Daily Health Policy Report

Tuesday, June 25, 2013

Last updated: Tue, Jun 25

KHN Original Reporting & Guest Opinion

Health Reform


Health Care Marketplace

Public Health & Education

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Capsules: Sebelius: Administration Is Negotiating Rates In Federal Exchanges

Now on Kaiser Health News' blog, Phil Galewitz reports: "Hoping to get consumers the best prices, the Obama administration is negotiating with insurers looking to sell policies in online health insurance marketplaces this fall, Health and Human Services Secretary Kathleen Sebelius said Monday" (Galewitz, 6/24). Check out what else is on the blog.

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FAQ: Medicare Beneficiaries May See Increased Access To Physical Therapy Or Some Other Services

Kaiser Health News: FAQ: Medicare Beneficiaries May See Increased Access To Physical Therapy Or Some Other Services
Reporting for Kaiser Health News, in collaboration with The Washington Post, Susan Jaffe writes: "For years, seniors in Medicare have been told that if they don't improve when getting physical therapy or other skilled care, that care won't be paid for. No progress, no Medicare coverage -- unless the problem got worse, in which case the treatment could resume" (Jaffe, 6/25). Read the story.

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Pittsburgh Researchers Look For Ways To Prevent Depression In Seniors

Judith Graham, reporting for Kaiser Health News in collaboration with The Washington Post, writes: "A year ago, Bernard Belisle was in a bad way. Pain throbbed in his legs all day, every day, and he was angry and irritable much of the time. Then, he enrolled in a novel study on preventing depression in older adults at the University of Pittsburgh Medical Center. Belisle says the move has changed his life" (Graham, 6/25). Read the story and the related sidebar or watch the video.

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NFL's Help Sought On Promoting Obamacare Insurance Plans

Kaiser Health News staff writer Phil Galewitz reports: "Top federal health officials are in talks with the National Football League to promote the health law’s insurance marketplaces that begin enrolling people Oct 1. … Sebelius said the administration is also talking to other major sports franchises about improving public awareness of the Obamacare online insurance exchanges, which are a critical way the federal health law expands insurance coverage" (Galewitz, 6/24). Read the story.

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Political Cartoon: 'Pain In The Neck?'

Kaiser Health News provides a fresh take on health policy developments with "Pain In The Neck?" by Jen Sorensen.  

Meanwhile, here is today's health policy haiku:


Rebates are coming.
Americans are happy
Insurers are not.
- 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

Sebelius Ramps Up Enrollment Push

The Obama administration unveiled a revamped HealthCare.gov website, the centerpiece of its campaign in more than 30 states to enroll people in health coverage, as well as a 24-hour consumer call center. Health and Human Services Secretary Kathleen Sebelius aims to enroll 7 million people by late March with help from major sports franchises and moms.

The New York Times: U.S. Unveils Health Care Web Site And Call Center
The Obama administration announced new steps to expand coverage under the federal health care law on Monday, less than a week after the Government Accountability Office, a nonpartisan investigative arm of Congress, found that the federal government and many states were "behind schedule" in setting up marketplaces where Americans are supposed to be able to buy insurance (Pear, 6/24).

The Wall Street Journal's Washington Wire: 'Obamacare' Insurance Publicity Campaign Steps Up
The Obama administration showed off its work to prepare to sign up millions of Americans for new health-insurance products on Monday, unveiling a revamped version of the healthcare.gov website that will be a centerpiece of this fall's official enrollment campaign. The website uses a Q-and-A format and includes a video describing the experience of shopping for coverage through new insurance exchanges as well as a live-chat feature, in the hopes of raising people’s awareness of the law. A new hotline that people can call is also up and running (Radnofsky, 6/24).

Marketplace: 1-800-Obamacare (Audio)
Repeat after me: ‘We’ve got to get people to sign up, we’ve got to get people to sign up,’… That’s the mantra at CMS for the next eight months as the federal government furiously tries to construct a health insurance exchange system that makes it as easy as possible for people to get health insurance. The latest effort: The Obama administration today launched its new HealthCare.gov website and the 24-hours-a-day consumer call center to help Americans prepare for open enrollment and ultimately sign up for private health insurance (Gorenstein, 6/24).

CNN Money: Question About Obamacare? Here’s A Number To Call For Help
The administration on Monday launched a toll-free helpline and revamped its HealthCare.gov site to answer basic questions about the state-based health insurance exchanges that will open for enrollment in October. A Spanish-language site, CuidadoDeSalud.gov, is also available. The helpline, 800-318-2596, is available 24/7 and can provide assistance in 150 languages. There is also a new live-chat feature on HealthCare.gov (Luhby, 6/24).

Politico: Kathleen Sebelius: Exchange Enrollment Goal Is 7 Million By End Of March
For Obamacare the magic number is 7 million. That's how many people the Obama administration hopes to enroll in its new health insurance marketplaces by the end of March. It is starting a huge public education campaign to get people on board with hopes for an assist from the NFL and other professional sports leagues (Haberkorn, 6/24).

CQ HealthBeat: CMS Launches Website, Call Center In Bid To Kick-Start Outreach
The Obama administration announced Monday a relaunch of its HealthCare.gov website and a new call center that will be open 24 hours a day as part of its effort to help consumers begin enrolling in the new health law marketplaces on Oct. 1 (Reichard, 6/24).

To get the message out, top health officials are seeking assistance from the National Football League -

Kaiser Health News: NFL's Help Sought On Promoting Obamacare Insurance Plans
Top federal health officials are in talks with the National Football League to promote the health law’s insurance marketplaces that begin enrolling people Oct 1. … Sebelius said the administration is also talking to other major sports franchises about improving public awareness of the Obamacare online insurance exchanges, which are a critical way the federal health law expands insurance coverage (Galewitz, 6/24).

McClatchy: Wanted: Moms And Athletes Needed To Help Sell Health Care Overhaul
The Obama administration continued to implement the national health care overhaul on Monday with the launch of a redesigned consumer information website, a new 24-hour Affordable Care Act hotline and plans to huddle with the National Football League. Health and Human Services Secretary Kathleen Sebelius said she’ll ask the NFL, other sports leagues and even mothers for help in spreading the word about getting people enrolled for health coverage next year – especially younger adults (Pugh, 6/24).

And here's how it's playing on the state level -

Kansas Health Institute: Getting The Word Out About Obamacare
The big push by federal officials to get the word out in the next few months about the Affordable Care Act mostly will bypass Kansas, but even in this generally anti-Obama red state there are organizations and community groups gearing up to inform the public about the new health insurance exchange scheduled to launch on Oct. 1 (Shields, 6/24).

CT Mirror: Health Insurance Exchange Starts Marketing Itself, Obamacare
There are more than 337,000 people without health insurance in Connecticut, and a new marketplace for buying coverage called Access Health CT is intended to make a dent in that number. In just over three months, it will be open for business, ready to enroll people in private health plans that take effect next year. But first, the uninsured need to know it’s there, and how to use it. So will people who have coverage but want another option. And so, Access Health -- the state's health insurance exchange, created as part of the federal health reform law -- is undertaking a major marketing campaign. It will include broadcast advertising in English and Spanish, major and ethnic newspapers, billboards, and posters in convenience stores, clinics, beauty salons and barber shops, trying to get a few points across: Federal health reform is happening (Becker, 6/24).

California Healthline: State Gearing Up For Public Education Campaign Targeting Latinos
Eager to maintain the state's reputation as a leader in implementing the Affordable Care Act, California officials are putting the finishing touches on a plan to send thousands of newly hired emissaries to spread the word about health care reform. Officials hope their massive public education and outreach campaign starting next month will reach deep into hidden pockets of the state and attract a large pool of newly insured individuals into Covered California, the state's health insurance exchange. Exchange officials hope to enroll 1.4 million next year from a pool of about 5.3 million who will be eligible (Hart, 6/24).

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Government To Bargain With Insurers Over Exchange Plans

The government will take a "more active role in selecting" insurance plans.

Kaiser Health News: Sebelius: Administration Is Negotiating Rates In Federal Exchanges
Hoping to get consumers the best prices, the Obama administration is negotiating with insurers looking to sell policies in online health insurance marketplaces this fall, Health and Human Services Secretary Kathleen Sebelius said Monday (Galewitz, 6/24).

The Hill: Sebelius: HHS Negotiating With Insurers On Premiums
The federal government is taking a more active role than expected in selecting plans for ObamaCare's new insurance exchanges, Health and Human Services Secretary Kathleen Sebelius said Monday. ... The healthcare law sets up an insurance exchange in each state. It allows each state to choose whether it will be an "active purchaser" — negotiating with insurers and rejecting plans that don't offer a good enough deal — or simply accept all policies that meet federal standards. HHS had said it would use the latter approach in the exchanges it operates. But officials said Monday that the department is still exerting some pressure on insurers (Baker, 6/24).

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Where States Opt Against Mediaid Expansion, Working Poor Likely To Lose

News outlets also report the latest developments regarding the Medicaid expansion debate in Michigan and Mississippi.

Bloomberg: Working Poor Losing Obamacare As States Resist Medicaid
Rose Ruiz collects $8 an hour cooking, cleaning, checking the oxygen tanks and changing the diapers for a 67-year-old diabetic confined to a studio apartment on the south side of Austin, Texas. Ruiz, a home health aide to Medicaid patients, has no medical insurance herself. Her best shot at getting access to doctors and medicines for her own needs was through President Barack Obama’s expansion of the federal-state Medicaid programs. That hope was scuttled for Ruiz and thousands of other health-care workers across Texas when the state opted out of the Medicaid expansion earlier this month (Wayne and Mildenberg, 6/25).

MLive: Michigan Gov. Rick Snyder Plans Statewide Talks On Medicaid Expansion Proposal Stalled In Senate
Michigan Gov. Rick Snyder, who recently blasted Senate Republicans for beginning summer break without voting on a Medicaid expansion and reform plan, is heading out on the road to tout the benefits of the proposal. Snyder's office on Monday announced "A Conversation With the Governor," a series of informal discussions with various audiences across the state (Oosting, 6/24).

Detroit Free Press: Snyder Won't Force Senate Back In To Vote On Medicaid Expansion
Gov. Rick Snyder said Monday that he won't try to legally force the Michigan Senate to return from summer vacation to vote on his Medicaid expansion plan. For one thing, it's unclear whether he has the legal power to do so, he said (Erb, 6/24).

Jackson (Miss.) Clarion-Ledger: Special Session Thursday Won't Include Medicaid Expansion Talk, Governor Says
State lawmakers are expected to be back at the Capitol on Thursday to deal with Medicaid funding and reauthorization, but Gov. Phil Bryant hasn't included Medicaid expansion as an option for discussion. ... House Democrats, pushing for Medicaid expansion to cover up to 300,000 additional "working poor" in Mississippi, blocked the regular funding and reauthorization of the program, trying to force a vote on expansion. Republicans, although in the majority, were a few votes shy of preventing this. Republicans used procedural maneuvers to block a vote on expansion and also killed Senate measures that would have reauthorized the program for the coming year (Gates, 6/24).

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Lawsuits, Or Threat Of Them, Hover Over Medicare Policy

News outlets report on the government's position on releasing doctor-specific information and on Medicare patients' access to physical therapy. And, ProPublica investigates prescribing practices.

Modern Healthcare: Doctor-Specific Medicare Claims Data Could Be Released
For decades, the CMS has kept secret its records on Medicare claims payments to individual physicians. But Justice Department statements in a recent lawsuit and the first-ever releases of other provider charge data this year suggest the federal government's position on keeping doctor-specific information secret may be changing. Proponents of releasing the data say it could help identify patterns of waste and fraud and help patients and insurance companies find doctors who deliver the most efficient and highest quality care. But medical groups have successfully fought to keep the payment information secret (Carlson, 6/24).

Kaiser Health News: FAQ: Medicare Beneficiaries May See Increased Access To Physical Therapy Or Some Other Services 
For years, seniors in Medicare have been told that if they don't improve when getting physical therapy or other skilled care, that care won't be paid for. No progress, no Medicare coverage -- unless the problem got worse, in which case the treatment could resume. ... In January, a federal judge approved a settlement in which the government agreed that this "improvement standard" is not necessary to receive coverage (Jaffe, 6/25).

In other Medicare news -- 

ProPublica/NPR: Top Medicare Prescribers Rake In Speaking Fees From Drugmakers
When the blood pressure drug Bystolic hit the market in 2008, it faced a crowded field of cheap generics. So its maker, Forest Laboratories, launched a promotional assault on the group in the best position to determine Bystolic's success: those in control of prescription pads. ... The strategy worked. In the 2012 fiscal year, sales of Bystolic reached $348 million, almost double its total from two years earlier, the company reported. Now, data obtained and analyzed by ProPublica suggest another factor in Bystolic's rapid success: Many of the drug's top prescribers have financial ties to Forest (Ornstein, Weber and Lafleur, 6/25).

MedPage Today: Many Medicare $$$ Go To Preventable Illness
Nearly 80 percent of the roughly $92 billion in acute care Medicare costs in 2010 were racked up by the 10 percent of patients who comprise the high-cost cohort, and 9.6 percent of those costs were for potentially preventable hospitalizations, researchers found. Among Medicare patients who fell short of the highest expenditures, 16.8 percent of costs were spent on preventable hospitalizations, Karen Joynt, MD, of Brigham and Women's Hospital in Boston, and colleagues wrote online in the Journal of the American Medical Association (Petrochko, 6/24).

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Health Care Marketplace

Tenet's Acquisition Of Vanguard Health Part Of Plan To Buy Other Hospitals

While news emerges regarding Tenet's plan to acqure Vanguard Health for $1.73 billion, the Ford Motor Co. announces its plans to launch a two-year health management program.  

The Wall Street Journal: Tenet To Acquire Vanguard Health For $1.73 Billion
Dallas-based Tenet said it would expand to 79 hospitals from 49, and significantly increase its geographic reach, adding markets such as Detroit and Chicago and particularly deepening its presence in Texas. Tenet also said the acquisition marks what it hopes will be a stepped-up effort to acquire other hospitals, where its deal pace has been relatively slow (Mathews and Kamp, 6/24).

The Wall Street Journal: Ford Adopts Health Management Program
Ford Motor Co. and a United Auto Workers union trust fund that provides health care to retired union auto workers are launching a two-year pilot program that seeks to cut costs by adding more care to workers and retirees with chronic illnesses (Ramsey, 6/24).

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Supreme Court Sides With Generic Drug Makers

The case involved a "badly injured patient" in New Hampshire.

Reuters: Justices Block Generic Drug Liability Lawsuits
The Supreme Court ruled on Monday that generic drugmakers cannot be sued under state law for adverse reactions to their products, a decision that consumer advocates called a blow to patient safety. In a 5-4 vote, the court ruled for Mutual Pharmaceutical Co, owned by Sun Pharmaceutical Industries Ltd, overturning a multimillion-dollar jury award to a badly injured patient in New Hampshire who alleged a generic drug she had taken was unsafe based on its chemical design (Hurley and Berkrot, 6/24).

The Hill: Supreme Court Blocks Lawsuits Against Dangerous Drugs
A previous high court ruling shielded generics from most lawsuits over their warning labels, but some states also allowed lawsuits over the safety of the product itself (Baker, 6/24).

MedPage Today: Supreme Court Nixes State Suits Against Generics
The case, Mutual Pharmaceutical v. Bartlett, involves a woman who, in 2004, was prescribed Clinoril, the brand name for the nonsteroidal anti-inflammatory drug sulindac. ... The Supreme Court said the federal Food, Drug, and Cosmetic Act allows only the FDA to make labeling changes and supersedes state law -- including the one in New Hampshire where this case originated -- that tries to force drugmakers to make labeling or design changes when safety issues arise (Pittman, 6/24).

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Public Health & Education

Study: Despite Struggles With Poverty, More Children Getting Health Insurance

And, another study examines the number of children with mental disorders, by condition.

Reuters: Health Of U.S. Children Improves, But More Live In Poverty: Report
Families in the United States are making gains in education and health, two key factors in their overall well-being, a report released on Monday showed, adding to data that suggests the U.S. economy is slowly rebounding from the 2007-2009 recession. Still, the latest findings on the state of U.S. children and their parents by the Annie E. Casey Foundation found many families continue to struggle ... Most states also saw more children with health insurance, improvements in birth weights, and fewer youth deaths between 2005 and 2011, it said (Heavey, 6/24).

HealthyCal: Study: One In Five U.S. Children Have Mental Disorder
As many as one in five children in the United States suffer from a mental disorder in a given year, according to national data recently compiled by the Centers for Disease Control and Prevention. The CDC study released last month was the first comprehensive report to assemble data on specific mental health illnesses among children ages 3 to 17 in the United States. Attention-deficit/hyperactivity disorder (ADHD) topped the list, with 6.8 percent of children experiencing the disorder (Bartos, 6/25).

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Health Panel Urges Baby Boomers Be Tested For Hepatitis C

The New York Times: Hepatitis C Test For Baby Boomers Urged By Health Panel
An influential health advisory group has reversed itself and concluded that all baby boomers should be tested for hepatitis C, meaning that under the new health law many insurance plans will have to provide screening without charge to patients. The group, the United States Preventive Services Task Force, announced its change of heart on Monday, saying there was likely to be some benefit from such screening (Pollack, 6/24).

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State Watch

Health IT Firm Athenahealth Plans Expansion

Health information technology firm athenahealth, which offers electronic health records and care coordination products, will expand and create hundreds of new jobs in Georgia and Massachusetts.

Georgia Health News: Major Health IT Firm To Expand In State
The booming health IT industry in Georgia is getting a little bigger. Gov. Nathan Deal announced Monday that athenahealth Inc. will expand its presence in the state, creating 500 new jobs and investing $10.8 million. athenahealth provides cloud-based services for electronic health records, practice management and care coordination. Based in Watertown, Mass., the company acquired Alpharetta-based Anodyne Health in 2009. athenahealth will consolidate its Alpharetta workforce of about 100 at its new location at Ponce City Market in Atlanta, and will add 500 additional jobs over the next five years, Deal’s office said (Miller, 6/24).

The Boston Globe: 1,900 New Jobs, $9.5m Tax Break For Athenahealth
Athenahealth Inc., one of the companies leading efforts to computerize health care records across the country, has promised to add 1,900 workers at its Watertown headquarters in exchange for a state tax break, the biggest economic development deal reached with Massachusetts in years. The electronic medical records company, which already has nearly 1,100 employees in Watertown, pledged to nearly triple that by 2022 in exchange for $9.5 million in state tax credits under a tentative deal worked out with Massachusetts economic development officials. The state Economic Assistance Coordinating Council is expected to formally sign off on the tax break at its meeting on Wednesday (Wallack and Weisman, 6/25). 

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Supreme Court Agrees To Hear Challenge To Massachusetts Abortion Law

This challenge is rooted in issues related to free speech.

Politico: Supreme Court To Take Up Massachusetts Abortion Law
As lawsuits over early abortion laws spring up across the country, the Supreme Court on Monday agreed to hear a different kind of abortion challenge — this one involving free speech. The court will consider a case challenging a Massachusetts law that bans demonstrations within 35 feet of entrances and driveways of abortion clinics. The 1st Circuit Court of Appeals in January sided with the state in McCullen v. Coakley, ruling that the law strikes the right balance between protecting free speech and patients' rights (Millman, 6/25).

The Boston Globe: Justices Will Examine State’s Clinic Buffer Law
To the surprise of many observers, the court decided it will hear a challenge to the state’s 2007 law from a group of abortion opponents, who say it unlawfully restricts their free speech rights. In taking the case, the court appears poised to weigh two competing, strongly held rights: freedom of speech and the ability of women to seek abortion services. ... Massachusetts is one of just three states with buffer zone laws, along with Colorado and Montana, according to the Guttmacher Institute, a nonprofit group focused on sexual and reproductive health research. Some cities, including Chicago and New York City, have such laws. In Burlington, Vt., a federal judge this year upheld an ordinance that also provided a 35-foot buffer (Schworm, 6/24).

The Associated Press: Court To Hear Appeal Of Mass. Abortion Buffer Zone
The U.S. Supreme Court has decided to reconsider the constitutionality of a 2007 Massachusetts law that bars protests within 35 feet of abortion clinic entrances, exits and driveways. The justices agreed Monday to hear an appeal from abortion opponents who want the law thrown out, saying it violates their free speech rights (6/25).

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State Highlights: Many States Missing Out On Medicaid Money For Prisoners

A selection of health policy stories from New York, Texas, New Mexico, North Carolina, Wisconsin and Oregon.

Stateline: States Missing Out On Millions In Medicaid For Prisoners
Only a dozen states have taken advantage of a long-standing option to stick the federal government with at least half the cost of hospitalizations and nursing home stays of state prison inmates. The other states have left tens of millions of federal dollars on the table, either because they didn't know about a federal rule dating to 1997 or they were unable to write the laws and administrative processes to take advantage of it. States and localities have a constitutional obligation to provide adequate health care to prisoners, and they must pay for it out of their own budgets (Vestal, 6/25).

The Wall Street Journal: Hospital in Long Beach Remains Closed Since Sandy
Long Beach has sputtered back to life in recent weeks, as crowds once again stream to its shores, but the Long Island community's hospital remains closed almost eight months after it sustained $20 million of damage from superstorm Sandy (Dawsey, 6/24).

Texas Tribune: Interactive: The Impact of Proposed Abortion Restrictions
Senate Bill 5 -- the omnibus abortion legislation that Republican lawmakers are racing to approve before the special session ends Tuesday night -- has been labeled as among the strictest abortion regulations in the country. This interactive shows which of the 42 abortion facilities in Texas would meet the stricter regulatory standards in SB 5 (Aaronson, Murphy and Luthra, 6/25).

The Associated Press: Audit Shows NM Mental Health Companies Overbilled
Fifteen New Mexico providers of mental health and substance abuse services failed to meet standards, overbilled the federal and state government by tens of millions of dollars, and may have taken part in fraudulent activities, according to a new state audit released Monday (Ramirez and Contreras, 6/24).

North Carolina Health News: Group Homes Provide Support, Keep Mentally Ill From Hospital
People with mental illness who live in group homes are anxiously waiting on lawmakers to decide about funding for their facilities for the coming year. Advocates plan to rally Tuesday in front of the General Assembly to make sure their needs are addressed in the state budget (Hoban, 6/24).

Milwaukee Journal Sentinel: State 2nd Worst In Poor Kids' Dental Care
Only one state in the nation has a worse track record than Wisconsin for providing dental care for low-income children, a report released Tuesday by Pew Charitable Trusts says. In Wisconsin, 71.5 percent of Medicaid-enrolled kids did not see a dentist in 2011 -- second only to Florida, where three-fourths of Medicaid-enrolled kids didn't get dental care that year. … Nationwide, more than 14 million low-income children didn't have dental care, according to the Pew report. Lack of access to dental care for low-income families is one of the most entrenched, widespread and overlooked problems in the U.S. health care system (Herzog, 6/25).

Oregonian: Oregon Faces Critical Dentist Shortage, Report Shows
Oregon suffers from one of the most severe dentist shortages in the country, according to data released today. A Pew Research Center report to be released Tuesday reveals that approximately 17 percent of Oregonians live in a dentist shortage area and therefore likely won't receive adequate dental care. Oregon ranks 10th worst in the nation for dentist shortages. The report attributes the worsening coverage gap – which would require 6,000 new dentists to bridge – to an unequal distribution of dentists across the country that leaves rural areas neglected (Karlamangia, 6/24).

Health Policy Solutions (a Colo news service)/I-News Network: Law Requiring Physical Activity In Schools A Bust
A 2011 state law requiring 30 minutes of physical activity a day for elementary students was supposed to provide a new tool in the fight against childhood obesity – but in reality it did little more than reinforce the status quo, an I-News examination found. The measure was so gutted during the legislative process that it has meant virtually no meaningful changes in the way elementary schools are operated. The standard imposed by the law, which allows recess to count as physical activity time, was already being met by districts across the state. Two years later, the school day looks exactly the same for students across the state as it did before the law was passed (Vaughan, 6/24).

California Healthline: Senate Report Examines Goals For Alzheimer’s Care
Alzheimer's is an "impending public health crisis" in California and needs immediate and continued state attention, according to a new report from the California Senate Office of Research. The statewide focus on Alzheimer's disease began in earnest two years ago, according to the report released last week. "The year 2011 was significant for Alzheimer’s disease, as the first baby boomers turned 65 years old," the report said. That was the year California unveiled its action plan for the 2011–2021 decade, and when the National Alzheimer’s Project Act was signed into law (Gorn, 6/24).


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Editorials and Opinions

Viewpoints: Exploring The Bond Between Caretaker And Patient; Missouri Looks Beyond Expansion To Reform Medicaid

The New York Times: The Care Taker (video)
This Op-Doc video explores the relationship between an immigrant caretaker and an elderly woman in the last months of her life. Joesy, a Fijian immigrant, works long hours providing live-in care for 95-year-old Haru Tsurumoto in Sonoma County, Calif. Through intimate and quiet scenes, we explore Joesy’s complex relationship with Haru. The two respect each other in part because each has experienced being an outsider in the United States — Joesy as an undocumented immigrant who fears she could be sent back to Fiji, and Haru as a Japanese-American who was sent to an internment camp during the Second World War (Theo Rigby and Kate McLean, 6/24).

Wall Street Journal: Medicare By The Scary Numbers
In their report, the trustees acknowledge that current law envisages dramatic reductions in future Medicare outlays which may be "difficult to sustain." The president's new budget also paints a rosy picture of Medicare's present and future finances. Yet even with these unrealistic assumptions about Medicare costs, the future looks bleak. The unfunded liability in Medicare, the trustees tell us, is $34 trillion over the next 75 years. Looking indefinitely into the future, the unfunded liability is $43 trillion—almost three times the size of today's economy (John C. Goodman and Lawrence J. Kotlicoff, 6/24). 

Forbes: How To Fix Our Crippled Social Security Disability Insurance System
Social Security Disability Insurance has often been forgotten in the debate over the broader Social Security program. But Congress is beginning to pay attention, perhaps because the program is due to become insolvent by 2016. The program needs to be fixed. The question is, as always, how (Howard Gleckman, 6/24).

Kansas City Star: Medicaid Expansion Dead In Missouri, But Reform Is Alive And Kicking
Make no mistake. There will be no Medicaid expansion in Missouri. Not this year, not as long as Republicans control both chambers of the General Assembly. There may, however, be Medicaid reform in Missouri. And should that happen to provide insurance coverage for more low-income Missourians and bring the state closer to compliance with the federal Affordable Care Act, well, so be it. Just don’t use the “e” word. There are now three legislative committees set up to study Medicaid reform — one in the Senate and two in the House (Barbara Shelly, 6/24).

Tampa Bay Times: Health Care Act Improves Coverage, At Lower Cost
The Affordable Care Act promises access to affordable and comprehensive health insurance regardless of age or health status. The opponents predicted that health insurance rates would skyrocket due to the law's new requirements, but that is not happening. In many states where health insurers have priced policies for the health exchanges, the law is bringing consumer choice, transparency and competition to what has been a dysfunctional marketplace, producing better coverage at reasonable prices (6/22).

Forbes: Even In Over-Regulated Washington State, Obamacare Will Increase Individual Health Insurance Premiums By 34-80%
For all the talk about rate shock—next year’s Obamacare-induced spike in health insurance prices—there are a few states where you’d think rate shock shouldn’t happen. In Maine, New Jersey, New York, Vermont, and Washington, insurance markets are already regulated in much the same way that Obamacare will. These states force insurers to cover everyone, despite pre-existing conditions, and they oblige carriers to charge similar rates to younger and older customers. Despite these factors, it turns out that in Washington state, Obamacare will still increase the underlying cost of individually purchased health insurance by 34 to 80 percent, on average (Avik Roy, 6/23).  

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Stephanie Stapleton

Andrew Villegas

Lisa Gillespie
Shefali Luthra

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