Daily Health Policy Report

Tuesday, May 7, 2013

Last updated: Tue, May 7

KHN Original Reporting & Guest Opinion

Health Care Marketplace

Health Reform


Capitol Hill Watch

Administration News

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Doctors' Diagnostic Errors Are Often Not Mentioned But Can Take A Serious Toll

Reporting for Kaiser Health News, in collaboration with The Washington Post, Sandra G. Boodman writes: "Recent studies underscore the extent and potential impact of such errors. A 2009 report funded by the federal Agency for Healthcare Research and Quality found that 28 percent of 583 diagnostic mistakes reported anonymously by doctors were life-threatening or had resulted in death or permanent disability. A meta-analysis published last year in the journal BMJ Quality & Safety found that fatal diagnostic errors in U.S. intensive care units appear to equal the 40,500 deaths that result each year from breast cancer. And a new study of 190 errors at a VA hospital system in Texas found that many errors involved common diseases such as pneumonia and urinary tract infections; 87 percent had the potential for 'considerable to severe harm' including 'inevitable death'" (Boodman, 5/7). Read the story.

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Insuring Your Health: Health Law's Medicaid Expansion And Online Marketplaces Offer Veterans New Care Options

In her latest Kaiser Health News consumer column, Michelle Andrews writes: "Military veterans will have more health insurance options under the Affordable Care Act, but some vets, like many Americans, may still struggle to find affordable, accessible care that meets their needs. Roughly 40 percent of the 22.3 million military veterans receive health-care services from the Veterans Health Administration, which operates a nationwide network of medical centers, hospitals and clinics" (Andrews, 5/6). Read the column.

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Capsules: 2 Studies Assert Lower Spending Growth Is Due To Structural Health Changes; Boston Children's Hospital Creates 'Living' Practice Guidelines

Now on Kaiser Health News' blog, Jordan Rau writes about the findings of two studies regarding the nation's lower spending growth: "Two new studies assert that the country's unusual slowdown in health spending growth rates may be due more to structural changes in the health care system than to the lagging economy, and thus could continue even after business picks up" (Rau, 5/7).

Also on Capsules, Julie Appleby reports on Boston Children's Hospital's practice guidelines: "Now, though, Boston Children's Hospital says it has found a way to create guidelines that have reduced costs and variation in care while improving patient outcomes – all without angering doctors. Called SCAMPS, the program aims to standardize care for a variety of medical conditions – all while allowing its guidelines to evolve as new information is collected and analyzed, according to a paper published Monday in the journal Health Affairs" (Appleby, 5/6). Check out what else is on the blog.

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Political Cartoon: 'You'll Shoot Your Eye Out?'

Kaiser Health News provides a fresh take on health policy developments with "You'll Shoot Your Eye Out?" by Jimmy Margulies.

Meanwhile, here is today's health policy haiku:


Health care prices climb,
but not as fast as before. 
A blip or a trend?

 If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

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Health Care Marketplace

Studies Suggest Slowdown In Health Care Costs May Last

The two studies in Health Affairs suggest that recent decreases in the rate of growth of health care spending may be a result of changes in how consumers pay for care and greater efficiency in how it is delivered and, therefore, may continue after the economy recovers.

The Wall Street Journal: Muted Health-Expense Growth May Persist
Two new economic analyses suggest a recent slowdown in health-spending growth may reflect lasting change due to fundamental shifts in how health care is delivered and paid for. The findings come as economists and policy experts debate whether the damped growth is a temporary phenomenon tied to the recession and its aftermath or is more linked to permanent changes, such as increased efficiency among health-care providers (Mathews, 5/6).

Kaiser Health News: Capsules: 2 Studies Assert Lower Spending Growth Is Due To Structural Health Changes
Two new studies assert that the country's unusual slowdown in health spending growth rates may be due more to structural changes in the health care system than to the lagging economy, and thus could continue even after business picks up (Rau, 5/7).

The New York Times: Slowdown In Health Costs' Rise May Last As Economy Revives
One of the economic mysteries of the last few years has been the bigger-than-expected slowdown in health spending, a trend that promises to bolster wages and help close the wide federal deficit over the long term — but only if it persists (Lowrey, 5/6).

Bloomberg: Health-Care Cost Slowdown Seen Saving Up To $770 Billion
People with health insurance saw increases in their medical costs slow from 2009 to 2011, signaling potential structural changes in the industry that could cut health-care inflation and save the U.S. hundreds of billions of dollars, according to two studies. The changes include greater use of generic drugs, higher out-of-pocket costs and more efficient care, a trend encouraged by the 2010 health-care overhaul, said David Cutler, a Harvard University health economist (Bloomberg, 5/7).

NPR: Why A Slowdown In Health Spending Is Starting To Look Real
While not solved, the growth in health spending has definitely slowed. That's the consensus of a series of studies out in the past few week. The latest bunch are in this month's issue of the policy journal Health Affairs (Rovner, 5/6).

Politico: Will Health Care Cost Slowdown Last?
Maybe health care won’t bankrupt the country after all. A dramatic slowdown in the growth of health care spending in recent years could be here to stay, according to two studies published Monday by Health Affairs (Norman, 5/7).

PBS NewsHour: U.S. Health Costs Rising More Slowly, But Will It Last?
Americans still pay more than twice the price for health care than most other developed countries, but the sticker shock has come with a bit of good news in recent years: Costs are rising more slowly. "Exceptionally slowly," as the authors of a new Health Affairs study put it. Between 2009 and 2011 -- years that included and immediately followed the recession -- health spending grew at about 3 percent per year. That's down quite a bit from the 5.9 percent increase seen in the previous 10 years (Kane, 5/6).

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Health Reform

For Health Law Backers, Part Of Challenge Is Managing Expectations

Some Democrats worry they will face political repercussions if there are snags that can be exploited by Republicans.

The New York Times: New Worries For Democrats On Health Law
As the administration struggles to put in place the final, complex piece of President Obama's signature health care law, an endeavor on a scale not seen since Medicare's creation nearly a half-century ago, Democrats are worried that major snags will be exploited by Republicans in next year's midterm elections (Calmes, 5/6).

CQ HealthBeat: Backers Say Health Law Success Must Not Be Judged In One Year, But…
Amid growing indications that next year's expansion of coverage under the health care law could fall far short of original projections, supporters and analysts increasingly say its success must be judged over a period of years, not just by what happens in 2014. But while millions of Americans may in 2014 have access to treatments and medications they've never had before, talk about the law may be dominated by a potentially wide gap between expectations and actual enrollment gains (Reichard, 5/6).

Meanwhile, USA Today ticks through some of the key changes that consumer can expect to see -

USA Today: Next Year Heralds Major Changes In Nation's Health Care
Within the next 12 months, consumers could get a quick check-up at the pharmacy, text glucose levels to a doctor through a smart-phone app or earn bonuses for treadmill time from their employer--all as the nation grapples with growing health care costs (Kennedy, 5/6).

Also in the news, The Washington Post's Fact Checker investigates the veracity behind claims that the law is causing workers' hours to be limited and The Texas Tribune reports on the latest legal challenge to the overhaul -

The Washington Post's Fact Checker: Is Long Beach Really Limiting The Hours Of 1,600 Workers Because Of 'Obamacare'?
Just one day after the Los Angeles Times published an article titled "Part-timers to lose pay amid health act's new math," one of its factoids became a frequently-mentioned talking point for Republicans. Indeed, the Republican National Committee "War Room" e-mailed the article to subscribers on its listserve the morning it was published. … Certainly employers are trying to figure out how they are impacted by the new law, but in general politicians should be careful about drawing policy implications from anecdotes. Already, in fact, some employers, such as Darden Restaurants Inc., have pulled back from cutting hours because of a public backlash that affected sales. No one can really judge what employers do or do not do until there is some hard data after the law has been implemented. But we were curious about what’s going on in Long Beach because the Times article was a bit contradictory (Kessler, 5/6).

The Texas Tribune: Hotze To File Suit Over Federal Health Reform
Steve Hotze, a Houston-area physician and major Republican campaign donor who has built his career around alternative medicine, says he is filing suit against the federal government to try to prevent the enforcement of the Affordable Care Act in Texas. He'll announce the suit, to be filed against U.S. Health and Human Services Secretary Kathleen Sebelius, on Tuesday morning in a press conference hosted by Lt. Gov. David Dewhurst (Ramshaw, 5/6).

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HHS Takes First Steps In Outreach Effort To Enroll Consumers In Health Exchanges

CQ HealthBeat reports that the Department of Health and Human Services is now collecting contact information for consumers so the agency can provide updates. Meanwhile, Illinois opened a competitive grant process to award funds to community groups to help with the state's consumer education effort.

CQ HealthBeat: Uninsured? HHS Wants To Reach Out And Text You
Consumers may not be able to actually sign up yet for health insurance through the exchanges, but they can submit their contact information to the government now in preparation for updates via text or email, Health and Human Services Secretary Kathleen Sebelius said Monday (Norman, 5/6).

The Associated Press: Illinois Opens Grant Process For Health Guides
The race is on in Illinois for $28 million in grants to help consumers learn how to shop for health insurance. Illinois Gov. Pat Quinn's office announced Monday a competitive grant process to distribute the federal money to community groups that want to help educate consumers about the new online insurance marketplace (Johnson, 5/6).

Also, reports from Connecticut and New Jersey highlight overlap and interaction between coverage through Medicaid and the health exchanges -

CT Mirror: Malloy Proposing State Funds To Help Parents Who Would Lose Medicaid Coverage
Democratic legislators effectively rejected a plan by Gov. Dannel P. Malloy to cut about 37,500 poor parents from Medicaid and leave them to buy federally subsidized health insurance from a new marketplace being established as part of health care reform. Now the Malloy administration is taking another shot at the cut, with a twist: using state dollars to help those parents buy private insurance. Office of Policy and Management Secretary Benjamin Barnes, Malloy's budget director, said Monday that state funds could reduce what poor parents have to pay to buy health insurance through the new marketplace, called the exchange (Levin Becker, 5/6).

Modern Healthcare: N.J. Health System To Offer Medicaid Plan, Sell Insurance On Exchange
A for-profit company that owns three hospitals in New Jersey said that it has formed a health system and is planning to offer a Medicaid plan and sell insurance on the state exchange about to launch under the healthcare reform law. The Jersey City, N.J.-based company, previously called Hudson Holdco, has acquired the 170-bed Bayonne Medical Center, the 381-bed Christ Hospital in Jersey City and the 204-bed Hoboken University Medical Center in recent years. The new system, rebranded CarePoint Health, will include hospitals, primary care and preventative health centers, insurance plans, and a network of roughly 1,000 physicians, according to a news release (Lee, 5/6).

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Medicaid Expansion: Different States Rely On Different Strategies

The decision-making process in West Virginia was long and involved, while the outcome of Arizona Gov. Jan Brewer's push for the expansion is still in flux. In Ohio, advocates are considering taking the proposal to the voters if the legislature won't pass it.

The Associated Press: Long, Vexing Process Led To W. Va. Medicaid Decision
Gov. Earl Ray Tomblin's decision to open Medicaid to more low-income West Virginians was reached neither quickly nor easily, administration officials say. The path to last week's announcement began in June, when the U.S. Supreme Court upheld the federal health care law (Messina, 5/7).

The Associated Press: Brewer Still Confident Expanded Medicaid Will Pass
Gov. Jan Brewer said Monday she remains confident her proposal to expand Medicaid to 300,000 additional poor Arizonans will be enacted despite a reluctant Legislature whose leaders are opposed to the plan. Brewer sidestepped a question about whether she would veto the state budget if it didn't include her plan, something her spokesman repeated just last week (Christie, 5/6).

Columbus Dispatch: Ballot Is Backup For Medicaid Expansion Plan
If Republican lawmakers won't pass Medicaid expansion, it could be up to Ohio voters. "We are beginning as of today. We will start reaching out and put together a coalition," said Scott Borgemenke, a veteran Republican operative who would lead an effort to extend insurance coverage for hundreds of thousands of poor Ohioans by getting voters to approve a constitutional amendment. ... Borgemenke, former chief of staff for Secretary of State Jon Husted, began a new job yesterday as senior vice president of advocacy for the Ohio Hospital Association. The hospitals are among the largest proponents of Gov. John Kasich's proposed Medicaid expansion (Candisky, 5/6).

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Premium Hikes Or Not? That Is The Question

An analysis by the New York Health Benefits Exchange projects that in New York, unlike in many other states, the health law will likely lead to lower health premiums next year. In Minnesota, though, one of the state's largest insurers is seeking a rate increase of about 13 percent this summer -- a few months before major provisions of the law take effect. And, in North Carolina, the state's largest insurer is warning of steep increases ahead.

The Washington Post's Wonk Blog: Obamacare Could Lower Premiums In New York, New Study Finds
There's pretty widespread acknowledgement that, under Obamacare, many in the individual market will see premiums go up. Health and Human Services Secretary Kathleen Sebelius has acknowledged this, as have other top Democrats. That's the case in most of the country — but not in New York State. There, the state is actually expecting some big changes likely to lower health premiums, according to a new analysis prepared for the New York Health Benefits Exchange (Kliff, 5/6).

Pioneer Press: Medica Asks For A Rate Hike. Are Other Minnesota Health Insurers Next?
A recent uptick in health care costs could start ballooning some insurance premiums for Minnesota workers this summer. Medica, one of the state's three largest health insurers, is seeking an average rate increase of 13 percent for about 5,000 people covered through their small-business employers when they renew policies in July (Snowbeck, 5/6).

Charlotte Observer: Blue Cross: Rates Will Rise Under New Federal Health Care Law
In a signpost pointing to health insurance changes under the nation's new health care law, North Carolina's largest insurer has warned of steep rate increases for customers who have typically paid below-average premiums. A third of Blue Cross and Blue Shield's customers who buy individual policies – or about 125,000 residents – should prepare for unusually large rate increases, according to the Chapel Hill company. The remaining quarter-million customers who buy individual policies will see increases in line with previous years. ... Blue Cross did disclose that insurance costs for employees who work for businesses with 1 to 50 employees will rise about 18 percent in 2014 because of increased coverage and benefits, as well as eight new taxes and fees in the Affordable Care Act. But the effects on small businesses are so wide-ranging that they will result in reductions as deep as 41 percent and increases as high as 284 percent (Murawski, 5/6).

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Medicare Studies: Payment Cuts Don't Mean Insurers Pay More

Medicare payment cuts to hospitals don't necessarily mean private insurers end up paying more, one study finds. Another reports that unifying Medicare's benefits into a single plan could save the program $180 billion over 10 years, while lowering seniors' out-of-pocket costs.

Politico: Study: Cuts To Medicare Trim Costs To Insurers
When Medicare payment rates for hospital inpatient care are cut, do insurers end up paying more? A new study published Monday in Health Affairs finds they don't -- contradicting the well-known "cost shifting" theory (Smith, 5/7).

The Hill: Unified Medicare Benefit Would Save Billions, Study Says
Combining Medicare coverage under a unified benefit could save $180 billion over 10 years while lowering out-of-pocket costs for beneficiaries, according to a new study. Researchers with the Commonwealth Fund, a non-profit research foundation, proposed a simplified Medicare program in which beneficiaries receive hospital, physician, drug and supplemental coverage in a single package (Viebeck, 5/6).

Another study finds that for those close to retiring, the cost of health care is one of the biggest worries --

Reuters: Health Concerns Top List Of Retirement Worries In U.S.: Study
Health problems and the cost of health care are the biggest concerns for those entering retirement, according to a study released on Monday from Bank of America Corp's Merrill Lynch. The findings, part of a larger study focused on how people are feeling about and preparing for retirement, were based on a survey of more than 6,300 individuals aged 45 and older across the United States (5/6).

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HHS Launches Probe Into Unusual Billing Patterns For Inpatient Hospice Care

Modern Healthcare: Unusual Billing Patterns Spur Probe Of Inpatient Hospice Care
HHS' inspector general's office is launching an in-depth investigation into cases where Medicare hospice beneficiaries get inpatient care, following unusual billing patterns that surfaced during recent research on the $1.1 billion industry. Medicare hospice is designed to provide comfort to patients with six months to live, not life-saving treatments. However, in some cases, Medicare hospice patients do qualify for palliative inpatient care—and a new OIG study found that a high proportion of those lucrative services go to patients who stay in a certain type of provider, raising questions about the bills in those settings (Carlson, 5/6).

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Capitol Hill Watch

Health Care Issues At Center Of Capitol Hill Questions About 'Political Intelligence'

Also in the news, new draft "track and trace" legislation was released by two congressional panels.

The Washington Post: How 'Political Intelligence' Can Come From Congress Itself
On the same morning a congressional staffer told investors in a private call that odds were improving for a government decision that would help medical insurers, trading spiked in a major health-care company. The private call, arranged by a consulting firm called Capitol Street, took place the morning of March 18. At 11:05 a.m., a certain form of speculative trading in Humana, the health insurer, jumped. That day, there was nearly 10 times as much volume as any day in the previous two weeks (Yang, Hamburger and ElBoghdady, 5/6).

Medpage Today: Congress Eyes 'Track-And-Trace' Drug Bill
Draft bills released by separate committees in the House and Senate would require manufacturers to place bar codes on packages of drugs they ship. That bar code would be scanned by wholesalers and other middlemen on the way to the pharmacy to track who has touched the drug and ensure the authenticity of products. The pharmacy would finally verify drugs it dispenses to ensure they have always been in safe hands. … While there is general agreement that there is a need for such a system, it's difficult to know how prevalent such counterfeiting and theft events are (Pittman, 5/6).

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Administration News

Feds Move To Tighten Oversight Of Tanning Beds

The Wall Street Journal: FDA Seeks Cancer Warning For Use Of Tanning Beds
Federal health regulators moved to tighten oversight of tanning beds and said people younger than age 18 shouldn't use the beds at all. The move comes amid growing evidence that indoor tanning is linked to melanoma, the most deadly form of skin cancer, in young people. Tanning beds continue to be used by millions of teenagers (Dooren, 5/6).

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State Watch

State Roundup: Medicaid Contractor Sues La. Over Canceled Deal

A selection of health policy stories from Louisiana, California, North Carolina, Georgia, Maryland and Minnesota.

The Associated Press/Washington Post: Medicaid Contractor Sues Jindal Administration In La., Over Scrapping Of $200M Deal
A Maryland-based company whose nearly $200 million Medicaid contract was canceled amid an ongoing federal investigation sued Louisiana Gov. Bobby Jindal's administration Monday for terminating the deal (5/6).

Reuters: California High Court Affirms Local Right To Ban Medical Pot Shops
The California Supreme Court dealt a blow to the state's faltering medical-marijuana industry on Monday by ruling that local governments may outlaw dispensaries that sell the federally banned drug. The unanimous opinion, which comes as elected officials across the nation grapple with regulating a growing medical pot industry, upheld a ban the southern California city of Riverside enacted on pot shops in 2010 (Cohen, 5/6).

North Carolina Health News: DHHS Announces Additional Medicaid Shortfall
Medicaid will have a bigger shortfall this year than predicted, state health officials announced Thursday morning. In a press release, Department of Health and Human Services spokesman Ricky Diaz said the problem is a result of Medicaid forecasting during the administration of Gov. Bev Perdue that "overestimated the amount of federal receipts to North Carolina due to an error in the forecasting model" (Hoban, 5/3).

Georgia Health News: Phoebe Reduces Document Burden For Hospitals
Phoebe Putney Health System, facing a wave of protests over its subpoenas to Georgia hospitals, has pared back its request for industry financial information as it pursues its legal fight with the Federal Trade Commission. The Albany system, among other revisions, has reduced the "look-back" period for financial documents to three years from seven years requested in the subpoenas it recently sent to all hospitals in the state. But the reduction of documents requested may not be enough to satisfy hospital officials around the state (Miller, 5/6).

Baltimore Sun: Maryland Hospitals Oppose State Plan To Update Waiver
The Maryland Hospital Association has sent a letter to state health officials saying it will not support a proposal that would link medical spending to the state's economic growth. The state presented the proposal to the Centers for Medicare and Medicaid Services in March as part of an application to update its Medicare waiver, an agreement with the federal government unique to Maryland that allows the state to set uniform hospital rates (Walker, 5/6).

Sacramento Bee: CalPERS Seeking To Catch Errors, Fraud In Health Enrollment
CalPERS is moving to strike from government health care rolls tens of thousands of people it believes are mistakenly or fraudulently receiving benefits. The fund, which is the second-largest health care purchaser in the nation after the federal government, figured last year that removing an estimated 29,000 wrongly listed children, spouses and domestic partners of government employees would save approximately $40 million annually (Ortiz, 5/7).

Star Tribune: 'Care Guide' Show Another Face Of Health Reform
By offering a friendly ear -- but no medical advice -- they have been able to influence patients when MDs could not. Dr. Richard Adair insisted that they spell it out clearly when the jobs were first posted: No experience required. The idea was to hire people with no medical background, give them two weeks of training, and send them off to clinics to start seeing patients. Five years later, these so-called "care guides" are fixtures at more than two dozen Allina Health clinics in the Twin Cities, and groups around the country are calling to find out how the concept works (Lerner, 5/6).

California Healthline: Snickers, Seriousness Expected For Junk Food Bill
This week, an Assembly committee will take up a plan to change the foods offered in vending machines in state buildings. No more empty calories for state workers, according to the proposed law. AB 459 by Assembly member Holly Mitchell (D-Los Angeles) is scheduled to be heard Wednesday in the Assembly Committee on Appropriations. A similar bill authored by Mitchell last year stalled in committee. This year's bill earned initial approval two weeks ago in the Business and Professions Committee. … AB 459 would phase healthier foods into vending machines in state buildings, with the goal of reaching 100% healthy foods in machines by 2017 (Gorn, 5/6).

California Healthline: Statewide Soda Tax Gaining Momentum In Calif. Legislature
Fueled by a recent survey showing growing public support, a penny-per-ounce tax on sugary drinks appears to be gaining traction in the California Legislature. Two Senate committees approved a bill by Sen. Bill Monning (D-Carmel) that would add a penny to every ounce of sugar-sweetened beverage sold in California. SB 622 has two goals: discourage consumption of sugary drinks and generate income to fund programs aimed at reducing childhood obesity. … Taxing sugary beverages is not a new idea in California. A similar bill was introduced but died in the Legislature in 2010. Last fall, voters in two California cities defeated ballot measures to create local soda taxes (Lauer, 5/6).

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Editorials and Opinions

Viewpoints: Medicaid's Effect On Health Debated; Young Adults Central To Lowering Anxiety About Online Marketplaces

The New York Times' Room For Debate: More Medicaid, More Health?
A study comparing low-income people in Oregon who received access to Medicaid over the past two years with those who did not, found that those on Medicaid visited doctors and hospitals more often, suffered less from depression and were more financially secure. That said, the Medicaid recipients saw little average improvement in blood pressure, blood sugar and other measures (5/7). 

Bloomberg: Why Cash Can’t Replace Health Insurance
Since the release of the Oregon Health Study last week, conservative columnist Ross Douthat and liberal blogger Matt Yglesias have both written articles broaching the idea that the government should offer poor people more cash benefits in place of health benefits. Douthat argues more broadly for re-conceiving health insurance as something akin to homeowners insurance: a backstop against catastrophic losses, not a comprehensive package covering everyday expenses (Josh Barro, 5/6).

The Wall Street Journal: Florida Flips Back
The nine Republican Governors who decided earlier this year to pump some helium into the ObamaCare balloon and expand Medicaid forgot about that saving grace of American politics: the separation of powers. On Friday Florida became the latest state to reject the expansion, as Governor Rick Scott failed to convince the GOP-controlled legislature to approve his Medicaid flip. Mr. Scott's Medicaid plans stalled as the Florida Senate and House stalemated and adjourned for the year. Unless the Governor recalls legislators for a special session, the state won't participate in new Medicaid. Opposition is concentrated in the lower chamber, where conservatives are concerned about Medicaid's large and growing costs and the Florida budget's dependence on federal funds (5/6).

Tampa Bay Times: The Governor Who Wasn't
Only in political life do we stumble across people who aspire, yearn, crave to hold high and powerful offices without the slightest clue about what the job requires. ... Scott also meekly came out in support of accepting $50 billion in federal Medicaid funding over the next 10 years to help 1 million Floridians get health insurance. Then he promptly went back to sleep instead of using the bully pulpit of his office to hammer a tea-party-beholden Weatherford and an ideologically recalcitrant House to accept the money. He didn't. They didn't. And more than a million Floridians are now left holding an empty Medicaid bag (Daniel Ruth, 5/6).

The Wall Street Journal: Health-Care Exchanges Will Need the Young Invincibles
In less than five months, on Oct. 1, the Affordable Care Act's insurance exchanges will go live online. Millions of Americans will suddenly be able to log on to a website and choose their own heath-care coverage from a menu of subsidized options for prices and coverage levels. As the opening day gets closer, anxiety is increasing over how well these online exchanges will function (Ezekiel Emanuel, 5/6). 

Bloomberg: Buying Insurance Should Be As Easy As Using An iPad
In March, a draft of the Obama administration's application form was released online. Unfortunately, the form was complex, long and immensely difficult to navigate. Skeptics asked a reasonable question: How can the law possibly work, if people can’t understand the forms they need to fill out to get insurance in the first place? Last week, the Department of Health and Human Services released a radically revised application form, and there’s excellent news. It's much simpler. ... Although the tale of the streamlined health-insurance application form has a happy ending, it also offers three general lessons (Cass R. Sunstein, 5/6).

Fox News: Obama Plays Truth Or Dare With Your Health Care
At his impromptu news conference last Tuesday, President Obama demonstrated he is either so detached he doesn't know what's happened as the Affordable Care Act (aka ObamaCare) is being implemented or that he knows but intends to brazen his way through an emerging policy debacle.  Whichever it is, it's likely to be a political disaster for the president and his party. Saying that while there were big changes for those now uninsured, it was a different situation "for the 85 to 90 percent of Americans who already have health insurance," Mr. Obama said. The only impact for them, he assured us, is that "their insurance is stronger, better, more secure than it was before. Full stop. That's it. They don't have to worry about anything else" (Karl Rove, 5/6).

Los Angeles Times: A Plan To Make The Morning-After Pill A Moot Point
It's a new front in the long-running battle over reproductive rights, playing out this time as a clash between politics and science. Doctors say there's no medical reason to keep girls of any age from having easy access to the morning-after contraceptive known as Plan B. A judge's ruling last month would do away with current age restrictions. But the Justice Department appealed that ruling last week. The Obama administration wants to make the over-the-counter pill off-limits to girls younger than 15, unless they have a prescription. Activists have denounced Obama's plan as an assault on women's rights. But the women in question this time are 12, 13, 14 years old (Sandy Banks, 5/7). 

Tampa Bay Times: Plan B Appeal A Setback For Public Health
President Barack Obama told an audience at the National Academy of Sciences last month that his administration would not let politics interfere with science. Now the president has broken that promise. The Justice Department has announced that it will appeal a federal court ruling that grants unlimited access to emergency contraception for younger teens. What is certain is that Obama is sacrificing the reproductive freedom and health of girls by ignoring the evidence and playing politics (5/6).

The Washington Post: The Senate Aims To Clean Up Compounding Pharmacies
When a doctor sticks a needle in you, you expect that the drugs it carries won't be tainted. But, possibly owing to a strange gray area in federal law, thousands of patients last October got injections for back pain that contained highly dangerous fungal meningitis, and dozens of them died. Members of the Senate Health, Education, Labor and Pensions Committee are now seeking to fix the government's oversight of the obscure world of compounding pharmacies. The reforms they want are overdue (5/6). 

Politico: Advanced Nurses Lower Costs, Improve Care
As our nation prepares to implement the bulk of the provisions of the Affordable Care Act, the issues of access to care and unsustainable cost continue to loom large. What can we do about an aging population with increasing chronic health issues and millions more needing care? How can we meet the increasing demand, maintain quality and not break the bank? Legislators looking for solutions to these questions can unleash the skills of nurse practitioners by removing regulatory barriers that prevent them from practicing to the top of their education and training (Sheila Burke and Bill Novelli, 5/6).

The Lund Report: Author Points Out What’s Wrong With Health Care Reform
Health reform was not initiated with ObamaCare. We have been reforming in spurts unsuccessfully for decades, always driven by populism. Beliefs that win the contest of ideas do not usually endure the requirement of proof of concept (Stephen Gregg, 5/6).

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Stephanie Stapleton

Andrew Villegas

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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.