Daily Health Policy Report

Wednesday, May 7, 2014

Last updated: Wed, May 7

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch

Health Care Marketplace

Health Information Technology

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Need A Doc? These Companies Will Hook You Up In A Hurry

Kaiser Health News staff writer Daniela Hernandez, working in collaboration with Wired, reports: “Grand Rounds is one of many healthcare startups bringing on-demand, concierge-like services once reserved for the ultra-rich to the middle class – similar to what tech outfits like Google, Amazon, Uber, and Lyft have done for personal shopping and transportation. These budding companies offer basic access to medical advice, appointments and other assistance. Some operate regionally, others nationally. Their services and prices vary substantially—but all aim to fill gaps in the existing health care system, in part by using the Internet” (Hernandez, 5/7). Read the story.

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Employers Eye Moving Sickest Workers To Insurance Exchanges

Kaiser Health News staff writer Jay Hancock, working in collaboration with The Daily Beast, reports: “Can corporations shift workers with high medical costs from the company health plan into online insurance exchanges created by the Affordable Care Act? Some employers are considering it, say benefits consultants. ‘It's all over the marketplace,’ said Todd Yates, a managing partner at Hill, Chesson & Woody, a North Carolina benefits consulting firm. "Employers are inquiring about it and brokers and consultants are advocating for it’” (Hancock, 5/7). Read the story.

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Capsules: Chemo Costs In U.S. Driven Higher By Shift To Hospital Outpatient Facilities

Now on Kaiser Health News’ blog, Roni Caryn Rabin writes: “The price of cancer drugs has doubled in the past decade, with the average brand-name cancer drug in the U.S. costing $10,000 for a month’s supply, up from $5,000 in 2003, according to a new report by IMS Institute for Healthcare Informatics, a health information, services and technology company” (Rabin, 5/6). Check out what else is on the blog.

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For Asian Immigrants, ACA Coverage Contains Mysteries

The Philadelphia Inquirer's Robert Calandra, working in partnership with Kaiser Health News, reports: "Last week, Sung, whose husband works full time, went to the Southeast Asian Mutual Assistance Association Coalition (SEAMAAC) in South Philadelphia to learn about her new policy, an Independence Blue Cross silver-tier Keystone HMO Proactive plan. 'She doesn't know what steps to do next and she is concerned,' said Zing Thluai, a SEAMAAC worker who speaks one of three Burmese dialects. For 30 years, SEAMAAC has been addressing the concerns of Asian immigrants in this region. In the fall, it realized the ACA enabled many of the city's 23,000 uninsured Asian Americans to buy coverage" (Calandra, 5/6). Read the story.  
 

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Political Cartoon: 'Foul Shot?'

Kaiser Health News provides a fresh take on health policy developments with "Foul Shot?" by Adam Zyglis. 

Here's today's health policy haiku: 

INSURERS TALK ABOUT PREMIUMS AND NEW ENROLLEES

Most paid up, but the
numbers hide other key facts...
like the duplicates.
-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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Health Reform

Insurers Say Most Obamacare Enrollees Pay First Premium

But they say the eight million enrollment figure includes many duplicate signups, The New York Times reports. News outlets also report on a health law provision that extends Medicaid coverage for former foster children until they turn 26.

The New York Times: Insurers Say Most Who Signed Up Under Health Law Have Paid Up
Most of the people choosing health plans under the Affordable Care Act — about 80 percent — are paying their initial premiums as required for coverage to take effect, several large insurers said Tuesday on the eve of a House hearing about the law. But the health insurance industry said the total of eight million people who signed up included “many duplicate enrollments” for consumers who tried to enroll more than once because of problems on the website (Pear, 5/6).

Kaiser Health News: Employers Eye Moving Sickest Workers To Insurance Exchanges
Can corporations shift workers with high medical costs from the company health plan into online insurance exchanges created by the Affordable Care Act? Some employers are considering it, say benefits consultants. "It's all over the marketplace," said Todd Yates, a managing partner at Hill, Chesson & Woody, a North Carolina benefits consulting firm. "Employers are inquiring about it and brokers and consultants are advocating for it" (Hancock, 5/7).

The Texas Tribune:  In ACA Foster Youth Provision, Texas Faces Tough Task
Among the more popular aspects of the Affordable Care Act is a provision that allows young people to stay on their parents’ health insurance plan until age 26. But a similar, little-known provision of the federal health reform law also grants certain young people who were formerly in foster care extended health coverage through Medicaid, the joint state-federal insurer, until the same age. State officials say they expect to enroll thousands of former foster youth in the extended Medicaid coverage this year with the help of outreach efforts. But the responsibility of locating and enrolling these young people, which falls on individual states because the U.S. child welfare system is state-run, could prove daunting (Ura, 5/7).

The Miami Herald:  ACA Gives Former Foster Kids Health Benefits Though They May Not Know It
Rain clouds couldn’t spoil Kenisha Anthony’s afternoon as she emerged from the BankUnited Center in Coral Gables on Saturday with an associate degree in social work from Miami Dade College. The 22-year-old from Miami had survived the school of hard knocks that is Florida’s foster care system to reach this moment. Now a provision of the Affordable Care Act promises to help her make an even better start. As of Jan. 1, Anthony and others who aged out of foster care became eligible for Medicaid until they turn 26, just as other young adults can stay on their parents’ health plans to that age as part of the ACA. But not all former foster children may know about this little-discussed Obamacare benefit, especially if they’re no longer in the system (Borns, 5/6).

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DC OKs Health Insurance Tax To Pay For Exchange

The 1 percent tax will be imposed on all health-related insurance products sold in the nation's capital. Meanwhile, four more companies apply to sell insurance on the Washington state exchange and The Oregonian examines the reasons that state opted to participate in the federal insurance marketplace.

The Washington Post: D.C. Council Approves Broad New Tax On Health Insurance To Cover City’s Exchange
The D.C. Council on Tuesday unanimously approved a broad tax on all health-related insurance products sold in the nation’s capital to solve a big money problem faced by its online health insurance exchange. Under the measure, which will take effect on an emergency basis but eventually face congressional review, the exchange will fund its operating costs through a 1 percent tax on more than $250 million in insurance premiums paid annually by those who live and work in the District (Davis, 5/6).

The Wall Street Journal: D.C. Council Approves Tax To Aid Health Exchange
The city council of Washington, D.C., voted Tuesday to allow a tax on all health insurers selling inside the district to fund its Affordable Care Act insurance marketplace. The plan, submitted by the city's DC Health Link insurance exchange, gives the city the power to tax all health-insurance carriers inside the district for exchange funding. The council opted for taxing all carriers, not just those selling in the exchange, to make the levy lower, according to a copy of the approved resolution (Radnofsky, 5/6).

The Associated Press:  Four More Companies Want To Join Washington Exchange
Four more companies want to join the state's health insurance exchange, and one has applied to sell health insurance in the individual market outside the state-run exchange, the state insurance commissioner announced earlier this week. If the companies' applications are successful, residents of every Washington county will have at least one more choice for health insurance when enrollment opens again in November. The state also would be able to open its promised statewide insurance marketplace for small businesses if a proposal by Moda Health Plan Inc. is approved (Blankinship, 5/6).

The Oregonian: Cover Oregon: State Moves To Federal Exchange, But Oracle Technology Lives On
In the end, there were 73 million compelling reasons for Oregon to dump its expensive, troubled in-house health care exchange in favor of the federal exchange. Trying to make the Oracle-based system fully functional would have cost at least $78 million, on top of the $248 million already spent, compared to about $5 million for moving to the federal system, Oregon Chief Information Officer Alex Pettit said Tuesday to the Legislature's Joint Committee on Legislative Audits, Information Management and Technology. The third option, adopting another state's exchange, would have cost an estimated $45 million, Pettit said (Manning, 5/6).

The Minneapolis Post:  Resigned MNsure Director Linked To Failed Oregon Exchange
One day after MNsure executive director April Todd-Malmlov resigned her position last December, a consultant for the troubled Cover Oregon health insurance exchange emailed two top Oregon officials recommending Todd-Malmlov as someone “who may want to dig into some kind of temporary project ASAP.” The email was obtained last week by the U.S. House Oversight Committee, which requested a log of correspondence between state and federal officials from a handful of health insurance exchanges, including MNsure, in March (Henry, 5/6).

NPR: Big Ambitions And Flawed Technology Tripped Up State Exchanges
Among the states that looked to expand health coverage to nearly all their citizens, Massachusetts was an early front-runner. The state passed its own health care law back in 2006 mandating near-universal insurance coverage. That law became a model for federal action. And after the Affordable Care Act went through in 2010, Massachusetts had a head start in bringing health coverage to the uninsured. Yet Massachusetts threw in the towel Tuesday on the problem-plagued online marketplace that was supposed to make health insurance shopping a snap (Hensley, 5/6).

Meanwhile, the impasse over Medicaid expansion in Virginia could have huge fallout on hospitals and doctors --

Modern Healthcare:  Virginia Hospitals Face Financial Pain As Medicaid Expansion Battle Continues
Some Virginia hospitals could take a financial hit and doctors in the state may become less inclined to see Medicaid patients if the state government stops functioning because a current budget impasse does not get resolved by July 1 when the state's new fiscal year begins. A government shutdown could mean a halt to Medicaid payments to hospitals and doctors. If that happens, organizations such as Virginia Commonwealth University Health System and the University of Virginia Health Systems could suffer long-term financial damage, depending on how long the shutdown lasts, said Rick Mayes, an associate professor in the University of Richmond's department of political science, and co-director of the university's Healthcare Studies major (Dickson, 5/6).

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GOP Establishment Candidate Wins N.C. Senate Nomination

North Carolina's Senate race is being closely watched because the incumbent, Democrat Kay Hagan, is considered one of the most vulnerable this campaign season because of her support of the health law. Also in the news, The Washington Post does some fact checking in regard to the latest round of Obamacare attacks, and the U.S. Chamber of Commerce launches a major ad buy.

The Associated Press: NC Lawmaker Wins GOP Senate Nomination
North Carolina House Speaker Thom Tillis captured the Republican nomination to oppose imperiled Democratic Sen. Kay Hagan Tuesday night, overcoming anti-establishment rivals by a comfortable margin in the first of a springtime spate of primaries testing the strength of a tea party movement that first rocked the GOP four years ago. … Hagan is among the Democrats’ most vulnerable incumbents in a campaign season full of them, a first-term lawmaker in a state that is ground zero in a national debate over the health care law that she and the Democrats voted into existence four years ago. Americans for Prosperity, a group funded by the billionaire Koch brothers, has run about $7 million worth of television commercials criticizing Hagan for her position on the law (5/6).

The Washington Post’s The Fact Checker: New Obamacare Attacks: A Round-Up
We are going to do a quick round-up of two recent claims about the Affordable Care Act. We can’t always get to them, and indeed the quote above was first spotted by our colleagues at PolitiFact. But it is simply too good to pass up. We also regret not finding the time to fact check the radio ad by Sen. Kay Hagan (D-N.C.), which claimed that GOP hopeful Thom Tillis (R) had said that Obamacare was a “great idea” (Kessler, 5/7).

The New York Times: Chamber Of Commerce Makes Ad Buy Supporting Pro-Business Republicans
Though the ads range in topic, President Obama’s signature health care law figures significantly into several of the commercials. The ad for Mr. Heck, a doctor, warns that the Affordable Care Act has led to “higher taxes, increased premiums and fewer choices” (Parker, 5/6).

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Capitol Hill Watch

House Democrats Offer Alternative Mental Health Proposal

Many view the plan as controversial because it could hinder efforts toward bipartisan mental health reforms. Republicans offered their own measure about six months ago. In other congressional news, Rep. Kevin Brady, R-Texas, who chairs the House Ways and Means Health Subcommittee, told hospital executives Tuesday that addressing the two-midnight rule is a high priority for him.   

Politico Pro: Fears Of Slowed Progress With New Mental Health Bill
A new mental health bill proposed Tuesday by a group of House Democrats is stoking fears that it could hinder progress toward bipartisan reform. While some advocates suggested the legislation could add to ideas already on the table from Republicans, others said they’re underwhelmed by the proposal and wonder why the Democrats felt a need to present it at all. And it was immediately blasted as a stripped-down, politically orchestrated effort by Rep. Tim Murphy of Pennsylvania, the GOP’s champion of a sweeping mental health reform bill. The Democrats’ measure, led by Rep. Ron Barber of Arizona, comes six months after Murphy rolled out his far broader legislation (Cunningham, 5/6).

The Hill: House Dems Push Mental Health Alternative
House Democrats on Tuesday unveiled an alternative to a sweeping mental health overhaul from Republicans, further complicating a reform push that was already at risk of failing. The wide-ranging bill from Rep. Ron Barber (D-Ariz.) abandons a series of aggressive and controversial steps proposed by Rep. Tim Murphy (R-Pa.) that are intended to empower family members coping with extreme cases of mental illness (Viebeck, 5/6).

Modern Healthcare:  Doc Fix, Two-Midnight Rule Remain High Priorities For Congress, Lawmaker Tells AHA
Finding a permanent fix to the Medicare payment formula for doctors remains a top priority for House Republicans, according to Rep. Kevin Brady (R-Texas), who chairs a key health committee.  "We're working very hard toward a permanent solution," Brady said, speaking Tuesday at the American Hospital Association's annual membership meeting in Washington. "We hope sooner rather than later” (Demko, 5/6).

CQ Healthbeat:  Relief for Hospitals Pledged on Two-Midnight Rule
The chairman of the House Ways and Means Health Subcommittee told hospital executives Tuesday that he plans an effort to shield their industry from the damaging effects of Medicare’s controversial “two-midnight” rule. “The time for regulatory relief to the two-midnight debacle is now,” Rep. Kevin Brady, R-Tex., told attendees at the American Hospital Association annual membership meeting in Washington, D.C. (Reichard, 5/6).

Meanwhile, Sen. Tom Coburn, R-Okla., introduces new legislation to encourage end-of-life planning --

Reuters:  Lawmakers Propose Incentives For End-of-life Planning
If you are one of the estimated 70 percent of Americans who have not documented your end-of-life healthcare preferences, Republican Senator Tom Coburn of Oklahoma hopes a cash incentive will prompt you to do the paperwork. Under his newly introduced Medicare Choices Empowerment and Protection Act, seniors could pocket up to $75 for completing advance directives. Directives are written instructions in which people specify what healthcare actions should be taken if they cannot speak for themselves (Belisomo, 5/6).

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Health Care Marketplace

Humana's Profit Shrinks On Higher Expenses

The insurer said it expects to add more customers to its Medicare Advantage and individual plan businesses. Meanwhile, a few hospitals say they are doing simple surgeries for some uninsured patients for free to keep their problems from turning into emergencies that would be more expensive to treat, and those who developed meningitis as a result of tainted products seek compensation.

The Wall Street Journal: Humana Earnings Shrink On Higher Costs; Results Top Views
Humana Inc. said first-quarter profit shrank 22 percent as the Medicare-focused insurer's higher expenses offset its improved revenue. Still, revenue and earnings came in well above analysts' forecasts. Humana and its peers face shrinking government funding for Medicare Advantage plans, which are the private industry's version of the health plan for the elderly and disabled. Humana is more tethered to these plans than any other big insurers, making its ability to manage lower payments while guarding profit margins a significant issue (Rubin, 5/7).

Reuters:  Humana Sees 2014 Medicare Advantage, Exchange Customer Growth 
Managed care company Humana Inc said on Wednesday that it expects to add more customers to its Medicare Advantage plans in 2014 despite government cuts to funding and that its individual business will grow through new Obamacare plans. Humana, whose first-quarter profit beat analyst expectations but still fell as it spent more on marketing and investments related to new products, said it will add 435,000 people this year to Medicare Advantage plans (5/7).

Marketplace: Hospitals Save Money By Doing Surgery For Free
Across the country, a few hospitals have come up with a counterintuitive way to save themselves money: offer minor surgery for free. To understand how that’s possible, consider the case of 32-year-old Lammon Green, a caretaker for the developmentally disabled in Macon, Georgia. He’s a really cheerful guy, but he’s been bothered for a long time by a cyst behind his ear. “It’s been kind of giving me problems for the last few years,” he said. “It gets to about the size of a lemon when it gets infected.” Most people would get something like that cut off pronto, but Green doesn’t have insurance (Ragusea, 5/6).

The Associated Press: Settlement Seeks $100M Fund For Meningitis Victims
A settlement filed with a federal bankruptcy judge would create a fund of more than $100 million to compensate victims of a nationwide meningitis outbreak linked to a Massachusetts pharmacy, lawyers said Tuesday (5/6).

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Health Information Technology

Obama Official: Make Health IT Real For People To Speed Adoption

Elsewhere, only four hospitals are enrolled in stage 2 of "meaningful use" -- where they are paid for using electronic health records, and concierge medical services expand.

Politico Pro: Experts: Health IT Needs To ‘Get Real For People’ — And Get Reimbursed 
It took the disaster of Hurricane Katrina to get Louisiana’s doctors to open their minds to new medical technologies, and if health IT is going to win support nationwide, it’ll have to “get real for people,” the Obama administration’s top health IT official argued Tuesday. “It has to become tangible and real for the person, the family member, the doctor, the nurse,” said Karen DeSalvo, the national coordinator for health information technology, who was a physician in New Orleans when Katrina hit in 2005 and later became the city’s health commissioner. But the technologies also have “to demonstrate benefit,” she added. Speaking at a Politico breakfast panel on connected health, DeSalvo said that without a national embrace of electronic health records and related systems and devices, the United States misses the chance to vastly improve care and prevent disasters like a hurricane from disrupting care (Cheney, 5/6).

Modern Healthcare: Few Hospitals, Docs At Stage 2 Meaningful Use, CMS Officials Says 
Only four hospitals have achieved Stage 2 meaningful use of electronic health records seven months into the reporting period for hospitals enrolled in the federal EHR incentive-payment program, a CMS official reported today. Among physicians and other eligible professionals -- who are four months into their reporting year -- only 50 have attested to Stage 2 meaningful use, said Elisabeth Myers, policy and outreach lead at the CMS' Office of eHealth Standards and Services, during a presentation to the agency's Health Information Technology Policy Committee (Conn, 5/6).

Kaiser Health News: Need A Doc? These Companies Will Hook You Up In A Hurry
Grand Rounds is one of many healthcare startups bringing on-demand, concierge-like services once reserved for the ultra-rich to the middle class – similar to what tech outfits like Google, Amazon, Uber, and Lyft have done for personal shopping and transportation. These budding companies offer basic access to medical advice, appointments and other assistance. Some operate regionally, others nationally. Their services and prices vary substantially—but all aim to fill gaps in the existing health care system, in part by using the Internet Hernandez, 5/7).

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State Watch

State Highlights: SEIU, Hospital Strike Deal In Calif.; N.Y. Medicaid Audit; Dental Therapists

A selection of health policy stories from California, New York, Connecticut, Georgia, Indiana and North Carolina.

Los Angeles Times: Hospitals And Union Make Deal To Avoid Ballot Measure Fight
California hospitals have reached a deal with the state's largest health care union to avoid an expensive and potentially nasty ballot measure fight this fall that would have cast a harsh spotlight on high medical costs and executive salaries. As part of Tuesday's agreement, the Service Employees International Union-United Healthcare Workers West dropped proposed ballot initiatives to limit hospital charges and cap what nonprofit hospitals pay their executives (Terhune, 5/6).

The Wall Street Journal: SEIU, California Hospitals Will Create $100 Million State Medicaid Fund
The nation's biggest health care union and the California hospital industry said Tuesday they had reached a multiyear deal to create a $100 million fund to improve a state-run Medicaid system they say falls short on hospital reimbursements. But after months of public threats and private talks, the Service Employees International Union didn't appear to win one of its biggest demands: access to tens of thousands of hospital workers for an organizing drive (Trottman and Maher, 5/6).

The Associated Press: Federal Audit Faults NY Medicaid Claim Rate
Federal auditors say New York should repay $60.8 million in Medicaid reimbursement for unallowable costs for room and board for taking care of developmentally disabled people (5/7).

The Hill:  Issa Demands NY Return Medicaid Payments
The chairman of the House Oversight Committee is demanding the federal government recoup $61 million in fraudulent Medicaid payments made to the state of New York. A Health and Human Services (HHS) report Tuesday concludes New York was wrongfully reimbursed for room-and-board costs at state-run facilities by the Centers for Medicaid and Medicare Services between 2009 and 2011 (Al-Faruque, 5/6).

USA Today: Dental Therapists Aim To Fill In Oral Health Shortfalls
A few states are trying to alleviate their oral health care shortages by allowing the licensing of dental therapists -- a fairly new class of dental care providers, essentially dentistry's version of physicians' assistants. They face strong resistance from dentists (McElhaney, 5/6). 

The CT Mirror: End-Of-Life Care Proposal Wins Final Passage
The House of Representatives has given final passage to a proposal aimed at creating a formal process for people with terminal illnesses to discuss their end-of-life care options with a health care provider and document their choices in a medical order. The measure, which passed the House and Senate unanimously, now heads to Gov. Dannel P. Malloy, who has said he supports it. The bill would allow the state Department of Public Health to create a pilot program for “medical orders for life-sustaining treatment,” or MOLST. The program would include training for health care providers on discussing options with patients, who could then document their choices in a form that would direct medical personnel on how to respond (Becker, 5/6).

The CT Mirror: Time Running Short On For-Profit Hospital Proposal. What Then?
Time is running out for legislators to act on one of the most complex and controversial issues they’ve faced this session: whether to craft a new regulatory and statutory framework for nonprofit hospitals to convert to for-profits. And with hospitals in Waterbury, Bristol, Manchester and Vernon poised to become for-profit, the possibility of no legislative action raises a question with no clear answer: What then? Tenet Healthcare, the for-profit company poised to acquire the four hospitals, says it can complete the conversions without legislation. But Attorney General George Jepsen said it’s not certain that the company’s plans would pass legal scrutiny under current law (Becker, 5/6).

Georgia Health News: Hepatitis C: The High Cost Of A Cure
Probably the biggest ethical dilemma now confronting the health care world involves two expensive new drugs to treat hepatitis C. The issue boils down to a tradeoff between efficacy and cost. … Some patients face even longer treatment periods – and higher costs. Georgia Medicaid covers the drugs, though with some restrictions, for its 1.6 million beneficiaries. In March, Georgia’s Drug Utilization Review Board recommended that Medicaid add Sovaldi and Olysio as “non-preferred,” and needing a state approval in each case (Miller, 5/6).

The Associated Press:  Indiana Medicaid Stops Funding Some Early Births
Indiana's Medicaid program no longer will pay for early, elective childbirths beginning July 1 as part of the state's effort to reduce its infant mortality rate, the Family and Social Services Administration announced Monday.The state-federal health care program for needy families no longer will pay a hospital or physician for the delivery of a child prior to 39 weeks gestation unless it is medically indicated or occurs naturally, the agency announced in conjunction with the Indiana State Department of Health (5/6).

The Associated Press:  More Turnover At DHHS As Medicaid Official Resigns
The turnover continues at the North Carolina agency responsible for running the Medicaid health insurance program for poor children, older adults and the disabled. A state Department of Health and Human Services spokesman said Tuesday that Medicaid chief financial officer Keith Brennan resigned Tuesday. DHHS spokesman Kevin Howell offered no other explanation about Brennan's departure (5/6).

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Editorials and Opinions

Viewpoints: Evidence For Obamacare Saving Lives; A Continuing Role For MinnesotaCare

Los Angeles Times: Yes, Obamacare Will Save Lives, And Here’s The Evidence
People asking the ultimate question about the Affordable Care Act--will it actually save lives?--now have an answer, and it's yes. The documentation comes from a team at the Harvard School of Public Health. Benjamin D. Sommers, Sharon K. Long, and Katherine Baicker conducted the most extensive study of mortality rates in Massachusetts following that state's 2006 health insurance reform, which is the precursor to the ACA (Michael Hiltzik, 5/6). 

MinnPost:  MinnesotaCare Works For Working Minnesotans
MinnesotaCare plays an essential role in Minnesota’s health care system, even after the creation of MNsure. As we note in our new issue brief, MinnesotaCare: A Vital Part of Minnesota’s Health Care System, this unique program ensures access to health insurance for lower-income, working Minnesotans who lack coverage through their employers and cannot afford it in the private market (Brugh, 5/6). 

The Washington Post: Hillary Clinton Talks About Mental-Health At Convention Putting Focus On Early Intervention
Last year’s annual conference of the National Council of Behavioral Health brought thousands of therapists to Las Vegas, where showgirls opened the program showily and those who treat addictions got an after-hours view of all they’re up against. This year, though, the conference is underway at the Gaylord National Resort at National Harbor outside Washington, and the showgirls have been replaced with a couple flashing far less flesh, dressed as George and Martha Washington. The biggest draw was keynote speaker Hillary Rodham Clinton, but the hottest topic here this week is psychosis prevention — or at least the kind of early intervention that can keep young people experiencing a “first break” with reality from ever having another psychotic episode (Melinda Henneberger, 5/6). 

The New York Times: The Global Polio Threat, Back Again 
Just when it looked as if polio was headed toward eradication around the world, the disease is once again on the march. The World Health Organization declared on Monday that the spread of polio virus to new countries in 2014 had become “a public health emergency of international concern” that warranted aggressive measures to control transmission. It was timely advice on the eve of what is typically the onset of the high season for transmitting the virus (5/6).

WBUR: Facing The Inevitable: From Lost Keys To Dementia
I recently turned 50 and, on cue, my AARP card came in the mail and my doctor told me to schedule my first colonoscopy. Also on cue, I’ve noticed what seems to be my own increased mental scattered-ness — misplaced keys, sluggish name recall. As a catastrophizer, I immediately link this apparent (but my doctor assures me normal) ever-so-slight decrease in cognitive sharpness to full blown Alzheimer’s and the start of a bleak, diminished future (Rachel Zimmerman, 5/6).

The CT Mirror: Op-ed: Mental Health Treatment Is Not Perfect, But It Can Be Life-Saving
The assertions of the writer of the op-ed "More mental health nonsense" are inaccurate. First, NAMI-CT is not supported by pharmaceutical companies, but by grants from foundations, state grants and donations. Second, I am not a former member of NAMI-CT. I am a very proud current member of this organization that does so much to advocate for people who live with mental illness as well as educate the public and provide support services. I have also held a number of certifications in mental health, addictions and other counseling and treated over 7,000 patients directly or through supervision. Third, there is ample evidence from many research facilities that conduct brain research that mental illness is a biological disease (Barbara Sloan, 5/6).

Los Angeles Times: To Help Cure California’s Voter Registration Woes, Look To The Obamacare Website 
But maybe my favorite cliche is true: It's always darkest before the dawn. Covered California — the state's Obamacare exchange — is mailing voter registration cards to 4 million Californians who shopped on the exchange for insurance. The cards are being sent out in hard-to-miss envelopes, in different languages, and they're postage paid. The healthcare exchanges, because they offer a public service, are required by the National Voter Registration Act to offer voter registration (Daniel Zingale, 5/6). 

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ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
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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.