Daily Health Policy Report

Wednesday, June 27, 2012

Last updated: Wed, Jun 27

KHN Original Reporting & Guest Opinion

Health Reform

Campaign 2012

Capitol Hill Watch

Health Care Marketplace

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

New Rules Will Ban ER Debt Collections At Charitable Hospitals

Kaiser Health News staff writer Jenny Gold, working in collaboration with NPR, reports: "On Friday, the U.S. Treasury Department released new proposed rules to protect patients from abusive debt collection practices at nonprofit hospitals. The rules were required by the 2010 federal health law. In releasing the rules, the Obama administration alluded to stories like Waldin's, which have come to light in the course of an investigation of Accretive Health launched by the Minnesota attorney general" (Gold, 6/27). Read the story.

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FDA Seeks To Tame Exploding Medical App Market

Kaiser Health News staff writer Jenny Gold, working in collaboration with USA Today, reports: “In fact, there are 40,000 medical applications available for download on smartphones and tablets—and the market is still in its infancy. But that growth is in the crosshairs of new regulatory efforts from the Food and Drug Administration” (Gold, 6/26). Read the story or check out the related sidebar.

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Capsules: Health Policy Groups Prepare For Day Of Spin

Now on Kaiser Health News' blog, Shefali S. Kulkarni reports: "The anticipation over the Supreme Court’s health law ruling has the health policy world busy with activity. Interest groups, advocates and other stakeholders are not only awaiting for the Court's decision, they are strategizing and agonizing over the best ways to get their reactions out to the public — just as soon as they figure out what to say" (Kulkarni, 6/27). Check out what else is on the blog.  

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Political Cartoon: 'High Wire Act'

Kaiser Health News provides a fresh take on health policy developments with "High Wire Act" By Chris Weyant.

Meanwhile, here are a pair of health policy haikus - inspired, we assume, by our single-minded focus on the Supreme Court decision, which is expected tomorrow: 


The clock is ticking...
Just one more day til we know
what's been decided.


Nervous? Excited?
How will you sleep tonight, with
Decision so close?

 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

Decision Anticipation: Everyone Is Looking For Clues And Making Plans For What Comes Next

News outlets are examining the high court's decisions earlier this week to find signals of what to expect in tomorrow's health law decision. Meanwhile, the White House, congressional Democrats and Republicans, lobbyists, and even the general public offer glimpses of their views.

Reuters: The Immigration Ruling: A Hint On Healthcare?
The Supreme Court's decision in the Arizona immigration case on Monday showed a conciliatory streak within a divided court that could emerge again when the justices issue their climactic healthcare decision on Thursday. What the Arizona compromise will augur for the most closely watched case of the term is anyone's guess. Yet the justices' evident search for common ground in the immigration ruling and a few other cases this term could portend a healthcare decision that does not predictably cleave along political lines (Biskupic, 6/26).

The Wall Street Journal: Americans Divided On Health Law
With the court's decision on the law set for Thursday, nearly four in 10 Americans told a new Wall Street Journal/NBC News poll that they would have "mixed feelings" if the justices struck down the whole law. Just over a quarter said they would be very pleased, while 17% said they would be very disappointed by that outcome (King and Lippman, 6/26).

ABC: Health Care Law Lacks Support—But So Does The Status Quo
Americans are equally dissatisfied with the current health care system and with the federal law intended to improve it – suggesting that the U.S. Supreme Court’s decision on that law will by no means end the country’s sharp political debate over health care policy. Just 36 percent in this ABC News/Washington Post poll express a favorable opinion of the health care law under Supreme Court review. But ratings of the health care system as it currently stands are about as weak, 39 percent favorable. That means that while the intended fix is unpopular, so is the status quo – leaving the public still in search of solutions (Langer, 6/27).

Politico: Four Ways To Patch Up A Post-SCOTUS Obamacare
The best fixes would be legislative — but that's not likely when half of Congress wants to repeal whatever's left of the law. Yet health experts say the administration does have a handful of backstops. The problem? They're pretty weak. Here are four options the president could invoke to try to cover more Americans — and why they wouldn't resurrect the full strength of the law's individual mandate (Feder, 6/27).

Reuters: White House Says Ready For Supreme Court Health Decision
The White House said on Tuesday it was ready for a Supreme Court verdict on President Barack Obama's flagship health reform law and remained convinced the legislation would be upheld. "We are, as I have said in the past, confident that the Affordable Care Act is constitutional, in keeping with decades of precedent under the commerce clause," White House spokesman Jay Carney told reporters aboard Air Force One (6/26).

The Hill: Both Sides Poised For Health Care Ruling
Lawmakers and interest groups don't know how the Supreme Court will rule on President Obama's healthcare law, but they're ready to respond as soon as the decision is released. The court is expected to issue its decision shortly after 10 a.m. Thursday. Once the ruling is announced, the courthouse steps and the Capitol, just across the street, will become circuses of spin. House Republicans will likely hold multiple press conferences throughout the day. The party leadership will likely want to address the ruling, especially if the court strikes down all or part of the law (Baker, 6/26).

Politico: GOP In No Rush To Legislate If ACA Goes Down
Republicans still have only one thing in mind when it comes to President Barack Obama's health care law: full repeal. If the Supreme Court wholly or partially strikes down the law on Thursday, House Republicans won't rush to pass a bill that allows young adults under 26 to stay on their parents' insurance. They won't pass legislation forcing insurance companies to cover people with pre-existing conditions. And the gap in drug coverage that requires seniors to pay more out of pocket — the so-called donut hole — won't immediately be closed (Sherman, 6/27).

National Journal: House Republicans Roll Out New Health Talking Points
Two days ahead of the Supreme Court's historic decision on the health care law, House Republicans are circulating new talking points for members who want to give critiques of the law beyond the individual mandate. Staff for Majority Whip Kevin McCarthy, R-Calif., sent the pamphlet--titled "It's Not Just the Individual Mandate: Ten More Reasons To Support The Full Repeal Of The President's Health Care Law"--to Republican conference members on Tuesday. The flier was passed out in hard copy to members last week (McCarthy, 6/26).

CQ HealthBeat: Harkin Prepares Options In Case Court Rejects Health Insurance Mandate
A top Senate Democrat said he has provisions "ready to go" if the Supreme Court, when it rules Thursday, overturns the requirement in the health overhaul law that individuals buy insurance. “If the court strikes down the individual mandate, which I hope they don’t . . . but if they do, we are going to have to think of some other approaches. And I have been thinking about it, and we have things ready to go,” Tom Harkin, chairman of the Senate Health, Education, Labor and Pensions Committee, told reporters Tuesday (Ethridge, 6/26).

Marketplace:  Lawyers And Lobbyists Play Waiting Game
Washington policy wonks are having a very tough time this week, waiting and then waiting some more for Thursday's Supreme Court ruling on health care.  Marketplace's Nancy Marshall-Genzer reports the anticipation is killing them and their productivity (Marshall-Genzer, 6/26).

The New York Times' The Caucus: Political Pitfalls In A Hasty Reaction To The Health Care Ruling
Shortly after 10 a.m. on Thursday, the world will get its first reports from the United States Supreme Court about the fate of President Obama's health care law. And if Monday was any indication, the initial result will be total confusion (Shear, 6/26).

The Hill: Justices' Personal Health Struggles May Influence Their Decision
The Supreme Court justices who will rule Thursday on President Obama's healthcare law have grappled with a wide variety of health issues throughout their lives. The experiences are not expected to play a major role in the historic ruling, which will come down with the reliable mix of judicial reasoning and analysis. But health struggles shape people’s perspectives, and the justices are no exception. A review of prior news articles and the justices’ own writings provides a personal glimpse of the individuals who are about to play a leading role in what is expected to be a watershed moment in the nation’s history (Viebeck, 6/27).

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The Ruling's Possible Market Repercussions

The uncertainty surrounding the fate of the health law has triggered a guessing game by some investors.

The Wall Street Journal: Health Ruling Drives Options Game
A Supreme Court ruling Thursday on the president's health-care plan has the potential to spur big moves for insurers' stocks. But with considerable uncertainty surrounding a verdict, some investors brave enough to trade have sought cheaper, safer ways to play the outcome. Wall Street's consensus view, according to analysts and investors, is that the Supreme Court will throw out the individual mandate, which requires citizens to buy health insurance, and toss some other provisions that might increase expenses (Scaggs, 6/26).

USA Today: Supreme Court Health Care Ruling Watched By Investors
Investors are almost as interested in what the Supreme Court does with health care reform Thursday as patients and doctors (Krantz, 6/26).

Politico: Supreme Court Health Care Ruling: For Health Industry, 'Every Man For Himself'
Cable TV hosts are talking nonstop about the Supreme Court's decision on President Barack Obama's health care law. Politicians are waiting anxiously for it. And the health industry is plotting to win the aftermath. In corporate suites, K Street conference rooms, and Wall Street investment shops, industry players haven't all been content to wait and see what the court does (Allen and Haberkorn, 6/26).

The Wall Street Journal: Health Deals Going Strong
Despite uncertainty tied to the Supreme Court's coming health-care decision, the industry is moving forward with acquisitions, with several deals unveiled recently, and others actively in the works. The deals reflect strategies linked to the federal health overhaul, the sweeping 2010 law that could be struck down by the Supreme Court, in whole or in part, in a ruling expected on Thursday (Mathews, 6/26).

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Campaign 2012

Romney, Obama Offer Messaging Previews For The Coming Health Law Decision

GOP presidential hopeful Mitt Romney says if the court strikes down the law, it shows President Barack Obama wasted three years. If court upholds it, he promises to get rid of the law if elected. Obama tells a campaign crowd the law is critical to expanding coverage to those who can't get it.

Los Angeles Times: Romney And Obama Preview Reactions To Healthcare Ruling
In dueling Southern campaign stops Tuesday, President Obama and Mitt Romney previewed their likely responses to the Supreme Court's highly anticipated healthcare ruling, with the Democratic incumbent warning against refighting the reform battle and the Republican deeming the question one of states' rights and personal responsibility (West and Memoli, 6/27).

Bloomberg: Romney Poised To Claim Victory As Court Rules On Health
Whichever way the Supreme Court rules on the health-care law tomorrow, Mitt Romney is preparing to claim victory. If the court invalidates the statute, "then the first three-and-a-half years of this president's term will have been wasted on something that has not helped the American people," Romney told voters yesterday at an outdoor rally at Carter Machinery, a construction company in Salem, Virginia. "If it is deemed to stand, then I'll tell you one thing -- then we'll have to have a president, and I'm that one, that's going to get rid of Obamacare," the presumptive Republican presidential nominee said (Hirschfield Davis, 6/27).

The New York Times' The Caucus: Romney Previews His Response To The Supreme Court's Health Ruling
Mitt Romney's campaign is eagerly awaiting the Supreme Court's decision on President Obama's health care law, which is expected on Thursday morning. But on Tuesday, at a machinery company here, Mr. Romney offered a preview of the possible responses he has been readying for when the ruling finally comes (Parker, 6/26).

Boston Globe: Romney Prepares For Court's Decision On Health Care Law
If the law is rejected, Romney plans to argue that Obama wasted both his time, and the time of the American people, by pursuing a policy that doesn’t pass constitutional muster. If the law is upheld, Romney would argue that opponents need to elect him so that he can overturn it himself (Viser, 6/26).

Reuters: Romney Presses Attacks On "Obamacare" Before Ruling
Republican Mitt Romney stepped up his criticism on Tuesday of President Barack Obama's signature domestic policy achievement, saying if the U.S. Supreme Court does not overturn the 2010 healthcare overhaul when it decides its fate this week he would dump it if elected in November. Eager to change the subject back to Obama's economic stewardship after nearly two difficult weeks focusing on immigration, Romney accused Obama of taking his eye off the ball when he pushed the healthcare measure through Congress in 2010 (Reid, 6/26).

The Wall Street Journal's Washington Wire: Romney Blasts President's Obamacare Legacy
If the health-care law is deemed unconstitutional, it’s sure to be a black eye for the president. But it could complicate Mr. Romney’s message as well by increasing the clamor for the candidate –and Congressional Republicans — to be more specific about the health care policies they would try to instate. So far Mr. Romney has been able to use the health care law as a rallying cry to pump up supporters that are opposed to the bill (Murray, 6/26).

The Wall Street Journal's Washington Wire: Obama Defends Record In Florida Visit
Mr. Obama also delivered, as he did in every speech through four states, a lengthy defense of his record, including his controversial health-care reform law. In doing so he challenged his audiences, saying whether these accomplishments are maintained depends on them (Lee, 6/26).

The Associated Press: Romney Attacks 'Obamacare' Ahead Of SCOTUS Ruling
With an eye on the Supreme Court ruling this week, Mitt Romney on Tuesday said President Barack Obama's time in office would have been wasted if the high court strikes down the president's signature health care overhaul. ... At a fundraiser in Atlanta Tuesday, Obama countered that his health care law was critical to expanding health care coverage for millions of Americans and preventing companies from discriminating against people who are sick. "We don't need to refight this battle over health care. It's the right thing to do," Obama said (Peoples, 6/26).

In related news -

Politico: 2010 Dem Losers: No Regrets On Health Care Vote
Fifty-two Democrats lost in 2010, and public outrage over the health care law played a huge role in those losses, which handed the House to Republicans and put the Obama presidency on the defensive. But interviews with half a dozen of those 2010 Democratic losers reveal virtually no second-guessing and hardly any regrets (Nocera, 6/27).

Reuters: Democrats Lament Not Making Healthcare Sale
Prominent U.S. Democrats conceded on Tuesday they could have done a better job of selling President Barack Obama's healthcare overhaul to the public, but said the law could still be an effective campaign issue even if it is struck down by the Supreme Court. Two days before the high court rules on the law's constitutionality, congressional Democrats told the Reuters Washington Summit they hoped to put Republicans on the defensive during the campaign for opposing the law's more popular elements (Whitesides, 6/26).

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Hatch Overcomes Primary Challenge

The veteran Utah senator campaigned heavily on his seniority and experience, maintaining that they put him in a powerful position to work on issues related to deficit spending and health care costs. Meanwhile, a Missouri candidate is being hammered over his stance on the insurance mandate.    

The New York Times: Hatch Overcomes Challenge In Republican Primary In Utah
Mr. Hatch campaigned heavily on his seniority. He argued that he would be positioned to lead the Finance Committee should Republicans take control of the Senate, giving him a powerful perch to attack deficit spending and the ballooning costs of Medicaid and Social Security (Healy, 6/26).

St. Louis Beacon:  Republicans Challenge Nixon's Contention That He Has 'Never' Supported Insurance Mandate
Missouri Republicans are hammering at Gov. Jay Nixon over his assertion in Webster Groves earlier this week that he has "been pretty clear"’ that he opposes the federal mandate that would require most Americans to purchase health insurance by 2014.  Lt. Gov. Peter Kinder and two of the Democratic governor's GOP rivals -- Dave Spence and Bill Randles -- contended that Nixon has been anything but clear during the past three years of public debate over the issue.  They asserted that the governor is trying to be on the correct side of what Republicans predict will be a U.S. Supreme Court decision Thursday striking down the mandate (Mannies, 6/26).

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Capitol Hill Watch

Senate Sends FDA User Fee Bill To Obama; House GOP Putting Pressure On AARP

In rare show of bipartisanship, the Senate overwhelmingly approved the FDA measure. On the other side of the Capitol, top Republicans delved into whether AARP represented its members' interests when the lobby group for seniors supported the health law.

The Washington Post: Measure To Increase FDA Funds Through New Company Fees Goes To Obama
A measure that would generate $6 billion in fees over five years for the Food and Drug Administration is headed to President Obama for his signature after passing the Senate on Tuesday, a rare moment of bipartisan cooperation in a divided Congress (ElBoghdady, 6/26).

Politico: FDA User Fee Bill Passes Senate, 92-4
The Senate voted Tuesday to send the Food and Drug Administration Safety and Innovation Act to President Barack Obama, in what's almost certain to be the last major health care legislation before the fall elections. The vote was 92-4 (Norman, 6/27).

The Associated Press: Congress Passes Bill Increasing Drug Inspections
A Food and Drug Administration bill designed to increase inspections of foreign drug factories, while also speeding approvals of new drugs at home, is headed to the president's desk after an overwhelming approval in the U.S. Senate. The Senate approved the must-pass piece of the legislation by a vote of 92-4, and President Barack Obama is expected to sign it into law within days (Perrone, 6/26).

Medscape: Senate Bill Uses ACA Savings To Block Medicare Pay Cut
Senator Rand Paul, a Kentucky Republican, introduced legislation today to eliminate the 27% cut in payments for physicians who treat Medicare patients that is scheduled to take effect January 1, 2013.  (The bill) would give doctors an annual cost-of-living pay raise of up to 3%. ... The Paul bill's estimated $440 billion cost over 10 years to eliminate the pay cut and increase Medicare reimbursement would be paid with approximately $1.7 trillion in savings over 10 years from repealing the Medicaid expansion and subsidy payments required by the Affordable Care Act, according to his spokeswoman (Jaffe, 6/26).

Meanwhile, Republicans in the House are focusing on AARP's role during the health care debate.

The Seattle Times: Dave Reichert Accuses AARP Of Misleading Congress On Health-Care Law
Did AARP executives mislead Congress when it said it supported the 2010 health-care law solely out of its members' best interest? Dave Reichert suspects so, and he's demanding answers. With the Supreme Court ruling on the Affordable Care Act just days away, Reichert has accused the nation's leading advocacy group for older Americans of working with the Obama administration to pass the law despite opposition from a majority of its members (Song, 6/26).

CQ HealthBeat: Ways And Means Republicans Join In Pressing AARP On Health Care Law Support
Republican members of the Ways and Means Committee are joining their colleagues on Energy and Commerce in asking for answers from AARP about the seniors' group's actions during the debate over the health care law. In a letter sent Monday to AARP Chief Executive Barry Rand, Wally Herger of California and Dave Reichert of Washington said that in the past, Republicans have "engaged in an energetic and detailed discussion" with AARP about the group's support of proposals in the overhaul that would cut Medicare spending on providers. "When pressed about AARP's incongruous position, AARP argued that it was solely representing the interests of its members," said Herger, chairman of the Health Subcommittee, and Reichert (Norman, 6/26).

And Senate Majority Leader Harry Reid objects to an effort by Sen. Paul to introduce an anti-abortion bill.

The Hill: Reid Vows To Block Vote On Paul's 'Life At Conception' Amendment To Flood Bill
An exasperated Senate Majority Leader Harry Reid (D-Nev.) said that he would not allow a vote on an amendment clarifying that life begins at conception, which Sen. Rand Paul (R-Ky.) offered to a flood insurance bill. Paul has been known to offer unrelated amendments to Senate bills throughout the 112th Congress, often frustrating Reid. On Tuesday morning, Reid indicated he has had enough, and said Republicans need to control Paul or run the risk that the flood bill might not go through as planned (Kasperowicz, 6/26).

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Health Care Marketplace

When It Comes To Health Care Clinics, Wal-Mart Falling Behind Rivals

The Wall Street Journal: Wal-Mart Lags In Clinic Race
Five years after Wal-Mart Stores Inc. promised to open thousands of health-care clinics in its sprawling supercenters, it has fallen far behind its industry rivals in what has become a race to provide basic medical care in stores (Banjo, 6/26).

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State Watch

Mass. Insurers To Rebate $57M To Small Businesses, Individuals

The rebates, by five of the state's largest insurance companies, will go to 50,000 individual policy holders and 50,000 small businesses.

The Associated Press/Washington Post: Mass. Officials OK $56.8 Million In Health Insurance Rebates For Small Businesses, Residents
State officials say Massachusetts residents and small employers will benefit from $56.8 million in health insurance rebates. Insurance commissioner Joseph Murphy said on Tuesday that the rebates, from five of the state's largest insurers, will be delivered to some 50,000 individual policy holders and another 50,000 small businesses in Massachusetts (6/26).

Boston Globe: Mass. Insurers Returning $57 Million
Insurers in Massachusetts will return $57 million to individuals and small businesses because they spent too much of the money collected as premiums on administrative costs or surpluses. That's about $10 million more than was expected based on filings the insurers made to the state earlier this month. Barbara Anthony, undersecretary of Consumer Affairs and Business Regulation, said some insurers miscalculated what they owed (Conaboy, 6/27).

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California Plan To Move 880,000 Children Into Medi-Cal Met With Skepticism

A budget plan to save money by moving thousands of children into the Medicaid program is scrutinized while legislators scramble to draft companion legislation to implement the budget.

KQED: California Budget Proposal Would Move 880,000 Children Off Healthy Families
The Healthy Families program currently serves children whose families earn too much for Medi-Cal but might not otherwise access private insurance. … Because the Medi-Cal program is cheaper, [Governor Jerry] Brown's plan would save $73 million in 2013-2014 by shifting the children to that program. But advocates say this wouldn’t be the case, because of a related tax that only gets political support because of the Healthy Families program. The Sacramento Bee reports that it is a tax collected on managed care plans (Dornhelm, 6/26).

The Associated Press: Governor Faces Deadline On California Budget Plan
The governor and Democratic leaders had announced an agreement last week to restructure the state's welfare program, streamline health insurance for low-income children and reduce child care coverage and college aid. But Democrats who control the Legislature have been scrambling to draft companion legislation needed to implement the budget. They were scheduled to vote on some 20 so-called budget trailer bills Wednesday (Lin, 6/27).

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State Roundup: Conn. Budget Chair Threatens Governor On Health Cuts

A selection of health policy stories from Connecticut, Pennsylvania, Texas, Massachusetts, Washington state, Iowa and California.

CT Mirror: Budget Chairwoman Threatens To Scuttle New Restrictions On Health Care For Poor
The House chairwoman of the legislature's budget panel threatened Tuesday to scuttle new restrictions on health care for the poor sought by Gov. Dannel P. Malloy's administration after learning patients were warned of changes before they had been enacted. Rep. Toni Walker, D-New Haven, who not only co-chairs the Appropriations Committee, but also an advisory panel conducting a hearing Tuesday on the changes, charged the Department of Social Services with overstepping its bounds (Phaneuf, 6/26).

Philadelphia Inquirer: Report: Pa. Did Not Adequately Monitor Medicaid Services To Elderly, Disabled
Pennsylvania was one of seven states that failed to monitor adequately the quality of services provided to the elderly and disabled at home or in community settings under a Medicaid program, according a report issued this week by the Office of the Inspector General of the U.S. Department of Health and Human Services. Federal regulations require states to review service plans for beneficiaries of the Medicaid program, ensure that service providers are qualified, and have a system to track abuse, neglect and exploitation by those who work in the beneficiaries' homes. Pennsylvania failed on all three counts, according to the report (Brubaker, 6/27).

Bloomberg: Teen Fights For Benefits As Medicaid Contractor Says No
Melody and Steve Lancaster’s 16- year-old foster son, who's paralyzed from the neck down, needed a mechanized ceiling lift to help him get into the bathtub or his favorite beanbag chair. While Texas Medicaid officials had already paid as much as $13,000 for similar devices for others, the company that the state hired to look after the teenager's health needs refused. Superior Health, a unit of Centene Corp. (CNC) that covers about 800,000 Texas Medicaid recipients, also rejected at least two other requests for lifts, state records show. … The teen's story shows how states may be limiting patients’ benefits by outsourcing Medicaid, the $460 billion public health program for the poor and disabled, to for-profit companies with "little or poor oversight" from authorities, Hofer said (Flavelle and Babcock, 6/27).

Modern Healthcare: Alaska Medicaid Agency To Pay $1.7 Million In HIPAA Settlement
Alaska's state Medicaid agency has agreed to pay HHS $1.7 million to settle possible violations of the security-rule provisions of the Health Insurance Portability and Accountability Act of 1996 and take actions to guard the electronic protected health information of the state's Medicaid beneficiaries. An investigation conducted by HHS' Office for Civil Rights found that Alaska's Health and Social Services Department did not have adequate policies and procedures established to safeguard electronic protected health information (Zigmond, 6/26).

Boston Globe: Catholic Leaders Urge Opposition To Contraception Mandate
The archbishop of Boston and Catholic lay leaders called on the faithful Monday night to join in the public debate over government policies they say force Catholic institutions to choose between living the tenets of their faith and fulfilling the church’s call to provide services to the needy. In a live forum broadcast on the CatholicTV network from the Monsignor Francis T. McFarland Television Center in Watertown, Cardinal Seán P. O’Malley spoke out against government policies that violate Catholic teachings but do not include a religious exemption (Fox, 6/26).

(Vancouver, Wash.) Columbian: Partnership Has Helped Veterans, State For Decade
In the last decade, nearly 15,000 veterans and their dependents have been connected to Veterans Affairs benefits to which they were entitled but weren't receiving. One tangible result of those connections? More than $35 million in health care savings for the state of Washington. Those connections and savings are attributed to an innovative partnership between the Washington State Health Care Authority and the Washington State Department of Veteran Affairs -- a partnership that celebrates its 10th anniversary this summer (Harshman, 6/25).

Des Moines Register: Polk County Supervisors For The First Time Will Start Paying Part Of Their Health Insurance
Starting next week, and for the first time perhaps in history, Polk County’s elected officials will be paying for a portion of their taxpayer-subsidized health insurance. The move, which is expected to save taxpayers between $1,800 and $3,000 in combined yearly insurance premiums for 10 elected office holders, was made in relative secrecy this morning when Polk County supervisors approved a new employee manual for elected officials (Eckhoff, 6/26).

California Healthline: Autism Task Force Bill Moves to Assembly Health Committee
SB 1050 establishes a telehealth task force under the State Department of Developmental Services to develop evaluation and diagnostic procedures for autism and other autistic spectrum disorders.  It is sponsored by The Children's Partnership, a national nonprofit, non-partisan, child advocacy group with offices in Santa Monica and Washington, D.C. The bill is expected to result in a demonstration project to test the task force's recommendations. The pilot, targeting the underserved rural and inner city communities, would be developed by an academic institution, in conjunction with state regional centers and/or school districts (Edlin, 6/27).

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Editorials and Opinions

Viewpoints: Look Who's Worried About Activist Judges Now; No Matter What The Court Decides, A Bipartisan Plan Will Be Needed

The New York Times: The Liberal Embrace Of Judicial Restraint
It's a great pleasure, in this week when the entire political world is hanging on the Supreme Court's health care ruling, to welcome so many liberals to a cause dear to my heart: The crusade for judicial restraint (Ross Douthat, 6/26). 

Lexington Herald-Leader/McClatchy Newspapers: Dump The Politics And Fix The U.S. Health Care System
Whatever the Supreme Court decides, this is the question each Kentuckian should ask his or her representative and senators: How will you work with members of the other party to create a system that gives all Americans access to good, affordable health care? How will you provide us with access to insurance coverage as good as what the government provides for you (Tom Eblen, 6/27)?

Richmond Times-Dispatch: At Least Reduce Waste, Fraud, Abuse
Recently, the Government Accountability Office (GAO) told Congress that "more needs to be done" to reduce improper payments due to waste, fraud, and abuse in Medicare and Medicaid. That's an understatement. Last year, Medicare alone made $43 billion in improper payments. Medicaid made an estimated $21.9 billion in improper payments in 2011. The Affordable Care Act — the 2010 federal health reform law — took some major steps to help ensure that Medicare and Medicaid dollars are spent wisely. Unfortunately, those efforts may stall if the Supreme Court finds the more controversial parts of the act unconstitutional this week (Bill Lucia, 6/27).

Richmond Times-Dispatch: Both Sides, Back To The Drawing Board
This week, the ACA's destiny lies in the hands of the Supreme Court's justices, who have worked for months to determine whether the legislation will stand, be minced into pieces, or chucked entirely. Because it was jammed through Congress on a strongly partisan basis, real health care reform has taken a back seat as the court mulls over the legislation's constitutionality. Regardless of the Supreme Court decision, Congress should discuss, debate, and pass reforms that promote patients' rights while controlling health care costs, improving quality, and expanding access (Donald J. Palmisano, 6/27).

Bloomberg: The Unhealthy Politics Of Health Care
Reforming health care self-evidently involves intensely political choices, but the issues aren’t exclusively political. Getting to grips with such a complex issue also demands a widely accepted body of analysis. Never in control, but somewhere in the picture, must be the trusted nonaligned expert (Clive Crook, 6/26).

Bloomberg: Federal Mandates Are Almost Always A Bad Idea
Although I am open to having state governments require more health coverage, I fear a federal government with too much power to control individual behavior. The track record of federal interventions in managing markets suggests a strong case for limiting that power. The question of bestowing appropriate power on the federal government depends not on the health-care issue alone, but on whether you think -- on the whole -- that the U.S. government does good things when it heavily regulates behavior (Edward Glaeser, 6/26).

The Wall Street Journal: What Good Is A GOP Senate?
Will it matter if Republicans take over the Senate this November? Not much if you judge by the TV ads trashing Paul Ryan and the House budget reforms, courtesy of Republican Senate candidate Denny Rehberg. The six-term Montana Congressman is gunning for Jon Tester, in what is one the GOP's best chances to defeat a Democratic incumbent. The Montana Republican Party has been running 30-second TV spots touting Mr. Rehberg as an "independent thinker," and neither word is true. The ad goes on to note (with a glint) that "Rehberg refused to support a Republican budget plan that could harm the Medicare program so many of Montana's seniors rely on," and in "a partisan town"—presumably not Billings—"Rehberg refuses to toe the party line" (6/26).

Des Moines Register: Ryan's Federal Budget Plan Is Bold And Compassionate
The Obama approach jeopardizes our long-term ability to pay for America's social safety net. The budget office reports that Obamacare made health care cost containment worse, not better. It says mandatory federal spending on health care will increase from 5.4 percent of gross domestic product to 10.4 percent of GDP over the next 25 years (Tom Quiner, 6/26).

The Atlanta Journal-Constitution: The Fiscal Fallout Of Obesity
There are two key components to ensure this initiative is a success. The first is the recognition that we all have to take more personal responsibility when it comes to managing our weight…. The second component involves working together to make sure our communities are more conducive to choices and practices that will help curtail obesity (Dr. Phillip L. Williams, 6/26).

The Atlanta Journal-Constitution: Epidemic Has Heavier Price For Children
Most importantly, we must, as a state, focus on those who are paying the true price of obesity and that's our children. We're doing that through Georgia SHAPE, a statewide childhood obesity initiative, because we know the longer a person struggles with obesity the greater the chance for harm. So we're starting early in addressing obesity from birth through the elementary, middle and high school years (Dr. Brenda Fitzgerald, 6/26).

JAMA: Health Information Technology In The Era Of Care Delivery Reform
The inspiration for a better approach to HIT can best be described by the concept popularized by the Bauhaus school of architecture: "form ever follows function." Applied to HIT, this suggests beginning with the "function" of integrated, efficient, team-oriented care and following with the "form," or design of the IT. However, much of HIT today is designed to track billable episodes of care and focuses on maximizing revenue under fee-for-service payment systems. These EHR systems generally do not facilitate integrated, team-oriented, cost-conscious care (Dr. Asaf Bitton, Lydia A. Flier and Dr. Ashish K. Jha, 6/27).

JAMA: Assessing Individual Physician Performance
If US society needs physicians as change leaders, it must consider how their motivation is affected by assessments that quantify and reward their behaviors. The motivation of highly skilled persons who perform complex work has been widely studied in the management sciences and psychology literatures. Insights from these disciplines should be considered as incentive programs in health care are developed and refined (Drs. Christine K. Cassel and Sachin H. Jain, 6/27).

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Stephanie Stapleton

Andrew Villegas

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Shefali Luthra

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