Daily Health Policy Report

Monday, May 7, 2012

Last updated: Mon, May 7

KHN Original Reporting & Guest Opinion

Capitol Hill Watch

Health Reform

Campaign 2012


Health Care Marketplace

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Insurers Embrace 'Virtual' Doctor Visits

Kaiser Health News staff writer Phil Galewitz, working in collaboration with USA Today, reports: "Insurers such as UnitedHealthcare, Aetna and Cigna, and large employers such as General Electric and Delta Air Lines are getting on board, pushing telemedicine as a way to make doctor 'visits' cheaper and more easily available. Proponents also see it as an answer to a worsening doctor shortage. But some physician and consumer groups worry about the trend" (Galewitz, 5/7). Read the story or watch a related video.

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War On Smoking Offers Some Lessons For Obesity Fight

Reporting for Kaiser Health News, in collaboration with USA Today, Judith Graham reports: "The similarities between the two public health challenges are compelling. Tobacco use is the nation's No. 1 cause of preventable deaths in the U.S., killing 467,000 people in 2005, according to a landmark study by Harvard University researchers. Being obese or overweight caused an estimated 216,000 deaths from heart disease, diabetes and other conditions, researchers estimated, while another 191,000 deaths resulted from being physically inactive – another key contributor to expanding waistlines" (Graham, 5/5). Read the story.

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Capsules: Ain't No Sunshine Yet For Docs; Rivlin On Medicare And The Debt: 'We Know What To Do'

Now on Kaiser Health News' blog, Jenny Gold reports on a new timelime for implementation of the Physician Payments Sunshine Act: "CMS has announced that the agency will not require companies to collect transparency data before January 1, 2013. The new timeline is a delay from the original ... which required HHS to come up with final reporting procedures by October 1, 2011. Instead, draft regulations were released in December of 2011; during the following 60-day comment period, CMS was bombarded with more than 300 comments from stakeholders (Gold, 5/7).

Also on the blog, Christian Torres reports: "Whoever ends up controlling the White House next year – Barack Obama or Mitt Romney – will have to make compromises if they are to solve the nation's current budget and health care crises. 'I think we know what to do,' Alice Rivlin, a former director of the Office of Management and Budget, said Friday afternoon as part of a Brookings Institution panel about how the next president could curb spiraling health care costs" (Torres, 5/4). Check out what else is on the blog.

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Obama On The Stump: Don't Turn Back The Clock On Health Reform (Video)

Kaiser Health News has video clips of a pair of speeches Saturday by President Barack Obama, in which he fired up Democratic party faithful in Ohio and Virginia. He spoke about his plans for -- and record on -- Medicare, health insurance and birth control. And he vowed that the country "will not go back to the days when insurance companies had unchecked power to cancel your policy." Watch the video excerpts or read the transcript of the health care parts of his speech in Columbus, Ohio.  

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Political Cartoon: 'Promises, Promises'

Kaiser Health News provides a fresh take on health policy developments with "Promises, Promises" by Harley Schwadron.

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


Medicare dragnet:
The feds recover millions;
bad docs pay the price.

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

House GOP Budget Cuts Social Programs – Including Medicaid -- To Stave Off Pentagon Cuts

As Congress returns after a weeklong recess, House Republicans will advance legislation to trim almost $380 billion from the federal budget, with social programs bearing the brunt of the cuts. On the Senate side, lawmakers will work on legislation to prevent the doubling of interest rates on college loans. The real issue continues to be how to pay for the fix: whether to use the health law's prevention trust fund or increase Social Security and Medicare payroll taxes for high earners.

The Associated Press: GOP Plan Boosts Pentagon, Cuts Social Programs
The Republicans who control the House are using cuts to food aid, health care and social services like Meals on Wheels to protect the Pentagon from a wave of budget cuts come January. The reductions, while controversial, are but a fraction of what Republicans called for in the broader, nonbinding budget plan they passed in March. Totaling a little more than $300 billion over a decade, the new cuts are aimed less at tackling $1 trillion-plus government deficits and more at preventing cuts to troop levels and military modernization (Taylor, 5/7).

Reuters: House Republicans Target Social Cuts To Shield Military
Republicans in the House of Representatives on Monday will fire their first shots of the next deficit-reduction battle, advancing legislation to cut nearly $380 billion largely from social programs while protecting defense spending. The cuts to food stamps, child tax credits and Medicaid healthcare for the poor, among others, are certain to stall in the Democratic-controlled U.S. Senate. But they stake out Republicans' negotiating stance on replacing $1.2 trillion in automatic, across-the-board spending cuts that are due to take effect in January (Lawder, 5/7).

The Associated Press: Senate Turns To Partisan Fight Over Student Loans
The Senate is the newest arena in the election-year face-off over federal student loans, and both sides are starting out by pounding away at each other. With Congress returning from a weeklong spring recess, the Senate plans to vote Tuesday on whether to start debating a Democratic plan to keep college loan interest rates for 7.4 million students from doubling on July 1. The $6 billion measure would be paid for by collecting more Social Security and Medicare payroll taxes from high-earning owners of some privately held corporations (Fram, 5/7).

In other news from Capitol Hill: the Food and Drug Administration user-fee bill -

Politico: User Fee Bill Appears Safe From GOP Poison Pills
A major Food and Drug Administration user fee bill is so "must-pass" that it's unlikely to get entangled in more GOP efforts to defund or repeal the 2010 health law, according to congressional staffers and industry sources pushing hard to get the bill through (Norman, 5/6).

Baltimore Sun: State Biotech Firms Hope Congress Will Act
A proposal to speed the approval of new prescription drugs has patient advocates and biotech firms — including many based in Maryland — hoping that Congress will deliver a rare dose of bipartisanship this year. Lawmakers are proposing a 6 percent increase in the fees that pharmaceutical firms pay the Food and Drug Administration to offset the cost of approving new drugs. If the measure is not signed into law by the end of September, the FDA would lose the ability to charge any fees and be forced to lay off 2,000 workers, significantly slowing review times (Fritze, 5/5).

Bloomberg: Drugmakers' Deal With Obama Said To Be Probed By House
Pfizer Inc. and Merck & Co. are being pulled into an expanding congressional investigation about the agreement drugmakers reached with the Obama administration to support the Democrats' overhaul of the U.S. health-care system, according to three people familiar with the talks. The probe began last year, with Republicans on the House Energy and Commerce Committee seeking documents from an industry trade group, said the people, who aren’t authorized to speak publicly. When that group didn't cooperate, the panel decided to target Pfizer, the world’s biggest drugmaker, along with Merck, Amgen Inc., Abbott Laboratories and AstraZeneca Plc, said one of the people (Armstrong, 5/4).

Lastly, news outlets report on how the post-election landscape might undermine the chances for compromise in Congress -  

Politico: Post-Election Compromise May Be More Difficult
By the end of last summer's grueling debt ceiling fight there was really only one thing Democrats and Republicans agreed on: They can't get anything big done until after the election. That might have been too optimistic. Many longtime Washington observers now think there's a good chance the dynamics driving the campaign may make a compromise even harder on taxes, spending and entitlements. Republicans will vow fealty to the party's anti-tax stance to sustain tea party support, while Democrats will rally their troops around Medicare, the health law's insurance coverage expansion, and other social programs (Feder and DoBias, 5/6).

MedPage Today: Election May Not Help Curb Health Costs, Wonks Say
Whether Republicans or Democrats win control in the November elections, nothing will happen that will bring healthcare costs under control without a willingness to deal, healthcare policy experts agreed. A post-election debt-reduction plan should have a bipartisan Medicare compromise such as the Ryan-Wyden plan, according to economist and former director of the Office of Management and Budget Alice Rivlin (Walker, 5/5). 

Kaiser Health News: Capsules: Rivlin On Medicare And The Debt: 'We Know What To Do' 
Whoever ends up controlling the White House next year – Barack Obama or Mitt Romney – will have to make compromises if they are to solve the nation’s current budget and health care crises (Torres, 5/4).

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Health Reform

CMS Delays Sunshine Act Data Collection Until 2013

Implementation of this provision of the health law, which is designed to shed light on the financial arrangements between doctors, drug makers and medical device companies, will now begin in 2013.

Minnesota Public Radio: Govt. Won't Begin Collecting Physician Payment Data Until 2013
The federal government will delay carrying out a key part of the health care overhaul aimed at shedding light on the financial relationships between doctors, drug companies, and medical device makers. The Centers for Medicare and Medicaid announced in a blog post that it needs more time and won't begin collecting the data under the so-called Physician Payments Sunshine Act until 2013 (Stawicki, 5/4). 

Modern Healthcare: CMS Delays Data Collection For Sunshine Act To 2013
The CMS has again extended the implementation of the Physician Payments Sunshine Act and will not require drug and device manufacturers to begin collecting data on payments to providers until 2013. The Physicians Payments Sunshine Act is a provision in the Patient Protection and Affordable Care Act that is intended to increase public accountability and transparency (Lee, 5/4).

CQ HealthBeat: Grassley, Kohl Unhappy At CMS Delay On Physician Sunshine Initiative
Two senators said on Friday that they were disappointed to learn that the Centers for Medicare and Medicaid Services is postponing implementation of a provision in the health care law designed to disclose financial relationships between drug manufacturers and doctors. Republican Charles E. Grassley of Iowa and Democrat Herb Kohl of Wisconsin pushed for the "sunshine" requirement in the law. Most manufacturers of drugs, medical devices, biologics and medical supplies will have to publicly list many payments of value to doctors and teaching hospitals (Norman, 5/4).

Kaiser Health News: Capsules: Ain't No Sunshine Yet For Docs
CMS has announced that the agency will not require companies to collect transparency data before January 1, 2013. The new timeline is a delay from the original Physician Payments Sunshine Act, which required HHS to come up with final reporting procedures by October 1, 2011. Instead, draft regulations were released in December of 2011; during the following 60-day comment period, CMS was bombarded with more than 300 comments from stakeholders (Gold, 5/7.

In other news related to the health law -

The Hill: White House Touts Health Law's Benefits For Nurses In New Report
The 2010 healthcare law is benefiting nurses and helping to cure nursing shortages, the Obama administration says in a new report to be released on Monday. The report's release coincides with the start of National Nurses Week and comes as President Obama launches his reelection effort with special attention to healthcare issues. The campaign launched a nursing-specific initiative — Nurses for Obama — in March. "Thanks to the President's new healthcare law, there will be significantly more nurses to help make our healthcare system stronger," White House official Cecilia Munoz writes in a blog post (Viebeck, 5/7).

Meanwhile, on the political front -

CQ HealthBeat: What If Republicans Go Big On Health Care? Dr. Price Has A Plan
Take an ambitious plan laid out by Rep. Tom Price of Georgia, a House Ways and Means Committee member who chairs the Republican Policy Committee. … Price is one of the fiercest House critics of "Obamacare." Yet his proposal, if looked at in the broadest terms, shares some similarities with the health law. It aims to give most, if not all, Americans access to health care. It would give lower income people financial help to buy coverage. And it relies on pooled purchasing to help insurance buyers get a better deal (Reichard, 5/4).

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Campaign 2012

Obama, Romney And Their Supporters Debate Government Role In Health Care

News outlets cover health care issues in the 2012 campaign as it heats up.

Chicago Tribune: Clinton Plugs Emanuel, Obama Initiatives
[Bill] Clinton defended the Affordable Care Act that Obama signed into law in 2010, which is now the subject of debate among U.S. Supreme Court justices who are weighing the constitutionality of the legislation's requirement that all people have health insurance (Meyer, 5/6).

Kaiser Health News: Obama On The Stump: Don't Turn Back The Clock On Health Reform (Video)
In a pair of speeches on Saturday, President Obama fired up Democratic party faithful in Ohio and Virginia. He spoke about his plans for -- and record on -- Medicare, health insurance and birth control (5/7).

Des Moines Register: Virginia AG Ken Cuccinelli Says He'll Campaign For Romney – When He's Asked
Cuccinelli said he doesn’t think the Massachusetts health-care plan has worked. "I think it was constitutional, unlike what the president did," he said. He said if the Supreme Court doesn't overturn Obamacare, Romney has committed to repealing it. "And I take him at his word and believe him," Cuccinelli said (Obradovich, 5/5).

NPR: Romney's 1994 Senate Loss Left Lasting Marks
Then came an epic October debate ... "I have supported the Roe v. Wade [decision]. I am pro-choice," [Sen. Ted] Kennedy said. "My opponent is multiple choice." Romney replied with an answer that has dogged him ever since: "My mother and my family have been committed to the belief that we can believe as we want, but we will not force our beliefs on others on that matter. And you will not see me wavering on that, or be a multiple choice, thank you very much." Later as governor, Romney changed his position — he now calls himself pro-life (Shapiro, 5/7).

Los Angeles Times: Fractious Florida Weighs Heavily On Presidential Campaigns
Romney is also trying to cut Obama's support among Jewish voters, about 5% of the electorate, by highlighting the administration's rocky relations with Israel. Obama, in turn, is wooing independents, including suburban women turned off by Romney's attacks on Planned Parenthood and his decision to side with conservatives in the debate over healthcare coverage for contraceptive services (West, 5/7).

The New York Times: Independent Senate Run In Maine Puts Parties In A Pinch
His opponents will have fodder: [Former Gov. Peter] King left the state with a budget deficit before he headed off with his wife in an R.V., accepted a $102 million loan guarantee financed by a federal stimulus program to pay for a wind-power project and supports President Obama's health care law, in addition to not saying which party he would support to lead the Senate (Weisman, 5/6).

The Associated Press/Arizona Republic: Democrats Accuse Kelly Of Changing Stance On Key Issues
Democrats are slamming 8th Congressional District Republican candidate Jesse Kelly for what they say are major changes in his stance on privatizing Social Security and Medicare designed to woo seniors turned off by his previous positions. Kelly's spokesman John Ellinwood on Friday called the candidate's most recent statements a "clarification," saying Kelly just wanted to assure seniors that he supports honoring the government's commitment (Christie, 5/4).

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Recession Drives Medicaid Spending

Job losses and diminishing income have pushed Medicaid spending to new heights, according to a study released Friday.

Reuters: Fewer Jobs Means More Spending On U.S. Medicaid
Millions of people turned to the Medicaid health insurance program for the poor during the 2007-2009 recession as families coped with job losses and drastic drops in income, pushing Medicaid spending up by an average of 6.6 percent per year, according to a study released on Friday. The study by the nonprofit Kaiser Foundation found that state and federal spending on the program, which states administer with partial reimbursements from the U.S. government, grew to $400 billion in 2010 from $330 billion in 2007 (5/4).

Meanwhile, it's not just Medicaid that is facing spiraling costs -

Stateline: High Health Care Spending Seen Driven by Price
The rising cost of health care has plagued state Medicaid programs for decades, with the federal-state health plan for low-income patients now claiming more than a quarter of state budgets. But Medicaid is not the only health plan struggling to keep up with spiraling costs. When private and public health care spending is combined, the U.S. health care bill is bigger than that of any other industrialized nation, while the quality of care is no better (Vestal, 5/7). 

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Health Care Marketplace

Health Costs, Disability Issues Cause Concern Among People Nearing Retirement

USA Today reports on new poll findings that indicate health care costs are a prominent fear among older workers. Also, Reuters reports on what might be behind the recent rise in disability claims among people in that same age group.  

USA Today: Health Care Costs Worry Workers Nearing Retirement
Health care costs are a top retirement fear, and that's even though many older workers vastly underestimate how much they'll have to pay. … Nearly half of affluent Americans, who have at least $250,000 in household assets, say they are scared that rising health care costs will deplete their retirement savings, according to a Harris Poll released today by Nationwide Financial (Dugas, 5/6).

Reuters: Job Disability A Headache For Recovery
The 47-year-old from Michigan is among the 8.7 million American workers on the U.S. disability rolls, an important part of the social safety net. Since the recession began in 2007, she has been joined by a record number of people seeking disability benefits, raising questions about the program's solvency and casting a pall over future prospects for U.S. economic growth... Economists say part of the rise in disability claims may be due to people nearing retirement who ignored a health problem when the job market was strong, but then seek benefits when they lose their job as a bridge until they qualify for Social Security pension plans (Ciancio, 5/6).

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State Watch

Calif., Ore. And Mass. Try New Ways To Control Health Costs

In Massachusetts, House lawmakers released their proposal to curb health care spending by setting a goal.

The Wall Street Journal: Same State, New Stab At Health Care
Massachusetts is laying the groundwork for an ambitious new effort to rein in health spending that would be closely watched nationally in a state that's become a health-policy bellwether. Key state legislative leaders unveiled a bill Friday that proposes setting a target for the rate at which overall health spending should rise -- a step that would once again put the state in the forefront of efforts to remake the American health care system (Levitz and Mathews, 5/4).

Politico Pro: Massachusetts Bill Would Limit Cost Growth
Top lawmakers in the state's House of Representatives introduced legislation Friday that they claim could wring $160 billion in savings from the state's health care system over 15 years. They'd do it in part by urging providers and insurers to slow cost growth to about 3 percent a year, slower than the state's economy (Cheney, 5/4).

Boston Globe: House Targets Health Spending
Providers that charge prices deemed excessive and that they cannot prove are linked to above-average quality would pay a tax, similar to the luxury tax Major League Baseball imposes on the big-spending New York Yankees and Boston Red Sox. That money also would be redistributed to financially-shaky hospitals (Kowalczyk, 5/4).

WBUR's CommonHealth blog: A New Approach To Cutting MA's Health Costs: Throw Spaghetti 
Clearly some folks will be disappointed that the plan didn't go far enough. Gov. Deval Patrick introduced legislation in February 2011 that would have allowed greater government oversight of contracts between insurers and health care providers and moved more medical groups into global payment systems that put doctors and medical groups on a budget (Zimmerman and Goldberg, 5/4).

Also in the news -

Boston Globe: What Happens When You Change An Entire Health Care System?
When it comes to what really happens to patients, doctors, and budgets when health care systems change, the evidence is shockingly sparse. It’s not easy, after all, to experiment on a health care system. Stepping into that gap is the MIT economist Amy Finkelstein, who recently won the prestigious John Bates Clark Medal, largely for her work on the economics of health care (Rothman, 5/6).

In the meantime -

Sacramento Bee: Jerry Brown Orders Task Force On Californians' Health Care
Gov. Jerry Brown ordered Health and Human Services Secretary Diana Dooley this week to form a task force to write a 10-year plan for improving Californians' health and controlling health care costs. ... The group is to report by Dec. 15 on targets for reducing diabetes, asthma, childhood obesity and other chronic conditions (Siders, 5/4).

The Lund Report: The Applications Are In: CCOs Will Be in Every Part of Oregon
The expected but still jaw-dropping announcement that the federal government would give Oregon $1.9 billion over five years to help jump start health care reform in Oregon shadowed an equally important development: the Oregon Health Authority’s receipt of 14 applications from potential coordinated care organizations that would provide care to 90 percent of the state's Oregon Health Plan population. ... The 14 applications cover all parts of the state (Waldroupe, 5/5).

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Ariz. Governor Signs Bill Banning Public Funding Of Planned Parenthood

Supporters of the Arizona bill said the law was needed to keep money from indirectly funding abortions. In the Texas case, the panel of federal appeals judges said Texas must continue funding Planned Parenthood until a lower court decides the case.

Los Angeles Times: Arizona Gov. Jan Brewer Bans Public Funding Of Planned Parenthood
Arizona Gov. Jan Brewer has put an end to tax dollars going to Planned Parenthood by signing a bill that she says closes loopholes for funding abortions. The bill, known as the "Whole Woman's Health Funding Priority Act," tightens existing state regulations and prevents any government entity -- city, county or state -- from giving money to an organization that offers family planning that may indirectly fund abortions (Castellanos, 5/5).

The Associated Press: Arizona Gov. Signs Planned Parenthood Funding Ban
Gov. Jan Brewer on Friday signed into law a bill to cut off Planned Parenthood's access to taxpayer money funneled through the state for non-abortion services. Arizona already bars use of public money for abortions except to save the life of the mother. But anti-abortion legislators and other supporters of the bill say the broader prohibition is needed to ensure no public money indirectly supports abortion services (5/4).

Arizona Republic: Arizona Abortion-Services Bill Signed Into Law
Planned Parenthood officials said the bill essentially would no longer allow them or other groups that also provide abortions to seek reimbursement from the state for non-abortion services provided to residents enrolled in the Arizona Health Care Cost Containment System, the state's Medicaid program. However, a spokeswoman for AHCCCS told The Republic late last month it is doubtful the bill would affect its services because the program sends public dollars to private providers, who can choose which partners to work with. The spokeswoman said the agency is still analyzing the bill's potential effects (Sanchez, 5/4).

Reuters: Arizona Bans Funding To Planned Parenthood In Abortion Fight
Arizona Governor Jan Brewer on Friday signed into law a bill banning abortion providers like Planned Parenthood from receiving money through the state, her office said in a statement. The Republican-backed Whole Woman's Health Funding Priority Act cuts off funding for family planning and health services delivered by Planned Parenthood clinics and other organizations offering abortions (Schwartz, 5/5).

Meanwhile, in the latest twist in a Texas fight over public funding for Planned Parenthood, a federal appeals court ruled Friday that the state can't exclude the program from a public Women's Health Program while a lawsuit is being litigated.

Reuters: Planned Parenthood Can Be In Texas Health Program, Court Says
Planned Parenthood can participate for now in a Texas health program for low-income women despite a new state rule that bans affiliates of abortion providers, a U.S. appeals court ruled on Friday. The court order from the 5th U.S. Circuit -- which lifts an emergency halt that was put in place on earlier this week -- is the latest in a series of alternating victories for Planned Parenthood and Texas. But the court battle is not over (MacLaggan, 5/4).

The Texas Tribune: Court: Texas Must Include Planned Parenthood in WHP
Gov. Rick Perry's communication staff indicated he is ready to continue fighting Planned Parenthood in court. Here's their statement: "Today's developments do not change our concerted effort in coordination with Attorney General Abbott to defend the will of Texans and our state law, which prohibits taxpayer funds from supporting abortion providers and affiliates in the Women’s Health Program. We are confident in the attorney general's appeal and will continue to pursue all available legal options in this effort" (Tan, 5/4).

Los Angeles Times: Federal Judges Lift Texas Stay On Planned Parenthood Funding
A panel of federal appeals court judges ruled Friday that Texas cannot ban Planned Parenthood from receiving state funds while a federal lawsuit over funding is pending. The lawsuit, filed last month, concerns a law Texas legislators passed last year that would have eliminated funding to 49 Planned Parenthood clinics Tuesday. On Monday, before that could happen, a federal judge in Austin granted an injunction barring the state from enforcing the law until the federal case is resolved. Within 24 hours, the state had appealed and a federal appeals court judge had stayed the injunction (Hennessy-Fiske, 5/4).

The Associated Press: Judge: Texas Can't Cut Funds To Planned Parenthood
A federal appeals court ruled Friday that Texas cannot ban Planned Parenthood from receiving state funds, at least until a lower court has a chance to hear formal arguments. A three-judge panel of the Fifth Circuit Court of Appeals agreed Friday with a lower court that there's sufficient evidence the state's law preventing Planned Parenthood from participating in the Women's Health Program is unconstitutional. The program provides basic health care and contraception to 130,000 poor women (Tomlinson, 5/4).

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Medicaid Programs In Ga., Ill. Under Microscope

States wrestle with Medicaid funding and opportunities to reshape the programs.

Georgia Health News: New Group Gains Role In State's Medicaid Planning 
A task force working with state officials on restructuring Medicaid has given rise to a new group -- one that's specifically concerned with mental health and substance abuse issues. Members of the new group say it offers them an unusual opportunity to help shape requirements for what is likely to be a huge state health care contract (Miller, 4/6). 

The Associated Press/Chicago Sun-Times: Behind The Rhetoric On Ill. Health Care, Pensions
Gov. Pat Quinn recently lit a fire under the simmering questions of what Illinois will do about climbing pension and Medicaid costs. He proposed cuts in both and warned inaction could mean financial disaster. Quinn says the cost of providing health care for 2.7 million Illinoisans is climbing so fast the state can’t keep up (Wills and Johnson, 5/6).

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State Roundup: Conn. Retiree Health Plan Expansion Could Endanger Protections

A selection of health policy stories from California, New York, Iowa, Connecticut, Florida, Minnesota, Alaska and North Carolina.

Los Angeles Times: Near Melrose, A National Health Care Predicament Plays Out
Neighbors were already concerned about the growing number of group homes for the elderly and recovering addicts in the area, many of them for profit. A Times analysis found 24 licensed facilities offering residential care for the elderly within a mile of the proposed project and three more waiting for state approval. It is one of several such clusters that have emerged in Los Angeles County -- including parts of the San Fernando Valley and South Bay -- where families can afford fees that run into thousands of dollars per month. Large swaths of the county's less affluent areas have no such facilities (Zavis, 5/7).

The New York Times: Cuomo Seeking New Agency To Police Care Of Disabled
Gov. Andrew M. Cuomo, seeking to strengthen the state's chronically weak response to abuse of disabled people who live in publicly financed homes, plans this week to propose creating an agency dedicated to investigating problems with the care of nearly one million vulnerable New Yorkers (Hakim, 5/6).

The Connecticut Mirror: Federal Opinon Undermines State's Health-Pool Concept 
The U.S. Department of Labor has advised the Malloy administration that opening Connecticut's state employee and retiree health plan to nonprofits and small businesses could jeopardize the legal protections it now enjoys as a government plan. The advisory opinion sought by Gov. Dannel P. Malloy could undermine a health care pooling bill passed last year and an expansion proposed by House Speaker Christopher G. Donovan (Pazniokas, 5/4).

KQED's State of Health blog: High-Deductible Health Plans: Health Access or High Risk?
Health care costs are skyrocketing and premiums along with them forcing some employers -- especially small businesses -- to drop coverage altogether. But others are moving to "high-deductible health plans." Five times as many businesses offer high deductible health plans as in 2005, according to the UCLA Center for Health Policy Research. But how do these plans play out for employers -- and workers themselves? (Weiss, 5/4). 

Related, earlier KHN story: Quick Facts About High-Deductible Health Plans (Kulkarni, 4/27). 

Los Angeles Times: Hospital Violated Patient Confidentiality, State Says
State regulators determined that a Redding hospital owned by Prime Healthcare Services Inc. violated patient confidentiality by sharing a woman's medical files with journalists and sending an email about her treatment to 785 hospital workers (Terhune, 5/5).

Modern Healthcare: Cancer-Care ACO To Launch In Florida
Baptist Health South Florida and oncology practice Advanced Medical Specialties, both of Miami, are working with Florida Blue, a Jacksonville-based Blue Cross and Blue Shield company, to set up an accountable care organization specifically for cancer treatment. The program will use a value-based reimbursement model that aims to lower the cost of cancer care while also improving care quality, according to a Florida Blue news release. It will focus on the treatment of the most common types of cancer (Kutscher, 5/4).

Des Moines Register: Wellmark Selects 4 Cities For Health Campaign
Four northern Iowa cities have been chosen for the first "Blue Zone" demonstration projects as part of a campaign to make Iowa the healthiest state in the nation. The winning towns are Cedar Falls, Waterloo, Mason City and Spencer. They will receive expert assistance in encouraging residents to lead healthier, more fulfilling and longer lives. The announcement was made Friday at the Des Moines headquarters ofWellmark Blue Cross/Blue Shield, a health insurer that plans to spend more than $20 million on the five-year campaign (Leys, 5/4). 

KQED/The California Report: Traditional Hmong Healers Learning to Partner With Valley Doctors 
Thousands of Hmong refugees settled in the Central Valley in the 1970s. ... [T]he Hmong were more likely to see a shaman than a doctor when they got sick and that has presented something of a challenge for health care professionals here in California. A hospital in Merced is addressing that with a program called "Partners in Healing" (Kalantari, 5/4). 

Minnesota Public Radio: Minn. Test Of Meds Delivery In Emergency Goes Well 
The Minnesota Department of Health and U.S. postal workers responded to a fictional airborne anthrax attack in the Twin Cities this weekend. ... "Operation Medicine Delivery" was the first full-scale test of a strategy for distributing medicine in the event of an epidemic or large-scale anthrax attack. About 300 mail carriers on Sunday delivered empty pill bottles to thousands of homes ... Once she did start thinking about it, [Claire] Thompson realized she has lots of questions. "How would they know how much medication to deliver to a home? Where are you going to get this stockpile anyway? I assume if everybody is so sick they can't leave their house, how you going to count on your mail service?" (Shenoy, 5/7). 

Sacramento Bee: Bill Seeks To Ban California Chiropractors From Offering Laser 'Cure' For Allergies
Claims that laser therapy can be used to cure allergy symptoms have been popping up across the country, touted by some chiropractors who say the treatment represents an innovative approach to an age-old problem. But critics question the science behind the claims, and now a far-reaching bill before California's Legislature would prohibit chiropractors from performing and advertising allergy treatments altogether (Van Oot, 5/5).

MSNBC: Alaska's Senators Welcome Agreement For Rural Health Care
Alaska's Senators are welcoming an agreement by the Veterans Administration that allows Rural Alaska veterans to receive health care benefits at Native health clinics. A release from Senator Mark Begich's office says the VA, 14 Alaska Native Tribal Health Programs and the Department of Veterans Affairs signed an agreement that allows Alaska Native veterans to get care at participating village clinics. The VA will then reimburse the clinics. Before the veterans had to travel to Anchorage or as far away as Seattle for health care (Ebert, 5/5).

Healthy Cal: Community Clinics Try To Fill Dental Care Gap
Roughly three million poor and disabled Californians had their coverage for dental services cut three years ago, and community dental clinics have struggled to cover preventative services ever since. ... Dental services aren't mandated under the federal Medicaid program and California, with a program called Denti-Cal, was once one of the few states to cover non-emergency services for adults. But with the state budget crisis, legislators cut the non-mandatory services (Shanafel, 5/4).

California Healthline: Newborn Test Takes Baby Step Forward
A bill to require hospitals to screen all newborns for congenital heart conditions recently was presented to the Assembly Committee on Appropriations -- where it was expected to get a rough reception. ... California hospitals' cost of administering the screening test to newborns, the Assembly analysis estimates additional cost to the Department of Health Care Services to launch and run the program -- up to $1 million annually, as well as start-up costs of $300,000. The legislative analysis of AB 1731 also saw potential cost savings of $350,000 a year by avoiding expensive emergency room visits and operations to treat congenital heart disease (Gorn, 5/7).

North Carolina Health News: To Save Money, Improve Health, NC Changes Mental Health System – Again
Last summer, the legislature decided to turn the agencies that oversee $2.5 billion worth of publicly-funded mental health services into small insurance companies. The plan is based on the experience of one agency that has been functioning as a pilot project for the past six years. ... But for all the good intentions and high-minded rhetoric, the changes have been fraught with controversy in the courts, anxiety, and 'misunderstandings' between the state’s model provider agency, mental health consumers, local officials and advocates (Wilson, 5/7).

The Dallas Morning News: Texas Regulators Launch New Investigation Of Parkland Memorial Hospital
Parkland Memorial Hospital fired a social worker for complaining about pressure to break safety rules, a new lawsuit alleges. Texas regulators said Friday that they’re investigating the matter, which comes to light at a particularly difficult time for the Dallas public hospital. It is struggling to carry out a huge do-or-die overhaul that federal regulators recently ordered because of widespread threats to patient safety(Egerton, 5/4).

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Editorials and Opinions

Viewpoints: Diabetes, Future Health Ills & The GOP; Debate On FDA OTC Plan; Sen. Brown's Daughter's Health Insurance

The New York Times: No Longer Just 'Adult-Onset'
A study of diabetes in overweight and obese youngsters bears an ominous warning about future health care trends in this country. It found that Type 2 diabetes, a new scourge among young people, progresses faster and is harder to treat in youngsters than in adults. ... Congressional Republicans, meanwhile, are bent on dismantling health care reforms that could greatly assist in curbing the obesity epidemic. ... Killing off [the prevention fund] would be hugely costly to Americans’ health, and future health care costs. There is no explanation for this move, except for the usual anti-health care reform demagogy (5/6).

USA Today: Editorial: FDA Prescription Drugs Plan Would Empower You
Now, some of the same naysayers are trying to derail a Food and Drug Administration proposal that could make more prescription-only drugs — such as those to treat asthma, migraines, high blood pressure and elevated cholesterol — more accessible without visits to a doctor. Today is the deadline for public comments (5/6).

USA Today: Opposing View: Don't Bypass Physicians
As physicians, our primary concern is ensuring the health and safety of our patients. The Food and Drug Administration has offered a new concept to make more prescription drugs available over the counter (OTC). Proponents claim it could improve patient health and outcomes, reduce patient costs and promote proper medication use. We are skeptical that it would achieve any of these goals (Dr. Peter W. Carmel, 5/6).

Boston Globe: Health Coverage: Helping Ayla Brown
The 23-year-old professional singer Ayla Brown surely ran into the same issue many other workers her age face: If a young, self-employed worker needs health insurance, the most affordable way for her to get it is to stay on her parents’ policy, as allowed under Massachusetts law and President Obama’s 2010 health care law. The fact that her father, Scott Brown, opposed Obama's health care overhaul doesn’t make him a hypocrite, as critics charge. Opposition to a law doesn’t oblige Brown or anyone else to pretend that it doesn’t exist (5/5). 

The New York Times: I Promise That If Elected, Everyone Will Win The Lottery
Henry IV of France guaranteed a chicken in every pot in the 16th Century. So did the Republicans in 1928. Neither party succeeded, but the potted-chicken notion seems positively modest by the standards of today's political promises. ... What [voters] should really worry about are [Romney's] incredibly bad ideas, like passing a balanced-budget amendment that would limit federal spending to 20 percent of the economy; converting Medicaid into a block grant; and converting Medicare into a voucher system (Andrew Rosenthal, 5/4).

Chicago Tribune: Accretive Health And The True Cost Of Outsourcing
Chicago-based Accretive (Health) says (Minnesota Attorney General Lori) Swanson has presented a gross misrepresentation of its tactics. But legalities aside, the dust-up points up an aspect of outsourcing that isn't always given enough consideration: For all the emphasis on what a company gets by subcontracting, such as cost containment or expertise, it is also giving up something very important. Control (Phil Rosenthal, 5/5).

The New York Times: Are Oral Arguments Worth Arguing About?
It is true that [Solicitor General Donald B.] Verrilli coughed and stumbled a bit at the beginning of the crucial second day of the health care argument, and it is possible to imagine crisper answers than some of the ones he gave. ... But the small band of lawyers who argue frequently before the Supreme Court say his performance was solid, conveying the points he was paid to make in sober and deliberate fashion (Adam Liptak, 5/5).

The Philadelphia Inquirer: Get Employers Out Of Health Insurance Business
It may have been prudent more than a half-century ago to create this type of financing of health-care services, but it makes no sense in a free and autonomous society for employers to be involved in our health insurance or decision-making — at any level. We need to emancipate ourselves from employer-based control of our ability to flourish (Stephen Gambescia, 5/6).

The Philadelphia Inquirer: Stop Playing Politics With Women’s Lives
Too many Americans don't get the preventive health care they need to stay healthy because of cost. President Obama's health-insurance-reform law expands access to important cancer-prevention tools, saving and adding years to women's lives, and eliminating difficult choices that women ... face every year (Gabrielle Union, 5/7).

McClatchy: What About Rights Of Women In The Abortion Debate?
On a 3-0 vote in a [South Carolina] Senate panel, a budget clause that would eliminate a woman’s ability to get an abortion through a state health plan if she’s a victim of rape or incest was approved. It is expected to be debated by the full Senate in May. And because the state has not elected a woman to the Senate, that debate will take place only among men (Issac J. Bailey, 5/7).

CNN: Why Emergency Rooms Don't Close The Health Care Gap
After all, it is a commonly held belief that no one can be denied care (in the emergency room). So -- in essence -- everyone can get free health care if they need it. We have a universal system after all. That, of course, is not true. … You can't get preventive care in the emergency department. … The costs of treatment in the emergency room are not quickly dismissed or written off (Dr. Aaron Carroll, 5/7).

Detroit Free Press: When Jails Must Be Mental Clinics
With the closing of most state psychiatric hospitals and cuts in community mental health programs, jails will continue to hold thousands of mentally ill prisoners. Easing the problem will require sheriffs to work closely with local Community Mental Health authorities, assess mentally ill prisoners immediately, maintain medications, and divert more nonviolent offenders from costly jail time to treatment. Federal and state lawmakers should enact legislation requiring insurance and Medicaid benefits to continue in jail (Jeff Gerritt, 5/6). 

The Kansas City Star: All Pay For Untreated Mental Illness
In the face of financial pressures on our city, state and federal government, ensuring the needs of those suffering from severe mental illness are met can appear challenging. Yet the fiscal risks of not addressing these medical and social needs results in far greater costs and puts our society at risk. ... the costs to metropolitan Kansas City of untreated mental illness is more than $624 million per year (Bernard Franklin, 5/6).

Sacramento Bee: Big Tobacco's Unlikeliest Ally
Wearing a lab coat and speaking from an exam room, La Donna Porter looks every bit the wise physician, even as she does the bidding of the tobacco industry, which contributes to the deaths of 443,000 Americans every year. Porter is the star of tobacco-funded radio and television commercials intended to snuff out Proposition 29, the initiative on the June 5 ballot that would raise taxes by $1 per pack on cigarettes (Dan Morain, 5/6).

The Washington Post: Forget Gambling — Prince George's Should Go All In On Health Care
I propose a different approach to solving Prince George’s [County, Md.] budget dilemma: Make the county the go-to destination for quality health care in the region. ... A large, 21st-century health-care sector would be a much more reliable way to bring revenue and good, permanent jobs to the county in an industry with huge potential for growth. And it also would address another stubborn challenge facing the county: finding a way to improve health care in Prince George’s, which falls near the bottom of many regional health-care measurements (Melony G. Griffith, 5/5).

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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.