Daily Health Policy Report

Monday, May 21, 2012

Last updated: Mon, May 21

KHN Original Reporting & Guest Opinion

Health Reform

Coverage & Access

Health Care Marketplace

Campaign 2012

Capitol Hill Watch

Medicare

Public Health & Education

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Higher Prices Charged By Hospitals, Other Providers, Drove Health Spending During Downturn

Kaiser Health News staff writer Julie Appleby reports: "Higher prices charged by hospitals, outpatient centers and other providers drove up health care spending at double the rate of inflation during the economic downturn– even as patients consumed less medical care overall, according to a new study" (Appleby, 5/21). Read the story.

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Second Guessing Medicare's Star Rating System

Kaiser Health News staff writer Marilyn Werber Serafini, working in collaboration with The Washington Post, reports: "As the federal government pumps billions of bonus dollars into private Medicare health plans to encourage better care, the quality rating system used to award the bonuses is coming under increasing fire" (Werber Serafini, 5/20). Read the story.

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Capsules: Sebelius Tells Georgetown Students To Follow Their Own Moral Compass

Now on Kaiser Health News' blog, Christian Torres reports: "About 200 students earned degrees this year from Georgetown University's Public Policy Institute, but most of the attention at Friday's graduation ceremony was focused on one person: Kathleen Sebelius. The Health and Human Services Secretary gave commencement remarks – with only one major interruption – to a largely supportive audience" (5/28). Check out what else is on the blog.

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Political Cartoon: 'Sky High?'

Kaiser Health News provides a fresh take on health policy developments with "Sky High?" by Lisa Benson.

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

OH YES, WAIT A MINUTE MR. POSTMAN

Innovator grants
As justices mull the law
Check is in the mail?
-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

Some States Taking Federal Funds Are Still Hesitant About Building Health Exchanges

Several articles look at the efforts around the country to establish these insurance marketplaces.

CQ HealthBeat: On Exchanges: The Money Is There But States Still Drag Their Feet
Health and Human Services officials dispatched $181 million in grants to six states this week to help establish health insurance exchanges. But some state officials who are about to receive checks aren't rushing to create the new marketplaces. News reports from Illinois, South Dakota and Tennessee indicate that despite the additional money, governors and state legislators remain loath to move forward on setting up the marketplaces for individual and small group insurance policies that are supposed to launch in 2014 (Norman, 5/18).

Minnesota Public Radio: Federal Officials To Review Minn.'s Progress On Health Exchange
Minnesota Commerce Department officials say federal officials will review the state's progress on developing a key part of the federal health care overhaul next week. ... The federal officials will assess Minnesota's progress in developing a central pillar of the federal health care overhaul, the state health insurance exchange (Stawicki, 5/18).  

Modern Healthcare: Somewhere In The Middle
The outlook for the establishment of state-run health insurance exchanges may be neither as rosy as their supporters claim nor as dark as their critics expect. Even as several states recently rejected the insurance marketplaces required by the 2010 U.S. healthcare overhaul, federal regulators laid out a path that will make it easier for states to change their minds and give more time for them to do so. The combined effect of the disparate federal and state actions indicates that state-run exchanges are less likely in the original time frame of 2014 and more likely over a longer period (Daly, 5/19).

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Two Health Care Nonprofit Co-Ops Receive Health Law Loans

These two co-ops, located in Nevada and Michigan, received a total of $135 million in loans from the Centers for Medicare & Medicaid Services.  

CQ HealthBeat: More Than $135 Million In Loans Made To Health Co-ops In Nev., Mich.
Health and Human Services officials announced Friday that they have awarded loans to two more health care nonprofit co-ops, one in Nevada and one in Michigan. The Hospitality Health Co-op in Nevada was awarded $65.9 million and is sponsored by the Culinary Health Fund, the United HERE labor union and the Health Services Coalition, according to an announcement from the Centers for Medicare and Medicaid Services (Norman, 5/18).

Modern Healthcare: Add Michigan, Nevada To CO-OP List
Michigan and Nevada on Friday became the latest states to receive Consumer Operated and Oriented Plan, or CO-OP, loans from the CMS, bringing the award total to more than $982 million for these not-for-profit insurers created by the Patient Protection and Affordable Care Act. Directed by customers, CO-OPS are supposed to offer both small businesses and individuals more-affordable health insurance options and will be offered through the health insurance exchanges or in plans outside the exchanges starting on Jan. 1, 2014 (Zigmond, 5/18).

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Coverage & Access

New Poll Explores What It's Like To Be Sick In The United States

A poll by NPR with the Robert Wood Johnson Foundation and Harvard School of Public Health asked people to share their experiences with the health care system.   

NPR's Shots Blog: Poll: What It's Like to Be Sick In America
In the lull between the Supreme Court arguments over the federal health overhaul law and the decision expected in June, we thought we'd ask Americans who actually use the health system quite a bit how they view the quality of care and its cost (Knox and Neel, 5/21).

NPR: Stories Of Being Sick Inside The U.S. Health Care System
To get a feeling for what being sick in America is really like, and to help us understand the findings of our poll with the Robert Wood Johnson Foundation and the Harvard School of Public Health, NPR did a call-out on Facebook. We asked people to share their experiences of the health care system, and within 24 hours, we were flooded with close to 1,000 responses (Knox and Neighmond, 5/21).

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Health Care Marketplace

Study Explores What Factors Drive Health Care Spending

A report out today from the Health Care Cost Institute analyzed what insurers and households paid for medical care from 2007 to 2010.  

The Washington Post: Data Trove May Shed Light On Health-Care Uncertainties
How much do hospitals and doctors actually charge insurers for their services? How much and which of those services are privately-insured patients using? And, most significantly, what drives changes in health-care use, costs, and total spending? (Aizenman, 5/21).

Politico: Study: Higher Prices For Care May Be Driving Health-Care Costs
A new study could pose a challenge to the basic premise of President Barack Obama's approach to controlling health costs — that spending will come down if doctors don't give patients as much unnecessary medical care (Feder, 5/21).

Kaiser Health News: Higher Prices Charged By Hospitals, Other Providers, Drove Health Spending During Downturn
Higher prices charged by hospitals, outpatient centers and other providers drove up health care spending at double the rate of inflation during the economic downturn– even as patients consumed less medical care overall, according to a new study (Appleby, 5/21). 

Bloomberg: Health-Care Costs Rise Faster Than U.S. Inflation Rate
Doctors, hospitals and drugmakers raised prices faster than inflation in 2010, driving U.S. health costs higher as fewer Americans sought care after the recession. Spending on workers covered on the job grew 3.3 percent per person in 2010, twice the general inflation rate, according to a report today from the Health Care Cost Institute, a Washington group that examined data from insurers including UnitedHealth Group Inc. (UNH) and Aetna Inc. (AET) While costs increased, enrollment in employer-sponsored plans declined, the researchers said (Nussbaum, 5/21).

Modern Healthcare: Rising Prices Drove Higher Spending Among Commercially Insured: Study
Rising prices meant higher health spending for patients with insurance through a job in 2010 even as demand for medical care stagnated, according to the first report generated from a trove of claims data from private insurers. The report, which analyzed what insurers and households paid for medical care from 2007 to 2010, was released by the Health Care Cost Institute, a not-for-profit with access to insurance claims from Kaiser Permanente, Aetna, Humana and UnitedHealthcare. The project was launched last year (Evans, 5/21).

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DaVita To Buy Privately Held HealthCare Partners

The deal between the dialysis services provider and the doctor network operator is estimated to tally $4.42 billion in cash and stock.

Reuters: DaVita Eyes New Markets With $4.4 Billion HealthCare Deal
DaVita Inc, the biggest U.S. operator of dialysis clinics, has agreed to buy privately-held HealthCare Partners for about $4.42 billion in cash and stock to expand into new markets to help offset potential revenue pressures in its main business. ... The deal follows changes to the way health care companies are reimbursed by U.S. state-run health insurer Medicare which could put pressure on revenues across the industry (5/21).

The Associated Press: DaVita To Buy HealthCare Partners In $4.42B Deal
Kidney dialysis services provider DaVita Inc. said Monday that it has agreed to buy the doctor network operator HealthCare Partners in a cash-stock deal worth about $4.42 billion. ... HealthCare Partners manages and runs medical groups and doctor networks, with operations in California, Nevada and Florida. It coordinates care for more than 667,000 patients and provides primary and specialty doctor care. HealthCare Partners had $2.4 billion in revenue last year (5/21).

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Campaign 2012

Gallup Poll: Obama Edges Out Romney On Health Care Issues, But Romney Leads On The Budget Deficit

This new survey measures how the public views President Barack Obama and GOP presidential hopeful Mitt Romney on three top issues. Meanwhile, news outlets examine how candidates and organizations are positioning themselves on the campaign trail.

Politico: Poll: Barack Obama, Mitt Romney On 3 Top Issues
Eighty-four percent believe that the cost of health care is an extremely or very important issue facing the country; 82 percent believe the same for unemployment; and 82 percent believe so for the federal budget deficit, the Gallup survey shows. Obama and Romney split ownership of the top three issues: Obama is preferred over Romney 51 percent to 44 percent on the issue of health care; while Romney beats Obama 54 percent to 39 percent on the issue of the budget deficit (Mak, 5/21).

The Associated Press: Romney, U.S. Sen. Brown Play Down Past Connections
Democrats are busy trying to make voters aware of the ties between Romney and Brown, especially in Massachusetts, where Brown faces a tough fight against likely Democratic challenger Elizabeth Warren. Democrats note that Romney and Brown both supported an amendment in the Senate this year that would have allowed employers or health insurers to deny coverage for services they said violated their moral or religious beliefs, including birth control. The amendment failed (LeBlanc, 5/21).

Des Moines Register: Romney Targets Swing State Voters In Conference Call With Iowans
Romney had a specific message for seniors and young voters. "Seniors are having a hard time with this president and have been very disappointed," he said. "One thing I can tell you, I'm not going to be out there cutting Medicare. I'm going to make sure that we keep Medicare solvent, and Social Security solvent, so our seniors can always depend on a program which is not just there for them but is there for coming generations" (Jacobs, 5/18).

Reuters: Top Republican Woman In Congress Becomes A Force
[Rep. Cathy] McMorris Rodgers said she is determined to court women to support the Republican Party -- and Mitt Romney's bid for president -- by talking about pocketbook issues such as jobs and health care. That includes eliminating Obama's health care overhaul, which she says is too expensive and hurts small businesses. "Republicans who only talk about finances are not going to attract women voters," McMorris Rodgers said. "Let's talk about health care choices ... families, raising children and trying to find a job in a tough economy. These are women's issues and Republican issues for 2012" (Ferraro, 5/18).

And a health care group spent more than $44 million in 2010 to help fund TV ads attacking Democrats --

Politico Pro: Report: 'Patients' Rights' Group Funded Ads
A group that sounds like it's entirely focused on health care doled out more than $44 million in 2010 to other tax exempt groups that aired television ads attacking Democrats, according to an investigation by the Center for Responsive Politics released Friday. The Center to Protect Patients’ Rights has begun spending money on similar attempts this year, according to the CRP, a nonpartisan money-tracking group (Haberkorn, 5/18).

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Capitol Hill Watch

GOP Leaders Link Efforts To Control Health Entitlement Spending To Debt Ceiling Hike

Boston Globe: Boehner Sticks By Call For Linking Spending Cuts, Debt Ceiling Hike
In an appearance on NBC's "Meet the Press," Representative Paul Ryan of Wisconsin, a Republican, backed Boehner and blamed Democrats for what he characterized as their unwillingness to curtail expensive health care entitlements. "If we fix the programs that are the drivers of our debt, then we reduce a debt crisis likelihood,"’ Ryan said. "Then we actually bring borrowing down, which opens up certainty for investors" (Borchers, 5/21).

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Medicare

Medicare Expenditures, Quality Rating System Grab Headlines

Kaiser Health News looks at criticisms of the government's program for rewarding higher-quality Medicare Advantage plans, while Modern Healthcare reports on a memo from the Medicare actuary that projects expenditures in the federal health care program.

Kaiser Health News: Second Guessing Medicare's Star Rating System
As the federal government pumps billions of bonus dollars into private Medicare health plans to encourage better care, the quality rating system used to award the bonuses is coming under increasing fire (Werber Serafini, 5/20). 

Modern Healthcare: CMS Actuaries See Higher Medicare Costs
Based on the premise that the 2012 Medicare Trustees Report's projections are "clearly unrealistic," a new memo from the CMS Office of the Actuary lays out hypothetical alternatives that estimate higher expenditures for the federal healthcare program. The annual Medicare Trustees Report is based on projections under current law; the most recent report was released last month. But the report portrays a view that is too optimistic, the CMS memo contends, as it incorporates mandated reductions for most Medicare services (Zigmond, 5/20).

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Public Health & Education

Legislation Takes New Approach To Reducing Cost Of AIDS Drugs

News outlets report on efforts to address the cost of drugs for HIV/AIDS as well as other related developments.

The Washington Post: 'Radical' Bill Seeks To Reduce Cost Of AIDS Drugs By Awarding Prizes Instead Of Patents
Prizes, not patents. That could be the slogan for a radical idea that leading economists say would lower the price of new drugs for treating HIV/AIDS (Vastag, 5/19).

CQ HealthBeat: U.S. Continues Action On AIDS Drugs, Testing As July Global Summit Nears
As Washington prepares for a major international AIDS conference this summer, developments on the drug front are once again elevating the subject of the continuing epidemic in the public eye. Advisory panels recommended recently that the Food and Drug Administration approve both a drug to prevent the HIV infection and an at-home diagnostic kit. Also, Sen. Bernard Sanders is offering a way to reduce the steep costs of drug treatments for people with HIV and AIDS (Norman, 5/18).

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Teen Diabetes Soars -- A Sign Of The Obesity Epidemic

NPR: A Dire Sign Of The Obesity Epidemic: Teen Diabetes Soaring, Study Finds
Karlton Hill was only 12 years old when when he found out he had diabetes. Even though he was only in seventh grade, Karlton knew what diabetes was; he had watched the disease destroy his great-grandmother's life (Stein, 5/21).

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State Watch

Calif. Petitions Submitted In Effort To Get Ballot Measure To Tighten Regulation Of Health Insurance Rates

Supporters are seeking a November vote on proposal that would allow state regulators to reject rate increases.

Los Angeles Times: Backers Of Health Insurance Rate Regulation Edge Closer To Ballot
Supporters of a proposed ballot measure seeking tighter regulation of health insurance rates in California turned in 800,000 petition signatures, confident that they will qualify for the Nov. 6 election (Terhune, 5/19).

Sacramento Bee: Petitions To Be Submitted On Health Insurance Rates In California
Supporters of a proposal to give state regulators power to reject health insurance rate increases say they are submitting 800,000 voter signatures to election officials in hopes of qualifying for the November ballot. ... Under the proposed initiative, changes to heath insurance policy rates would need approval from the state insurance commissioner. Voters approved a similar process for auto insurers, also backed by Consumer Watchdog, in 1988 (Van Oot, 5/19).

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Colo. Gov. To OK Medicaid Payment Pilot Program, And Other Medicaid News

Medicaid programs are covered by news outlets in Colorado, New York, Illinois, Minnesota and Georgia.

Modern Healthcare: Colo. Governor Expected To Sign Medicaid Payment Reform
A bipartisan bill in Colorado creating a Medicaid payment reform and innovation pilot program is expected to be signed soon by Gov. John Hickenlooper. Co-sponsored by state Reps. Cheri Gerou and Dave Young, the measure creates a process by which the state's health care policy and financing department would pilot-test fee-for-service alternatives and regional care collaborative organizations. Pilots could incorporate elements such as global payments, risk-sharing and aligned payment incentives (Robeznieks, 5/20).

Modern Healthcare: N.Y. Medicaid Development Center Rates Too High: Audit
The New York Medicaid program provided $1.4 billion in "excessive" payments to development centers in a recent year, HHS' inspector general found. The finding, which came amid continued budget pressure to reduce the cost of the New York Medicaid program, has spurred the state and the CMS to initiate a reset of those rates (Daly, 5/18).

Chicago Sun-Times: Senate Democrats' Spending Plan Offers Deeper Cuts Than Quinn Proposed
Senate Democrats on Friday outlined a spending plan that cuts deeper than Gov. Pat Quinn's budget proposal, shaving about $250 million more from areas such as human services and public safety -- but Republicans contended still more cuts were needed. The plan assumes legislators will come to terms on big-ticket items such as a Medicaid package that plugs a $2.7 billion hole as well as facility closures. Democratic budget leaders did not specify how those items would come together, although they did suggest a Medicaid solution was imminent (Maloney, 5/18). 

Minneapolis Star Tribune: Feds Probe Minnesota's Medicaid Bills
Congressional investigators are raising new questions about how Minnesota bills federal taxpayers for Medicaid costs, seeking evidence that the state has been overpaying state Medicaid contractors to cover losses from state-run public health programs. The letter to Minnesota Human Services Commissioner Lucinda Jesson, obtained Friday by the Star Tribune, revives allegations of inflated payments and represents an escalation in one of three continuing federal probes into the state's use of Medicaid funds over the past decade under Republican and Democratic governors. It comes three weeks after a U.S. House panel made the state the focus of a grueling public hearing (Diaz, 5/18). 

Georgia Health News: Progress On Mental Health, But Gaps Remain 
Former first lady Rosalynn Carter said Friday that she has concerns about how Georgia's restructuring of its Medicaid program will affect the state's revamped mental health system. Mrs. Carter also noted that while the state's 2010 agreement with the Department of Justice to improve Georgia's mental health system is "a good settlement," it fails to address the needs of children and adolescents (Miller, 5/18). 

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State Roundup: Fla. Dismisses Fraud Cases

A selection of health policy news from Florida, Texas, Kansas, Massachusetts, New York, California and North Carolina.

Health News Florida: Legal Opinion Kills Fraud Case
Professional boards have always held doctors and dentists responsible for filing accurate claims and honest bills. Deliberate overcharges or fraud could end a career. Now a legal opinion in a South Florida dental case has placed that assumption in question (Gentry and Sexton, 5/18).

The Texas Tribune: TDI Won't Seek Federal Funds to Prolong Health Program 
The Texas Department of Insurance will not reapply for a federal grant to prolong a program designed to help Texans navigate the health insurance market, agency spokesman John Greeley confirmed on Friday. The state-run Consumer Health Assistance Program was established in 2010 under federal health reform to help consumers enroll in health coverage and file complaints and appeals against health plans. Texas CHAP staffers have given public service announcements, made field presentations and taken calls on a hotline that helped an estimated 9,000 Texans last year (Park, 5/18). 

Kansas Health Institute News: Gavels Drop On 2012 Legislature
The Kansas Legislature ended its longest ever wrap-up session on Sunday evening after both chambers worked through the weekend and finally agreed to a budget plan. ... [Legislators] failed to agree on creating a new legislative committee to oversee the implementation of KanCare, the governor's proposed Medicaid makeover, which is scheduled to begin Jan. 1, pending federal  approvals (Shields, 5/20).

WBUR's CommonHealth blog: Deval Patrick On Health Reform: Not Persuaded Hospital 'Luxury Tax' Needed
[Gov. Patrick]: "You're talking about the differences between what some of the downtown medical centers and the community hospitals charge for similar -- I would say similar and routine procedures. And that's a concern. Now some of that is addressed by greater transparency and making sure that people know what the charges are ... I had a hip replaced a few years ago and you could go online and see the difference between what the cost of that hip replacement would be at a community hospital or the downtown medical center where I had it done, but in either case my co-pay was 100 bucks; so -- no skin" (Goldberg, 5/18).

Bloomberg: Health Bargain Hunters Use Websites to Cut Doctor Bills
Surgery to remove your appendix in one California hospital could cost $180,000. Have the operation at a different facility in the same state and the bill might be as little as $1,500.  That kind of disparity, typical across the country, combined with escalating medical spending and the increasing amount of data available online, has prompted several startups to get into the business of helping companies and their employees save health-care dollars. "This is about changing the way people shop for health care, and as a consequence, changing the way care gets delivered," said Giovanni Colella, co-founder of Castlight Health Inc., a San Francisco-based company that helps patients shop for medical care (Flinn, 5/21). 

Boston Globe: State Allows Pharmacies To Offer More Vaccines
Get ready to see more advertisements in Massachusetts pharmacies for a wide variety of vaccines that consumers will now be able to receive in the stores. A new policy adopted by state health regulators grants pharmacists the authority to administer 10 adult vaccines in addition to the annual flu shot they already can give. The new vaccines being offered are for measles, mumps, and rubella; tetanus, diptheria, and whooping cough; shingles; pneumonia; hepatitis A; hepatitis B; polio; HPV; chickenpox; and meningitis (Lazar, 5/21).

The New York Times: Down To One Hospital, Rockaway Braces For Summer Crowds
Summer is coming to the Rockaway Peninsula, the thin strip of land lapped on either side by Jamaica Bay and the Atlantic Ocean. And with the warmth will come the usual hordes who play and bask on its beaches, and, inevitably, suffer heatstroke, volleyball sprains, beach glass lacerations and near-drownings -- the sorts of seaside scrapes that send people to the emergency room every season (Nir, 5/20).

WBUR: Wellesley Economist Finds Income Inequality Drives Teen Birth Rate
[R]esearchers say they have now found a connection between income inequality and the teen birth rate. Despite declining in recent years, the U.S. still has the highest rate among developed countries. ... [W]hile other research has shown that poor teens are considerably more likely to give birth than those whose families are at middle-and-high-income levels, [Wellesley College economist Phil] Levine said the issue goes much deeper (Oakes and Jolicoeur, 5/21).

Boston Globe: Hospitals Mobilize On Health Cost Bill
Last Monday, leaders from Partners HealthCare System Inc. gathered in the dark-paneled office of Massachusetts House Speaker Robert DeLeo to lay out their objections to his expansive 278-page plan to tame health care costs. The House proposal, unveiled 10 days earlier, called in part for closer oversight of the prices and operations of hospitals and their physicians groups, especially more costly ones like those owned by Partners, and influential board chairman Jack Connors requested a meeting (Kowalczyk, 5/20).

California Healthline: Slower, Phase-In Approach For CBAS
The Department of Health Care Services has announced the conversion of adult day health care centers to a managed care system has been divided into a two-part process. About 12 percent of the centers, which serve about 8 percent of the state's ADHC population, will still make the conversion to managed care by July 1. That leaves the bulk of the centers -- including Los Angeles County centers which  serve two-thirds of the state's Medi-Cal beneficiariens receiving ADHC care -- to make the transition three months later, on Oct. 1 (Gorn, 5/21).

North Carolina Health News: Remote Stroke Treatment Helps Save Lives Around N.C.
For years, Lexington’s ED had telephoned neurologists to get a second opinion on a patient’s eligibility for [a Food and Drug Administration-approved drug called] tPA.  Like many rural EDs, Lexington does not have a neurologist on staff, so they conferred with neurologists like [Charles H.] Tegeler about CT scans and other patient examinations over the phone.  But in December 2009, this process became more high tech. Some patients have called Tegeler "the robot doctor."  It's no wonder, because the first look they get at Tegeler is when the doctor drives a 5-foot-tall machine into their room, Tegler's face clearly visible on the monitor. He's in Winston-Salem; they're in one of nine North Carolina hospitals that contract with Wake Forest Baptist for its telestroke services (Braden Balderas, 5/21). 

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Editorials and Opinions

Viewpoints: A Gamble On Alzheimer's Research; Hidden Costs Of Insurance Rebates

The New York Times: A New Attack On Alzheimer's
The Obama administration has announced a bold research program to test whether a drug can prevent the onset of Alzheimer's disease well before any symptoms appear. It is a long shot, but the payoff could be huge (5/20).

The New York Times' Opinionator: Entitlement Reform For The Entitled
When it comes to Social Security and Medicare, Republicans emphasize cuts and privatization, while Democrats strongly oppose both approaches. ... But here is a better bipartisan reform: Graduated eligibility. Instead of having a fixed age at which people can get Social Security and Medicare, we should link the age of eligibility to lifetime wealth. The richer you are, the older you would have to be to be eligible for Social Security and Medicare (Ezekiel J. Emanuel, 5/20).

Forbes: Putting The 'Insurance' Back In Health Insurance
If we really want to make health insurance affordable and accessible to everyone, we need to go back to basics, and understand all of the government-induced distortions that have made health insurance look nothing like actual insurance. ... Reforming the system involves, first and foremost, encouraging people to buy insurance for themselves, by eliminating the tax-code discrimination against individually purchase health insurance. Second, people should be able to buy insurance across state lines. ... Third, we should eliminate federal mandates that drive up insurance costs, especially in the individual market (Avik Roy, 5/21).

The New York Times: Waiting For Health Care
This Op-Doc video, adapted from my feature-length documentary "The Waiting Room," presents a composite day in the life of patients at Highland Hospital in Oakland, Calif. — edited from five months of filming in 2010 (Peter Nicks, 5/20).

Roll Call: Health Care Plan Rebates Have Hidden Costs
Some consumers and businesses might see a little extra cash this summer as a result of the 2010 health care law. ... The rebates are required by an obscure regulation in the health care law, called the "minimum loss ratio," which also contains longer-term incentives for health insurers to increase costs that will be passed along to all of us. Instead of rushing to spend these extra dollars, rebate recipients are better off pocketing it to pay for higher premiums in the future (Christopher Conover and Jerry Ellig, 5/21).

Des Moines Register: Medicare Payment Board Merits Repeal
More than 500,000 seniors in Iowa rely on Medicare for their health care needs — and they might be in for a surprise next year. Unless Congress takes action to stop it, a new all-powerful government panel called the Independent Payment Advisory Board could soon force dramatic reductions in seniors' access to health care under Medicare (Jim Swanstrom, 5/18).

Los Angeles Times: A Campaign Bombshell
At first glance, the political implications might look simple. If the court upholds the law, Obama's biggest legislative achievement, the president wins; if the court declares the law unconstitutional, he loses. But as with many things in politics, it may not be that simple at all (Doyle McManus, 5/20).

iWatch: Spinning The Supreme Court's 'Obamacare' Decision
The reason Obamacare is built around the individual mandate is because of the relentless lobbying by insurers, and not just on Capitol Hill. Representatives of the industry made frequent trips to the White House during the debate on reform to twist the arm of President Obama, who had campaigned against the mandate when he was running for president (Wendell Potter, 5/21).

Politico: Deb Fischer: Anatomy Of An Upset
In the closing week – just as late deciders were tuning in – [Nebraska Republican Senate candidate Deb] Fischer signed the Repeal Pledge, a comprehensive promise to repeal, push back, defund and dismantle "Obamacare." ... How did that turn out? Well, among Nebraska primary voters, "Obamacare" repeal ranked highest of any single issue as the determining factor in the respondent's vote. Roughly 57 percent of respondents said that Fischer signing the Repeal Pledge mattered to them (Hadley Heath and Heather R. Higgins, 5/19).

USA Today: The Fatter The Nation Is, The More You Pay
Ever wonder why health care costs keep rising faster than inflation? One major contributor is America's struggle with weight. Estimates of the cost of treating obesity-related conditions run from $150 billion to $190 billion a year, the majority of which is passed on to others in the form of higher insurance premiums and government expenditures. The fatter the nation is, the more you pay (5/20).

Bloomberg: U.S. Obesity Plateau Shows What Works In Weight Battle
Obesity has become a danger far greater than hunger. Yet amid the alarming stories about its harm to America's health and economy, one bit of information has been drowned out: The percentage of U.S. adults who are obese appears to have plateaued. ... It should not, however, be reason to give up the fight. Rather, the findings lead us to twin conclusions: We can make gains against obesity, and we should find ways to accelerate that progress (5/20). 

San Francisco Chronicle: Congress Needs To Fund Veteran's Services
No one should have to wait a year or more to have his or her claim decided, especially if suffering from post-traumatic stress disorder and traumatic brain injury after multiple combat deployments. ... Do we really think that overworking VA staffers will result in better efficiency and accuracy? And, given the time it takes to train new workers, we are looking at years before that situation improves. Better to call in federal retirees and train veterans coming out of the current wars as claims processors (Douglas Nelson, 5/21).

Boston Globe: Doctors, Hospitals Should Back Blue Cross On Painkillers
Blue Cross Blue Shield of Massachusetts is taking a measured step to curb the abuse of prescription painkillers by limiting the amount of medication a patient can receive without the insurer's prior approval. There is some concern that the plan could inconvenience legitimate sufferers and burden busy doctors with extra documentation. But on balance, this is a carefully crafted approach that other health plans would do well to duplicate (5/21).

Arizona Republic: Prison Health Care Needs Overhaul, Not Simple Outsourcing
Last week, the Arizona Department of Corrections responded to the lawsuit by denying claims that they have ignored the basic health-care needs of prisoners. The response comes on the heels of a prior announcement by the state prison system that it will outsource the delivery of health care to Wexford -- a for-profit prison corporation that critics say has a history of incompetence, waste and corruption. As bad as conditions are in the Department of Corrections, the state's decision to hire Wexford will only make things worse (Doris Marie Provine, 5/20).

Los Angeles Times: Old Folks Have To Live Somewhere
People generally don't think of the elderly as nuisance neighbors. They rarely throw loud late-night parties, play loud music or have loud sex. Nevertheless, the issue of elderly group homes is a controversial one in single-family neighborhoods (5/20).

Chicago Sun-Times: County Health Struggle Moves To Springfield
[A] waiver would let 100,000 low-income people in Cook County [Ill.] join Medicaid in July. The problem is, when the legislature was banning people from signing up for Medicaid, it neglected to also adopt a law banning them from being sick. So the last-resort county hospitals -- Stroger and Provident, plus 16 ambulatory care clinics — are forced to treat more people for free than they already do: some 55 percent, 80 percent in the ERs. That is not a healthy business model (Neil Steinberg, 5/20).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Ankita Rao
Marissa Evans

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2012 Kaiser Health News. All rights reserved.