this law includes automatic cuts, or sequestration, designed to cut half from defense spending and half from nondefense programs like Medicare, Head Start and other investments in families and communities (Sen. Patty Murray, D-Wash., 5/15).

Politico: GOP Is The Real Party Of American Women
For the past few months, the Democrats have been accusing Republicans of waging a "war on women" as if some honest disagreements between the parties — over matters like how an "Obamacare" mandate should affect religious institutions or the proper scope of federal law on tribal land — constitute a deliberate GOP campaign to take away women's rights. Nothing could be further from the truth, and Republican women have been at the forefront exposing these myths (Rep. Cathy McMorris Rodgers and Rep. Sandy Adams, et. al., 5/15).

The Dallas Morning News: Promoting The Business Of Cancer Research
The Cancer Prevention and Research Institute of Texas has perhaps been praised as much for the responsible way it hands out public funds as for its ambitious mission…. It was therefore a surprise when Dr. Alfred Gilman, the top scientific officer at the institute and the architect of the peer-review system, resigned last week in protest over recent funding decisions…. At issue is a $20 million grant given to a joint project between Rice University and the University of Texas M.D. Anderson Cancer Center. The one-year award, according to Gilman, was given after a cursory examination and based on a "non-scientific description of a plan to conduct early-stage, pre-clinical drug discovery"…. The lesson here is that promoting business, while a core and expanding mission of the institute, needs to be done in the most transparent manner possible (5/15).

Denver Post: A British Expatriate Weighs In On The Affordable Health Care Act
I had lived all my life in the United Kingdom, and took the National Health Care system for granted. ... I then discovered that no such things existed in this country. ... Yes, we had very good medical insurance through my husband's company, but that could be taken away from us at somebody's whim. ... When ACA became law it felt like a great victory for everyone. ... Isn't it time for us to put aside these divisions and work together to make this country a caring, prosperous society that helps people who are not living the American Dream? (Lesley Jackson, 5/16).

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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.