Daily Health Policy Report

Tuesday, May 21, 2013

Last updated: Tue, May 21

KHN Original Reporting & Guest Opinion

Health Reform

Medicare

Capitol Hill Watch

Health Information Technology

Quality

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

How Will The 'Unbanked' Buy Insurance On The Exchanges?

Kaiser Health News staff writer Sarah Varney, working in collaboration with NPR, reports: "When movie stars become unbankable, they’re no longer a slam dunk at the box office. When investments become unbankable, they’re relegated to the junk pile. For ordinary Americans deemed unbankable, those who don’t have a traditional checking or savings account, it can be hard to simply pay bills. And that is about to become a big problem for those who also lack health coverage -- and for the health insurance companies trying to sell them coverage. After all, how do you sell a product to a customer who has no way to pay you?" (Varney, 5/20). Read the story.

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Texas' Rio Grande Valley Presses For Medicaid Expansion

Kaiser Health News staff writer Sarah Varney, working in collaboration with NPR, reports: "When the sun rises over the Rio Grande Valley, the cries of the urracas – black birds – perched on the tops of palm trees swell to an unavoidable cacophony. That is also the strategy, it could be said, that local officials, health care providers and frustrated Valley residents are trying to use to convince Gov. Rick Perry and state Republican lawmakers to set aside their opposition and expand Medicaid, a key provision of the federal health law" (Varney, 5/21). Read the story.

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Insuring Your Health: Some Individual Policies Offer A Way To Shrink Deductibles

Kaiser Health News consumer columnist Michelle Andrews writes: "There is no free lunch. As more people buy high-deductible health plans, they're discovering that while premiums for such plans are more affordable, the trade-off can be high out-of-pocket costs before coverage kicks in. However, some plans sold on the individual market offer a way for healthy people to shrink their deductibles. Under these so-called deductible-credit plans, the deductible diminishes year by year for policyholders who don't spend a lot on health care" (Andrews, 5/21). Read the column.

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Political Cartoon: 'This Is Only A Test?'

Kaiser Health News provides a fresh take on health policy developments with "This Is Only A Test?" by Nick Anderson.

Meanwhile, here is today's health policy haiku:

PROMISE VS. POLITICS

Rio Grande Valley 
wants Medicaid expansion.
Governor says, "No." 
-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

Implementation Issues: Coverage 'Ping Pong' Among Emerging Concerns

The notion of how life events could cause disrupted health coverage is a focus for policy makers. In addition, news outlets also are reporting on developments related to high-risk pools, and a break between the White House and organized labor regarding how the implementation process is shaping up.

Los Angeles Times: Some Could Have Gaps In Medical Coverage Under New Law
When the national health care law takes full effect next year, millions of Americans risk disrupted health coverage because of common life events: getting married or divorced, having children or taking on a second job. As their family incomes change, so too will their eligibility for public insurance programs. And if nothing is done, policymakers warn, many low-income patients will lose access to their doctors and medications during this massive game of health coverage pingpong. Policymakers and health care industry leaders across the nation are paying close attention to the issue and working to close the coverage gaps before Jan. 1, said Alan Weil, executive director of the National Academy for State Health Policy (Gorman, 5/20).

The New York Times: Overruns Forcing Lower Payments To Some Providers In Stopgap Health Program
The Obama administration said Monday that it was cutting payments to doctors and hospitals after finding that cost overruns are threatening to use up the money available in a health insurance program for people with cancer, heart disease and other serious illnesses (Pear, 5/20).

The Hill: Labor Unions Break Ranks With White House On ObamaCare
Labor unions are breaking with President Obama on ObamaCare. Months after the president's reelection, a variety of unions are publicly balking at how the administration plans to implement the landmark law. They warn that unless there are changes, the results could be catastrophic (Bogardus, 5/21).

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Marketing New Health Insurance Options Poses Challenges

The Wall Street Journal explores issues surrounding the health law's "navigators," a small army of people who are supposed to help millions of Americans sign up for coverage. Meanwhile, Kaiser Health News reports on questions about how the one in five households who lack traditional bank accounts will be able to pay their insurance bills.

The Wall Street Journal: Role Of Health-Law 'Navigators' Under Fire
Lawmakers across the country are tussling over the Obama administration's plans to create a small army of assistants to guide millions of Americans as they sign up for new health-insurance options available this fall. Backers of the health-care overhaul face an uphill battle to spread the word about the law, in the face of consumer research that suggests most uninsured people know little about it and are skeptical about the value of health insurance generally. Some Democrats have openly worried that the administration is doing too little to make sure the enrollment process goes smoothly (Radnofsky, 5/20).

Kaiser Health News: How Will The 'Unbanked' Buy Insurance On The Exchanges?
When movie stars become unbankable, they’re no longer a slam dunk at the box office. When investments become unbankable, they’re relegated to the junk pile. For ordinary Americans deemed unbankable, those who don’t have a traditional checking or savings account, it can be hard to simply pay bills. And that is about to become a big problem for those who also lack health coverage -- and for the health insurance companies trying to sell them coverage. After all, how do you sell a product to a customer who has no way to pay you? (Varney, 5/20).

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Ground Battles Continue Over States' Medicaid Expansion

News reports from Texas, Louisiana, Iowa, Florida and Maine highlight states' continuing debates over this health law provision.

Kaiser Health News: Texas' Rio Grande Valley Presses for Medicaid Expansion
When the sun rises over the Rio Grande Valley, the cries of the urracas – black birds – perched on the tops of palm trees swell to an unavoidable cacophony. That is also the strategy, it could be said, that local officials, health care providers and frustrated Valley residents are trying to use to convince Gov. Rick Perry and state Republican lawmakers to set aside their opposition and expand Medicaid, a key provision of the federal health law (Varney, 5/21).

The Texas Tribune: House Gives Early OK To Medicaid Expansion Ban
In a surprise turn in the House on Monday evening, a bill to reform Medicaid long-term and acute care services became a vehicle for the GOP’s platform against Medicaid expansion…Leach’s amendment — which was adopted with a vote of 87 to 57 — would prohibit the Health and Human Services Commission from providing "medical assistance to any person who would not have been eligible for that assistance and for whom federal matching funds were not available" under the state’s existing criteria for medical assistance (Aaronson, 5/20).

Dallas Morning News: House OKs Requiring Legislative Input On Medicaid Expansion
The Legislature would have to approve any enlargement of Medicaid under a provision approved by the House late Monday. Medicaid expansion “is too big a decision for the future of this state to be made by one person,” said Rep. Jeff Leach, R-Plano, the provision’s author. Leach complained that unless lawmakers change existing state law, Gov. Rick Perry with one phone call could direct state social services overlord Kyle Janek to negotiate a deal with President Barack Obama’s administration on accepting federal dollars to cover about 1 million uninsured adults in Texas (Garrett, 5/20).

The Associated Press: La. Senate Budget Committee Stalls Medicaid Expansion
State senators rejected a proposal on Monday for Louisiana to offer government-subsidized health insurance to the working poor through the federal health overhaul law known as the Affordable Care Act. The 7-3 vote by the Senate Finance Committee largely fell along party lines, with all but one Republican voting against tapping into the federal Medicaid dollars available for the health coverage (Deslatte, 5/20).

New Orleans Times Picayune: Louisiana Senate Panel Kills Medicaid Expansion Measure
Legislation allowing Louisiana to use federal health overhaul dollars to expand Medicaid eligibility standards and to pay for private health insurance plans was deferred in committee Monday, effectively killing it for the remainder of the legislative session. Senate Bill 125, by Sen. Karen Carter Peterson, D-New Orleans, known as the Louisiana Health Care Independence Program, was heavily amended in committee in April to echo legislation that passed through the Arkansas Legislature. The model, known as the Arkansas plan, required the Department of Health and Hospitals to accept federal dollars under the Affordable Care Act (Kumar, 5/20).

The Associated Press: Branstad Says He's Open To Health Care Compromise
Gov. Terry Branstad said Monday he was prepared to consider accepting federal Medicaid expansion funding as part of a compromise health care plan for low-income Iowans. Branstad has opposed expanding the Medicaid program in the state, which is permitted under President Barack Obama's health care overhaul and is supported by Senate Democrats (Lucey, 5/20).

Des Moines Register: Branstad Hints He'd OK Medicaid Expansion If Federal Funding Pledges Were Secured
Gov. Terry Branstad on Monday appeared to soften his opposition to an expansion of Medicaid, a shift one leading Democrat said could help the stalemated Legislature resolve the issue. For months, the Republican governor has sternly rejected a broadening of the state-federal program that provides health care services for low-income people, arguing that the federal government can’t be trusted to uphold its promises to fund the expansion. Instead, he’s pushed a new program that relies less on federal funds but covers fewer people. But at his news conference Monday, Branstad seemed to indicate he might accept a form of Medicaid expansion if it came with "assurances" that the feds wouldn’t renege on funding commitments in years to come (Noble, 5/20).

Health News Florida: Bean: Medicaid Debate Not Over
State Sen. Aaron Bean, R-Jacksonville, says the debate over how exactly to implement the Affordable Care Act in Florida is far from over…Bean served on the committee given the task of studying implementation of the Affordable Care Act, including the option of expanding Medicaid using federal funds. The legislature also had to decide whether the state would run its own health insurance marketplace, or let the federal government do it (Watts, 5/20).

Bangor Daily News: Maine Senate Approves Bill That Links Medicaid Expansion To Hospital Debt Repayment
For the third time in a week, Democrats in the Legislature prevailed Monday on a vote to link an expansion of Medicaid eligibility in Maine to a plan to repay the state’s Medicaid debt to its 39 hospitals. After lengthy debate, the Senate voted 20-15 in favor of LD 1546, a bill that proposes repayment of Maine’s hospital debt, a restructuring of the state’s wholesale liquor contract and — after votes initiated by majority Democrats on  two legislative committees last week — an expansion of Medicaid eligibility in the state under the Affordable Care Act (Long, 5/20).

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Democrats Push Back Against Claims Of Health Law 'Rate Shock'

House Energy and Commerce Committee Democrats countered GOP claims that the health law is driving up insurance premiums by analyzing initial rate filings in five states.

The Hill: Dems: Early Data Show Premiums Falling Under Obama Health Law
Early filings show that insurers in some states are planning to lower their premiums after President Obama's healthcare law takes effect, Democrats noted on Monday. Democrats on the House Energy and Commerce Committee cited the initial rate filings to argue that the health law's Republican critics have oversold the potential effect on premiums (Baker, 5/20).

CQ HealthBeat: Debate Heats Up Over Impact Of Health Care Law On Premiums
In a highly politicized environment, it’s difficult to tell what impact the health care law will have on premiums that insurers will charge next year. On Monday, Democrats and their allies pushed back with numbers of their own to counter widespread Republican and insurer predictions of zooming rates that have marked the debate so far (Reichard, 5/20).

Modern Healthcare: Democratic Analysis Questions Validity Of Insurance Premium 'Rate Shock'
Where consumers live and their state's previous insurance rules may determine whether they experience "rate shock" this fall in their small business and individual plans. One of Republicans' key arguments opposing the health reform law has been that its insurance regulations will cause rates to go through the roof. House Democrats looked at recent insurer filings for 2014 premium rates (PDF) in five states and found that "in many cases, the Affordable Care Act appears to be reducing rates even before tax credits are taken into account" (Block, 5/20).

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Medicare

New Analysis Finds More Seniors Living In Poverty

The estimate, which takes health spending and other factors into account, concluded that 1 in 7 seniors lives in poverty. Projections indicate that number could go up if certain Medicare reforms took effect.

Politico: Report: More Seniors Are Living In Poverty
An alternative census estimate shows that more of America's seniors than originally thought are living in poverty -- and that means the poverty rate could spike under certain Medicare reforms, a new analysis finds. The estimate, which takes into account health spending and regional cost of living, finds 1 in 7 seniors lives in poverty. It was previously thought that just 1 in 10 did (Smith, 5/21).

The Washington Post: Senior Poverty Is Much Worse Than You Think
But under the [supplemental poverty measure], you'd count as poor as $15,000 – $10,000 = $5,000, which is below the relevant SPM threshold. And despite having Medicare, many seniors struggle with out-of-pocket medical bills. As my colleague Michelle Singletary pointed out over the weekend, the Employee Benefit Research Institute has found Medicare only pays for about 60 percent of seniors' total health costs. Sarah has written about how out-of-pocket costs tend to pile up particularly at the end of seniors' lives. Due in part to such burdens, a new Kaiser Family Foundation report finds that the SPM poverty rate for senior citizens is actually higher than the official rate: 15 percent vs. 9 percent. And when you include people living within 200 percent of the poverty line, the picture under SPM looks even worse (Matthews, 5/20).

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Capitol Hill Watch

Some GOP Lawmakers Target HHS Secretary Sebelius For Fundraising

The members of Congress are questioning Sebelius' efforts to solicit funds for Enroll America, which is trying to help get people signed up for benefits under the federal health law. 

Reuters: Analysis: Some Republicans See New Scandal In Sebelius Fundraising
With the White House already reeling from three major controversies, some Republican lawmakers are zeroing in on what they perceive is another possible scandal tied to President Barack Obama's landmark health reform law just as it nears implementation. On top of the troubles the administration is facing over its handling of the attack on the Benghazi mission, the Internal Revenue Service's targeting of conservative groups, and the Justice Department's seizure of Associated Press phone records, Republicans hope to target Health and Human Services Secretary Kathleen Sebelius. They are questioning her soliciting of funds on behalf of a non-profit group, called Enroll America, from two private entities, a practice which if not unprecedented is at the very least unusual (Morgan, 5/21).

Also in the headlines -

The Wall Street Journal: Tip Puts Lobbyist's Career On Hold
Mark Hayes was a Washington policy wonk on a long and steady ascent: a senior Senate health-care aide, a role writing President Barack Obama's health-care overhaul and a spin through the revolving door to a lobby firm where he banked 20 years of contacts. A series of emails to a client was all it took to put that carefully crafted career on hold (Mundy and Mullins, 5/20).

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Health Information Technology

Health Care Innovations In Technology Spotlight

A Silicon Valley conference offers insights regarding what's working and what is coming next for health care innovation. Meanwhile, some startup companies are aiming technology advances at medication adherence.

The Washington Post: Health-Care Training And Data Storage Innovations Featured At Silicon Valley Conference
This year's HealthBeat conference continues through Tuesday in San Francisco, with health technology innovators gathering to offer their take on what's challenging, what's working and what's next in innovation for the health care industry (Kolawole, 5/20).

The Wall Street Journal: Forget To Take Medicine? These Pills Will Tell Your Doctor
Startup companies are coming up with new technologies aimed at getting people to take medicine only as directed. Taking medication haphazardly—skipping doses, lapsing between refills or taking pills beyond their expiration date—has been linked to health complications and hundreds of millions of wasted dollars for insurers and hospitals (Hay, 5/20).

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Quality

Study: Physicians Increasingly Rely On ERs To Determine Whether Patients Need To Be Hospitalized

The New York Times: E.R.'s Account For Half Of Hospital Admissions, Study Says
Emergency rooms account for about half of the nation’s hospital admissions and accounted for virtually all of the rise in admissions between 2003 and 2009, according to a study released on Monday. Although emergency rooms are widely considered expensive places for diagnostic care, physicians are increasingly relying on them to determine whether a patient needs to be hospitalized (Abelson, 5/20).

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State Watch

State Programs, Agreements With Feds Aim At Better Mental Health Care Delivery

States seek to improve how they deliver mental health care: In Georgia, a revamp shows success stories; Connecticut seeks an agreement to better care for children with mental health problems; and in Texas, lawmakers back a diversion program to keep the mentally ill from jail.

Georgia Health News: DOJ Pact Shows Results, But Challenges Remain
A man who lived for years in a crude shelter in the woods is now housed in an apartment. A young woman who was institutionalized for a dozen years now lives in her own home, and is using the bathroom by herself for the first time in her life. The two individuals’ transitions are among the success stories of Georgia's 2010 agreement with the U.S. Justice Department to revamp the state's system to care for people with mental illness and developmental disabilities (Miller, 5/20).

CT Mirror: Proposal Seeks To Lay Groundwork For Better Children's Mental Health
In an effort that grew out of personal experience, advice from experts and the stories parents told in the wake of the massacre at Sandy Hook Elementary School, the head of the legislature’s Committee on Children Monday unveiled a proposal aimed at making it easier for families to access mental health services for children. The bill is a first step, a framework for the mental health system, Sen. Dante Bartolomeo, a freshman Democrat from Meriden, said as she outlined the measure, flanked by mental health experts and parents of those killed at the Newtown school (Becker, 5/20).

The Texas Tribune: House Backs Mental Health Jail Diversion Program
The House tentatively approved a bill Monday that would allow Harris County Jail to start a pilot program that officials hope would become a model for reducing mental illness in local lockups across Texas. Senate Bill 1185, by Sen. Joan Huffman, R-Southside Place, would create a program that connects mentally ill inmates with social, clinical, housing and welfare services during the first weeks after the person's release from jail (Grissom, 5/20).

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State Roundup: Nearly 13,000 Calif. Hospital Workers Set To Strike

A selection of health policy news from California, Louisiana, Vermont, Minnesota, North Carolina, Arkansas and Pennsylvania.

Los Angeles Times: Patient Care Workers Set To Start Walkout At Five UC Hospitals
Respiratory therapists, nursing aides, surgical technicians and other patient care workers plan to stage a walkout starting Tuesday morning at five University of California medical centers. More than 12,000 workers from the American Federation of State, County and Municipal Employees are expected to participate in the two-day strike over staffing, pay and pension reform, union officials said. An additional 3,400 workers from the University Professional and Technical Employees union plan a one-day sympathy strike (Gorman, 5/21).

Reuters: Health Care Workers Set To Strike California Public Hospitals
Nearly 13,000 health care employees at five University of California medical centers plan to strike on Tuesday in a move that threatens to back up emergency rooms and already has forced the postponement of elective surgeries (Cohen, 5/21).

The Associated Press: Proposals Would Limit Cuts In La. Medicaid Program
Proposals that would make it more difficult to cut the rates paid to private hospitals and nursing homes for taking care of Medicaid patients are nearing final passage in the Louisiana Legislature. Overwhelming support from lawmakers comes despite concerns the constitutional amendments would further limit budget areas available to cut when Louisiana has financial woes -- and leave public colleges more vulnerable to slashing (Deslatte, 5/20).

New Orleans Times Picayune: Louisiana Senate Panel Approves Dual Provider Rate Bills
Two pieces of legislation designed to draw down more federal Medicaid dollars for Louisiana's hospitals and nursing homes were passed by a Senate committee Monday, even as they faced opposition from the administration of Gov. Bobby Jindal and two prominent think tanks. House Bill 532, sponsored by House Speaker Chuck Kleckley, R-Lake Charles, and Speaker Pro Tem Walt Leger, D-N.O., would allow hospitals to assess a fee on themselves, which would then be placed into a state-run "Hospital Stabilization Fund." This fund would then be used to draw down matching federal Medicaid dollars. House Bill 533, sponsored by the same two representatives, would constitutionally protect provider rates already issued by nursing homes, pharmacies and intermediate care facilities used to draw down Medicaid dollars. Both bills would involve amendments to the state constitution and would go to the state's voters before final approval (McGaughy, 5/20).

The Associated Press: Vermont Is 4th State To Legalize Assisted Suicide
After years of debate, Vermont became the fourth state in the country Monday to allow doctors to prescribe lethal doses of medicine to terminally ill patients seeking to end their lives. Gov. Peter Shumlin signed the bill into law at a Statehouse ceremony even as opponents vowed to push for its repeal (5/20).

WBUR: Vermont Legalizes Physician-Assisted Suicide
Vermont has become the third state in the country, and the first in the east to legalize physician assisted suicide. The Vermont state legislature passed a so-called death with dignity bill last week. And in so doing, it became the first state to approve such a measure through legislative efforts, rather than through a voter referendum. The bill was signed into law just moments ago by Vermont Governor Peter Shumlin (5/20).

KQED: Surgery Rates Vary Dramatically Across California: Look Up Your City
Where you live matters. And in health care, it matters in all sorts of ways you might not think of immediately. If you're having elective surgery, one of the major factors determining what kind of treatment you will receive depends on where you live, according to new research released Tuesday. In health policy, "elective" does not necessarily mean cosmetic surgery. Treatments for early stage cancers are considered "elective" because there are a range of options (Aliferis, 5/21). 

The Associated Press: Bill Would Bring Sunshine To California Health Care Reform
Two lawmakers are pushing legislation to strip broad secrecy provisions from the state agency overseeing health-care reforms in California that could shield from the public how hundreds of millions of dollars are spent, officials said Monday. The bill by Republican Sen. Bill Emmerson and Democratic Sen. Mark DeSaulnier was introduced in the state Senate less than two weeks after The Associated Press reported the degree of privacy granted Covered California appears unique among states attempting to establish their own health insurance exchanges under President Barack Obama's signature law (Blood, 5/21).

The Wall Street Journal: Minnesota To Allow Home Day-Care Workers To Unionize 
Minnesota is set to allow unions to organize workers who provide home day-care services and other home care, giving organized labor a rare victory at the state level. The state House, by a vote of 68 to 66, passed legislation Monday that allows unions to negotiate on behalf of providers whose clients receive government subsidies -- including through Medicaid, the federal health program for low-income and disabled people (Peters and Maher, 5/20).

North Carolina Health News: A First Look At Health Care In The Senate Budget
Senate leaders rolled out their proposed $20.58 billion budget for the coming biennium late Sunday night with a plan that increases overall state spending by 2.3 percent, including increased spending on Medicaid. But the plan also includes a lot of cuts (Hoban, 5/20).

Politico: Arkansas 12-Week Abortion Ban Blocked For Now
A federal judge has temporarily blocked an Arkansas law banning abortions after 12 weeks into pregnancy, the first legal test of state early abortion laws passed in 2013. Judge Susan Webber Wright of the U.S. District Court for the Eastern District of Arkansas on Friday granted a preliminary injunction against the law, ruling from the bench after a hearing on a challenge brought by abortion rights advocates (Smith, 5/20).

Philadelphia Inquirer: Casey Promotes Health Care Research As A Job Source
U.S. Sen. Bob Casey says he doesn't have an answer to the national need for balance in creating health-care financing solutions, but he knows that National Institutes of Health funding helps put and keep jobs in the Philadelphia region. … A Democrat from Scranton, Casey said at the Friday meeting that unlike most topics dividing Congress, funding for medical science has a "bipartisan consensus, less so on financial levels, but we're not as far apart as we are on other issues." Pennsylvania got about $1.46 billion in NIH funding in 2012. That was fourth highest among the states (Sell, 5/21).

California Healthline: Federal Ruling, State Law May Conflict
In 2011, the Legislature went along with the governor's plan to cut Medi-Cal provider rates by 10 percent. Provider groups immediately went to the courts to stop it, saying that patient access to care would be threatened by such a severe reduction. Now the final decision rests with a federal judge. A ruling is expected soon. If a federal judge signs off on the law, Medi-Cal providers in California will have rates cut by 10 percent and also will need to pay back two years' worth of that 10 percent reduction. The effect would be a 15 percent rate cut for the next four years and a 10 percent cut thereafter (Gorn, 5/20).

California Healthline: Health Care Issues High On Latino Community Agenda
Health care, traditionally a vital issue in Latino communities, is still high on the list, but the focus may be shifting, according to Latino leaders who convened for a statewide summit last week in Sacramento. … The Latino Community Foundation, a statewide philanthropy based in San Francisco, convened more than 100 leaders of California Latino organizations for a "Sacramento Summit" last week. The event launched the California Latino Agenda, a campaign to unite leadership, establish goals and lobby for policy positions (Lauer, 5/20).

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Editorials and Opinions

Viewpoints: Slowing Health Costs; What Causes Genetic Testing To Be So Expensive; Iowa Governor Offers Medicaid Supports A 'Glimmer Of Hope'

Modern Healthcare: Cost Sustainability
We have done it. We have decreased the increase in the cost of healthcare. ... Is this decline the desperately needed bend in the healthcare cost curve or just the impact of the depressed economy? ... A slower growth of healthcare cost would mean less burden on the individual family, freeing that family to invest in and live a higher quality of life. ... The good news is that it can be done. And the blueprint for eliminating waste, lowering the cost and maximizing the value is actively being considered by voices that rise above partisan bickering (Drs. Manoj Jain and Bill Frist, 5/18). 

The New York Times: The Outrageous Cost Of A Gene Test
Angelina Jolie's revelation that she had had a preventive double mastectomy was eloquent and brave. She had learned that she inherited a faulty copy of a gene, BRCA1, that put her at high risk for invasive breast cancer as well as ovarian cancer. Now women everywhere are asking: Should I get the same test? What will it cost? ... Unlike routine tests for diabetes or high cholesterol, however, the BRCA gene evaluation — performed by only one company in the United States, Myriad Genetics — is phenomenally expensive, with a "list price" close to $4,000 when a related genomic-rearrangement test is included in the analysis, which oncologists typically recommend. The question is why? Today, molecular scientists like me can sequence all of an individual’s genes — at least 20,000 of them — for about $1,000. About five cents per gene (David B. Agus, 5/20). 

The Wall Street Journal: Gene Patents Drive Medical Innovation
The biotech industry began in 1978 when the University of California applied for a patent on the gene for the human growth hormone. Since that filing nearly 20% of the 20,000-plus genes in our DNA have been patented. The current Supreme Court case challenging the patent on the breast cancer gene (Association for Molecular Pathology v. Myriad Genetics) could invalidate thousands of these patents, affecting hundreds of diagnostic and therapeutic products. The biotech industry saves tens of thousands of lives and creates as many jobs. However, a ruling against the patent will deep-six future life-saving technologies as investor support for such discoveries disappears (Kevin Kimberlin, 5/20). 

The New York Times: New Efforts To Undercut Health Reforms
Congressional Republicans are trying to exploit two controversies bedeviling the Obama administration to undermine the health care reform law. They are using an uproar over misguided tactics by Internal Revenue Service employees to target conservative political groups seeking tax-exempt status as an excuse to prohibit the agency from playing a pivotal role in carrying out the Affordable Care Act. And they want to use a controversy over efforts by the secretary of health and human services, Kathleen Sebelius, to encourage private donations to help enroll people in new health care exchanges as a cudgel to disrupt such efforts (5/20).

Des Moines Register: Medicaid Debate Has A Glimmer Of Hope
So it's hard to know whether a glimmer of potential compromise on health care, based on Gov. Terry Branstad’s comments Monday, is genuine. It looks promising, however. Branstad hinted Monday that he might be willing to use federal Medicaid expansion dollars for a new low-income health care program in Iowa, under certain conditions (Kathie Obradovich, 5/20).

New Orleans Times Picayune: House Should Approve Medicaid Money
Lawmakers have another chance to do the right thing Tuesday (May 21) when the House of Representatives considers a bill that would allow tens of thousands of uninsured residents to use Medicaid money to buy private insurance. House Bill 233 is a response to Gov. Bobby Jindal's refusal to accept the expansion of Medicaid under the federal Affordable Care Act. The bill takes a similar approach to legislation approved in Arkansas that Gov. Mike Beebe is hopeful will get federal approval (5/21).

Kansas City Star: By Not Acting On Medicaid, Missouri Legislature Failed To Help Patients
The Missouri legislature ended its session Friday after failing to act on a rare opportunity to transform Medicaid. However, for the good of Missouri, this critically needed transformation must proceed. Missourians cannot afford a lengthy delay — 300,000 of our neighbors remain uninsured, including more than 13,000 veterans and 4,000 spouses of veterans who live below or near the federal poverty level. Unfortunately, Missourians' tax dollars now will be spent by other states on their versions of Medicaid reform as Missouri businesses and individuals pay more (Herb Kuhn, 5/19).

Lund Report: Cost Of Coverage – The Real Measure Of Health Reform Impact
Prior to actual plan pricing being available, everyone, including me, tried to predict how much the Affordable Care Act (ACA) would increase premiums. Estimates generally ranged from 25 percent to 38 percent, and I was on the high end. So we all knew premiums were most likely going to increase, we just weren’t sure how much. All these efforts to predict were generally done on a false assumption that similar plans to the new Platinum, Gold, Silver and Bronze plans were available already, and all we had to do was predict the added cost of the new 2014 ACA requirements (John Gridley, 5/20).

Bloomberg: Wildly Varying Hospital Prices Keep Health Care Expensive
If further proof were needed that price competition doesn’t exist in the expensive U.S. health-care market, it arrived this month. The Centers for Medicare and Medicaid Services published 2011 charges for medical treatments set by more than 3,000 American hospitals. … The wide -- and wild -- variation exposes a critical weakness in the national effort to control costs (5/20).

Milwaukee Journal Sentinel: Bill To Ban Mandated Flu Vaccinations An Unwise Idea
The flu season is winding down around the country, but this year — as in past years — thousands of people required a visit to the hospital after contracting the disease. That's why the Centers for Disease Control and Prevention recommends that most people get an annual flu shot. And that's why health care workers often are required by their employers to be vaccinated. But that requirement would be illegal under legislation now being drafted by a Republican legislator from Fond du Lac. State Rep. Jeremy Thiesfeldt told The Associated Press that he began drafting the bill after health care workers complained they had been fired for refusing to be vaccinated (5/20). 

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Marissa Evans
Lisa Gillespie
Shefali Luthra

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.