Daily Health Policy Report

Friday, June 28, 2013

Last updated: Fri, Jun 28

KHN Original Reporting & Guest Opinion

Health Reform

Women's Health

Coverage & Access

Medicare

Administration News

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Big Changes Ahead For Those Who Buy Their Own Insurance

Kaiser Health News staff writer Julie Appleby, working in collaboration with USA Today and U.S. News and World Report, writes: "Most of the debate about how the health law will change the individual market has centered on whether consumers will experience 'rate shock' from higher premiums when key changes go into effect next year. But there's a flip side: new rules that broaden benefits, prohibit discrimination against those with health issues and cap consumers' out-of-pocket costs, which can cut far deeper than premiums" (Appleby, 6/28). Read the story.

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Facing A Tight Deadline, Long-Term Care Panel Holds First Meeting

Reporting for Kaiser Health News, Susan Jaffe writes: "The Commission on Long-Term Care held its first meeting Thursday on Capitol Hill with some members acknowledging that their late start adds to their challenges in offering Congress recommendations on how to finance the expensive services for seniors and disabled Americans. The panel is hobbled with a meager budget and staffing, and it is facing a three-month deadline for its report. Speakers at the meeting reminded the commission that the effort is daunting" (Jaffe, 6/28). Read the story.  

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Capsules: No Mandate For Those Left Out Of Medicaid Expansion; What Affirmative Action Decision Might Mean To Med Schools

Now on Kaiser Health News' blog, Alvin Tran reports on what becomes of the individual mandate for people left out of the Medicaid expansion: "Low-income Americans who live in states that have decided not to expand Medicaid eligibility will not face penalties if they fail to buy insurance next year. That's according to a final rule on exemptions to the health law's individual mandate – the law's controversial requirement that most Americans have health coverage or pay a penalty in 2014. That rule was published Wednesday" (Tran, 6/27).

Also on the blog, Ankita Rao reports on how the recent high court ruling on affirmative action might impact medical school admissions: "In the competitive world of medical school admissions, the intention of creating a diverse student body can include attention to racial background. But that doesn’t sit well with everyone – and the Fisher v. University of Texas at Austin case that the U.S. Supreme Court offered an opinion on Monday is proof" (Rao, 6/28). Check out what else is new on Capsules.

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Political Cartoon: 'Shirt On, Shoes Off?'

Kaiser Health News provides a fresh take on health policy developments with "Shirt On, Shoes Off?" by Steve Kelley and Jeff Parker.

Meanwhile, here is today's health policy haiku:

BAD NEWS, GOOD NEWS

Can't get Medicaid?
No health coverage for you
but no penalty.
-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

Impact Of Health Law On Costs Reaches Beyond Premium Pricetags

Much of the debate about the overhaul's costs has focused on "rate shock," but other issues also are in play.

Kaiser Health News: Big Changes Ahead For Those Who Buy Their Own Insurance
Most of the debate about how the health law will change the individual market has centered on whether consumers will experience "rate shock" from higher premiums when key changes go into effect next year. But there's a flip side: new rules that broaden benefits, prohibit discrimination against those with health issues and cap consumers' out-of-pocket costs, which can cut far deeper than premiums (Appleby, 6/28).

Politico: How Much Will Obamacare Cost?
This is the summer when the country will find out just how "affordable" the Affordable Care Act will be. There's been a sneak peek this spring, when states started to reveal health insurers' proposed rates for 2014, the first year insurers can no longer turn away sick patients and must offer a more robust set of benefits to everyone (Millman, 6/28).

Also in the news -

CQ HealthBeat: Chamber Urges Slower Start To Health Care Law To Lessen Rate Shock
Major aspects of the health care law meant to make comprehensive insurance affordable to people who have a difficult time getting coverage because of poor health should be implemented more slowly instead all taking effect Jan. 1, the U.S. Chamber of Commerce said in wide-ranging recommendations released Thursday (Reichard, 6/27).

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If No Medicaid Expansion, Low-Income State Residents Won't Face Mandate

A rule published Wednesday exempts low-income people from the health law's requirement to buy insurance if they live in states that decide against expanding Medicaid. News outlets also report on the latest related developments from Ohio, New Hampshire, Minnesota, Oklahoma and California.

Kaiser Health News: Capsules: No Mandate For Those Left Out Of Medicaid Expansion
Low-income Americans who live in states that have decided not to expand Medicaid eligibility will not face penalties if they fail to buy insurance next year. That's according to a final rule on exemptions to the health law's individual mandate – the law's controversial requirement that most Americans have health coverage or pay a penalty in 2014. That rule was published Wednesday (Tran, 6/27).

Reuters: Republican Battles Over Medicaid Turn To God And Mortality
Ohio's Republican Governor, John Kasich, is no fan of President Barack Obama's health reform law. But he has become an unlikely proponent of one element of Obamacare - expansion of Medicaid healthcare coverage for the poor - and he has a warning for his fellow party members about the moral consequences of blocking it (Morgan, 6/26).

The Associated Press: Lawmakers OK $10.7 Billion Budget, Medicaid Study
The New Hampshire Legislature passed a $10.7 billion bipartisan budget Wednesday that eases the waiting time for services to the disabled and mentally ill, but puts off a decision on whether to expand Medicaid to 58,000 poor adults. The Senate voted unanimously to pass the budget, followed by the House passing each bill in the two-bill package by over 300 votes (Love, 6/28).

MPR News: Minnesota Likely To Avoid States' Budget Shock From ACA's 'Welcome Mat' Effect
State spending on Medicaid programs could rise substantially, even for states that have opted out of the federal health care law's Medicaid expansion, according to a University of Minnesota study. U of M researchers say several factors will encourage people who are eligible for Medicaid, but haven't enrolled before, to sign up. … The analysis is based on the experience of Massachusetts, which in 2006 enacted a requirement to obtain health insurance similar to the "individual mandate" in the federal law, which requires all U.S. citizens (with a few exemptions) to have coverage starting January 1, 2014 (Stawicki, 6/27).

Tulsa World: State Advised To Use 'Enhanced Federal Funding' To Ease Uninsured Numbers
Oklahoma should use "enhanced federal funding," including expanded Medicaid, to ease the number of uninsured people in the state, the Oklahoma Health Care Authority was told Thursday. The Medicaid funding would not be used to create a new government insurance program but would underwrite the purchase of private insurance for Oklahomans, similar to a program recently approved for Arkansas, the authority was told (Greene, 6/27).

The Associated Press: Consultants Unveil Plan For Oklahoma Uninsured
Utah-based Leavitt Partners presented its much-anticipated report to the governing board of the Oklahoma Health Care Authority, the state agency that oversees the federal Medicaid program. The firm was hired to help Oklahoma answer the question of how to expand health insurance coverage after Gov. Mary Fallin rejected an opportunity to expand the state's Medicaid program under the federal health care law, the Affordable Care Act (Murphy, 6/27).

Los Angeles Times: New Budget Expands Health Care In California
In addition to more funding for schools, public universities and social services, the budget package that Gov. Jerry Brown signed Thursday includes legislation expanding the state's health care program for the poor, part of California's effort to implement President Obama's national overhaul. The new spending plan is set to take effect Monday. The public health care program, known as Medi-Cal, is expected to grow by 1 million enrollees and could soon cover about one in four Californians. Millions more people will be able to buy insurance through a state-run market (Megerian, 6/27).

Also, a progress report from California regarding the development of the state's health exchange -

Politico: California’s Health Insurance Exchange At Forefront
State leaders planning to run their own Obamacare health insurance exchanges are under enough pressure to get everything ready in time for open enrollment this fall. Peter Lee, who runs California’s exchange, knows the spotlight is even greater on his state because the White House put it there (Millman, 6/28).

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GOP Senators Press Sebelius To Back Away From Helping Nonprofit

The group of 28 senators are also seeking more information about the health secretary's efforts to help the nonprofit Enroll America to get more people signed up for coverage available through the health law. Meanwhile, the head of the House Republican Study Committee urged the NBA and the NFL not to promote the health care law.

The Wall Street Journal’s Washington Wire: GOP Senators To Sebelius: Stop Helping Nonprofit
A group of 28 Republican senators told HHS Secretary Kathleen Sebelius Thursday to stop helping a nonprofit campaign that is gearing up to enroll Americans for health coverage this fall. The lawmakers said Ms. Sebelius hasn’t provided specific answers about steps she has taken on the nonprofit’s behalf. Republicans say Ms. Sebelius acted unethically by asking health-care companies to help Enroll America sign up consumers for health insurance under the 2010 health care law, the administration’s signature achievement (Radnofsky, 6/27).

The Hill: GOP Doubles Down On Sebelius Fundraising Calls
Republican senators are pushing Health and Human Services (HHS) Secretary Kathleen Sebelius to reveal more about her ties to Enroll America and her fundraising efforts on behalf of the pro-ObamaCare group. In a letter Thursday, 28 GOP senators demanded that Sebelius send a more complete response to a May inquiry about her requests that health industry players donate money to Enroll America. The Health Department says Sebelius only made two phone calls and that the actions were legal (Viebeck and Baker, 6/27).

The Hill: Republican Lawmaker To NFL And NBA: Don't Do ObamaCare's 'Dirty Work'
The head of the conservative Republican Study Committee pressed the NBA and the NFL on Thursday not to promote President Obama's healthcare law. In a letter to league commissioners, Rep. Steve Scalise (R-La.) asked for details on recent talks between the NBA, the NFL and Health and Human Services (HHS) Secretary Kathleen Sebelius (Viebeck 6/27).

At the same time, a small health law tweak picks up momentum -

The Washington Post: Congress Contemplating Small Tweaks To Help Small Businesses Weather Health Care Reform
An effort to repeal a tax on insurance companies in the new healthcare reform law is gaining momentum in Congress, fueled by concerns that the fee would hit small businesses particularly hard. The legislation would eliminate a fee on health insurance companies scheduled to take effect when the law goes into full effect next year (Harrison, 6/27).

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Appeals Court Green Lights Hobby Lobby's Legal Challenge To Contraceptive Rule

A federal appeals court in Denver said Thursday that companies, whether they are for profit or not, have religious rights and that the challenge brought by Hobby Lobby Stores Inc. and its sister company can go forward.

The Associated Press: Court: Hobby Lobby Can Challenge Health Care Law
An appeals court said Thursday that Hobby Lobby and a sister company that sells Christian books and supplies can fight the nation's new health care law on religious grounds, ruling the portion of the law that requires them to offer certain kinds of birth control to their employees is particularly onerous, and suggesting the companies shouldn't have to pay millions of dollars in fines while their claims are considered (Wyatt, 6/27).

The Wall Street Journal's Law Blog: For-Profit Corporations Have Religious Rights Too, Says Court
A divided federal appeals court said Thursday that companies, whether for profit or not, have religious rights. The ruling came in a challenge by arts and crafts chain Hobby Lobby Stores Inc. and Christian bookstore chain Mardel Inc. to a part of President Barack Obama‘s 2010 health care overhaul -- namely, a requirement that employee health insurance plans include free contraceptive coverage (Palazzolo, 6/27).

Los Angeles Times: Poll: Hobby Lobby Vs. Contraception Mandate -- Who's Right?
The Supreme Court settled one of the biggest legal fights over the Patient Protection and Affordable Care Act (a.k.a. Obamacare) by ruling last year that its requirement that virtually every adult American obtain insurance was constitutional. But several other fights are ongoing, including an equally bitter one over the law's requirement that employers include free contraception in their insurance plans. A Denver appeals court handed the law's opponents a victory Thursday on the latter issue, but it may just set the stage for a return to the Supreme Court (McGough and Healey, 6/27).

Reuters: U.S. Court Accepts Challenge To Obama Contraception Rule
Arts and crafts chain Hobby Lobby may be exempt from a requirement in U.S. President Barack Obama's 2010 health care overhaul to provide free contraception coverage in its employee health insurance plans, a federal appeals court ruled. Thursday's decision by the 10th U.S. Circuit Court of Appeals in Denver could spare the family-owned company from potentially paying millions of dollars in fines as soon as next week for not complying with the law (Baynes, 6/27).

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Women's Health

High Court Moves Tentatively Toward Hearing Case On Abortion-Inducing Drugs

The Supreme Court asked Oklahoma's Supreme Court to clarify a law that state judges had struck down as an unwarranted curb on medical practice and the right to abortion.

The New York Times: Supreme Court Takes Step Toward Hearing Abortion Case
The Supreme Court took a tentative step on Thursday toward hearing a case on the regulation of abortion-inducing drugs, asking the Oklahoma Supreme Court to clarify the meaning of a law that state judges had struck down as an unwarranted curb on medical practice and the right to abortion (Eckholm, 6/27).

Los Angeles Times: Supreme Court Tells Oklahoma To Review Abortion Pill Law
The Supreme Court told the high court of Oklahoma on Thursday to clarify a new state law restricting the use of the RU-486 abortion pill, setting the stage for a possible future ruling on how far states can go in regulating the practice of abortion. Legislators in several states, including Oklahoma, have passed laws to strictly regulate the practice of abortion. Among them are measures that require all women seeking abortions to undergo an ultrasound test. Oklahoma also adopted a law restricting the use of RU-486 (Savage, 6/27).

The Wall Street Journal: Abortion-Drug Case on High Court's Docket For Now
The high court hasn't previously considered what kind of rules on drug-induced abortions might pass constitutional scrutiny. In the 1973 Roe v. Wade ruling and subsequent decisions modifying it, the Supreme Court has said women have a right to an abortion, while upholding certain state restrictions, such as waiting-period requirements (Radnofsky and Kendall, 6/27).

Reuters: U.S. Justices Show Interest In Oklahoma Abortion Pill Case
The U.S. Supreme Court on Thursday said it could consider an Oklahoma case about a state law restricting use of the abortion pill mifepristone, or RU-486, but first sought clarification from the state's high court over the legislation. At issue is a law passed by Oklahoma in 2011 but never enacted due to legal opposition that bans the off-label use of drugs known to have abortion-inducing properties (Hurley and Clarke, 6/27).

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Coverage & Access

Panel Studying Long-Term Care Issues Holds First Meeting

The commission, established by Congress in January, faces some hurdles in getting a report done by September.

Kaiser Health News: Facing A Tight Deadline, Long-Term Care Panel Holds First Meeting
The Commission on Long-Term Care held its first meeting Thursday on Capitol Hill with some members acknowledging that their late start adds to their challenges in offering Congress recommendations on how to finance the expensive services for seniors and disabled Americans (Jaffe, 6/28).

Politico Pro: Long-Term Care Commission Seeks Bipartisan Solutions
The sprint is officially on for the new federal long-term care commission. The 15-member panel met for the first time Thursday afternoon, facing just a three-month window to overcome partisan differences and recommend reforms for long-term care delivery and financing after the highly publicized demise of the CLASS Act (Millman, 6/27).

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Medicare

CMS Proposes Medicare Payment Adjustment For Home Health Agencies

A proposed rule released Thursday would cause home health agencies to experience a 1.5 percent reduction in their Medicare payments for 2014, which the Centers for Medicare & Medicaid Services estimates could reduce payments to these facilities by $290 million next year. 

CQ HealthBeat: Home Health Agency Payments Decline Under Medicare Proposal
Medicare payments to home health agencies in 2014 will fall by 1.5 percent, or $290 million below calendar 2013 levels, according to a proposed rule released late Thursday. The rule comes as home health agencies and other post-acute care providers have faced added scrutiny from the Medicare Payment Advisory Commission and members of Congress (Adams, 6/27).

Modern Healthcare: CMS Adjustments Plan Would Cut Medicare Pay Rates
A series of rebasing and coding adjustments from the CMS would cause home health agencies to see a 1.5% reduction in their Medicare payments for 2014, which the CMS estimates could lower total payments to these facilities by $290 million next year. In a proposed rule Thursday, the CMS said the decrease reflects a 2.4% home health payment update amounting to a $460 million increase in overall payments, combined with a host of adjustments that would decrease payments by $750 million (Zigmond, 6/27).

And on the Medicare politics front -

The Washington Post: 4 Pinocchios For The Latest ‘Mediscare’ Ad
The ad, like similar attacks last year, tries to give itself credibility by citing The Wall Street Journal, which has a conservative-leaning editorial page. But it is quoting from a 2011 news article about a House Republican plan for Medicare — and badly truncates the quote (Kessler, 6/28).

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Administration News

Feds Shut Down More Than 1,600 Fake Online Pharmacies

Authorities from the Food and Drug Administration closed these illegal pharmacy websites and sent letters to hundreds more that sell counterfeit prescription drugs and dangerous supplements.

The Wall Street Journal: Authorities Shut Down 1,600 Fake Pharmacy Websites
Federal regulators and law-enforcement agencies shut more than 1,600 illegal pharmacy websites this week, including fake Walgreens and CVS websites. The Food and Drug Administration also issued warning letters to operators of hundreds of websites that sell counterfeit prescription drugs and potentially dangerous supplements that contain active ingredients used in erectile-dysfunction drugs (Dooren, 6/27).

CNN: FDA Shuts Down 1,677 Online Pharmacies
The prices may look tempting, but ordering from an online pharmacy is often a bad deal, according to Interpol and the U.S Food and Drug Administration, announcing a crackdown Thursday on thousands of websites. The FDA said it has shut down 1,677 sites for selling counterfeit or substandard medication, or for selling drugs without appropriate safeguards. Other sites received regulatory warnings. Officials said they also arrested 58 people and seized more than $41 million worth of illegal medicines (Hellerman, 6/27).

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State Watch

D.C. Officials Plan $47M Medicaid Payback After Claims Processor Collapse

The collapse of a company that managed Medicaid claims in the District of Columbia -- D.C. Chartered Health -- left health care providers without any way to be reimbursed for care they gave under the District's Medicaid program.

The Washington Post: Deal Pending On Chartered Health Plan's Unpaid Bills
Health care providers who have seen their bottom lines damaged by the collapse of D.C. Chartered Health Plan could be made whole by summer's end under a plan detailed Thursday by city officials (DeBonis, 6/27).

The Associated Press/Washington Post: DC Reaches Deal To Pay Back Health Providers After Collapse Of Medicaid Firm
The District of Columbia has reached a tentative deal to pay back health care providers who've been stuck with unpaid bills since the collapse of the company that managed the city's Medicaid claims. Mayor Vincent Gray announced Thursday that hospitals and community-based health providers will be reimbursed for $47 million in unpaid claims by the end of August (6/27).

In the meantime, Medicaid programs in other states make news --

The Associated Press: Mississippi House Votes To Renew Medicaid, Set Budget
The Mississippi House voted overwhelmingly Thursday to renew and fund Medicaid beyond this coming weekend, when the program has been set to expire. Bills also must pass the Senate, which is expected to act on today (Pettus, 6/27).

The Lund Report: New Clinic Serves Medicaid Patients Only
While Oregon Health Plan patients often report difficulty finding providers who will treat them due to low reimbursement rates, a physician in Umatilla County has bucked the trend – opening a clinic that serves Medicaid patients exclusively. The Pendleton Primary Care Clinic opened its doors in February and so far is open three days a week, staffed by Dr. Bruce Carlson, along with a nurse practitioner, receptionist and medical assistant (McCurdy 6/27).

St. Louis Post-Dispatch: State-Owned Hospital Asked To Pay Back $21.4 Million In Medicaid
An audit released today said Missouri should return $21.4 million in federal Medicaid payments made to a state-owned children's hospital in St. Louis County. The Federal Office of Inspector General report found Hawthorn Children's Psychiatric Hospital on Pennsylvania Avenue near Pagedale failed for nearly five years to fulfill regulatory requirements to qualify for the federal Medicaid reimbursements (Cambria, 6/28).

Los Angeles Times: Bill To Fine Big Firms With Workers On Medi-Cal Comes Up Short
A California proposal to fine large companies that have workers on Medi-Cal came up short in an initial vote in the Assembly amid strong business opposition. The proposed fines could reach about $5,000 per full-time employee who receives Medi-Cal, the state Medicaid program for the poor (Terhune, 6/27).

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Texas Steels For New Abortion Bill Fight -- Set For Monday

A special session set for Monday in Texas will reignite debate over a controversial abortion bill that was blocked this week after a marathon filibuster and shouting fracas by the bill's detractors. Texas Gov. Rick Perry was critical of the lawmaker who led the filibuster.

Reuters: Texas Governor Slams State Lawmakers Who Stalled Abortion Bill
Texas Governor Rick Perry made a highly personal criticism on Thursday of the state senator who thwarted a Republican proposal to restrict abortion, saying she had not learned from her own experience as a teenage mother born to a single mother. In a speech to the largest anti-abortion group in the United States, Perry also accused abortion rights supporters and Democrat Wendy Davis, who talked for more than 10 hours on Tuesday to block the abortion bill, of hijacking the democratic process (Garza, 6/27).

Politico: Abortion Tables May Turn In Texas On Monday
Texas Gov. Rick Perry has a message for those hailing new liberal icon Wendy Davis for bringing down a restrictive state abortion measure: Enjoy it while it lasts. Come Monday, the Texas Legislature will reconvene in special session, and enacting far-reaching abortion limits is a top Perry priority (Glueck, 6/27).

CBS News: Wendy Davis' Filibuster A "Hijacking Of The Democratic Process," Texas Gov. Says
Disparaging the pro-choice "mob" that flooded the Texas State Capitol Tuesday night, Gov. Rick Perry, R-Texas, urged supporters at the National Right to Life convention to "match their intensity" in backing a pro-life agenda. "It's important to remember that as a state, while we are under an obligation to protect the health and safety of people who live here, who are at no obligation to make things easier for the abortionist," Perry said in his keynote address to the convention Thursday in Dallas. "The ideal world is a world without abortion" (Haven, 6/27).

The Texas Tribune: How Activists Yelled An Abortion Bill To Death
Minutes before midnight in the Texas Capitol on Tuesday, thousands of protesters stopped a restrictive abortion bill in its tracks by yelling at the top of their lungs. The remarkable and surprisingly successful moment had not been planned by the established groups like Planned Parenthood, NARAL Pro-Choice Texas and the Texas Democratic Party that had done much of the organizing for the protests against Senate Bill 5 (Batheja, 6/28).

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State Highlights: Maine To Permit Rx Drugs From Canada

A selection of health policy stories from Maine, Oregon, Georgia, Minnesota, Connecticut, Massachusetts, Washington, Missouri and California.

NPR: Maine Once Again Allows Mail-Order Canadian Drugs To Cut Costs
For the first time in several years, a state has acted to allow its citizens to purchase prescription drugs by mail from other countries. The idea is to take advantage of those nations' lower prices, which can be half the cost of those at American pharmacies (Rovner, 6/27).

The Lund Report: Senate Sends Hospital And Nursing Home Assessment Tax To Kitzhaber
The Senate passed the hospital and long-term care assessment tax Wednesday, ensuring that Oregon will be able to raise $1.4 billion from the federal government over the next two years to fund health and human services, including the state's Medicaid program. The hospital assessment was renewed and expanded for just two years, while the long-term care facility, or nursing home assessment, will run through 2020 (Gray 6/27).

Georgia Health News: Nurses Say State Shortchanges Licensing Board
Georgia nurses are concerned that lack of funding for their state licensing board will create problems in protecting patients from an impaired, unlicensed or dangerous nurse. A new law that goes into effect Monday will require nurses to report suspected professional violations to the Georgia Board of Nursing (Kanne 6/27).

Minneapolis Star Tribune: Views Clash At Hearing On Minnesota Childhood Vaccinations
State Health Department has proposed expanding the list of required childhood shots. Opponents say the risks are too high. In testimony that was often personal and sometimes passionate, dozens of parents turned out Thursday for a hearing on a state proposal to expand the number of required vaccinations for Minnesota children (Griffin, 6/27).

CT Mirror: State Launches Website To Promote Long-Term Care Options, Jobs
The state has launched a website and media campaign to increase awareness about the choices Connecticut residents have for receiving long-term care and the career options for caregivers. The campaign, called My Place CT, is part of an effort to expand the ability of seniors and people with disabilities to live in communities, rather than institutional settings like nursing homes (Becker, 6/27). 

Boston Globe: AIDS Action, Fenway Health Forge New Partnership
Two of Boston's landmark AIDS organizations are joining forces, announcing Thursday a "strategic partnership" between Fenway Health and AIDS Action Committee of Massachusetts that leaders say will improve care at a time when people are living longer with the virus, while bolstering the stability of services amid shrinking federal and state funding. … Under the new partnership, approved by the boards of both organizations, Fenway Health and AIDS Action will unite to become one corporate structure but each will retain its nonprofit status, name, and mission (Lazar, 6/27).

Oregonian: Small Oregon Insurer Drops Plans To Offer 2014 Individual Policies
Just a day after learning its state-approved premium will be 35 percent less than the firm requested, Portland-based FamilyCare Health Plans is dropping its plan to expand into the individual market next year. FamilyCare will not offer health insurance to people who buy their own insurance and are not on Medicare, says the firm's Jeff Heatherington. "It doesn't fit our business model," he said. The move is not based on the premium cut, he added. In fact, FamilyCare had hoped the state would cut the firm's rates, after seeing some of the lower rates requested by competitors in the individual market (Budnick, 6/27).

Boston Globe: Psychiatric Patients Neglected In Quincy
State inspectors found filthy conditions and patients left unattended on Quincy Medical Center’s psychiatric ward for seniors, prompting regulators to temporarily prohibit admissions to the unit last month while the hospital fired at least two managers. Inspectors made a surprise visit May 23, responding to concerns about the geriatric unit at the hospital, owned by Steward Health Care (Conaboy, 6/28).

Seattle Times: Mental-Health Program Shuts Down Operations In Normandy Park
A controversial, for-profit mental-health-treatment program is shutting down its operation in a suburb south of Seattle after struggling financially and failing to be licensed by the state. Hanbleceya informed its clients several weeks ago that they had until Sunday to find new living arrangements. The Seattle Times reported last July that the company had opened a clinic in Normandy Park Towne Center, bought three homes and rented two others in Normandy Park, then secretly placed mentally ill and drug-addicted clients in the homes with no state oversight (Willmsen, 6/27).

St. Louis Post-Dispatch: Mercy Health Abandons Arkansas Hospital Deal
Facing stiff resistance from the Federal Trade Commission, the Vatican and community leaders, Mercy Health has abandoned its efforts to sell its hospital in Hot Springs, Ark., to a for-profit health system. The announcement, issued Thursday by Chesterfield-based Mercy Health and Franklin, Tenn.-based Capella Health Care Inc., comes after a lengthy FTC investigation and several months of talks with Catholic officials (Doyle, 6/28).

California Healthline: Pharmacists Can Be Part Of Health Reform
The No. 1 challenge for pharmacists, according to one expert, is inclusion in the health care reform discussion. … A bill in the state Legislature, SB 493 by Sen. Ed Hernandez (D-West Covina), would expand the scope of practice of pharmacists by allowing them to screen people for diabetes, for instance. Hernandez addressed yesterday's convention of the California Society of Health-System Pharmacists, but didn't mention his specific bill, which is currently stuck in committee (Gorn, 6/27).

California Healthline: Retail Clinic Growth Sparks New Partnership In San Diego
The growth of retail clinics is fostering new partnerships and in some cases new forms of cooperation rather than -- or in addition to -- competition. San Diego's Sharp HealthCare and MinuteClinic, the retail health care division of drug store chain CVS Caremark, have teamed up to expand primary care access around San Diego. The move is partly in anticipation of full implementation of the Affordable Care Act on Jan. 1, 2014 (Zamosky, 6/27).

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Editorials and Opinions

Viewpoints: The Entitlement Crisis Is Not Over; VA Needs To Deal More Effectively With Mental Health Issues; Iowa Gives Governor New Abortion Duty

The New York Times: Economix: A World Of Rising Health Care Costs
Americans are used to hearing that health care will bust the budget. The Congressional Budget Office projected last year that Medicare, Medicaid and other government health programs would eat up 9.6 percent to 10.4 percent of the nation’s gross domestic product by 2037, crowding out many other vital programs. But a new report from the Organization for Economic Cooperation and Development suggests that the United States is not the only country that will struggle to contain public spending on medical care (Eduardo Porter, 6/27). 

The Washington Post: The Left Needs To Get Real On Medicare, Social Security And The Deficit
There is a rising chorus on the left, most recently articulated in an op-ed Monday by Neera Tanden and Michael Linden ["Deficits are not destiny"] of the Center for American Progress, that our fiscal conversation should be declared over and plans for meaningful entitlement reforms mothballed. These voices argue that we can have substantial new spending on public investments, a secure safety net, no middle-class tax increase — all without addressing entitlement spending. Lo, if it were so (Jon Cowan and Jim Kessler, 6/27). 

Politico: Congress Must Save Veterans Affairs Clinics
The American people expect Congress to demonstrate that it can govern effectively in a bipartisan manner. A new medical access problem for military veterans offers an excellent opportunity for House and Senate leadership to prove its ability in this area. ... In our home state of Louisiana, VA mismanagement delayed the opening of two new clinics in Lafayette and Lake Charles. The Congressional Budget Office's new cost-estimate rule places these and other VA-approved clinics in permanent jeopardy (Sen. Mary Landrieu, D-La., and Rep. Charles Boustany, R-La., 6/28).

Tampa Bay Times: Remove Stigma So More Veterans Get Help For Head Injuries
Nearly one-third of Iraq and Afghanistan veterans who received VA health care in the decade after 2001 were diagnosed with PTSD, and the numbers are only expected to climb. ... Unfortunately, because of inequities in the law, treatment for brain injuries often solely focuses on physical restoration, overlooking the critical mental health component (Rep. Gus M. Bilirakis, R-Fla., 6/27).

The Wall Street Journal: ObamaCare Hail Mary?
President Obama, a father of two girls, has said that if he had a son he'd "have to think long and hard" before letting him play football. But that's not stopping the president's Department of Health and Human Services from reaching out to the NFL to help sell ObamaCare to young people. ... Whether or not a partnership is created, the outreach effort is indicative of the challenge faced by ObamaCare proponents, who must convince healthy young people to pay insurance companies huge subsidies for medical care that will go to someone else. We're not sure even Eli Manning could pull that off (Harry Graver, 6/27).

The Wall Street Journal: Worse Than ObamaCare
Small businesses in California often complain about being targeted by Democrats in Sacramento. So to demonstrate that they're equal opportunity harassers, Democrats are trying to ram through legislation that would punish large businesses and nonprofits that employ Medicaid beneficiaries. Democrats say they're merely trying to deter businesses from cutting workers' hours to circumvent the ObamaCare mandate, which requires employers with 50 or more full-time employees (as defined as working more than 30 hours per week) to offer health coverage or pay a $2,000 penalty per worker (Allysia Finley, 6/27). 

Des Moines Register: Iowa's Medicaid Abortions Are Hardly Common
Last week, Gov. Terry Branstad signed legislation to provide health insurance to low-income Iowans. The law includes a provision giving the governor the final say on whether Medicaid will pay for medically necessary abortions. Though offensive to many women and outrageous to pro-choice groups, it is unlikely even a pro-choice governor would want the responsibility of approving or denying a specific medical procedure for an Iowan. Will lawmakers next want him to review and approve or reject reimbursements for birth control prescriptions? ... Medicaid only covers abortions for poor women in cases of rape or incest, to save the mother’s life or when the fetus is severely abnormal. Medicaid paid for a total of nine abortions this fiscal year (6/28).

Seattle Times: Washingtonians Should Stand With Wendy Davis, Protect Abortion Rights
Washington is not Texas. Thankfully, lawmakers here are not pursuing misguided regulations to curb reproductive rights for women. But I still think the massive response to Tuesday's nearly 12-hour filibuster in the Texas Senate by Wendy Davis demonstrates why we cannot take the right to make our own private decisions about our health for granted. Look at what's happening nationwide (Thanh Tan, 6/27). 

WBUR: Cognoscenti: Forced Intimacy: When Illness Makes Us Let Down Our Guards
My name is Holly Ladd, and I am a 58-year-old woman with ALS ("Lou Gehrig’s Disease"). I was diagnosed in August 2012, after five months of increasing difficulty walking. Ten months later, I live my life from a wheelchair, no longer able to walk, and I am quickly losing use of my arms and hands. My voice is soft and muffled, and will be useless in a few months. In December 2012, I left my 30-year career in public health and international development, in which I traveled alone to Africa and South East Asia. Now, I can't travel alone from my bedroom to the bathroom (Holly Ladd, 6/28). 

Boston Globe: Life Sciences Center Pays Off In Jobs, New Tax Revenues
As many other industries around them contracted, the biotech and medical-device sectors in Massachusetts added more than 8,000 jobs over the past five years. What's more, while life-sciences employment nationwide increased 12 percent nationally since 2000, Massachusetts' grew more than twice as fast. The state's edge? The Massachusetts Life Sciences Center, according to a recent Boston Foundation report. With these kinds of results, the center is one job-creating initiative lawmakers should continue to fund generously (6/28).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Marissa Evans
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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.