Daily Health Policy Report

Wednesday, May 30, 2012

Last updated: Wed, May 30

KHN Original Reporting & Guest Opinion

Campaign 2012

Capitol Hill Watch

Health Reform

Health Care Marketplace

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Some Patients Can Choose To Be Hospitalized At Home

Writing for Kaiser Health News, in collaboration with USA Today, Judith Graham reports: "Dr. Elizabeth Ward bent over (the patient) after checking his temperature, blood pressure, and oxygen levels and finding that all were normal. 'Would you rather stay home or go to the hospital?' she asked Frank Blondin, 52. ... 'Home,' Blondin responded, without hesitation. Soon, the doctor was managing a 'hospital at home' admission for Blondin -- an arrangement allowing him to receive intensive care and medical monitoring in the quiet of his own bedroom (Graham, 5/30). Read the story.

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Capsules: Psychiatric Manual May Soon Include 'Gambling Disorder'

Now on Kaiser Health News' blog, consumer columnist Michelle Andrews writes: "The proposed revisions to the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, would add 'gambling disorder' to alcohol and drug problems as a 'substance use and addictive disorder' that insurers and others would use to make decisions about treatment and coverage" (5/29). Check out what else is on the blog.

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Romney Clinches Nomination, Promises Health Law Rollback On 'Day One' (Video)

This Kaiser Health News video offers highlights from last night's Las Vegas speech, in which he warns that health law will "make it harder for small businesses to hire and grow" (5/30).


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Political Cartoon: 'Career Path'

Kaiser Health News provides a fresh take on health policy developments with "Career Path" by David Fitzsimmons.

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


Texas gives Romney
the votes to claim the title...
Health plan to follow.
- 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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Campaign 2012

Romney Clinches GOP Nomination With Texas Vote

As GOP presidential hopeful Mitt Romney steps up his political attacks on President Barack Obama, the health law will be one of his frequent themes. Also in the news, an aide says Romney will soon offer details on his health policy proposals.

The New York Times: Nomination His, Romney Steps Up Attack On Obama
For his part, Mr. Romney is trying to get voters to envision him as president. His debut television advertisements present what a "President Romney"” would do on "Day 1," with an announcer saying: "President Romney issues order to begin replacing Obamacare with common-sense health care reform — that's what a Romney presidency would be like" (Zeleny and Rutenberg, 5/29).

Kaiser Health News: Romney Clinches Nomination, Promises Health Law Rollback On 'Day One'
Video: Now the presumptive GOP nominee, the former Mass. governor warns in a Las Vegas speech that health law will "make it harder for small businesses to hire and grow" (5/30).

Reuters/The Chicago Tribune: Romney Clinches Republican 2012 Nomination In Texas
Romney in weeks ahead will turn to Obama's 2010 healthcare overhaul. The U.S. Supreme Court is to decide in late June on the constitutionality of the law's requirement that all Americans purchase health insurance. Romney has vowed to repeal the law if elected, citing it as an example of too much government under Obama. He has faced criticism from Republicans for the healthcare overhaul he developed for Massachusetts that Obama has called a model for revamping the U.S. system (Holland, 5/30).

Boston Globe: GOP Nomination Clinched, Mitt Romney Pushes Anew
Romney also has a potential health care curveball, with a Supreme Court decision coming within weeks that could strike down Obama's law. The issue remains tough political terrain for Romney. Although he has vowed to repeal Obama's federal law, Romney passed the state-level precursor while governor of Massachusetts. He has yet to fully spell out what changes he would make on a federal level (Viser, 5/30).

The Wall Street Journal's Washington Wire: Romney Economic Adviser: Details Coming Soon On Regulatory and Health Care Proposals
Glenn Hubbard, a top economic adviser to Republican presidential candidate Mitt Romney, said the former Massachusetts governor will soon detail proposals for health care and financial regulation. The remarks, made in a wide-ranging interview with Wall Street Journal reporters and editors, could give voters a clearer distinction between President Barack Obama's health care and financial regulatory laws and the changes Mr. Romney would like to make to them (Paletta, 5/29).

Also in the headlines -

The Hill: Poll: Majority Supports Special Courts For Malpractice Suits
The survey, conducted on behalf of Common Good, says 75 percent of those polled believe malpractice suits are contributing to the high cost of insurance and medical care. Republicans have made malpractice reform a central tenet of their healthcare platform, but trial lawyers and many Democrats say the GOP's proposed approach would do little to control the actual effect on healthcare costs (Baker, 5/29).

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Health Care, Women's Health Issues Split Midwest Voters Ahead Of Elections

In Ohio, working class voters are split on whether Mitt Romney or President Barack Obama more closely aligns with their views on health care.

Reuters: Ohio's White Working-Class Voters: On The Fence
Health care is an issue that might seem to work in Romney's favor. The Reuters/Ipsos poll shows mosts Rust Belt workers disapprove of Obama's push for the 2010 reform law and many bristle at the idea of Americans being forced to buy insurance. … Opposition to the law comes from left and right. If many see it as big government intrusion, others fault the president for being too timid in asserting a strong federal role (Roosevelt, 5/29).

And in Wisconsin, Gov. Scott Walker is being attacked for his views on women's health --

Politico Pro: Dems: Walker 'Extreme' On Women's Health
As polls show that Wisconsin Gov. Scott Walker is increasingly likely to survive efforts to recall him, Democrats on Tuesday accused him of trying to limit women’s access to health care. Rep. Gwen Moore (D-Wis.) said support for Walker from Virginia Gov. Bob McDonnell -- he's campaigning in the state Tuesday --underscores that the two are "birds of a feather." "Just as Gov. Bob McDonnell has tried the radical transvaginal ultrasound bill ... Scott Walker has indeed embraced extreme positions on women's health care," Moore told reporters on a conference call, citing Walker's "broken contracts" with the state's Planned Parenthood chapter (Haberkorn, 5/29).

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Capitol Hill Watch

U.S. House Poised For A Series Of Health-Related Votes

Included on the list is a bill to repeal the health law's medical device tax and another to repeal the OTC ban. The device-tax issue has already emerged as a hot topic in many congressional races.

Modern Healthcare: Refreshed Representatives Renew Reform Repeal
Refreshed after (another) brief recess, House members will return to Capitol Hill on Wednesday to a summer session that includes some significant healthcare votes. ... "Regardless of the outcome of the Supreme Court's decision on the constitutionality of Obamacare, we should all be able to agree on Erik Paulsen's (R-Minn.) bill to repeal the medical device tax and Lynn Jenkins' (R-Kan.) bill to repeal the OTC ban," House Majority Leader Eric Cantor (R-Va.) wrote in a memo to House Republicans that outlined the House's summer legislative agenda (Zigmond, 5/29).

Politico: Medical Device Tax Is Questioned
A controversial health care reform tax due to go into effect next year has become a prominent issue in a number of House and Senate races throughout the country (Haberkorn, 5/30).

Also in the news, work continues on the FDA bill -

The Hill: Revised FDA Bill Would Cut Deficit By $370 Million
House Republicans have changed their Food and Drug Administration bill enough to get a positive score from the Congressional Budget Office. The FDA bill is set for a floor vote this week. A new CBO analysis says the amended bill would reduce the deficit by $370 million over the next decade. The version that passed the Energy and Commerce Committee earlier this month would have added nearly $250 million to the deficit, according to CBO (Baker, 5/29).

The New York Times: Drug Maker Seeks Protection Within Bill Favoring Generics
One of the few bills moving through Congress with bipartisan support this spring would speed government approval of lower-cost generic copies of brand-name drugs. But one company, with help from an influential former congressman, is lobbying to protect its most lucrative brand-name product against generic competition and appears to have had some success in the House, potentially altering the bill to make it more favorable for the company (Pear, 5/29).

Meanwhile, the Social Security disability program's trust fund is hitting the skids - 

Bloomberg: Congress Unwilling To Address Disability Plan's Shortfall
A U.S. government entitlement program is headed for insolvency in four years, and it's not the one members of Congress are talking about most. The Social Security disability program's trust fund is projected to run out of cash far sooner than the better-known Social Security retirement plan or Medicare. That will trigger a 21 percent cut in benefits to 11 million Americans -- disabled people, their spouses and children -- many of whom rely on the program to stay out of poverty (Faler, 5/29).

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House To Vote On Bill Banning Abortions Based On Sex Of Fetus

According to rules governing the vote, the GOP will have to pick up about 50 Democrat votes to pass the bill. The vote may not be the end of abortion controversies on the Hill this year, however, as several measures have been inserted into national security bills, Politico Pro reports.

The Hill: House Plans Vote On Bill To Ban Sex-Selective Abortion
The House is set to vote Thursday on a controversial bill that aims to ban sex-selective abortions by fining or imprisoning doctors who perform them. Republicans must balance their need to appeal to female voters against pressure from conservatives on social issues. The GOP leadership will bring the bill to the floor under suspension of House rules, which means two-thirds of the chamber will have to express support for it to pass. This is unlikely, because it would require 50 Democrats to vote in favor (Viebeck, 5/29).

CQ HealthBeat: House To Vote On Sex-Selective Abortion Ban With Race References Removed
The House will vote Wednesday on a bill that would outlaw abortions sought on the basis of the fetus's sex, after dropping similar language for abortions sought on the basis of the race of the unborn child or its parent. It is unclear whether the move to focus the bill only on sex-selective abortions will win enough Democratic supporters for passage (Ethridge, 5/29).

National Journal: Republicans Leap On New Abortions Issue This Week
Unlike other abortion votes in the House, this bill is heading to the floor under suspension of the rules. It's a procedural maneuver typically reserved for less-controversial bills and requiring two-thirds of House members present and voting to pass. Somewhere around 287 members will have to vote "aye" in order for the bill to pass (depending how many members show up), meaning approximately 45 Democrats will have to sign on with Republicans. In other words, it's a higher bar to passing the bill (McCarthy, 5/29).

Politico Pro: Security Bills Latest Abortion Battlegrounds
Members on both sides of the Capitol -- and both sides of the aisle -- have inserted abortion provisions into several national security bills, setting the stage for political showdowns that could trip up the authorization and funding bills for some of the largest federal departments. The latest came late last week, when Sen. Jeanne Shaheen (D-N.H.) succeeded in attaching an amendment to the National Defense Authorization Act that would loosen strict limits on when the Defense Department will cover abortions for its service members and dependents. The department's current policy only covers abortion when the pregnancy is life-threatening. That makes it more restrictive than the limitations under the health plans that cover civilian federal workers and public programs governed by the Hyde Amendment, which also allow for abortions in cases of rape or incest (Feder, 5/29).

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Hospital Debt-Collection Practices To Be Examined At Wednesday Hearing

Sen. Al Franken, D- Minn., convened the hearing to find out whether aggressive efforts to collect debt from patients in hospitals broke any federal laws.

(St. Paul) Pioneer Press: Franken Hearing Wednesday To Focus On Fairview Collection Tactics
One of the witnesses scheduled to testify during a U.S. Senate field hearing about collection tactics at Fairview Health Services offered a preview of her comments on Tuesday, May 29. Jean Ross said the collection issue surfaced when her grandson was being treated in 2010 at Fairview Ridges Hospital in Burnsville after the 13-month-old boy had been rushed to the emergency room with what turned out to be an acute inflammation of the brain called encephalitis (Snowbeck, 5/29). 

The Associated Press/Minneapolis Star Tribune: Senate Hearing Will Spotlight Hospital Debt Collection
Health care executives will face tough questions Wednesday at a U.S. Senate field hearing after a lawsuit from Minnesota Attorney General Lori Swanson revealed aggressive efforts to collect debt from patients in Minnesota hospitals. Sen. Al Franken is holding the hearing of the Senate Health, Education, Labor and Pensions Committee in St. Paul. Franken is examining whether the debt collection practices broke federal laws (5/30).

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Health Reform

State Exchanges And Health IT Could Be Hurdles To Health Law Implementation

News outlets report on the challenges posed by various provisions of the health law.

The Associated Press: Obama's Health Care Aid To Small Firms Disappoints
It seemed like a good idea at the time. But a health insurance tax credit for small businesses, part of President Barack Obama's health care law that gets strong support in public opinion polls, has turned out to be a disappointment. Time-consuming to apply for and lacking enough financial reward to make it attractive, the credit was claimed by only 170,300 businesses out of a pool of as many as 4 million potentially eligible companies in 2010 (Alonso-Zaldivar, 5/30).

USA Today: Conservatives Campaign Against Insurance Exchanges
Conservative organizations have canvassed the country in recent months to try to persuade state legislators not to pass bills to create health insurance exchanges. ... Without state exchanges, the federal government will be unable to implement the 2010 health care law, ALEC [the American Legislative Exchange Council], the Cato Institute and other conservatives say. Exchanges are websites where consumers can compare costs and benefits of available insurance plans in the state, as well as buy insurance (Kennedy, 5/30).

Politico: IT Could End Up Being Health Reform's Highest Hurdle
If state health care exchanges survive the Supreme Court challenge to health care reform, the election and state tea party activists, health policy experts are worried they could still be brought down by a much more mundane problem: information technology (Feder, 5/29).

MedPage Today: Most Individual Health Policies Don't Meet ACA Rules
More than half of the people who had individual health insurance in 2010 were enrolled in plans that wouldn't pass muster under new standards set up by the Affordable Care Act (ACA), researchers found. So in 2014, most people with individual health coverage will see a marked boost in the quality of their insurance as well a reduction in cost, according to a study published in the June issue of Health Affairs. That's the year in which states must establish (or defer to the federal government to set up) health insurance exchanges, as required by the ACA (5/29).

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Judge Denies Injunction Seeking To Change What Washington Attorney General Argues On Health Law

A judge denied requests that would have made Attorney General Rob McKenna tell the Supreme Court what he's said publicly, that parts of the federal health care law should stand minus the individual mandate. 

The Seattle Times: Judge Denies Injunction In Health Care Lawsuit Against McKenna
A judge dealt an initial defeat Tuesday morning to plaintiffs in a lawsuit alleging Republican Attorney General Rob McKenna violated his ethical duties while participating in the multi-state lawsuit seeking to overturn President Obama's health care overhaul. King County Superior Court Judge Sharon Armstrong denied a request for a preliminary injunction sought by plaintiffs which would have required McKenna to change his legal tune in the case by filing amended briefs to the U.S. Supreme Court. The plaintiffs, dozens of women represented by attorneys allied with the Democratic Party, had argued McKenna should be required to argue to the Supreme Court what he has said publicly -- that the entire Affordable Care Act should not be struck down if the high court invalidates its controversial requirement that most adults maintain private health insurance (Brunner, 5/29).

MSNBC: Judge Denies Injunction Against McKenna’s Health Care Lawsuit
McKenna, a GOP candidate for governor, joined other GOP attorneys general in the federal health care lawsuit more than two years ago. He said that mandate was unconstitutional, though he supported other parts of the federal overhaul. The women's lawsuit targeted his efforts to overturn the whole law -- not just the part he disagrees with (5/29).

In Iowa, a fight is brewing over who may assist Iowans in finding health insurance coverage after the governor signed a bill requiring that health insurance "navigators" be licensed.

CQ HealthBeat: Iowa Governor Signs Law Requiring Exchange Navigator Licensing
Iowa's governor approved legislation late last week that AARP Iowa says is a "premature" and "backdoor" way of hampering the activities of whatever health insurance exchange the state eventually creates. Gov. Terry Branstad, a Republican, on May 25 signed into law a budget bill that includes a provision saying that the so-called navigators who will assist Iowans in finding health insurance coverage and advice must be licensed by the state under standards similar to those of insurance agents or brokers. Such navigators are required to work in tandem with state exchanges under the health care overhaul law (Norman, 5/29).

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Health Care Marketplace

With Adderall Shortage, Drug Counterfeiters Try To Seize A Market Opportunity

NPR: Counterfeiters Exploit Shortage To Market Fake Adderall Pills
A shortage of Adderall began last year, sending millions of people with attention deficit/hyperactivity disorder and narcolepsy on perpetual wild goose chases to find drugstores with the pills they need to stay alert and focused. So it's not surprising that Adderall counterfeiters have seized a big marketing opportunity. What is surprising is their clumsiness (Knox, 5/29).

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In New Models For Care, Seniors Look At Co-Housing Options While Patients Elsewhere Get Hospital Care At Home

Some elderly residents of North Carolina are exploring co-housing options to avoid having to leave their homes. Meanwhile, in a few spots health leaders are instituting the "hospital at home" concept.

North Carolina Health News: Aging In Place: NC Seniors Are Shaping Their Futures
Some elder North Carolinians are looking for ways to insure they never have to leave their own homes, that means exploring alternatives. One option is co-housing, a concept growing in popularity across the country with families and single adults of all ages. In co-housing environments, residents commit to living as a community and take an active role in designing and maintaining that community (Sisk, 5/30).

Kaiser Health News: Some Patients Can Choose To Be Hospitalized At Home
"Hospital at home" programs fundamentally refashion care for chronically ill patients who have acute medical problems -- testing traditional notions of how services should be delivered when people become seriously ill.  Only a handful of such initiatives exist, including the Albuquerque program, run by Presbyterian Healthcare Services, and programs in Portland, Ore., Honolulu, Boise, Idaho, and New Orleans offered through the Veterans Health Administration (Graham, 5/29).

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Caterpillar Union, Florida Unions Fight Plans That Would Affect Health Care

The contract proposal from Caterpillar would have a number of changes for workers, including requirements that they pay more for health care. In Florida, unions are seeking to stop a plan to save money by privatizing health care for prison inmates.

The Wall Street Journal: Union Urges Caterpillar Rebuff
Union leaders at a Caterpillar Inc. plant here say they will urge striking workers to reject a slightly revised contract offer from the maker of construction and mining equipment. ... The basic pay and benefit elements of the Caterpillar offer are unchanged. The six-year contract would allow Caterpillar to freeze wages for workers hired before May 2005. For those hired since then, the company could adjust wages based on its assessment of the labor market. Workers would pay more for health insurance and transition from a defined-benefit pension plan to a standard 401(k) retirement-savings program. Caterpillar would have more flexibility to require workers to switch to different shifts (Hagerty, 5/29).

Miami Herald: Unions Sue To Stop Prison Health Care Privatization Plan
(Florida) Gov. Rick Scott's administration was back in a familiar place Tuesday, the courtroom, where two unions are challenging a plan to save money by privatizing health care to the state's 100,000 inmates. The state has already hired two out-of-state firms to do the work at a minimum cost savings of 7 percent a year. But the Florida Nurses Association and American Federation of State, County and Municipal Employees (AFSCME) say the privatization plan is unconstitutional and want Circuit Judge Kevin Carroll to block its implementation (Bousquet, 5/29).

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State Watch

Ill. Lawmakers Race To Approve Cuts, Tax Increases To Fill Medicaid Budget Hole

A $1-per-pack cigarette tax increase moves along in that state's legislature.  It would help fill a budget gap in the Illinois Medicaid program. Lawmakers also approve a bill that further defines nonprofit eligibility for hospitals. In the meantime, lawmakers there also consider changes to retiree pensions and health care.

The Associated Press/Washington Post: $1-A-Pack Tax Increase For Cigarettes Passes Illinois Senate Committee Along Party Lines
Democrats argue the increase will help close a hole in the state Medicaid budget and also help prevent smoking. Republicans object to any tax increase. Officials face a $2.7 million budget problem for Medicaid. They've already approved spending cuts of roughly $1.6 billion (5/29).

Modern Healthcare: Tax-Exemption Legislation Heads To Ill. Governor's Desk
The Illinois Senate approved a bill that attempts to better define what makes a not-for-profit hospital eligible for tax-exempt status and increases the state's cigarette tax to fund its Medicaid program. The state's House approved the same bill last week (Selvam, 5/29).

Stateline: Illinois Rushes To Finish Budget, Medicaid And Pension Changes
What may be the nation's most fiscally troubled state is in the middle of a fateful week. Illinois legislators are racing to approve a new state budget and changes to the state's Medicaid and public employee pension systems ahead of their scheduled adjournment tomorrow. On Medicaid, legislators already approved $1.6 billion in cuts last week. Now, the state is poised to approve a dollar-a-pack cigarette tax increase that would help Medicaid meet its costs. The measure would more than double the amount of the tax (Goodman, 5/30).

Chicago Sun-Times: Unions: Pension Bill Forces Choice 'Between Harm ... Or More Harm'
A House Democratic push to force state workers and retirees to either surrender their automatic 3-percent pension increases or give up their state health insurance appeared to combust Tuesday in a flame of partisan bickering and heavy union pushback. ... Those unwilling to give up their automatic 3-percent annual pension increases would have to surrender their generous, state-subsidized health care coverage, and current employees would be barred from having future pay increases factored into the size of their pensions (McKinney & Maloney, 5/29).

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State Roundup: Minn. Defends Medicaid Billing; Cigna, N.H. Group Form Joint Venture; Health Coupons In Mass.

A selection of health policy headlines from Minnesota, New Hampshire, Massachusetts, California and Kansas.

Minneapolis Star Tribune: Minnesota Tries To Fend Off Criticism On Medicaid
Top Minnesota health officials pushed back Tuesday against a congressional committee probing allegations that the state overbilled federal taxpayers for Medicaid services to cover losses from in other state-run public health programs. In a letter to the House Oversight and Government Reform Committee, Minnesota Human Services Commissioner Lucinda Jesson defended reforms implemented under DFL Gov. Mark Dayton, saying "our focus has been on changing course rather than investigating the past." Jesson's letter was addressed to U.S. Rep. Darrell Issa, R-Calif., chairman of the House oversight committee, which has been focusing on a $30 million payment to the state last year from UCare, one of four state Medicaid contractors (Diaz, 5/29).

Modern Healthcare: Cigna, N.H. Group Form ACO
Cigna and the Granite Healthcare Network, a network of hospital organizations in New Hampshire, announced that they have formed an accountable care organization. … Cigna said it has established 26 of what it calls "collaborative accountable care initiatives." In March, the Bloomfield, Conn.-based insurer said it would form an ACO with Fairfax Family Practice Centers in Virginia (Lee, 5/29).

Boston Globe: Bill Would Legalize Medical Coupons
State lawmakers have prided themselves on being first in the nation, especially when it comes to health care, but a proposal making its way through the Legislature would make Massachusetts the final state to allow pharmaceutical drug coupons. Such coupons appear in magazine ads and online, but they are worthless in Massachusetts ­because of a 1988 state law that forbids any rebate for health care purchasing, with penalties of up to a $10,000 fine or even prison time (Metzger, 5/30).

WBUR's CommonHealth blog: But Will The Cost-Cutting Bills Really Save Money?
It may not rank at the tippy-top of the titillation scale, but this thoughtful discussion about reining in health care costs featuring Brian Rosman of Health Care For All, and Joshua Archambault of The Pioneer Institute, covers some key issues in the [Massachusetts] House and Senate cost-cutting proposals now pending in the Legislature. The plans are estimated to save about $150 billion over 15 years, but Archambault calls the proposals "faith-based initiatives," when it comes to savings projections. That's because he says it remains unclear if the new focus on prevention and wellness and the new payment models will actually save money (Zimmerman, 5/29).

HealthyCal: Dentist Shortage Leading To More Emergencies
The lack of dentists and specialists in rural Californian counties is leading to high rates of tooth decay and preventable dental emergencies, especially among low-income residents. ... A 2006 survey conducted in four northern Californian rural counties found that this combination of low access and low incomes hurts oral health. More than 28 percent of respondents living at or below the federal poverty level hadn’t been to a dentist in five or more years. Many of them had never seen a dentist. Only 40 percent of respondents had been to a dentist in the previous year -- the recommended length of time between visits (Shanafelt, 5/30).

Stateline: States, Feds Poised To Write New Chapter In Public Safety Communications
More than a decade after [the 9/11 attacks], Congress has approved $7 billion and the reallocation of 20 megahertz of spectrum airwave capacity to try to deal with the inter-communication problem. Those resources will help in the effort to create a national public safety network capable of transmitting both voice and data, including videos and photos. But many implementation challenges lie ahead, even with generous funding and broad bipartisan agreement that the network is a national priority (Maynard, 5/30).

California Healthline: CMS Weighs In On Enrollment Question
Federal health officials have informed the state that CMS would favor passive enrollment with an opt-out provision but it does not support lock-in enrollment for the dual-eligible demonstration project in California. That's according to Kevin Prindiville, deputy director of the National Senior Citizens Law Center in Oakland, who spoke to CMS officials on Friday (Gorn, 5/30).

Kansas Health Institute News: Governor Signs Jobs Bill For Disabled
Gov. Sam Brownback today signed into law a bill that he said would create jobs for people with disabilities, reducing their reliance on public assistance. … House Bill 2453 would give certain advantages in gaining state contracts to companies that employ people with disabilities. The companies could win bids up to 10 percent higher than the lowest competing bid, if 20 percent of their employees had a physical, developmental or mental disability. To qualify for the preference, the companies also would have to cover 75 percent of their employees’ health insurance premiums (Ranney, 5/29).

Kansas Health Institute News: Lobbying Prohibition Added To SRS Contracts
The Kansas Department of Social and Rehabilitation Services is adding new language to its contracts with service providers that is intended to tighten an existing restriction against the contractors using state or federal funding to influence legislation. … Interhab has been outspoken in its opposition to state policies that allow years-long waiting lists for services and the governor's plan to include long-term services for the developmentally disabled in KanCare, the governor’s plan for letting managed care companies run the state’s Medicaid program. The administration last month agreed to postpone including the services in KanCare for a year. … There’s nothing wrong or illegal, [a past president of Interhab] said, with Johnson County Developmental Supports belonging to Interhab or with Interhab testifying for or against proposed legislation (Ranney, 5/29).

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Editorials and Opinions

Viewpoints: Ryan Plan's 'Fiscal Cliff;' Does The FDA Have An App For That?

Roll Call: What Happens If We Go Off The Fiscal Cliff?
Here, we know the game plan from House Budget Chairman Paul Ryan (R-Wis.): Run on the Ryan budget, win it all, hold on until after the inauguration, and in the meantime, plan "the mother of all reconciliation bills" to negate the defense sequester, double down on discretionary domestic budget cuts, make permanent the Bush tax cuts, enact a new tax cut on top of them, reducing the top rate to 25 percent, and do as much to turn Medicaid into a sharply reduced block grant to the states and create a premium support system for Medicare as revised reconciliation rules will allow. What that plan would do to the fragile economy, to the safety net and to the long-term deficit and debt situation, is, or should be, a giant question now and through the election campaign (Norman Ornstein, 5/30).

The Wall Street Journal: Georgetown's Political Exorcism
Last week, some 43 plaintiffs, including Catholic University and the University of Notre Dame filed 12 lawsuits challenging the mandate on grounds that it compromised their religious freedom. Georgetown, the nation's oldest Catholic university, instead found itself on the receiving end of a different lawsuit altogether. "Exorcist" author William Peter Blatty has filed a canon lawsuit to have the school sanctioned for fraternizing with Catholics' declared legal nemesis in the abortion mandate fight (Collin Levy, 5/29).

The Wall Street Journal: There's A Medical App For That – Or Not
Even the most ideologically opposed politicians agree: Health care is choking on paperwork, and medicine is prone to errors of handwriting, lost information and guesswork. That's why the promotion of health information technology is one of the only demilitarized zones in Washington. ... Despite such broad political support—plus that of health insurers, providers, drug companies and patient groups—the Food and Drug Administration (FDA) unfortunately has rushed in to play bureaucratic spoiler just as this new engine of innovation was leaving the station (Dr. Scott Gottlieb and J.D. Kleinke, 5/29).

Boston Globe: Less Hospital Power Could Mean Lower Health Care Prices In Mass.
Perhaps the most vexing challenge the Massachusetts Legislature confronts as it seeks to lower health care costs is the disproportionate market power that certain hospital networks, including Partners HealthCare System, enjoy by virtue of their prestige, power, and customer appeal. ... There is, however, a market-based fix that could go a long way toward restoring equal bargaining power between such networks and insurers: Force all hospitals in a network to negotiate their fees separately. Thus, Partners wouldn’t have so much negotiating power when it comes to leveraging higher prices for its suburban affiliates (5/30).

Boston Globe: A Fiscal Forecast For Massachusetts
The bad news is that sometime over the next five years, the state will once again face an escalating structural deficit in that the projected growth in revenues at current tax rates will be insufficient to maintain existing state programs. This is the result of two trends: health care cost inflation plus state tax cuts implemented during past administrations. By next year, health care spending by the Commonwealth will account for 41 percent of state budgetary spending, up from 23 percent in 2000 (Barry Bluestone, 5/30).

Houston Chronicle: Good Nutrition Is Nonpartisan
Along with the rest of the nation, Texas faces the increasingly pressing dilemma of how best to deal with our unhealthy eating habits and their dire consequences -- fast-rising obesity, diabetes and medical costs…. But legislators are optimistic about achieving results in the next session. Human Services chair Richard Raymond, D-Laredo, told the committees they will need to take action, because "there are going to be some fairly immediate consequences." … More power to them. Let's hope it's catching (5/29).

KQED: Misperceived And Misunderstood
Mental health is not part of most traditional holistic and naturalistic concepts in Asian cultures. Mental health is truly a foreign concept for many Asians. … We can increase Asian Pacific Americans' psychological mindedness through programs that are linguistically and culturally competent (Dr. Jorge Wong, 5/30).

Chicago Sun-Times: Pension Reform May Quell Quinn's Summer Plans
Practically overnight — or at least over the Memorial Day weekend — Quinn switched from endorsing a pension reform plan that fell entirely on current state workers to one that allows them to share the pain with those who are already retired. Under the proposal advanced by House Speaker Michael Madigan, both current and future retirees would be forced to forego the annual 3 percent cost of living increases to which they are now entitled — or give up their rights to health care benefits (Mark Brown, 5/30).

Kansas City Star: Translational Medicine: From Research To Effective Cures
It currently takes a new discovery an average of 13 years to make it to market. Ninety-five percent of discoveries never even get that far, and those that do carry an extraordinary cost — averaging more than $1 billion. The process that takes a drug from discovery to demonstrating that it works in the clinic is known as translational research. Because of the immense challenges, now is the time we should engage our best minds, from different areas of expertise, in figuring out how to do it better (Lesa Mitchell, 5/29).

Baltimore Sun: Markets Are Less Competitive Than You Think, And Government Is Not Always Monopolistic
As our so-called "laboratories" of democracy, the state governments also provide competition or, at the very least, exert upward innovative pressure on Washington. To pick just one very salient example, the health care individual mandate that is the cornerstone of President Barack Obama's Affordable Care Act was partially modeled — to Mitt Romney's great chagrin — on the health insurance mandate that then-Governor Romney enacted in Massachusetts (Thomas F. Schaller, 5/29).

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Stephanie Stapleton

Andrew Villegas

Lisa Gillespie
Shefali Luthra

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