Daily Health Policy Report

Thursday, May 24, 2012

Last updated: Thu, May 24

KHN Original Reporting & Guest Opinion

Capitol Hill Watch

Campaign 2012

Health Reform

Health Care Marketplace

Public Health & Education

Quality

State Watch

Weekend Reading

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Can I Continue My Health Insurance After Quitting My Job? (Video)

Kaiser Health News Insuring Your Health columnist Michelle Andrews responds to a question from a reader contemplating quitting his job to stay home with his wife who has breast cancer and wondering how to keep health insurance. Watch the video.

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Capsules: Is The U.S. Military Too Soft On Fat?

Now on Kaiser Health News' blog, Shefali S. Kulkarni reports on a meeting Wednesday discussing the issue of obesity among members of the military: "It’s not just military retirees and veterans who are packing on the pounds. At a policy summit Wednesday, health and military experts said the obesity epidemic has become a significant threat to national security as the waistlines of military enlistees are expanding. Overweight and obese enlistees and soldiers are making it harder for recruiters to find physically fit candidates for military service" See what else is on the blog. (Kulkarni, 5/24).

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Political Cartoon: "Fact Check (Up)?"

Kaiser Health News provides a fresh take on health policy developments with "Fact Check (Up)?" By David Fitzsimmons, Arizona Daily Star.

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

NEVER TRUST ANYONE WHO IS OLD ENOUGH FOR MEDICARE

He’s seventy-one:
Robert Allen Zimmerman
How did this happen?
- 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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Capitol Hill Watch

FDA Reauthorization Bill Clears Senate By 96-1 Vote

The Senate voted overwhelmingly Thursday afternoon to pass a bill to reauthorize the Food and Drug Administration’s user fee programs.

Politico: FDA User Fee Bill Passed By Senate
Previous user fee authorizations have been contentious affairs. But notwithstanding the election-year and health care politics that dominate Congress, the bill sailed through with hardly a complaint. In part, that’s because it’s the No. 1 priority for the pharmaceutical and medical device industries. And in part, it’s because legislators on both sides have had a lot of input for a long time (Norman, 5/24).

Reuters: U.S. Senate Passes Bipartisan FDA Funding Bill
The bill, which passed by a vote of 96 to 1, aims to speed approval of new drugs and devices and ensure food safety. It reauthorizes fees from companies like Johnson & Johnson, Medtronic Inc and Roche Holding AG that help speed FDA evaluation of new medical products prior to approval (Yukhananov, 5/24).

CQ HealthBeat: Senate Passes FDA User Fee Bill, Spurns Drug Importation Amendment
Senators gave strong bipartisan backing to a five-year reauthorization of the Food and Drug Administration’s user fee programs Thursday, after rejecting a contentious drug importation amendment that had support from members of both parties. The bill (S 3187), passed 96-1, would renew the FDA’s programs that help fund reviews of prescription drugs and medical devices. The measure also would create user fee programs for generic drugs and generic biologic drugs. Vermont Independent Bernard Sanders cast the lone vote against the bill (Khatami and Lesniewski, 5/24).

National Journal: Senate Votes to Approve FDA Bill 96-1
The bill authorizes $6.4 billion in fees from the medical device and pharmaceutical industry to the FDA, to help cover the cost of making sure new products are safe and effective. ... The House is expected to take up and easily pass its own version of the legislation next week (McCarthy, 5/24).

Associated Press: Senate Bill Aims To Increase Drug Import Safety
Under the Senate bill, approved 96-1, the Food and Drug Administration would have more flexibility to inspect manufacturing sites in China, India and other foreign countries. ... Other sections of the bill would increase fines for drug counterfeiting and require drugmakers to notify the government earlier of potential drug shortages. ... The legislation also renews user fee programs under which drugmakers pay the FDA to review new products (5/24).

Earlier coverage:

The Hill: Senate Reaches Deal On FDA Bill Amendments
Under the agreement, the Senate will consider 17 amendments to the bill, the Food and Drug Administration Safety and Innovation Act (S. 3187), which reauthorizes a user-fee program for drug companies seeking FDA approval. The Senate will debate amendments until Thursday at 2 p.m. After votes on the amendments, the Senate will vote on the bill itself (Strauss, 5/23).

CQ HealthBeat: FDA Reauthorization Has Bipartisan Support; 17 Amendments In Question
After a day of delay, the Senate reached a deal to vote Thursday afternoon on 17 amendments, then on final passage of the bill to reauthorize the Food and Drug Administration’s user fee programs for five years. The FDA reauthorization bill has bipartisan support and is expected to pass. The only question is which amendments will be added to the measure. Some of the amendments may be adopted by voice vote, while others are much more controversial.“We have tomorrow to finish this. We should be able to do that,” Majority Leader Harry Reid, D-Nev., said on the floor Wednesday afternoon (Ethridge, 5/23).

Politico Pro: Senate FDA Bill Down To 17 Amendments
HELP Chairman Tom Harkin (D-Iowa) and ranking member Mike Enzi (R-Wyo.) parried offerings of various additions to their hard-negotiated bill and were expected to oppose the most controversial proposals, three lobbyists told POLITICO. Four amendments, in particular, are subject to the high bar of a 60-vote threshold, which cuts into their chances of success — but they're still expected to receive a vote when the Senate wraps up work on the bill Thursday (Norman, 5/24).

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Reid Says He Will Let Budget Cuts Go Forward Unless There Is A Concession On Revenue

Politico: Democrats Stiffen Spine On Sequester
In an interview with POLITICO, (Senate Majority Leader Harry) Reid said he was open to a compromise that would salvage about four-fifths of the Bush-era tax cuts. But absent some concession on revenues, the $110 billion in spending cuts ordered by the debt agreement last August would go into effect. "I am not going to back off the sequestration," Reid said. ... the recent House-passed reconciliation bill, which promises to forestall these very same cuts in January, was the last straw for Reid and helped fortify his position (Rogers, 5/24).

On a much different issue, the Boston Globe looks at an effort in the Senate on the health of nursing home residents.

Boston Globe: Senators Push For Informed Consent Before Nursing Homes Use Antipsychotic Drugs
Three U.S. senators are ratcheting up a campaign to slash the misuse of powerful sedatives, known as antipsychotics, in the nation's nursing homes. The three -- Senators Herb Kohl, D-Wis., Chuck Grassley, R-Iowa, and Richard Blumenthal, D-Conn. -- have filed a proposal that would require federal regulators to issue standardized rules for nursing homes to follow in seeking permission from patients, or their designated health care agents, such as a family member, before administering antipsychotics for so-called off-label use (Lazar, 5/23).

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Campaign 2012

New Ad Touts Obama's Commitment To Medicare

President Barack Obama's campaign rolled out ads pitched to seniors and veterans Wednesday. Meanwhile, Politico analyzes Mitt Romney's decision to emphasize his record as a businessman rather than as Massachusetts governor when he helped pass that state's health reform law.

The New York Times: New Obama Ads Focus On Medicare And Veterans
President Obama’s campaign on Wednesday rolled out two new ads promoting his achievements, part of a $25 million advertising effort that his campaign unveiled this month. In one ad, titled "Personal," Mr. Obama's campaign brags about efforts the president has made to protect Medicare from scams and fraud, and says he is working to "preserve Medicare now and for the future." The ad cites the president's upbringing by his grandparents to suggest that his desire to protect health care for the elderly is an important matter to him personally (Shear, 5/23).

The Washington Post: Obama Takes Break From Bain In Two New Ads
A second ad, "Personal," targets senior citizens, emphasizing the president's commitment to preserving Medicare. ... The ads are running in Colorado, Florida, North Carolina, Iowa, Nevada, Ohio and Virginia as part of the campaign’s $25 million May ad buy (Weiner, 5/23).

The Associated Press: Obama Focuses On Seniors, Veterans In Positive Ads
"Personal," which focuses on Medicare, is a clear appeal to senior citizens, one of the largest and most consistent voter blocs. The ad's claims about Obama's record on Medicare are true, although it ignores changes to the program that occurred under Obama. Medicare was cut by about 6 percent as part of Obama's overhaul of the health care system. The administration has said the cuts trimmed waste. By positioning himself as a protector of Medicare, Obama is also framing an election fight he's likely to have with Romney, who has expressed support for a budget blueprint passed by House Republicans that includes significant cuts and changes to Medicare and Medicaid (Jackson, 5/23).

Politico Pro: Mitt Romney In Massachusetts: The Lost Years
By choosing to emphasize his experience as a can-do businessman who ran the 2002 Salt Lake City Olympics and Bain Capital, Romney is shielding himself from the charge that he’s a hidden centrist who passed the nation’s most sweeping local health care reform bill, supported abortion rights and closed tax loopholes for the rich. President Barack Obama’s campaign, for its part, is happy to hammer Romney for job losses at companies acquired by Bain — and to mock him for dodging what they cast as a lousy record as governor. The result is one of the oddest political storylines in an oddball year. No candidate in modern history has so aggressively undersold what has been seen as the most desirable qualification for the presidency since the 1970s — running a state — nor downplayed a string of victories, tough calls and man-up moments that a typical politician would highlight in a heartbeat ... (Thrush, 5/23).

Meanwhile, in Arizona, the health care overhaul came up as part of a congressional candidates' debate.

Arizona Republic: Tucson District 8 Candidates Face Off
Candidates running to replace former U.S. Rep. Gabrielle Giffords agreed on one thing during their first public debate Wednesday: that they would change President Obama's health-care law. But Democrat Ron Barber, Republican Jesse Kelly and Green Party candidate Charlie Manolakis differed on how they would do it (Sanders, 5/23).

 

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Health Reform

Study Says Most Insurance Sold To Individuals Doesn't Meet Health Law Standards

A new report in Health Affairs finds that more than half of individual policies could not be sold on state health exchanges because they fail to meet the law's criteria for coverage.

The New York Times: Individual Health Policies Fall Short, A Study Finds
More than half of all medical insurance policies sold to individuals now fail to meet the standards of coverage set by the federal health care law under review by the Supreme Court, a new study says. Even if the law is upheld, employer-provided insurance plans are likely to continue to be more generous, but the law would significantly improve the quality of coverage for individuals in several ways, the researchers concluded (Abelson, 5/23).

National Journal: Report: Most Individual Health Plans Cover Less Than Health Care Law Requires
Most individual policies currently on the market could not be sold on state exchanges in 2014, a new report concludes. The report, published Wednesday in Health Affairs and funded by the Commonwealth Fund, analyzed individual plans from several states and concluded that 51 percent of the plans would fail to meet the minimum requirements established under the 2010 health care reform law (Sanger-Katz, 5/23).

The Hill: Study: Most Individual Insurance Plans Fall Short Of Health Law's Standards
According to the Health Affairs study, even the most basic plan under the ACA's new standards would be significantly more generous than what most people get today on the individual market. The ACA establishes new insurance marketplaces, called exchanges in every state and it sets minimum standards for plans sold through the exchanges. For the most basic policies, insurers have to cover 60 percent of a plans's total cost, leaving customers to pay no more than the other 40 percent (Baker, 5/23).

Bloomberg: Insurers Must Improve Benefits For New Health Exchanges
Half the people who buy their own health insurance, rather than depend on an employer, are in plans that have fewer benefits than what the U.S. health-care law will require beginning in 2014, a study found.  UnitedHealth Group Inc. (UNH), WellPoint Inc. (WLP) and other companies that participate in the insurance exchanges mandated by the law will have to improve benefits in some plans to meet requirements that they cover at least 60 percent of the cost of a person’s care, according to a study published today in Health Affairs (Wayne, 5/23).

Modern Healthcare: Individual Plans Miss Reform-Law Targets: Study
The majority of individual health plans in a representative sample for the year 2010 did not meet the standards and benefits required by the Patient Protection and Affordable Care Act, according to the findings of a new Health Affairs study. Researchers used the Kaiser Family Foundation/Health Research and Educational Trust 2010 Employer Health Benefit Survey to examine group plans and sampled enrollment data in five states through interviews with marketing managers at insurance carriers for the individual plans (Zigmond, 5/23).

Meanwhile, Politico finds that even with the better coverage promised under the health law, many people in the country face a tough time getting insurance and may have fewer options for subsidized care.

Politico: Millions Still Uncovered With Health Law Expansion
The health law, if upheld by the Supreme Court, will help up to 33 million Americans get coverage over the next decade. Around 26 million to 27 million will remain uncovered. And roughly one in four of the uninsured will be illegal immigrants, the Urban Institute has estimated. And as more tax dollars go toward subsidizing low- and middle-income Americans so they can get health coverage, advocates for immigrants say it may be increasingly difficult to care for the undocumented, who are excluded from the law’s coverage expansion and the new insurance exchanges. A few communities are testing solutions (Cheney, 5/23).

In other insurance industry news -

Modern Healthcare: Insurers May Face Credit Threat If Reform Stands: Moody's
Insurers could face credit stress if the Supreme Court upholds some or all of the healthcare reform law, according to Moody's Investors Service. The ratings agency, in a new report, called a decision from the court to uphold the Patient Protection and Affordable Care Act "a negative credit event" for insurers. The law restricts insurer revenue and introduces new regulations for the sector, the rating agency said (Evans, 5/23).

Kaiser Health News: Can I Continue My Health Insurance After Quitting My Job? (Video)
Kaiser Health News Insuring Your Health columnist Michelle Andrews responds to a question from a reader contemplating quitting his job to stay home with his wife who has breast cancer and wondering how to keep health insurance (Andrews, 5/23). Watch the video.

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Health Care Marketplace

In Changing Marketplace, Hospitals And Insurers Are Moving To Control Costs

A variety of reports look at changes in the hospital business, as well as doctors' concerns about malpractice costs.

The New York Times: For Hospitals And Insurers, New Fervor To Cut Costs
Giselle Fernandez is only 17 but she has had more than 50 operations since she was born with a rare genetic condition. She regularly sees a host of pediatric specialists. ... Her care has cost hundreds of thousands of dollars so far. ... While UCLA Health System has long prided itself on being at the forefront of treating patients like Giselle, it is now trying to lower sharply the cost of providing that care. By enrolling young patients with complex and expensive diseases in a program called a medical home, the system tries to ensure that doctors spend more time with patients and work more closely with parents to coordinate care. The program has cut emergency room visits by slightly more than half (Abelson, 5/23).

NPR: By Putting Patients First, Hospital Tries To Make Care More Personal
No one likes to go to the hospital. But some hospitals around the nation are trying to make their patients' stays a little less unpleasant. They're members of an organization called Planetree, which was founded by a patient named Angelica Thieriot, who had a not-so-good hospital experience back in the 1970s. ... Today Planetree has certified, or "designated," 30 hospitals and nursing homes in the U.S. and four countries as meeting a specific list of criteria that qualify them as providing truly patient-centered care (Rovner, 5/23).

The Wall Street Journal: Medical Devices In Hospitals To Go Wireless
Hospitals are getting ready to cut the cord. In place of knots of wires stuck to patients to monitor their blood pressure, heart rate, oxygen level and body temperature, doctors and the companies that supply them hope to use Band-Aid-like sensors to accomplish the same task wirelessly. The Federal Communications Commission is expected to vote Thursday to open up spectrum for wireless medical devices, raising the possibility of easier hospital-patient monitoring, fewer tubes in emergency rooms, and more remote monitoring at home (Linebaugh, 5/23).

And two news outlets look at malpractice litigation and its costs.

Modern Healthcare: Industry Leaders Voice Optimism On Curbing Defensive Medicine
Undertaking extensive efforts to improve the quality of care provided has not mitigated malpractice costs—including the cost of defensive medicine—for some providers, but it may in the future, representatives of several providers undertaking delivery reforms told a Senate panel. Dr. Lee Sacks, chief medical officer for Advocate Health Care, based in Oak Brook, Ill., told the Senate Finance Committee that the health system's medical liability costs were $90 million in 2011, despite the broad use of a model quality improvement system since 2004 (Daly, 5/23).

Reuters: Docs Win Most Malpractice Suits, But Road Is Long
Malpractice claims against U.S. doctors are often dismissed, and when they go to trial, the verdict is usually in the doctor's favor, according to a new study. But even when a case is dismissed, the road is typically long for both doctors and the patients suing, researchers said. … Medical malpractice claims have become a hot-button issue in the U.S., coming up repeatedly in debates about healthcare reform. Some specialists must pay a couple hundred thousand dollars a year in premiums for insurance against malpractice claims -- though rates vary by state (Norton, 5/23).

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Public Health & Education

IUDs, Implants Far More Effective At Preventing Pregnancy Than The Pill

A large study of birth control methods in the U.S. found that women using pills, skin patches or vaginal rings were 20 times more likely to have an unplanned pregnancy than women who used intrauterine devices (IUDs) or implants placed under the skin of the upper arm.  The failure rates were highest among teenagers and young women.

Reuters: Long-Term Contraception More Effective Than Pills
A large real-life test of birth control methods found more U.S. women got pregnant while using short-acting methods such as pills, patches and vaginal rings -- and the failure rate was highest when they were used by women under 21. In a new study published on Wednesday in the New England Journal of Medicine, about 7,500 women and teens in the St. Louis area were allowed to pick from a variety of contraception methods at no cost. … "One of the beauties of this study is that it shows that when you take cost out of the equation and you educate women objectively and effectively, about 75 percent of them chose a long-acting method," [Brooke Winner] said (Emery, 5/23).

MSNBC: Long-Term Birth Control Methods Work Better Than Pill
Women who use long-acting methods of birth control are less likely to wind up pregnant than women who use shorter-term methods, which require daily or monthly remembering, a new analysis says. The results showed that women using birth control pills, skin patches or vaginal rings were 20 times more likely to have an unplanned pregnancy than women who used intrauterine devices (IUDs) or implants placed under the skin of the upper arm. ... The study, which appears Thursday (May 24) in the New England Journal of Medicine, is one of the largest ever done in the U.S. to compare birth control failure rates over a three-year period, Peipert said. It's also one of the few to include a large number of women using IUDs and implants (Nierenberg, 5/23).

ABC (Video): Women Opting For Less Effective Birth Control
Dr. Linda Bradley says myths and lack of understanding limit IUD use in U.S. (5/23).

CNN: Study: IUDs, Implants Vastly More Effective Than The Pill
The study, published this week in the New England Journal of Medicine, compared the effectiveness of various types of birth control in a group of about 7,500 sexually active women in the St. Louis area. Over a period of three years, 9.4 percent of women using birth control pills, patches, or vaginal rings became pregnant accidentally, compared to just 0.9 percent of women who opted for IUDs or implants. The difference in these so-called contraceptive failure rates was especially dramatic among teenagers and young women, a group at high risk for unintended pregnancies. Women under age 21 who used short-term birth control were nearly twice as likely as their older counterparts to become pregnant, whereas the failure rate for IUDs and implants was less than 1 percent regardless of age (MacMillan, 5/23).

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U.S. Military Says Too Many Enlistees Are Overweight; Americans Find Doing Taxes Easier Than Eating Right

The military is seeking fitter members, saying overweight recruits could be a threat to national security. Meanwhile, a new survey says Americans find it easier to do their taxes than figure out healthy food options.

Kaiser Health News: Capsules: Is The U.S. Military Too Soft On Fat?
Now on Kaiser Health News' blog, Shefali S. Kulkarni reports on a meeting focused on the issue of obesity in the military: "It's not just military retirees and veterans who are packing on the pounds. At a policy summit Wednesday, health and military experts said the obesity epidemic has become a significant threat to national security as the waistlines of military enlistees are expanding. Overweight and obese enlistees and soldiers are making it harder for recruiters to find physically fit candidates for military service" (Kulkarni, 5/24).

National Journal: Sorting Taxes Easier Than Figuring Out Food, Survey Finds
Most Americans find it easier to figure out their taxes than to sort out what they should be eating, the International Food Information Council finds. The IFIC survey finds that while 55 percent are trying to lose weight, 85 percent calculated wrongly how many calories they need to maintain their weight. When the 1,057 people surveyed were asked which was harder, doing taxes or figuring out what to eat, 48 percent voted for the taxes and 52 percent said it’s harder to understand healthy eating (5/23).

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Quality

Doctors Disagree On New Prostate Cancer Screening Guidelines

One doctor suggests the problem is the rush to treatment, not the screening; another suggests that a failure to screen men could be more costly in the long run.

Los Angeles Times: PSA Test: The Real Problem Is The Rush To Treatment, Doctor Says
The test finds many cancers that are not life-threatening, and treatment causes side effects from surgery and radiation such as impotence and urinary incontinence. The harms weighed against benefit aren't enough to justify the screen, the task force concluded. But some doctors say the answer is to change the way that prostate cancer is handled in this country. When a biopsy reveals cancer, 90 percent of men are treated -- even though most prostate cancers won't threaten a man's life (Mestel, 5/23).

Medscape Today: Avoiding Prostate Cancer Screening Might Be Costly
This week, the USPSTF gave prostate cancer screening a grade of D (not recommended; harm outweighs benefits or no net benefit). However, the analysis by Dr. [E. David] Crawford and colleagues suggests that avoiding prostate cancer screening might ultimately cost more in terms of treating advanced disease and missing significant numbers of cases (Hitt, 5/23).

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State Watch

Union Reaches Contract Agreement With Minn. Hospitals

The agreement averts a threatened strike at eight Twin Cities hospitals.

Associated Press/(St. Paul) Pioneer Press: Twin Cities: Workers At Eight Hospitals Ratify Contract
Union workers have overwhelmingly ratified a new three-year contract that averted a strike at eight Twin Cities hospitals. The union represents 3,500 nursing assistants, technicians and support staff. The agreement was reached last week after union members voted to authorize a 2- to 5-day strike. The union says the new contract holds back on increases in health benefit premiums, retains overtime benefits and includes small wage increases (5/23).

Minneapolis Star Tribune: Workers At 8 Twin Cities Hospitals Ratify New Union Contract
The vote, by members of the Service Employees International Union Healthcare Minnesota, came just over a week after the union had threatened a two- to five-day strike as its contract was set to expire. The two sides reached a tentative agreement last Wednesday (Lerner, 5/23).

In other news from hospitals around the country -

Modern Healthcare: Sinai Health, Holy Cross Explore Affiliation
Two Chicago faith-based institutions—Jewish Sinai Health System and Catholic Holy Cross Hospital—are discussing a possible affiliation that would have the 282-bed Holy Cross joining the Sinai system. The two organizations are in the due diligence phase, which is expected to last until July, and a letter of intent signing is expected soon after, according to an e-mailed news release (Robeznieks, 5/23).

Kansas Health Institute News: State Hospitals' Troubles Worry Region's Officials
Mental health officials in western Kansas today sought assurances that Larned State Hospital will continue to provide inpatient care for the mentally ill. … High Plains Mental Health Center serves 20 counties in northwest Kansas, all of which are in the Larned hospital's 61-county catchment area. … [One mental health center executive director] said his anxiety was fueled by the news Monday that the hospital’s superintendent, Christopher Burke, had resigned amid the facility’s efforts to correct 30 deficiencies cited during a recent accreditation survey (Ranney, 5/23).

WBUR's Common Health blog: High-Cost Hospitals Perhaps Thorniest Issue In Health Reform 2.0
On one side is (Massachusetts state) Rep. Steve Walsh, the House point person on health reform, whose bill proposes the luxury tax of 10 percent on hospitals that charge more than 20 percent above the median price for their services and cannot justify the mark-up. On the other is Senate President Therese Murray, who "recently told the News Service she would not entertain the idea in eventual negotiations with the House" (Goldberg, 5/23).

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State Lawmakers Wrestle With Planned Parenthood Funding, Contraception Coverage

Legislation in Pennsylvania would bar the use of state and federal funding by Planned Parenthood. Also, some Georgia physicians fear their opposition to a state abortion bill has triggered retaliation.

Philadelphia Inquirer: GOP's Metcalfe Moves To Axe Planned Parenthood Funding In Pa.
The legislation, similar to anti-abortion bills crafted in other states, would bar all federal and state funding to the nonprofit, which provides abortions along with an array of other women's health services. … Metcalfe said the bill … would not reduce overall levels of public funding for women's health services, but would "prioritize" the funding so that hospitals, health centers, and other clinics would receive money first. Representatives for House Majority Leader Mike Turzai (R., Allegheny) and Gov. Corbett said neither had seen the bill and had no comment. Past efforts by Metcalfe to cut off Planned Parenthood’s funding have failed in the General Assembly (Worden, 5/24).

The Associated Press: NH Lawmakers To Negotiate On Contraceptive Bill
The New Hampshire Senate has grudgingly agreed to negotiate with the House on a bill that would allow some employers to exclude contraceptive coverage from health plans if they have religious objections. The bill would apply to businesses partly or wholly owned by a religious society and those formed for a religious intent (5/23).

The Atlanta Journal-Constitution: OB-GYNS Worried Burglaries, Fires Are Retaliation
Doctors who expressed concerns about a controversial abortion bill at the State House say they have since been victims of a series of property crimes, the latest of which was a fire Wednesday at a Marietta abortion clinic. ... Police have not yet concluded the incidents are connected, nor have they determined a motive…. But physicians who practice obstetrics and gynecology, however, worry that the incidents -- three burglaries and two suspicious fires in all -- weren't a coincidence, but were committed by someone bent on retaliating against them for raising concerns about the so-called "fetal pain" bill that passed in March (Simmons, 5/23).

Meanwhile, Catholic church officials have chosen Baltimore to launch a national campaign aimed at "promoting religious liberty" -  

Baltimore Sun: Catholics To Launch National Campaign With Mass In Baltimore
The Catholic Church, embroiled in a dispute with the Obama administration over new health insurance rules, has chosen Baltimore to kick off a national campaign it says is aimed at promoting religious liberty. Archbishop William E. Lori is scheduled to celebrate mass at the Baltimore Basilica on June 21 to open the "Fortnight for Freedom," a two-week national campaign of special liturgies, prayer services and other events leading up to the Fourth of July (Brown, 5/23).

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State Roundup: HHS Announces Community Health Center Grants; Blue Shield Of Calif. CEO To Retire

A selection of health policy news from California, New Hampshire, Georgia, Texas, Kansas, Pennsylvania and Maryland.

Texas Tribune: UT/TT Poll: Little Love For Legislative Branch
Texans generally don't like the federal health care law. … 45 percent said the court should overturn the entire law, 10 percent said the court should overturn the individual mandates and leave everything else in place, and only 26 percent said the court should leave the law intact (Ramsey, 5/24).

The Hill: Family-Run Health Centers Get $5 Million In Grants
The grants will fund health centers in all 50 states as well as Washington, D.C. "These centers provide the information that families need to make health care decisions that are right for their children," HHS Secretary Kathleen Secretary Sebelius said in a statement. "Family-to-Family Health Information Centers are a good investment and have a measurable and positive impact on families, and communities" (Baker, 5/23).

The Wall Street Journal: Healthcare Districts' Role Under Fire
Two (California) state assemblymen are training their sights on the municipal agencies known as healthcare districts, arguing they are outdated institutions whose funds would be put to better use helping county health systems. Healthcare districts today provide ambulance services, help build facilities such as nursing homes, allocate money to nonprofit health-care providers and run hospitals, among other things (White, 5/23).

California Healthline: Subcommittee Puts Co-Pay Idea On Hold
Co-pay is back. Last year, the Legislature passed and the governor signed a budget trailer bill that included Medi-Cal co-payments of $5 for some provider visits, up to $50 for emergency department visits and up to $100 for patients admitted to the hospital. That move required a CMS waiver but in February, federal officials denied it. Now, with the May budget revision, a scaled-down version of co-payments is back on the table (Gorn, 5/24).

Houston Chronicle: Texas Legislature Turning Its Attention To Healthy Eating
The growing problem of obesity, diabetes and health care costs for unhealthy habits will get plenty of attention in the state Capitol next year as lawmakers try to make getting access to nutritious food easier for Texans. "A quarter of the young people in this country are at risk for type 2 diabetes, and that's terrible," House Human Services Committee Chairman Richard Raymond, D-Laredo, said to open a joint hearing with the House Public Health Committee this week (Scharrer, 5/23).

Georgia Health News: Deal Launches State War On Obesity
Gov. Nathan Deal announced a major statewide initiative Wednesday to address the problem of obesity, calling it "one of the greatest challenges we face." The obesity program would combine efforts of state agencies, businesses, health care organizations, the philanthropic community, and Atlanta professional sports teams, Deal said. The initiative’s goals include promoting more physical activity and improved nutrition in schools, along with wellness policies in child care programs (Miller, 5/24).

Los Angeles Times: Blue Shield Of California CEO To Retire
Blue Shield of California's longtime chairman and chief executive, Bruce Bodaken, will retire at year's end, punctuating a career marked by praise for his early support of universal health coverage and criticism of his company's repeated rate hikes (Terhune, 5/24).

San Jose Mercury News: Blue Shield Of California CEO Bruce Bodaken To Retire In December
Bruce Bodaken, the longtime chairman, president and CEO of Blue Shield of California, will retire in December, the health plan announced Wednesday. Chief Operating Officer Paul Markovich will become president and a member of the board of directors on June 1, and will assume the CEO position upon Bodaken's departure (Kleffman, 5/23).

Modern Healthcare: Pa. Expands Telemedicine Coverage
Pennsylvania Gov. Tom Corbett said telemedicine coverage will expand under the state's Medicaid program. Corbett's office said in a news release that Pennsylvania's Medical Assistance program will now cover telemedicine care from additional specialty physicians, including cardiologists and neurologists (Lee, 5/23).

Kansas Health Institute News: Public Awareness Campaign Begins For Health Information Network
Starting June 1, patients of certain Kansas health care providers will receive privacy notices that tell them that their health records may be shared over a new statewide digital network. Today, officials in charge of regulating the network that is scheduled to go live July 1, briefed the media on what they think it will mean for patients and for the Kansas health care system. … Initially, patient information available on the network will be limited to demographics, medications, allergies, lab results, and medical history including problems, diagnoses, procedures, surgeries and immunizations. Down the road, more kinds of information likely will be available, such as a doctor's notes or dictation audio (Cauthon, 5/23).

Baltimore Sun: New Law Helps Schools Cope With Food Allergies
Maryland public schools will all soon be keeping emergency supplies of epinephrine on hand for students who may have an allergic reaction, and patient advocates are applauding the new law. … Susan Sweitzer, executive director of the Maryland-DC Chapter of the Asthma and Allergy Foundation of America, [said] in a statement, "While many students in Maryland public schools already carry epinephrine auto-injectors, or keep a prescribed supply with the teacher or nurse, many others don't have a prescription or even know that they are allergic to anything" (Cohn and Walker, 5/24).

HealthyCal: Removing The Stigma From Mental Illness
[A] Mental Health Summit is the first part of a campaign funded by a $100,000 grant from Riverside County to improve awareness of mental health issues, increase access to treatment, and reduce stigma. … The summit is tied to the data from the Health Assessment Resource Center (HARC), which tracks health data for the Coachella Valley. HARC’s 2010 Executive Report noted that 44% of people living in Eastern Riverside County have no mental health coverage. Their survey found that almost 30 percent of parents think their child had social or emotional difficulties, yet only one in five of those children actually sees a therapist or psychiatrist (Potter, 5/23).

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Weekend Reading

Longer Looks: When Is A Life Too Long?; The Rising Cost Of Children's Health Care

Every week, KHN reporter Shefali S. Kulkarni selects interesting reading from around the Web.

New York Magazine: A Life Worth Ending
I will tell you, what I feel most intensely when I sit by my mother's bed is a crushing sense of guilt for keeping her alive. Who can accept such suffering—who can so conscientiously facilitate it? ... In 1990, there were slightly more than 3 million Americans over the age of 85. Now there are almost 6 million. By 2050 there will be 19 million—approaching 5 percent of the population. ... By promoting longevity and technologically inhibiting death, we have created a new biological status held by an ever-growing part of the nation, a no-exit state that persists longer and longer, one that is nearly as remote from life as death, but which, unlike death, requires vast service, indentured servitude really, and resources. ... The longer you live the longer it will take to die (Michael Wolff, 5/20).

CNN: Cost Of Children's Health Care Hitting Families Harder
[Heather Bixler] was leaving her New York apartment with her 4-year-old daughter and infant son, who was in a baby carriage. ... The doorman, perhaps just to play around, picked up the stroller and held it almost vertical. Sean, the baby, fell out. His head bashed against the marble stair. ... Two years ago, the seizures started. So did the never-ending medical expenses. The Bixler family is just one example of how a child's chronic illness can strain a family emotionally and financially -- and children represent the fastest growing health care spending group in America, according to a new report (Elizabeth Landau, 5/21).

Time Magazine: Why Some Medical Students Are Learning Their Cadavers' Names
At Indiana University Northwest, an IU branch campus located in Gary, Ind., anatomy professor Ernest Talarico instructs his medical students to probe beyond the nerves and muscles of the bodies lying on their examination tables and think of the cadavers as their "first patients." ... His students also typically exchange letters with family members to glean more information about their patients' medical histories, hobbies and interests. ... While Talarico has won praise from many of the individuals involved in the program, he's also raised concerns among critics who question the ethics of his teaching technique (Dina Fine Maron, 5/17).

PBS NewsHour: Baby's Tumor Means Surgery Before Birth
Before Cami was born, a huge tumor began growing from her lower body and injured her hips and internal organs. To save her life, doctors had to operate on Cami en utero, half her body still inside a special incision in her mother Tami Dobrinski's womb. ... Cami's tumor, called a sacrococcygeal teratoma, is just one example of an uncommon category of tumors and cancerous growths that can occur in unborn children -- a teratoma like hers occurs in only one in 35,000 infants. ... hospitals that don't specialize in fetal care are not always familiar with all the possible treatments for rare conditions (Monty Tayloe, 5/18).

ABC News: Truvada Helps Couple Cope With Reality of Love and HIV
Nick Literski, 45, and Wes Tibbett, 39, have been together for six years, and their bond is strong. But when Tibbett was diagnosed with HIV in 2009, it was a major blow to the Seattle couple. Tibbett became terrified of giving the virus to Literski. ... According to the U.S. Center for Disease Control and Prevention, correct and consistent condom use greatly reduces the risk of HIV transmission. So does being in a monogamous, long-term relationship. But Tibbett and Literski still worried. Then both men started taking a daily pill, Truvada (Carrie Gainn, 5/21).

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Editorials and Opinions

Viewpoints: Politics Of The Medicare Debate; Measuring The Impact Of Catholic Bishops' Legal Challenge

Politico: Seniors Could Be Obama's Achilles' Heel
So don't expect the Obama administration to agree to any cuts in Medicare between now and Election Day. And don't expect them to show any support for Rep. Paul Ryan's plan to privatize Medicare. Holding strong on Medicare is the silver bullet for Obama. It may offset some of seniors' concerns about low interest rates on their savings (Martin Frost, 5/23).

Los Angeles Times: Put A Lid On Debt Ceiling Debate
(House Speaker John) Boehner wants to make the debt ceiling debate a substitute for debating Medicare, Medicaid or taxes by tying future increases in the limit to spending cuts, knowing Democrats will hold out instead for a mix of spending cuts and tax hikes. The impasse that would ensue would only remind financial markets of the last year's brinkmanship and dysfunction, when Congress' inability to reach a meaningful compromise persuaded one rating agency to downgrade Treasury securities for the first time in history. If it wants to engage in political theater, the House GOP would do better to pass bills rewriting the entitlement programs that are behind Washington's long-term fiscal problems than to threaten not to raise the debt limit (5/23). 

The Washington Post: The Battle Among Catholic Bishops
The headlines this week were about lawsuits brought by 43 Catholic organizations, including 13 dioceses, to overturn regulations issued by the Obama administration that require insurance plans to cover contraception under the new health-care law. But the other side of this news was also significant: The vast majority of the nation’s 195 dioceses did not go to court (E.J. Dionne, 5/23).

The Washington Post: Protecting Our Catholic Conscience In The Public Square
From an early age, Catholics are taught to see God in their neighbor. The Catholic faith finds its fullest expression in a loving act of sacrifice by one stranger for another. Imagine the church's surprise, then, to be told by the federal government that when a Catholic organization serves its neighbors, it isn't really practicing its religion. That is the unacceptable principle at the heart of a mandate, issued in February by the Department of Health and Human Services, that requires religious organizations to provide health-care coverage for abortion-inducing drugs, contraceptives and sterilization procedures, even if their faith teaches that those drugs and procedures are wrong (Cardinal Donald Wuerl, 5/23). 

CNN: How Damaging Is The Catholic Church's Obamacare Lawsuit For The President?
The Obama Administration tried to smooth things over with the church when the issue first bubbled over. As a compromise, they said insurance companies would have to provide contraception for employees who wanted it - so Catholic employers could avoid directly providing birth control. But that wasn't good enough for the church. ... Experts are split over whether these lawsuits will succeed, but either way it can't be helpful for the president in an election year. For those keeping track, President Obama has managed to anger both the black churches - over his support of gay marriage - and the Catholic Church over birth control (Jack Cafferty, 5/23).

The Wall Street Journal: Opinion: Fannie Med (Video)
Editorial board member Joe Rago on the Health and Human Services Department foray into venture capitalism (5/23). 

USA Today: Gregory House M.D.: RIP
Dr. Gregory House hung up his stethoscope and cane for the last time Monday night and shuffled off into eternal life in the Land of Reruns. House — the brilliant, misanthropic, drug-addicted, my-way-or-the-highway physician — has been an entertaining presence on Fox television since 2004. ... But as entertaining as he was, House was a throwback to an era in which the antisocial tendencies of some physicians were seen as irrelevant to their doctoring. As medical leaders strive to redefine "the great doctor" of today, House's departure is both timely and welcome (Robert Wachter, 5/22). 

Archives of Surgery: Are We Human Or Are We Surgeon?
In the past, faculty—especially surgeons—were placed or placed themselves on a pedestal. This has become less common today, but this study shows that we still have a ways to go. If we are indeed human and not just surgeons, is there a better way to let residents understand this so that they do not in turn become haughty and aloof? (Dr. Nicholas P. W. Coe, 5/23).

The Atlantic: Medicare and Medicaid: When Two Is Not Better Than One 
[U]nder the current system, the most expensive subset of Medicare and Medicaid beneficiaries are lost in a complicated web of multiple payers and programs that lack both the incentive and the ability to curb rising costs. ... For needy Americans who are likely to require aid from a variety of assistance programs, Congress should consider a holistic approach that would let states assign full responsibility for these people to a single program (Caroline Brown and Anna D. Kraus, 5/22).

New England Journal of Medicine: Primary Care Update — Light At The End Of The Tunnel?
[P]ublic policy can take delivery reform only so far. Unless we also address the income gap between specialists and primary care physicians, build high-performing teams that include nurse practitioners, physician assistants, and allied professionals, and reduce the rate of cost increases, the reform initiative will fall well short of expectations (John K. Iglehart, 5/23).

New England Journal of Medicine: Sharing The Care To Improve Access To Primary Care 
Creating [empowered health care] teams to share the care is not an end in itself. The purpose of this practice change is to address the national demand–capacity imbalance while enhancing quality and reducing clinician stress and burnout (Amireh Ghorob and Dr. Thomas Bodenheimer, 5/24).

California Healthline: Does Health Care's Profit Motive Hurt More Than It Helps?
The profit motive in health care can be a very bad thing. The incentive to maximize financial gain -- and not always at the benefit of patients -- can bring us too many surgeries and not enough primary care providers. At its worst, it can lead to massive fraud and abuse. But it can also spark positive changes -- or so the architects of the federal health reform law hoped (Dan Diamond, 5/23).

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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.