Daily Health Policy Report

Tuesday, May 25, 2010

Last updated: Tue, May 25

KHN Original Reporting & Guest Opinion

Capitol Hill Watch

Health Reform

Medicare

Administration News

Coverage & Access

Quality

Health Care Marketplace

Health Information Technology

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Spouses Face Hurdles When Caring For Themselves, Sick Loved Ones

Reporting for Kaiser Health News, in collaboration with The Washington Post, Paula Span writes: "They met on a blind date in 1949 and married two years later. They lived in the same Cape Cod-style house in Silver Spring for nearly 50 years. So when Leonard Crierie was diagnosed with Alzheimer's disease in 2005, there was no question that his wife, Betty, would take care of him at home for as long as she could" (Span, 5/25). Read the entire storyWatch the video.

This Story: Print | Link to | Top

KHN Consumer Column: Insuring Your Health – College Student Health Plans Often Get Low Marks

In this Kaiser Health News column, produced in collaboration with The Washington Post, Michelle Andrews writes: "Aaron Smith is learning the hard way that student health insurance has limits. After breaking his wrist snowboarding in 2008 and twisting his knee playing soccer last year, the 28-year-old Georgetown University law student racked up $925.69 in medical bills, his share of the cost under Georgetown's UnitedHealthcare student health plan" (Andrews, 5/25). Read entire column.

This Story: Print | Link to | Top

Capitol Hill Watch

Experts Question 'Doc Fix' As Reid Threatens Weekend Work On Bill With COBRA, Medicare Provisions

Politico: Experts are questioning the virtues of the three-year Medicare "doc fix" that would stave off cuts to Medicare doctors' pay but set up a larger fight down the road. ... In health policy circles, the 'doc fix' has become emblematic of Washington's worst habits: a potentially solvable policy problem run amok for about a decade now, bogged down in pure politics and accounting gimmicks. The 'doc fix,' a last-minute infusion of funds to head off a looming doctor pay cut under Medicare, hits the floor this week via the tax extenders bill ..."

"Without the fix, reimbursement rates to doctors would be cut by 21 percent starting June 1. The problem, many say, is that the "Sustainable Growth Rate," which sets the formula for reimbursement for doctors, assumed that a 1990s slowdown in physician payments would continue. The opposite happened. "The problem first became apparent in 2002, when Medicare costs outpaced the SGR. A Republican-led Congress stepped in with extra funding the following year, preventing a reduction in doctor payments. Congress has continued to do so for seven years now" (Kliff, 5/25).

The Hill: The bill that the "doc fix" is attached to — a package of tax cut "extenders" — also includes mandated drug discounts to hospitals that treat the poor. "The new language would require that discounts be provided for patients who don't have prescription drug coverage, a substantial change from the earlier provision that would have mandated discounts for all patients. Sources said they expect the drug industry to support it. The Pharmaceutical Research and Manufacturers of America (PhRMA) is not commenting on the legislation. … Under current law, drug makers must offer deep discounts to federally qualified health centers and other places that serve poor patients — but only for outpatient care." It would "only cost the federal government about $35 million over 10 years" which is relatively uncontroversial, however the passage of the broader, more expensive tax entender package "remains in doubt." The package also includes an extension of COBRA health insurance subsidies for newly laid-off workers (Pecquet, 5/24).

CongressDaily: As the House prepares to act on the legislation Tuesday or Wednesday, Senate Majority Leader Harry Reid is hinting that he may keep the Senate in session this weekend to finish work on the bill. "House Ways and Means Chairman Sander Levin said floor consideration could slip to Wednesday, leaving little time for the Senate to act. And if any changes enter the picture during Senate floor debate, the bill would have to come back to the House."

In the meantime, lawmakers are preparing a short-term fix for COBRA subsidies and the Medicare physician payment fix if action slips (Cohn, 5/25).

Related, earlier KHN coverage: How The Tax Bill Would Affect Medicare, Medicaid And COBRA Subsidies (Villegas, 5/21).

This Story: Print | Link to | Top

Health Reform

Federal Lawyers Ask Judge To Dismiss Virginia Overhaul Lawsuit

Obama administration officials asked a judge to dismiss Virginia's lawsuit challenging the new health reform law because the state does not have standing to sue over the requirement that individuals will be required to buy health insurance, The Washington Post reports. "Federal attorneys argued that individuals, not the state, are affected by the requirement. … Further, they wrote that the mandate causes no injury to the state and will not take effect until 2014, making the legal challenge not yet timely."

Virginia Attorney General Ken Cuccinelli, a Republican, filed suit, arguing that a recent Virginia law saying residents can not be forced to buy insurance gives his state standing. Federal attorneys said, "If states could manufacture standing in the way Virginia attempts to do here, every policy dispute lost in the legislative arena could be transformed into an issue for decision by the court." The Obama administration also argues that the requirement is allowed under Congress's power to regulate interstate commerce, but "Cuccinelli maintained in his statement that a person who chooses not to buy health insurance is not engaged in commerce" (Helderman, 5/25).

The Richmond Times-Dispatch provides background on the case: "In March, Cuccinelli filed suit against the federal government saying that the legislation's insurance mandate -- which would require nearly every American to obtain insurance or face a fine by 2014 -- was unconstitutional. Cuccinelli's suit argues that by including the mandate, Congress overstepped its authority under the Commerce Clause in Article 1 of the U.S. Constitution. As a result, he argues, a recently passed Virginia law that prohibits residents from being compelled to purchase health insurance should prevail." That argument separates the Virginia case from a suit brought by more than a dozen other states that challenges the health overhaul on the grounds that it violates the 10th Amendment, which protects states' power (Nolan, 5/25).

The Virginian-Pilot: Meanwhile, "[a]dvocates of the health care plan say it will extend coverage to millions of uninsured Americans, some of whom receive health care treatment but lack insurance, a situation that can burden the system." The federal lawyers wrote in their response to Cuccinelli's filing, "Foregoing health insurance, however, is not the same as foregoing health care. When accidents or illnesses inevitably occur, the uninsured still receive medical assistance, even if they cannot pay" (Walker, 5/25).

The Roanoke Times: Saying that the insurance requirement therefore affects interstate commerce, "[t]he U.S. attorneys argued that the minimal coverage provision in new federal law is essential" if health insurance is to be available and affordable. "They noted that the federal law will, beginning in 2014, prohibit insurance companies from denying coverage for pre-existing conditions and from basing eligibility on factors such as health status, medical condition or medical history." Cuccinelli said--as he has before-- "Just being alive is not interstate commerce" (Sluss, 5/25).

This Story: Print | Link to | Top

Health Law Bodes Well For Young People's Coverage, Isn't Helping Democrats

The New York Times reports that young people — representing nearly one-third of the 46 million uninsured in America — stand to "reap substantial benefits" from expanded coverage for them in the new health law.

The group, broadly defined as those aged 19-29, stand to benefit through "public programs like Medicaid or by buying private policies on competitive insurance exchanges established by the law. … In late September, insurers "will be required to cover children on family health plans through age 25, and many companies are making the change now so new college graduates do not face gaps in coverage." In addition, 7.1 million people will be eligible for Medicaid starting in 2014 because their income will be less than 133 percent of the federal poverty level, about $14,000 for an individual. "And up to 5.6 million uninsured young people will qualify for government subsidies if they buy private coverage through the insurance exchanges" (Rabin, 5/24).

In a consumer column, Kaiser Health News/The Washington Post reports that for some students who can't take advantage of their parents' health plans (or whose parents don't have coverage) "student health plans may be the only option. And unfortunately, many college plans offer limited protection, even for this generally healthy group. 'Sixty percent of the plans out there are pure junk,' says Stephen Beckley, a health-care management consultant for colleges and universities who's based in Fort Collins, Colo. In some important ways, the new law has the potential to stiffen the backbone of student plans. Starting in October, all health plans, including college ones, must eliminate lifetime limits on coverage and most annual limits as well." A government report found that in the past, nearly all student plans had imposed maximum lifetime benefits (Andrews, 5/25).

The San Jose Mercury News:  "Though reforms in the much-hyped federal health care legislation won't unfold fully until the end of the decade, young adults, small businesses and Medicare recipients can benefit as soon as this summer, and already people are shopping for better care." Insurance brokers are reporting that they are providing information to potential customers on the changes and that a report "released last week, the most detailed yet on how the federal legislation will play out locally, anticipates that 34,000 of the county's currently 44,000 uninsured will be covered by 2018. The gains will begin this year, the report confirms" (Alexander, 5/24). 

The Associated Press: On the political side of health law implementation, the picture isn't so rosy for Democrats. "Two months after Obama's health care overhaul narrowly passed Congress, polls suggest many Americans still either don't like the looming health care changes or are skeptical of them — and Republicans are seizing on that discontent at every opportunity" (Raum, 5/24).

This Story: Print | Link to | Top

State Regulators Mull Definition Of Medical Loss Ratio

News outlets report on efforts to define what will be  considered "medical expenses" when it comes to the mandated medical loss ratios in the new health law.

The law requires that health insurers spend 85 percent of premiums on medical expenses for customers in the large group market and 80 percent for customers in the small and individual markets, leaving the rest for "expenses that do not directly benefit customers -- like payroll, advertising, overhead and profits," CNN reports. "To enforce this new health care spending requirement … regulators are now trying to determine which costs should be classified as medical and which are administrative. ... The system that ultimately emerges could have a big impact on the medical care that many consumers receive. The new medical loss ratio requirements go into effect Jan. 1, 2011."

The Department of Health and Human Services has requested state insurance commissioners to submit proposals for how expenditures should be classified. "Many states already have minimum medical loss ratios, [Kim] Holland [secretary of the National Association of Insurance Commissioners] said, and most take a 'fairly conservative view' on what counts as health care -- but the criteria can vary widely. At issue are medical services such as nurse hotlines, said Dylan Roby, researcher at the UCLA Center for Health Policy Research." In addition, "[t]hough there's nothing to stop insurers from jacking up prices in the short term in order to distort their medical loss ratios, Roby said, HHS will review rate hikes annually. He thinks this will give insurers incentive to keep premiums low" (Pepitone, 5/25).

Reuters reports that state heath commissioners had been asked to submit their medical loss ratio proposals by June 1, but the NAIC "now say it will take at least another month to deliver a detailed response. NAIC said in a statement on Monday that it would respond to U.S. Health Secretary Kathleen Sebelius by June 1 but it 'will not include the final definitions and calculation methodologies.' The group said no date had yet been set, but a spokesman said the goal was July 1. … The ratio is closely watched by investors as a key sign of potential profitability and monthly premium rates" (Heavey, 5/24).

This Story: Print | Link to | Top

Medicare

HHS 'Special Mailing' On Health Law's Immediate Medicare Benefits Sparks GOP Grumbles

CQ HealthBeat: "Education or propaganda? Or 'beyond propaganda?' The Centers for Medicare and Medicaid Services announced Monday that it will soon send Medicare beneficiaries a special mailing on 'the immediate benefits they may see' from the health care overhaul law. Getting accurate information about key provisions of the law will help Medicare enrollees 'to be on the alert for any scams asking for personal information,' explained acting CMS Administrator Marilyn Tavenner in an agency news release Monday. ... CMS learned from implementing the Medicare prescription drug and other laws that 'unfortunately new opportunities for Medicare beneficiaries also bring new opportunities for scam artists to try and defraud seniors'" (Reichard, 5/24).

McKnight's Long Term Care News: "The mailing will outline the immediate impact of the Affordable Care Act on Medicare benefits. It will mention that the agency will issue a one-time check for $250 for seniors who will fall into the Medicare Part D coverage gap and will not receive Medicare Extra Help. ... Other changes include preventive care services, such as colorectal cancer screening and mammograms, without cost-sharing, as well as new crackdowns on criminals who are seeking to scam seniors and steal taxpayer dollars" (5/25).

Contra Costa Times: "The publication is [also] available under the 'What's New' section at www.medicare.gov." Among other changes, "the law promises to combat elder abuse and neglect and improve nursing homes. Although it gave no details, the publication said the law creates a voluntary insurance program called CLASS to help pay for long-term care and support at home" (Hughes, 5/24).

ABC News: "Other areas are massaged more carefully in the brochure. For instance, the law will cut by more than $130 billion over ten years government payments to companies that offer Medicare Advantage plans. About one quarter of Medicare beneficiaries are on these plans, which replace normal fee for service Medicare with a bundled plan overseen by a private administrator. In the mailing to seniors, [HHS Secretary Kathleen] Sebelius does not use the word 'cut,' but instead points out that the government pays more per person for these plans than for fee for service plans."

"While most experts agree that some Medicare Advantage providers will pull out of the market, Sebelius says that the new law will 'protect Medicare Advantage members by taking strong steps to ensure that at least 85 % of every dollar these plans receive is spent on health care, rather than administrative costs and insurance company profits.' She is referring to new rules on so-called Medical Loss Ratios that require all insurers – not just those providing Medicare Advantage plans – to spend between 80 and 85 percent of medical premiums on care" (Wolf, 5/24).

Congress Daily: "Republicans criticized the mailing as a purely political move by the Obama administration to gain support for the health law. 'This goes beyond propaganda and is blatantly political,' said Ways and Means ranking member Dave Camp. 'If this document is really about Medicare, then why is there information in there about 26-year-olds being able to stay on their parents' policies?' Camp asked in a statement" (McCarthy, 5/25).

Roll Call: "Public opinion surveys continue to show public dissatisfaction with the law, the centerpiece of President Barack Obama's legislative agenda over his first year in office. … Polls show seniors have particular concerns about the law's effect on Medicare" (Drucker, 5/24).

This Story: Print | Link to | Top

Administration News

DOJ Warns Hospitals, Insurers: Mergers Will Be Scrutinized

The Obama administration warned the health care industry Monday that it "won't hesitate to block mergers that threaten to stifle competition," The Associated Press reports.

"Justice Department antitrust chief Christine Varney told a lawyers' conference that vigorous enforcement of anti-monopoly laws is vital to the success of the new health care law, particularly in trying to control rising premiums." Varney listed both insurers and hospitals as potential targets of investigations. The new health exchanges should provide choice and competition for individuals and small businesses buying insurance policies directly, but "Varney said the goals of health care overhaul 'cannot be achieved' if insurer mergers reduce competition, or if big companies use their market clout to keep out upstarts" (Alonso-Zaldivar, 5/24).

Main Justice: "According to an internal DOJ study, Varney said, new insurers have trouble competing with large players in certain markets because they can't recruit new patients without provider discounts. It becomes a catch-22, she said, because they can't negotiate for discounts without a large number of patients. But in markets with a few medium-sized players, where no one plan has the clout to demand a larger discount, new firms are more likely to secure similar discounts, she said. 'It is, therefore, imperative that the division prevent mergers or acquisitions that will create, or even increase the size of, dominant health insurance plans, particularly in the small-group and individual markets,' Varney said."

In addition, the DOJ "will also challenge exclusive contracts between insurers and large providers that make it harder for the provider to negotiate with a new insurer, she said" (Viswanatha, 5/24).

This Story: Print | Link to | Top

Coverage & Access

Federal Law To Expand Coverage To Kids Is Off To Slow Start

USA Today: "A federal law that President Obama signed early last year to expand health insurance to 4 million more low-income children has gotten off to a slow start because of budget problems in the states. The law makes more than $10 billion in federal aid available each year through 2013 but requires state funds as well." As states have increasingly faced tightening budgets, fewer than half have used the federal assistance "to expand the Children's Health Insurance Program, studies by the Kaiser Family Foundation, National Academy for State Health Policy and Georgetown University Center for Children and Families show. About 15 states scaled back coverage by increasing waiting periods, raising premiums or making signup more complicated, Kaiser's study found." The result is that many states will leave federal money on the table and the target of covering 4 million children may not may not be reached. "The struggles in the states may offer a lesson for the broader insurance expansion projected under a new health care law, designed to cover 32 million more people over 10 years" (Wolf, 5/25).

The Associated Press/Chicago Tribune: Meanwhile, almost "three-quarters of children on Medicaid in nine states are not getting all of their legally required medical, vision and hearing examinations, including immunizations, according to a new government study. The Dept. of Health and Human Services Inspector General's study "estimated that 2.7 million of the 3.8 million children in those states, or 76 percent, did not receive one or more of the medical, vision or hearing screenings during 2007." The nine states are Arkansas, Florida, Idaho, Illinois, Missouri, North Carolina, Texas, Vermont, and West Virginia. "Doctors say regular checkups are especially important for low-income children who are at higher risk for chronic problems including obesity, depression and poor cognitive development" (Kennedy, 5/25).

This Story: Print | Link to | Top

Quality

Academic Researchers Say Tour Yielded 23 Percent Increase In Patients Who Got Best, Cheapest Drugs

Reuters reports that 150 academic researchers touring the U.S. to make recommendations on diuretics and best and cheapest practices for blood pressure medicine have reported a 23 percent increase in patients who get the recommended drugs, "twice the increase in the U.S. over the same period."

"'We thought it would make a bigger difference, but it did make some difference,' said Dr. Barry Davis, of the University of Texas School of Public Health in Houston, who worked on the study, published in the Archives of Internal Medicine. … In 2002, Davis was one of the researchers behind a large study comparing different blood pressure medicines. He found that the older, cheaper drugs -- so-called thiazide-type diuretics — did better than newer medications, and at a fraction of the price. But although the results soon made it into national guidelines, Davis was disappointed to see that this didn't seem to have a dramatic effect on doctors' prescriptions." With $4 million in National Institutes of Health funding, Davis and colleagues toured to tout the use of the cheaper medication. Others say so-called "academic detailing" is a way to fight commercial interests in the lucrative world of pharmaceuticals (Joelving, 5/24).

This Story: Print | Link to | Top

Health Care Marketplace

Gentiva Purchase Of Odyssey Would Create Largest U.S. Home Health And Hospice Provider

A plan from Gentiva Health Services to buy Odyssey HealthCare for almost $1 billion would create the largest U.S. provider of home health and hospice care, The Associated Press reports. "The boards of both companies have approved the acquisition, which is expected to close in the third quarter, pending approval by regulators and Odyssey stockholders. The companies said the deal will create a hospice care provider with an average daily patient census of about 14,000 and operations in 30 states. They anticipate the combination will create a company with more than $1.8 billion in annual revenue." Last week Gentiva acquired United Home Care Group, another such home care and hospice company (5/24).

The Wall Street Journal: "Jefferies & Co. analyst Arthur Henderson called Gentiva's acquisition of Odyssey 'a strategically sound move that will not only drive incremental growth for the company, but will also allow it to diversify its business while generating operations synergies.' Industry insiders for years have debated the merits of melding home nursing and hospice, with Gentiva a long-time proponent based on its view that the businesses can share referral sources, marketing staff and recruitment resources, Mr. Henderson said." Some analysts don't expect antitrust concerns "as the two companies' hospice businesses don't overlap much, [some analysts say]. … Gentiva is among the companies that recently received a letter from the Senate Finance Committee, which is questioning whether they deliberately increased the number of times they sent caregivers to patients' homes in order to trigger higher Medicare reimbursement payments" (Wisenberg Brin, 5/25).

In other acquisition news, Intuit has acquired Medfusion, which provides health information technologies, for $91 million, Modern Healthcare reports. "Privately held Medfusion, [of] Cary, N.C., provides Web-based services that allow patients to schedule appointments, pay bills and send providers prescription refill requests. Publicly traded Intuit, Mountain View, Calif., provides a Web-based service in collaboration with health plans to help patients keep track of their medical bills, copayments and insurance reimbursements. Both companies use each other's software and services, according to a company statement" (Conn, 5/24).

This Story: Print | Link to | Top

UnitedHealth Shareholders Reject Plan To Weigh In On Executive Pay

A proposal to allow UnitedHealth Group shareholders to make suggestions about executive pay was voted down by the same shareholders it would have empowered at the firm's annual meeting Monday, the Minneapolis Star Tribune reports. The proposal failed with only forty-six percent of shareholders supporting it. "While 'say on pay' has come up before -- garnering a vote of 38.5 percent last year -- the finances of insurance companies are under more scrutiny than ever with the passage of health reform." The proposal would have allowed non-binding, advisory comments by shareholders on executive pay at each annual meeting (Yee, 5/24).

Phoenix Business Journal adds that the company's board opposed the proposal. But, shareholders of "several large companies, including General Mills, approved say on pay proposals in the past year" (Grayson, 5/24).

Kansas Business Journal reports that another proposal was rejected, too. It "would have required the company to annually report to shareholders its lobbying expenditures and activities. … Health Care for America Now, or HCAN, a grass-roots health care reform group, pledged in a release to get both issues on the UnitedHealth Group ballot again next year" (Sherry, 5/24).

This Story: Print | Link to | Top

Penn. Doc Creates Medical Home As Part Of Health Care Transformation

The Philadelphia Inquirer reports on Joseph Mambu, a Pennsylvania doctor who created a medical home in 2001. At the beginning "Mambu didn't know where he was headed. Now he's at the vanguard of a movement sweeping America - the patient-centered medical home - in which physicians have more time for complex cases and are much more proactive in promoting the health of all patients, who have same-day access to their medical team." It's a concept promoted by the new health law and one many experts call "the future of primary care. … For four years, Mambu worked 80-hour weeks to build his new practice, Family Medicine, Geriatrics & Wellness, in Lower Gwynedd. He teamed with Lisa Albert, a nurse practitioner, and with his wife. ...  In 2005, Mambu was accepted into the TransforMED Demonstration Project run by the American Academy of Family Physicians. Fewer than 5 percent of medical school graduates were choosing primary care. A new model needed to be created. This project was going to be the laboratory. Just 36 practices in America were accepted. Mambu was the only Pennsylvanian" (Vitez, 5/25).

This Story: Print | Link to | Top

Health Information Technology

Federal Funding To Support Health IT Training; New Web Tools For Patients

A federally-funded health information training program is now underway, Modern Healthcare reports. "Last month, HHS' Office of the National Coordinator for Health Information Technology awarded $112 million of stimulus funds to dozens of universities and community colleges. … Boosting employment nationwide was a major goal of the stimulus law, and there is little doubt, according to the government and industry leaders, that tens of thousands of new jobs will be needed if the federal effort to push provider adoption of EHRs is to be successful." The funding will support courses from six-month certificates for job seekers to post-graduate degrees (Conn, 5/24).

"A new Web-based tool seeks to help patients spend less time in the waiting room before seeing their doctor," The Wall Street Journal reports. "The application, called MedWaitTime, allows patients to check before their appointment whether their doctor is running late, akin to getting a flight-status update before going to the airport." The system, which launched last week in Chicago with a group of 10 doctors, allows patients to check for changes on a website or receive text-message alerts to their cell phones (Wang, 5/25).

This Story: Print | Link to | Top

State Watch

State Roundup: Oklahoma, S.C. And Ill. Facing Tough Choices On Health Costs

States around the country are debating how to deal with health costs and tight budgets.

NPR: "State officials in Georgia are not happy about the new federal health law. The governor has joined 19 other states that have filed suit to nullify it. And the state insurance commissioner is refusing to set up a high-risk pool to sell health insurance to people with medical problems" (Silberner, 5/25).

The Associated Press/Houston Chronicle: "The Oklahoma Legislature considered several options Monday to raise revenue to help close a $1.2 billion hole in the state budget, and fell one vote short in the House in attempting to prevent a delay in funding for the health care needs of low-income residents. The House voted 67-33 for the emergency clause on a bill that institutes a 1 percent fee on paid health care claims, falling short of the 68 needed to pass it. Supporters say the measure would generate about $78 million annually, which could then be matched three to one with federal money to support health care programs" (Murphy, 5/24).

Kansas Health Institute: "The Kansas Department of Social and Rehabilitation Services has suspended voluntary admissions to the state's three hospitals for the mentally ill. All three facilities are full beyond licensed capacities, officials said. … It's become increasingly common for Larned State Hospital, Osawatomie State Hospital, and Rainbow Mental Health Facility in Kansas City to have four or five too many patients. Last week, however, each had at least nine too many. In recent years, SRS has been able to avoid suspending admissions by shifting referrals; patients who ordinarily would have been sent to one hospital were sent to another. That's not an option when all three hospitals are over census" (Ranney, 5/25). 

The (South Carolina) State: "The S.C. Senate must deal this week or next with a new round of House cuts aimed primarily at health care, which would eliminate breast cancer screenings for 16,000 poor S.C. women and limit poor patients to three prescription drugs a month. It's the House's way of dealing with a $21 million shortfall in court and public safety funds it does not want to cover with increased fees and fines. But $50 million in health care cuts, which some critics say has become the favorite target of Republican lawmakers, isn't a silver bullet, either, health care advocates say. Costs ignored on the front end typically have greater costs down the line. If people are not getting HIV drugs or cancer screenings, then people could die, the advocates say" (Burris, 5/25). 

Minnesota Public Radio: "The race for governor usually focuses on state-based issues like K-12 schools, the budget and taxes. But already in this campaign, federal issues, in particular federal health care, are generating attention. The main issue is a plan that would shift about 100,000 low-income Minnesotans from two state health programs into a federal program. … The shift, which requires $188 million more in state funds, would mean roughly $1.4 billion more in federal funds. Republicans balked at the idea and the two sides agreed to allow the next governor to decide the matter" (Scheck, 5/25).

Minneapolis Star Tribune: "Twila Brase has no idea why a magazine named her one of America's 100 most powerful people in health care, and, frankly, neither do her critics. … The 51-year-old nurse turned activist is hardly a household name. Yet in Minnesota political circles, Brase, founder of the St. Paul-based Citizens' Council on Health Care, enjoys the reputation of a self-made libertarian lightning rod, an increasingly powerful free-market contrarian who blocks more public policy than she creates. ... Brase opposes anything she thinks constricts individual freedom or invades privacy. That puts her at odds with many of the most popular concepts in modern health care: evidence-based medicine, electronic medical records, DNA databanks, doctor quality ratings" (Spencer, 5/24).

The (Springfield, Ill.) State Journal-Register: "Retired state employees would be charged premiums for health insurance under budget reforms being pushed by a group of Democratic lawmakers. ... Lawmakers must figure out how to deal with a $13 billion deficit while acknowledging there is inadequate support for tax hikes, deep spending cuts or borrowing, the three major alternatives for balancing the budget. ... Under the Democrats' plan, expected to raise $100 million a year, rates charged to retirees would be on a sliding, income-based scale." The plan would also cut "$200 million by instituting changes to Medicaid" (Finke, 5/24).

The Miami Herald: "Bill McCollum's campaign for governor recently began bashing his Republican rival [Rick Scott] for heading a hospital company that paid a record $1.7 billion fraud fine for bilking Medicare and Medicaid. But McCollum seemed to have a different perspective 12 years ago when he was a congressman and pushed legislation that, critics said, would have 'gutted' a federal whistleblower act and was designed to halt federal investigations of hospitals -- namely Columbia/HCA, which was run at one point by his new political rival, Rick Scott."

The Herald reports that, at the time, "McCollum was only quoted as defending hospitals under investigation. Months after McCollum filed the whistleblower legislation, he received $3,000 in congressional campaign contributions in a single day from Columbia/HCA executives, according published reports and the Center for Responsive Politics, a campaign finance watchdog group. Today, as the state's attorney general, McCollum fashions himself as a Medicaid fraud fighter. And he's made Scott and Columbia/HCA into a poster child of fraud" (Caputo, 5/25).

This Story: Print | Link to | Top

Editorials and Opinions

Today's OpEds: States Must Take On Public Health Challenges; Placing Blame For High Health Costs

Out With Rationing, In With Price Controls The Wall Street Journal
Britain's 'reform' will do little to improve access to life-extending drugs (5/25).

Blog Watch: A Conservative Conundrum Kaiser Health News
Bloggers found a lot to occupy their thoughts today–ranging from conservative beliefs about government health care spending to the future of health savings accounts and a study that found increasing out-of-pocket spending among the insured (Kate Steadman, 5/24).

Mass. Health Meltdown Is Your Future New York Post
The future of US medicine under ObamaCare is already on display in Massachusetts. The top four health insurers there just posted first-quarter losses of more than $150 million (Sally Pipes, 5/25).

Closing A Gap The (Milwaukee) Journal Sentinel
And if more people gain access to dental care, as seems likely when provisions of the recently passed national health care reform bill take effect, then more dentists will be needed to treat those patients. But there will need to be incentives to lure those dentists into poorly served rural areas (5/24).

State Must Renew Efforts To Curb Smoking Knoxville News Sentinel
Elected officials can blame the poor funding of anti-smoking programs on the current state of the economy, but that argument goes only so far. Tennessee brings in about $400 million in tobacco taxes and payments from a settlement agreement involving dozens of states and tobacco companies (5/24).

Blame Liberals For Higher Costs The Wheeling News Register
It is likely West Virginia public employees and retirees will pay more for health insurance next year. If so, they can blame President Barack Obama, House Speaker Nancy Pelosi, Senate Majority Leader Harry Reid - and members of Congress who voted for the new national health care law (5/24).

This Story: Print | Link to | Top


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.