Daily Health Policy Report

Thursday, June 21, 2012

Last updated: Thu, Jun 21

KHN Original Reporting & Guest Opinion

Health Reform

Campaign 2012

Capitol Hill Watch

Health Care Fraud & Abuse

Health Care Marketplace

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Health On The Hill: Political Jockeying In Anticipation Of Supreme Court Ruling

Kaiser Health News staff writers Mary Agnes Carey and Marilyn Werber Serafini join Jackie Judd to talk about the permutations of the impending Supreme Court decision on the constitutionality of the health care law. Carey says much is at stake for all people who touch the health care system while Werber Serafini outlines some of the Republican alternatives to the law (6/20). Watch the video or read the transcript.  

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Court Challenge Could Result In Medicaid Cutbacks Instead Of Expansion

Kaiser Health News staff writer Phil Galewitz reports: "The future of the nation's largest health insurance program -- Medicaid -- hangs in the balance of the Supreme Court's decision on the 2010 health law. The state-federal program which covers 60 million poor and disabled people would be greatly expanded under the health law, adding 17 million more people starting in 2014. But if the entire law is struck down, states for the first time since 2009 would be free to tighten eligibility and make it more difficult for people to apply" (Galewitz, 6/20). Read the story.  

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Awaiting The Court Ruling, A Consumer Guide To Health Reform Law

Kaiser Health News staff writer Mary Agnes Carey reports: "The Supreme Court is expected to rule within a week on some key constitutional challenges brought by states against the 2010 health care overhaul law. The decision will have sweeping ramifications for consumers, state officials, employers and health care providers, including hospitals and doctors" (Carey, 6/20). Read the story.

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Capsules: HHS Awards Health Center Grants

Now on Kaiser Health News' blog, Matthew Fleming writes: "Even as attention is focused on the much-anticipated Supreme Court decision regarding the health law's constitutionality, the Obama administration continues to roll out 'good news' announcements related to provisions that have already taken effect. Case in point: The Obama administration Wednesday announced $128.6 million in new grants designed to help community health centers across the country and in some U.S. territories expand their ability to treat patients" (Fleming, 6/20). Check out what else is on the blog.

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Political Cartoon: 'Til Death Do Us Part?'

Kaiser Health News provides a fresh take on health policy developments with 'Til Death Do Us Part?' by Harley Schwadron.

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


Parties strategize,
pundits blather. Clearly, it's 
the main show in town.


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

Political Jockeying Accelerates In Anticipation Of Decision

News outlets report on how political leaders, interest groups and the presidential campaigns have stepped up their messaging strategies surrounding the long-awaited Supreme Court ruling.

Kaiser Health News: Health On The Hill: Political Jockeying In Anticipation Of Supreme Court Ruling
Mary Agnes Carey and Marilyn Werber Serafini join Jackie Judd to talk about the permutations of the impending Supreme Court decision on the constitutionality of the health care law. Carey says much is at stake for all people who touch the health care system while Werber Serafini outlines some of the Republican alternatives to the law (6/20). 

Politico: Neera Tanden: Health Care Ruling Won't Be The End
A ruling against the health law would energize Democratic voters in the 2012 election, says one prominent backer. And a ruling in favor of it — even if that means at least one Republican-appointed justice upholds it — won't make its critics suddenly find it politically palatable, said one of the law's leading foes (Haberkorn, 6/20).

Politico: Health Lobby To Parse Words After Decision
When the Supreme Court hands down its ruling on the health care law, it's game on for K Street. Lawyers and lobbyists are preparing their rapid-response plans to dissect the decision and tell clients what it means. But no matter how quickly people figure out what the court said, don't expect corporate America to come out spiking the football (Palmer, 6/20).

Politico: Breaking ACA Into Bite-Size Sound Bites
In recent months on the trail, Obama has pulled out at least five of the law's most popular provisions and given them a feature role when talking to crucial voter groups, such as seniors, young people and women. The strategy makes sense: As unpopular as health care is as a whole, polling has repeatedly found that individual items in the law are popular with the public (Haberkorn and Samuelsohn, 6/20).

Roll Call: Mitt Romney, House GOP Prepare For Health Ruling
Presumptive GOP presidential nominee Mitt Romney dispatched two health care advisers to Capitol Hill this week and House GOP leaders met with their rank and file behind closed doors for a final time to promote a unified front ahead of Monday's anticipated Supreme Court decision on President Barack Obama's health care law. Regardless of whether the law is found constitutional, Republicans are hoping to avoid any intraparty squabbles that could jeopardize Romney's chances at the White House (Newhauser, 6/21).

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Analyzing The Court's Possible Impact

Consumers, small businesses and even the health insurance marketplace will face significant ramifications depending on how the court rules.    

Kaiser Health News: Awaiting The Court Ruling, A Consumer Guide To Health Reform Law
The Supreme Court is expected to rule within a week on some key constitutional challenges brought by states against the 2010 health care overhaul law. The decision will have sweeping ramifications for consumers, state officials, employers and health care providers, including hospitals and doctors" (Carey, 6/20). 

The Associated Press/Washington Post: The Possible Impact On Small Businesses After The Supreme Court Rules On Health Care
Small business owners will be watching when the Supreme Court issues its ruling on the constitutionality of the Patient Protection and Affordable Care Act. The overhaul of the nation's health care system requires that by 2014, all businesses with more than 50 employees must provide health care benefits that are deemed affordable under the law (6/20).

The Wall Street Journal: Not Just Insurance Is At Stake
It isn't just large employers, medical businesses and constitutional scholars who are invested in the court's decision. Chain restaurants, tanning salons, breast-feeding advocacy groups and others far afield of health care have a lot riding on whether the law stays in place (Adamy, 6/20).

CNN Money: Exchanges Could Survive Even If Health Reform Law Dies
The Supreme Court's review of health reform means any or all of the law's mandates, such as coverage of adult dependents up to age 26 and protections for people with pre-existing conditions, could be in jeopardy. But health insurance exchanges -- which also must be set up as part of the law -- may survive and flourish even if the entire Affordable Care Act is struck down, industry experts said. ... Regardless of what happens to the health reform law, "there is bipartisan support for states having some kind of health insurance exchanges," said Christopher Condeluci, a tax attorney with law firm Venable LLP and former tax counsel to the Senate Finance Committee (Kavilanz, 6/21).

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Supreme Court Spotlight: What Medicaid Changes Might Result From The Ruling?

There is a lot at stake for Medicaid's future, as the court weighs a challenge to the program's expansion. Some states, though, pledge to move forward regardless of the decision. 

Kaiser Health News: Court Challenge Could Result In Medicaid Cutbacks Instead Of Expansion
The future of the nation's largest health insurance program -- Medicaid -- hangs in the balance of the Supreme Court's decision on the 2010 health law. The state-federal program which covers 60 million poor and disabled people would be greatly expanded under the health law, adding 17 million more people starting in 2014 (Galewitz, 6/20).

Politico Pro: Ruling May Lead To Medicaid Cuts, Barriers
A broad Supreme Court ruling could reopen the door for states to slash their Medicaid rolls, although many experts don't expect a mad rush to boot people from the program. That may be a surprise, because many cash-strapped states started clamoring for repeal of the health care law's "maintenance of effort" rules preventing them from tightening eligibility requirements from the moment the law passed. But, experts say, most states are likely to take a more subtle approach to reducing participation, and it won't have a dramatic effect overnight (Feder, 6/21).

Politico Pro: 3 States: Ruling Won't Halt Medicaid Changes
Even if the Supreme Court overturns the Affordable Care Act's Medicaid expansion, some state Medicaid officials plan to move forward with reform plans that are already being put into place. Without the Medicaid expansion, there'll be 16 million to 20 million people who won't be added to the Medicaid rolls starting 2014 — and billions in federal funding for the coverage expansion won't be there. But some state Medicaid officials said they're already working toward changes that can move ahead, regardless of whatever the Supreme Court decides (Millman, 6/20).

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Some Small Businesses Frustrated By Health Insurance Tax-Credit Rules

The Wall Street Journal reports on how the health law's small business tax credit is working, while The Washington Post examines insurance rebates to consumers.     

The Wall Street Journal: Health-Care Tax Credit Eludes Some
Hundreds of thousands of small businesses are excluded from claiming a health-care tax credit, and many blame overly narrow restrictions. "You're penalized for giving people a higher wage and a more professional opportunity," said Michael Griffin, whose St. Louis ad agency offers health-insurance coverage to its six full-time employees. ... Government offices and small-business advocacy organizations had projected that millions of employers would be eligible for the health-care tax credit when the health-care overhaul law passed in March 2010 (Maltby, 6/20).

The Washington Post: Health Insurance Plans Owe $1.1 Billion In Rebates
[The] Affordable Care Act rule requires insurance companies to spend at least 80 percent of subscriber premiums on health-care claims and quality improvement initiatives. The other 20 percent is left for administrative costs and profits. Health insurance plans that don’t hit that threshold will send a rebate to consumers to cover the difference. There could, however, be one big hitch. If the Supreme Court overturns the health-care law — a decision that could come as early as Thursday morning — experts say those checks are unlikely to hit Americans’ mailboxes (Kliff, 6/20).

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New Report Tallies Death Rates Among People Who Lack Health Insurance

The report, released by Families USA, concluded that each year more than 26,000 working-age U.S. adults die prematurely because they lack health insurance.  

Reuters: Over 26,000 Annual Deaths For Uninsured: Report
More than 26,000 working-age adults die prematurely in the United States each year because they lack health insurance, according to a study published ahead of a landmark U.S. Supreme Court ruling on President Barack Obama's health care reform law. The study, released on Wednesday by the consumer advocacy group Families USA, estimates that a record high of 26,100 people aged 25 to 64 died for lack of health coverage in 2010, up from 20,350 in 2005 and 18,000 in 2000 (Morgan, 6/20).

The Hill: Group: Uninsured Americans Will Die Without Health Care Law
In a report, Families USA found that more than 130,000 Americans died between 2005 and 2010 because of their lack of health insurance. The group calculated that in 2010, the number of deaths due to a lack of coverage averaged three per hour and that the issue plagued every state. More than 3,000 people in California died in 2010 for lack of insurance, the report found (Viebeck, 6/20).

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Campaign 2012

Ads Take Issue With Health Law

News outlets report on various ad campaigns designed to criticize the Democrats' health law.  

The New York Times: Distaste For Health Care Law Reflects Spending On Ads
(Erika) Losse is precisely the kind of person President Obama's signature health care law is intended to help. She has no health insurance. She relies on her mother to buy her a yearly checkup as a Christmas gift, and she pays out of her own pocket for the rest of her medical care, including $1,250 for a recent ultrasound. But Ms. Losse, 33, a part-time worker at a bagel shop, is no fan of the law (Goodnough, 6/20).

The Associated Press: Women's Group Airs Ad Criticizing Health Care Law
A conservative women's group on Wednesday launched a $6 million ad campaign in presidential battleground states criticizing President Barack Obama's health care reform law. The 60-second ad from Concerned Women for America features a family physician, Ami Siems, warning that patients may be denied care under the new law and might not be able to choose their own doctor. Siems previously appeared in ads criticizing the health care reform proposal sponsored by another conservative group, Americans for Prosperity, in 2009 when the plan was being considered by Congress (Fouhy, 6/20).

CNN: Conservative Women's Group Takes Out Massive Ad Buy Against Obama
A conservative women's advocacy group on Wednesday announced a major ad buy aimed against President Barack Obama's sweeping health care reform. ... The six states in the ad buy include Minnesota, New Mexico, and Wisconsin-three states that lean toward Obama, according to CNN's Electoral Map. The ad will also run in Iowa, New Hampshire, and Virginia, all of which fall under the "toss-up" category, according to CNN analysis (Killough, 6/20).

Des Moines Register: Conservative TV Ad In Iowa Features A Doctor Bashing Health Care Law
Starting today, Concerned Women for America will run $6 million in TV advertising criticizing the federal health care law. ... Concerned Women for America is a conservative public policy organization with a 30-year history of bringing "Biblical principles into all levels of public policy," its website says. In response, Obama’s Iowa campaign spokeswoman, Erin Seidler, said: "If Mitt Romney and his extreme conservative allies repeal Obamacare, they are going to have to answer to the 42,000 Iowans who have saved money on prescription drugs, 18,000 Iowans under 26 who can now stay on their parent’s insurance and the two million Iowans who no longer have to worry about lifetime caps or losing insurance when they get sick" (Jacobs, 6/20).

Meanwhile, Catholic leaders announced a campaign for religious liberty.

USA Today: Catholic Bishops Press Cause Against Federal Mandates
U.S. Catholic leaders, claiming religious liberty is under assault from the Obama administration, are launching two weeks of non-stop nationwide teaching, preaching and public events to press their cause. The campaign kicks off Thursday. Government, they say, should not decide who is religious enough to be exempt from government mandates — particularly a requirement to provide free contraception insurance coverage — that would force the faithful to violate church doctrine (Grossman, 6/21).

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Capitol Hill Watch

Some Republicans Shy Away From Prevailing GOP View On Medicare, Budget

The Los Angeles Times reports that some Republican lawmakers have "economic visions" that are different from the budget plan advanced by Rep. Paul Ryan, R-Wis., and embraced by GOP presidential hopeful Mitt Romney.

Los Angeles Times: Not All Republicans Embrace GOP Budget, Medicare Changes
As both Democrats and Republicans try to make the November election a choice over competing economic visions for the country, not all congressional Republicans are fans of the GOP budget approach as crafted by Rep. Paul D. Ryan (R-Wis.) and embraced by the party's presumptive presidential nominee Mitt Romney (Mascaro, 6/20).

In other congressional action --

Politico: House Extends FDA User Fees
The House easily passed a bill reauthorizing the FDA's user fees Wednesday, sending it to the Senate for final approval. The measure passed by voice vote. The exact timing for Senate action on the bill is not yet clear, but that chamber is expected to take it up next week and send it to President Barack Obama (Norman, 6/20).

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Health Care Fraud & Abuse

Using Medicare Data To Curb Medicaid Fraud

Projects are underway to make Medicare data more useful to states in an effort to keep fraudulent providers out of their respective Medicaid programs.

Stateline:  States Seek Medicare Data To Keep Fraudulent Providers Out Of Medicaid
The federal government says it has ambitious projects underway to make Medicare data more useful to states, and to help states share information about their respective Medicaid programs. The problem, federal officials say, is that Medicare, which provides health coverage for seniors, is organized very differently from Medicaid. And each state organizes its Medicaid program in a different way, making data matches difficult (Vestal, 6/21).

Also in the news, Cuba defends its banks against Medicare money-laundering accusations --

The Associated Press/Washington Post: Cuba Defends Its Banks After US Prosecutors Say Medicare Fraud Money Sent To Island Accounts
A Cuban official said Wednesday that the country has strict controls to avoid money laundering and works closely with banks to detect and deter fraudulent transactions, responding to allegations by U.S. prosecutors that millions of dollars defrauded from Medicare were routed to the island’s financial system (6/20).

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Health Care Marketplace

The New Wave Of Health Care Thinking: 'Frugal Innovation'

Reuters: Analysis: Healthcare Sees Emerging Future In Frugal Innovation
The new wave of thinking effectively turns on its head the idea that healthcare innovation must always make something more high-tech, more sophisticated, more complex - and hence more expensive. With this kind of disruptive innovation, sometimes called "frugal innovation", instead of adding yet more bells and whistles, the idea is strip down to the bare necessities (Kelland, 6/20).

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Hospitals Attract Investors' Attention

Reuters: Analysis: Hospitals Find A Few Defenders On Wall Street
Such construction plans are just one example of how publicly traded U.S. hospital chains are preparing for a new era in healthcare. In many cases, operators like Community Health and Health Management Associates Inc are becoming turnaround strategists, taking over struggling nonprofit community hospitals for bargain prices and investing in new technology for the promise of a new revenue stream. Their actions are drawing new interest from some investors, who are lured by the companies' historically low stock valuations and the expectation that their expanding clout and focus on efficiency will help solve a growing national healthcare crisis (Kelly, 6/21).

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State Watch

States Wonder: What Happens To Us After Health Law Ruling?

States are anxiously considering the effect of the pending court decision. In Florida, Gov. Rick Scott says his state will comply with the health law if it is upheld. And in California, officials and lawmakers worry over what a ruling could mean for plans to institute consumer protections. 

The Associated Press: Florida To Carry Out Health Law If Upheld By Court
Florida's Republican governor -- one of the staunchest opponents of President Barack Obama's health care overhaul -- says his state will carry out the law if the Supreme Court upholds it. Gov. Rick Scott told reporters Wednesday "if it is the law of the land, then we are going to comply” (6/20).

The Hill: Gov. Scott: Florida Will Comply If Health Law Is Upheld
Florida Gov. Rick Scott (R) said Wednesday that his state will comply with all portions of the federal health care law if it is upheld by the Supreme Court. Scott added that he is "very optimistic" the Affordable Care Act will be declared unconstitutional, calling the law a "disaster for patients." "Every government program in the world rations care," the former health care executive told reporters. "This is going to be an unbelievable rationing of care" (Viebeck, 6/20).

Sacramento Bee: Imminent Court Ruling Could Undercut California's Health Plans
It is clear some provisions of the law will almost certainly remain intact in California no matter how the court rules. The state already has enacted its own legislation prohibiting most insurers from denying coverage to children because of pre-existing conditions and allowing people up to age 26 to remain on their parents' policies. Yet a reversal of part or all of President Barack Obama's signature health care law could deeply frustrate the administration's broader health care goals (Siders, 6/21).

California Healthline: Senate Rejects ACA/Exchange Bill
If the Supreme Court overturns part or all of the Affordable Care Act in a ruling expected within the next 10 days, California should be ready, according to Senator Tom Harman (R-Huntington Beach). Harman yesterday introduced SB 1321, which would require the California Health Benefit Exchange to submit a report to the Legislature within 90 days, if the Supreme Court reverses any part of the ACA. The Senate Committee on Health rejected the measure (Gorn, 6/21).

CT Mirror:  State Could Face Big Revenue Loss If Patient Protection Act Is Overturned
With the U.S. Supreme Court to rule this week or next on national health care reform, Connecticut officials are holding their collective breath, waiting to see if they must choose between cutting health care benefits for the poor and spending more state money to replace the hundreds of millions in federal dollars that will vanish. Both Connecticut's Medicaid for Low-Income Adults -- commonly known as LIA -- and the state's plans to serve a dramatically expanded general Medicaid population, could be thrown into legal limbo, depending on how the high court interprets the U.S. Patient Protection and Affordable Care Act. Shortly after the act passed in 2010, Connecticut became the first state to move its state-funded health program for poor adults without children under the federal Medicaid umbrella (Phaneuf, 6/20).

North Carolina Health News:  Health Care Leaders Discuss Effects Of Upcoming Supreme Court Decision
Leaders of some of the Triangle’s largest health care organizations met Tuesday to discuss the impact of the federal health care reform law as the U.S. Supreme Court gets ready to deliver its verdicts on the law’s various provisions.  A ballroom at the North Ridge Country Club was filled with hundreds of small business owners looking to get some idea of what the health insurance world would look like in the wake of a Supreme Court ruling (Tsipis, 6/20).

Chicago Sun-Times: Much At Stake With Pending 'Obamacare' Court Ruling
"There is a human cost here," Gov. Pat Quinn told the Chicago Sun-Times Wednesday. "We're talking about thousands of people with pre-existing conditions who now have insurance and thousands of young adults who are now covered by their parents' insurance. We're talking about people who are finally receiving the preventative care they need to lead healthier lives and avoid illnesses." ... "If the Medicaid expansion is thrown out, that would have a devastating impact for the county health system," said Marisa Kollias, spokeswoman for the Cook County Health and Hospitals System that operates the John H. Stroger, Jr. Hospital of Cook County (Sweet, Janssen and McKinney, 6/20).

Health Policy Solutions (a Colo. news service): Colorado Businesses Divided On Health Law
From the White House to the Capitol buildings in both Washington, D.C. and Colorado, elected officials and health policy experts are eagerly awaiting a ruling from the U.S. Supreme Court that could be the most significant in decades. ... In the U.S., businesses have for decades provided health care to employees. Now business leaders are at the center of the debate (Kerwin McCrimmon, 6/20).

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N.C. Budget Includes Additional Funds For Medicaid; KanCare Plan Triggers Nerves

Medicaid spending and revamp plans being advanced in various states are drawing headlines and public scrutiny.

North Carolina Health News:  Medicaid Fixes Dominate Healthcare In General Assembly Budget
House and Senate negotiators at the General Assembly announced an agreement Wednesday morning for a $20.2 billion overall state budget for the upcoming fiscal year. ... The budget will include additional dollars for Medicaid, no compensation for eugenics victims and deep cuts to prevention programs (Hoban, 6/20).

Kansas Health Institute News:  KanCare Plan Panned Again At Public Hearing
Top health officials from the administration of Gov. Sam Brownback today tried to reassure nervous members of the Kansas public that the Medicaid makeover plan they hope to launch Jan. 1 is a good idea and that problems seen in other states that have expanded managed care would be avoided here. ... The governor's plan, if implemented, would move the balance of the state's Medicaid population into fixed-cost managed care programs divided statewide among three companies. About 70 percent of the state's Medicaid population already is in managed care plans. KanCare would move the remainder into a system that would be similar to the current one but also different because it would improve health outcomes and lower costs thanks to a new emphasis on coordinated care, the officials said (Shields, 6/21).

CT Mirror:  DSS Concedes Eligible Low-Income Residents May Be Losing Health Care
The department is facing a huge backload of paperwork, the result in part of an antiquated computer system, fewer employees and an ever-higher caseload. ... Each month, DSS sends about 40,000 people a form to fill out and send back so the department can determine if they remain eligible for government-funded health care. .... [Lawyer Sheldon Toubman] said thousands of eligible low-income and disabled Connecticut residents are losing their benefits each month because of the backlog of paperwork the agency faces (Thomas, 6/20).

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State Roundup: Mass. Grapples With EHR Privacy Issues

A selection of health policy stories from Michigan, California, Massachusetts, New York and Florida.

Boston Globe: As Records Go Online, Clash Over Mental Care Privacy
Providers in separate networks are preparing to share patients' records more widely online -- to better coordinate care and cut wasteful spending. This will probably intensify the debate about what should and should not be shared, as well as fears about the unauthorized release of patient information. Both the House and Senate health care cost-control bills passed this spring require the state to create a system for sharing records across provider networks (Kowalczyk, 6/21).

Boston Globe: Children's Hospital Survey Finds Employers Using Limited, Tiered Networks To Cut Costs
Half of public employers and about one-third of private companies now offer plans that limit their workers' access to expensive hospitals and doctors, but many are confused about how these plans work, according to a survey and focus groups commissioned by Boston Children's Hospital (Kowalczyk, 6/20).

Florida Health News:  Electronic Health Records Provide $400M Payoff For FL
Doctors and hospitals in Florida have received over $404 million from the federal health agency as a reward for switching from paper to electronic health records, according to data released Tuesday. … Congress approved the incentive program separately from the Affordable Care Act, so it is not at risk in the pending Supreme Court ruling on the act, expected in the next 10 days (Gentry, 6/20).

The Associated Press/Detroit Free Press: Judge Blocks Law To Stop Health Care Union Dues
A judge blocked a new Michigan law Wednesday that's aimed at ending union dues paid by home health care workers who are private contractors and not public employees. The decision by U.S. District Judge Nancy Edmunds was a defeat for Republican lawmakers and GOP Gov. Rick Snyder (White, 6/20).

California Watch: Consumer Groups Criticize SF Health Department's Lobbying Budget
San Francisco Mayor Ed Lee spared the city's Public Health Department from cuts in his latest budget proposal, which benefited not just health care consumers, but also a lobbying group that consumer advocates say works against them. According to memos obtained by The Bay Citizen through the city's sunshine ordinance, the department plans to spend $330,000 for the California Hospital Association to lobby on its behalf -- by far the largest single recipient in the department's nearly $1 million lobbying budget (Smith, 6/21).

The New York Times: Albany Bill On Organ Donation Urges License Applicants To Act
The New York State Legislature passed a measure on Wednesday aimed at increasing the low number of organ donors in the state by encouraging driver's license applicants to make an active choice about their donation status. If the bill is signed by Gov. Andrew M. Cuomo, New York will become the second state, along with California, to make such a change in its donor registration process (Sack, 6/20).

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Editorials and Opinions

Viewpoints: Looking Beyond The Court's Eventual Decision

Los Angeles Times: Getting Past Healthcare's Individual Mandate
Speculation about the likely death of "Obamacare" has raged ever since the Supreme Court heard three intense days of legal arguments in March. The pundits have crowed about how the individual mandate is the Achilles' heel of President Obama's healthcare law (Theda Skocpol and Lawrence R. Jacobs, 6/20). 

Reuters: The Supreme Court, Healthcare And You
The political consequences (of the Supreme Court decision) may be immediate and severe, but the personal ramifications will be less extreme. Nobody should expect to lose part or all of their coverage overnight, and health costs won't immediately ratchet up or down in response. "We've gotten assurances that insurers and employers won't change anything mid-stream, and will hang on for a while," said Jeff Munn, a benefits consultant with Fidelity Investments, who works with employers (Linda Stern, 6/20).

Boston Globe: Obama Tries To Sell Health Care Law, But It’s Too Late
The failure to present health care reform as the big deal that Vice President Joe Biden said it was cries out for further explication. Instead of mounting a Koch Brothers-like effort to promote its benefits, the president let the other side demonize it. Once Ted Kennedy’s booming voice was silenced, no progressive in Washington — and certainly, no one in the White House — stepped up to frame access to decent, quality health care the way Kennedy framed it — as a fundamental American right, not a privilege (Joan Vennochi, 6/21).

Forbes: Whatever Its Pending Decision, The Supreme Court Won't Decide The Future Of Health Care
With the Supreme Court expected to rule on the Affordable Care Act later this month, here’s my prediction: Anyone who believes that this decision will settle the issue of health care reform, one way or the other, will be disappointed (John Lechleiter, 6/20).

Fox News: Curing Disease Matters More Than Supreme Court Decision On ObamaCare
All of Washington’s permutations of health "reform" – ObamaCare, RyanCare, Simpson-Bowles – all of them, regardless of where their creators sit on the ideological spectrum are about how we pay for treatments, rather than the bigger issue of how we improve health. Our health debate should be much more about medical science: curing disease, identifying who’s at risk to get a disease and helping them avoid it, and creating regenerative technology to end crippling disabilities. But in Washington, how you pay for something is the thing itself. How we pay for health care is health care (Jeremy Shane, 6/20).

Health Policy Solutions (a Colo. news service): Do-It-Yourself Health Care Reform
But, one job health care reform can’t do is change you. And why should you or I or any of us change? The simple answer is because the choices we make have a lot to do with how healthy we are. Besides lifestyle choices, the medical world talks a lot about the importance of preventive care. The idea is that if we can just make sure John Doe and Jan Doe never get diabetes, then we’ll never have to treat them for diabetes or any diabetes-related complications (Gena Akers, 6/20).

The New York Times: Anti-Abortion Grandstanding
Republican lawmakers in Iowa are demanding that the state Department of Human Services stop paying for any abortions, even in cases of rape or incest, or severe physical or mental deformities. Under federal law, federal money is available for abortions in those cases, and only those cases. ... If the state government goes along, Iowa stands to lose federal Medicaid money. It’s not clear how much. ... Perhaps the most ridiculous aspect of this story is that Iowa Republicans are willing to risk losing money for a glancingly small number of abortions (Andrew Rosenthal, 6/20).

JAMA: Mitt Romney: Physicians Should Be Like Car Salesmen
Mitt Romney gave a speech about health care last week. We all know he is in favor of repealing the Affordable Care Act (ACA). This speech, which laid out his ideas for its replacement, didn’t get a lot of attention. That may be good news for Romney, for the truth of the matter is that his plan for replacing the ACA is degrading to doctors and patients. For physicians, it would mean a loss of professional esteem. For patients, it would mean losing the consumer protections provided by the ACA and replacing them by passing a law that already exists. It's snake oil dressed up as policy, and it's scary (David M. Cutler, 6/20).

Roll Call: Obesity Epidemic Requires All-Out Response
When Hurricane Katrina hit the Baton Rouge, La., area in 2005, I worked with others in our community to turn an abandoned Kmart store into an improvised hospital to care for the casualties. Politics did not matter. This was a natural disaster, and it demanded an all-out, all-hands-on-deck response. The same is true of the national epidemic of obesity. This is why I co-hosted a briefing this week with Rep. Loretta Sanchez, a California Democrat, to inform Congressional staff and the general public about the physical and financial toll of weight-related problems (Rep. Bill Cassidy, R-La., 6/21). 

New England Journal of Medicine: The Burden Of Disease And The Changing Task Of Medicine
In many respects, our medical systems are best suited to diseases of the past, not those of the present or future. We must continue to adapt health systems and health policy as the burden of disease evolves. But we must also do more. Diseases can never be reduced to molecular pathways, mere technical problems requiring treatments or cures. Disease is a complex domain of human experience, involving explanation, expectation, and meaning (Drs. David S. Jones, Scott H. Podolsky, and Jeremy A. Greene, 6/21). 

New England Journal of Medicine: Automated Hovering In Health Care — Watching Over The 5000 Hours
[The] reactive, visit-based model in which patients are seen when they become ill, typically during hospitalizations and at outpatient visits ... falls short not just because it is expensive and often fails to proactively improve health, but also because so much of health is explained by individual behaviors, most of which occur outside health care encounters. Indeed, even patients with chronic illness might spend only a few hours a year with a doctor or nurse, but they spend 5000 waking hours each year engaged in everything else (Dr. David A. Asch, Ralph W. Muller and Dr. Kevin G. Volpp, 6/20). 

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Stephanie Stapleton

Andrew Villegas

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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.