Daily Health Policy Report

Tuesday, July 15, 2014

Last updated: Tue, Jul 15

KHN Original Reporting & Guest Opinion

Health Reform


Administration News

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Insuring Your Health: Readers Ask About Contraceptive Coverage And Medicare Enrollment

Kaiser Health News consumer columnist Michelle Andrews answers readers’ questions (7/15). Read her responses.

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Capsules: Obamacare Help Was In High Demand, Survey Shows; Avoid The Rush! Some ERs Are Taking Appointments

Now on Kaiser Health News' blog, Jenny Gold reports on assistance provided during the health law's open enrollment period: "During the Affordable Care Act’s first open enrollment period, about 10.6 million people received personal help from navigators and other enrollment assisters, according to an online survey of the programs released Tuesday by the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.) And the assistance was time consuming: 64 percent of the programs reported that they spent an hour to two hours with each consumer on average. The assisters and navigators included 28,000 full-time-equivalent workers across the country, funded by federal and state governments as well as outside sources, the survey found" (Gold, 7/15).

In addition, listen to Anna Gorman's California Public Radio report on a trend in which ERs are taking appointments: "In an era of increased competition driven by the nation’s health law, hospitals in California and around the country are hoping online ER appointments will help attract patients anxious to avoid long waits in a crowded and often chaotic environment" (Gorman, 7/14). Check out what else is on the blog.

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Tech-Savvy Subjects Test Exchange Website, Advise Changes

The Philadelphia Inquirer's Robert Calandra, working in partnership with Kaiser Health News, reports: "The three-month study was the idea of Charlene Wong, 31, a pediatrician at Children's Hospital of Philadelphia. Wong knew just how confusing and challenging buying insurance for her own family was, and she is a health policy researcher. What, she wondered, was it like for young adults doing it for the first time? Even more intriguing, what changes might the digital natives suggest to make the website more user-friendly? The results, published in the Annals of Internal Medicine, recommended six changes: rename 'catastrophic' coverage; identify dental coverage as a separate purchase early on; create an easily accessible glossary of terms with concrete examples; clearly explain that tax credits in the form of premium subsidies and cost reductions in deductibles, copays, and coinsurance are linked - in very different ways - to silver-level plans; prominently mention that preventive care is free and part of every plan on the site; and reposition tools that are already there (Calandra, 7/14). Read the story.

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Letters To The Editor: A New Medical Convenience; 'Copper Plans' And Other Coverage Issues

In this Kaiser Health News feature, readers comment on a variety of recent stories (7/15). Read reader's thoughts and responses.

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Political Cartoon: 'Diving Bored?'

Kaiser Health News provides a fresh take on health policy developments with "Diving Bored?" by Bob Englehart.

Meanwhile, here's today's haiku:


Is the suit legit?
That's the debate on the Hill...
Judge Judy will know.

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

North Carolina Gov. Leaves 'Door Open' To Medicaid Expansion

The Republican governor said he wants to fix the current system first but would consider expansion if federal officials allowed the state to craft its own plan. Meanwhile, the Washington Post reports that sign-ups for coverage in North Carolina beat those in nearly every other red state. Other media outlets track developments in Virginia and South Dakota.

The Washington Post: N.C. Gov. McCrory: ‘Door Open’ To Medicaid Expansion
North Carolina Gov. Pat McCrory (R) said Monday he would leave the door open to expanding Medicaid under the Affordable Care Act if federal officials allow his state to craft a plan that fits its own individual needs. In an interview on WFAE, Charlotte’s NPR affiliate, McCrory defended North Carolina’s refusal to expand existing Medicaid programs until fixes are made (Wilson, 7/14).

The Associated Press: McCrory Willing To Review Medicaid Expansion Later
Gov. Pat McCrory says he'd be willing to consider expanding Medicaid in North Carolina through the federal health care overhaul law once the state's system is repaired after years of cost overruns. McCrory told WFAE-FM in Charlotte on Monday he's "not closed the door" on offering Medicaid to more of the working poor, as the federal law gives the option to states. The governor signed a law last year preventing the expansion. Now he wants the legislature this year to give his administration the ability to develop a new way to pay for Medicaid services. McCrory says he would need federal regulators to give the state flexibility to target any Medicaid expansion based on North Carolina's needs and provide more certainty about what Medicaid expansion will cost the state (7/14).

Politico: In North Carolina, An Obamacare Disconnect
North Carolinians came out in droves for Obamacare enrollment, signing up at a rate that beat nearly every other red state. But that doesn’t mean they’re going to come out for the law — or the Democratic senator who supported it — at the voting booth in November. More than any other state, North Carolina may represent the huge disconnect between Obamacare’s success in getting people health insurance and its failure to help the Democratic politicians who voted for the law (Haberkorn, 7/15).

The Associated Press: Groups Spend Heavily Lobbying On Medicaid 
The trade group representing Virginia hospitals and the conservative advocacy group, Americans for Prosperity, spent heavily on lobbying during their fight over whether to expand Medicaid eligibility, newly filed reports show. The Virginia Hospital & Healthcare Association, the leading pro-Medicaid expansion advocate during this year’s legislative session, said it incurred more than $400,000 in lobbying expenses from May 2013 to April 2014 (7/14).

Meanwhile, the Medicaid expansion fight is part of state campaigns in South Dakota -

The Associated Press: Medicaid Expansion Big Issue For Candidate Wismer
Democratic governor candidate Susan Wismer hopes Medicaid expansion will be a winning issue in her battle against Gov. Dennis Daugaard. Wismer is campaigning across the state in favor of covering tens of thousands of low-income South Dakota residents through an expanded Medicaid program, The Argus Leader reported. She says it not only would help the uninsured but also would bolster hospitals by covering medical care they now are absorbing themselves. Wismer predicted South Dakota residents would support Medicaid expansion "when people really understand it as an issue that's important to the survival of their community health care institutions, (and) that it's important to their friends and neighbors that have jobs that do not afford them health care” (7/14).

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Feds Scrutinize Medicaid Backlogs

In two recent letters, Health and Human Services officials have demanded remediation plans from a handful of states to resolve application backlogs.

The Washington Post’s Wonkblog: The Feds Have Had It With Medicaid Backlogs
If you're a fan of Obamacare's coverage expansion, the quick and significant boost in Medicaid enrollment the past few months has been one of the law's biggest successes so far. But the rapid jump in Medicaid enrollment has also provided one of the biggest logistical headaches so far, with hundreds of thousands of people, and possibly millions, still waiting for their applications to get processed and their coverage confirmed (Millman, 7/14).

The Associated Press: States Told To Find Way To Clear Medicaid Backlog
A half-dozen states with backlogs for Medicaid enrollees were facing a federal deadline Monday to create plans for getting those low-income residents enrolled in health coverage. The federal Centers for Medicare & Medicaid Services sent letters dated June 27 to Alaska, California, Kansas, Michigan, Missouri and Tennessee asking those states to address gaps in their eligibility and enrollment systems that have delayed access to coverage for poor and disabled people (7/14).

Georgia Health News: Feds To Scrutinize Georgia’s Medicaid Backlog
A federal agency says it will review Medicaid eligibility and enrollment processes in Georgia and six other states due to “a substantial backlog of pending applications. The July 9 letter from the Centers for Medicare and Medicaid Services does not indicate how much of a backlog Georgia has or the reasons for it. The Georgia review will also cover the state’s PeachCare program for uninsured children (Miller, 7/14).

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Survey: More Than 10 Million People Received Help From 'Assisters'

According to the Kaiser Family Foundation, about 28,000 assisters nationwide were involved in helping as consumers explored their new health insurance options under the ACA.

The New York Times: Groups Under Health Act Are Said To Aid Millions
More than 4,400 consumer assistance programs created under the Affordable Care Act helped an estimated 10.6 million people explore their new health insurance options and apply for coverage during the initial six-month enrollment period, according to a new Kaiser Family Foundation survey (Goodnough, 7/14).

Kaiser Health News: Capsules: Obamacare Help Was In High Demand, Survey Shows
Signing up for Affordable Care Act insurance was nothing like that. It involved questions about income, taxes, family size and immigration status. And in most places in the country, there were myriad choices of plans with subtle differences between them. Guess what? People looked for help on the decision. During the Affordable Care Act’s first open enrollment period, about 10.6 million people received personal help from navigators and other enrollment assisters (Gold, 7/15).

Politico Pro: Survey: ACA Assisters Had Big Role With State-Run Exchanges
In-person assisters played a big part in the 8 million sign-ups of the first Obamacare enrollment season, particularly in states running their own health exchanges, according to a new Kaiser Family Foundation survey. The survey, released Tuesday, found that assister programs working with state-run exchanges helped twice as many people as programs in states that relied on HealthCare.gov for 2014 enrollment. They had a built-in advantage, though: Kaiser estimated that nearly half of the 28,000 assisters nationwide worked in those 16 states and District of Columbia — where just about a third of uninsured Americans live (Villacorta, 7/15).

The Hill:  Obamacare Assisters ‘Key’ To 2015 Enrollment
Navigators and assisters who educated consumers about health insurance options during ObamaCare’s first enrollment period will likely continue to play a “key role” according to a new report. An analysis by the Kaiser Family Foundation says assister programs helped educate 10.6 million people about their health insurance options but in some cases the programs had to turn people away because they didn’t have the resources to meet demand. During the 2014 enrollment period 12 percent of assisters said demand for their services far outpaced their abilities. Matters only got worse by late March when 24 percent of assisters said they couldn’t meet demand (Al-Faruque, 7/15).

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Fact Checker Finds Dems' Rhetoric On Hobby Lobby Decision Overheated

The Washington Post's Glenn Kessler says in some cases the response from Democrats "has gotten way ahead of the facts." Meanwhile, Senate Majority Leader Harry Reid, D-Nev., says the House Republicans push to sue President Barack Obama has no legal merit.

The Washington Post’s The Fact Checker: Democrats On Hobby Lobby: 'Misspeaks,' 'Opinion' And Overheated Rhetoric
In the wake of the Supreme Court's 5-to-4 ruling that, as a closely held company, Hobby Lobby was not required to pay for all of the birth-control procedures mandated by the Affordable Care Act, Democrats have rushed to condemn the court. But in some cases the rhetoric has gotten way ahead of the facts. Here's a round-up of some of the more noteworthy claims. In some cases, lawmakers concede that they [made] a mistake; in others, they ... argue that they are offering what amounts to opinion, even though the assertion was stated as fact (Kessler, 7/15).

Politico: Harry Reid: Judge Judy Would Toss Obama Suit
Would Judge Judy take up House Speaker John Boehner's lawsuit against the president? Harry Reid certainly doesn't think so. In a nearly 15-minute speech on Tuesday afternoon attacking the House's proposed legal action, the Senate majority leader concluded that the syndicated courtroom TV star — retired family court judge Judith Sheindlin — would swiftly toss out the House's lawsuit against President Barack Obama's executive actions on health care (Everett, 7/14).

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Help Wanted: CEO For Hard-To-Manage Federal Insurance Website

Health and Human Services Secretary Sylvia Burwell is expected to name someone to oversee the operations of healthcare.gov to keep it from becoming a joke again on late night TV. Also in the news is an examination of the small business marketplaces.

Marketplace: Why HealthCare.Gov Is Going To Get A CEO
File this under one of the toughest jobs in America. The federal Department of Health and Human Services (HHS) is beating the bushes for a CEO of HealthCare.gov, the site that became a punch line on late night TV last fall. The Obama Administration wants to make sure the funny guys get material from somewhere else. New HHS Secretary Sylvia Burwell hopes appointing a CEO to oversee the operation will make the jokes go away (Gorenstein, 7/14).

The Washington Post: Why We Still Don't Know How Many Small Business Signed Up Through Obamacare
In contrast to the widely publicized enrollment numbers on the health care law's individual marketplace, there's apparently no way to know how many business owners and employees have signed up through the law's new small-business exchanges. By all indications, though, it's not very many (Harrison, 7/14).

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HHS Offers $100 Million In Funds For States Medicaid Programs To Improve Payment Systems

The Centers for Medicare & Medicaid Services is offering the assistance in hopes that states will be able to streamline processes in ways that will ultimately lead to better patient care.

The Hill:  HHS Offers States $100M To Improve Medicaid
The Department of Health and Human Services (HHS) is offering $100 million to state Medicaid programs to reform payment systems and improve patient care. Governors and state Medicaid directors had pressed the Centers for Medicare and Medicaid Services (CMS) for funds to review and improve the health program. The federal dollars will help states streamline the payment process and review state Medicaid data to find ways to improve the care patients receive  (Al-Faruque, 7/14).

CQ Healtbeat: Officials Push States To Experiment With New Quality Measures, Payment Models
Federal officials announced Monday that they will provide up to $100 million in funding states will be able to tap to improve the quality and efficiency of treatment in Medicaid. States can suggest ways the money could be used to improve care, but CMS brass will contract with outside consultants to do much of the work involved. States can get several types of technical assistance. One is financial modeling to analyze ways of paying doctors and hospitals that save the most money without jeopardizing the quality of care. Officials want to test out ways to care for patients with very high medical costs and minorities whose health outcomes often are not as good as the rest of the population. CMS hopes to apply to a broader swath of the Medicaid population approaches that worked in smaller parts of that population or for people who have other types of coverage. States also could work with CMS and outside consultants to examine data from Medicare and Medicaid to find more efficient ways of delivering care (Adams, 7/14).

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Administration News

VA Makes Disability Payments Without Evidence To Cut Backlog

The Department of Veterans Affairs is making disability payments to thousands of veterans without adequate medical evidence they deserve the benefits as the agency attempts to cut a huge backlog of claims, a department watchdog says.

Los Angeles Times: VA Overpaid $230 Million In Disability Claims, Official Tells Congress
The Department of Veterans Affairs' disability system has improperly paid former service members at least $230 million over the last few years, according to the VA's inspector general's office. The overpayments stem largely from the department's attempts to clear a massive backlog of claims for disability compensation (Zarembo, 7/14).

Fox News: VA Is Making Disability Payment Errors In Rush To Cut Backlog, Watchdog Says
The Department of Veterans Affairs is making disability payments to thousands of veterans without adequate evidence they deserve the benefits as the agency attempts to cut the huge backlog of claims, a department watchdog said Monday. Without improvements, the VA could make unsupported payments to veterans totaling about $371 million over the next five years for claims of 100 percent disability alone, said Linda Halliday, an assistant inspector general, in prepared testimony at a House Veterans Affairs Committee hearing. VA whistleblowers also revealed widespread problems at VA regional offices at the hearing, saying mail bins of disability claims were ignored or shredded so employees could work faster (7/15).

The Associated Press: VA Says It Rushed To Cut Big Backlog Of Claims For Disability Benefits
In a rush to cut a huge backlog of claims for disability benefits, the Department of Veterans Affairs is making payments to tens of thousands of veterans without adequate medical evidence that they deserve the benefits, the department’s inspector general’s office said Monday. Acting Secretary of Veterans Affairs Sloan Gibson answers reporters’ questions about improvements within the medical care system on Friday in Jackson, Miss. Without improvements, the VA could make unsupported payments to veterans totaling about $371 million over the next five years for claims of 100 percent disability alone, said Linda Halliday, an assistant inspector general (7/14).

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State Watch

Florida Hospital To Pay $1M Settlement In False Claims Case

The settlement comes in what has been a closely watched Medicare overbilling case filed against Halifax Hospital. The Department of Justice must still sign off on the settlement. Advocate Health and Hospitals Corp. swatted away a class-action suit over last summer's data breach, but more are pending. Also in the news, a possible health worker strike in New York, and a North Carolina mayor walks to Washington to focus attention on the difficulties of rural hospitals.  

Modern Healthcare: Halifax Health To Pay $1M Settlement In Widely Watched False Claims Case
One of the most widely watched False Claims Act cases filed against a hospital is quietly approaching an end—Florida's Halifax Health is preparing to pay $1 million to settle an alleged $73 million Medicare overbilling case. Maximum damages in the trial, which had been scheduled to begin July 8, could have exceeded $200 million, which would have come on top of an $85 million settlement that the public health system in Daytona Beach, Fla., paid out in March to settle the first half of the case. The $1 million settlement won't become official until the Justice Department signs off on it this month, court records say. The False Claims Act makes it illegal for hospitals to submit inaccurate bills to Medicare. However, Presnell ruled July 1 (PDF) that it doesn't necessarily trigger the False Claims Act to bill Medicare for cases in which the medical record lacks “enough information to jusify admission” for inpatient care (Carlson, 7/14).

Modern Healthcare: Health System Beats Second Class Action Suit, Faces Others Over 2013 Data Breach
Advocate Health and Hospitals Corp. has now gone two for two in swatting away class-action lawsuits stemming from last summer's massive data breach involving more than 4 million of its patient records. Its legal challenges on this matter aren't over yet, however. Several other cases are pending. Kane County (Ill.) Circuit Court Judge James Murphy last week dismissed with prejudice a class-action suit in Matias Maglio et al., vs Advocate, citing the plaintiffs' lack of legal standing and failure to prove actual damages among other rationales in a three-page ruling in favor of the 10-hospital Advocate system. Advocate is based in the Chicago suburb of Downer's Grove, Ill. (7/14).

The Wall Street Journal: Health-Care Workers Eye One-Day Strike
About 70,000 New York City area nurses and other health-care workers are poised to authorize a one-day strike that would take place July 31. Negotiations over a new contract happen every three to four years, but now both union and hospital leaders are grappling with a new issue: an industrywide shift away from hospitals toward outpatient clinics (Krusisto, 7/14).

The Wall Street Journal’s Washington Wire: Small-Town Mayor Begins 273-Mile Walk To Washington
A small-town Republican mayor set out Monday on a 273-mile walk to Washington, D.C., to draw attention to the plight of rural hospitals. Mayor Adam O’Neal is fighting the recent closure of Pungo Vidant Hospital, the biggest employer in his coastal town of Belhaven, N.C. (pop. 1,700). The hospital’s situation was profiled in an article in The Wall Street Journal in May (Bauerlein, 7/14).

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Mass. Measure Introduced To Restore Some Protections After High Court Decision

The bill, which was filed by state Sen. Harriette L. Chandler, seeks to buttress existing laws and add new protections for women entering and leaving abortion clinics. It would do so within the confines of the Supreme Court's recent ruling on abortion clinic "buffer zones."

The New York Times: Abortion Clinic Protections Proposed In Massachusetts
Massachusetts lawmakers expressed support for a bill filed on Monday that they say would address safety concerns that arose when the United States Supreme Court last month struck down 35-foot buffer zones for demonstrators standing near entrances to abortion clinics. Supporters say the bill, filed by State Senator Harriette L. Chandler, would strengthen existing laws and add new protections from protesters for women entering and leaving abortion clinics, and would do so within the confines of the court’s ruling (Bigood, 7/14). 

WBUR: Buffer Zone Ruling Aftermath: Street Scene At Clinic, New Bill Filed
The 35-foot “buffer zone” outside the Planned Parenthood clinic on Commonwealth Avenue in Boston is gone, struck down by the Supreme Court’s buffer-zone ruling last month. But a bill filed today in the Massachusetts legislature would restore some added protections to staff and patients at the state’s reproductive health centers. Among them, Planned Parenthood writes, is police power to issue a “dispersal order” when a group has impeded access to a facility; a prohibition on using “threat or force to intentionally injure or intimidate” someone trying to enter or leave the facility; and a “clear passage” section that bans impeding anyone trying to come or go (Goldberg, 7/14).

The Associated Press: Bill Designed To Strengthen Abortion Clinic Safety
Police would be allowed to disperse groups substantially impeding access to Massachusetts abortion clinics under a bill filed Monday in response to the Supreme Court decision striking down the state's buffer zone law. After a dispersal order is issued, individuals would have to remain at least 25 feet from the clinic's entrances and driveways for a maximum of eight hours. A dispersal area would have to be clearly marked and the dispersal law posted. The bill would also prohibit any physical act or threat of force from being used to intimidate anyone trying to enter or leave a clinic. It would also prohibit anyone from knowingly impeding an individual or vehicle's access to a facility (LeBlanc, 7/15).

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States Grapple With Mental Illness Issues; Oregon Moves Closer To Limiting Medicaid Patients' Access To New Hepatitis C Drugs

A selection of health policy stories from Illinois, Maryland, Oregon, Colorado and others.

The Associated Press: Jails Struggle To Deal With Flood Of Mentally Ill
The numbers, posted daily on the Cook County sheriff’s website, would be alarming at an urgent care clinic, let alone a jail: On a Wednesday, 36 percent of all new arrivals report having a mental illness. On a Friday, it’s 54 percent. But inside the razor wire framing the 96-acre compound, the faces and voices of the newly arrested confirm its accidental role as Chicago’s treatment center of last resort for people with serious mental illnesses (Geller, 7/14).

Stateline: Helping the Mentally Ill Join The Workforce
Because of poor funding from state and other sources, the “supportive employment” that benefited (Cyrus) Napolitano is unavailable to most of those with serious mental illness. According to one study, only 1.7 percent of those served by state mental health systems received supported employment services in 2012, even though it has proven to be the most effective way to keep the mentally ill in steady jobs. Soon that situation may change. Under the Affordable Care Act (ACA), states can apply to use Medicaid funds to train and employ the seriously mentally ill, under the theory that steady employment is a form of treatment (Ollove, 7/14).

The Oregonian: Oregon Moves Closer To Limiting Access On Hepatitis C Drugs As Senate Investigation Begins
The state of Oregon appears to be nearing what could be a first-in-the-nation stance limiting availability to Medicaid patients of new hepatitis C treatments that offer great promise at a very high price of $84,000 per 3-month treatment. On July 31, a state committee will consider guidelines intended to limit treatment only to patients who face serious liver damage without the drug. If adopted later this year, the approach would reduce the state's costs from an estimated $168 million in the coming year to about $40 million (Budnick, 7/14).

Propublica/NPR: Why Are Obstetricians Top Billers For Group Therapy In Illinois?
A few years ago, Illinois' Medicaid program for the poor noticed some odd trends in its billings for group psychotherapy sessions. Nursing home residents were being taken several times a week to off-site locations, and Medicaid was picking up the tab for both the services and the transportation (Ornstein, 7/14).

Baltimore Sun: Maryland Lawmakers, Child Advocates Seek Probe Into Oversight Of Troubled Group Home
Maryland lawmakers and child advocates called Monday for an investigation into regulators' oversight of a troubled group home operator, asking why the state continued to give the company millions in taxpayer dollars despite long-standing financial and regulatory problems. State Sen. Joan Carter Conway, chairman of a committee that oversees group homes, said she would call a hearing this month to determine why state officials continued to award contracts to LifeLine even after it had filed for bankruptcy reorganization and a state audit found it insolvent. The company has faced years of problems, including many that state regulators were unaware of, a two-month investigation by The Baltimore Sun showed. This month, a 10-year-old boy died at an apartment that was part of the company's Laurel-area group[ home, even as the state was moving to take children from its care  (Donovan, 7/14).

The Associated Press: New Cook County Health CEO Searching For Savings
Dr. John Jay Shannon, the new chief of Cook County's health system, has a big job ahead: finding $67 million in savings to help erase a projected year-end budget deficit, according to a published report. Most of the anticipated budget shortage stems from CountyCare, the county's new Medicaid managed care program, which had been expected to bring more than $270 million in revenue this fiscal year. CountyCare started in 2013 as an early expansion of Medicaid to the low-income adults who would be eligible under President Barack Obama's health care overhaul in 2014. Shannon told Crain's Chicago Business there were "unrealistic expectations" that the CountyCare program would be "some kind of profit center" for the county's entire public health care system (7/14).

Denver Post: Birth Control Programs For Teens Gain Traction In Colorado, Nationally
Aggressive state and national programs supplying teens with long-term contraceptives have put a big dent in the teen birth rate, seemingly quieting what was once a loud policy debate. The success of these public health policies — boosted by donations from billionaire Warren Buffett — was highlighted recently by a 40 percent drop in teen births in Colorado over the last five years. The state handed out 30,000 free or low-cost contraceptives during that time. Advocates of abstinence-only say equipping teens for safe sex, without their parents' involvement, signals a surrender to reality rather than a victory. But health officials say that curbing the teen birth rate relies on a simple formula — and it has little to do with curbing teen sexual appetites (Draper, 7/15). 

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Editorials and Opinions

Viewpoints: 'Tradeoffs Among Access, Quality And Costs'; Obamacare As A Political Issue

The New York Times’ The Upshot: Why Improving Access To Health Care Does Not Save Money
One of the oft-repeated arguments in favor of the Affordable Care Act is that it will reduce people’s need for more intensive care by increasing their access to preventive care. For example, people will use the emergency room less often because they will be able to see primary care physicians. Or, they will not develop as many chronic illnesses because they will be properly screened and treated early on. And they will not require significant and invasive care down the line because they will be better managed ahead of time (Aaron E. Carroll, 7/14). 

The Washington Post: Licensing ‘Dental Therapists’ Could Get More Americans The Care They Need 
In 2009, 830,000 visits to emergency rooms around the country could have been prevented if the patients had seen a dentist earlier. In 2011, more than half of children on Medicaid went without dental care. These facts lie behind the story of Deamonte Driver, a Prince George’s County seventh-grader who died of a preventable infection that spread from his mouth to his brain in 2007. Maryland pushed through some reforms following Deamonte’s death, but the situation across the country has not dramatically improve (7/14).

Fox News: Are Media Downplaying Obamacare Progress — Or Is The GOP Just Giving Up On The Issue?
After a disastrous rollout last fall, ObamaCare has been fading from the news. But is it fading as a political issue? The fear of those who oppose the program was always that it would be impossible to repeal if enough recipients got hooked on the benefits. That was the hope of advocates as well -- that whatever potholes the ObamaCare bus hit, it would keep barreling toward a finish line of getting more Americans insured. ... But now some of the law’s proponents are declaring victory -- and the criticism has quieted down (Howard Kurtz, 7/15).

Journal of the American Medical Association: Engineering A Better Health Care System 
Millions of individuals have gained access to the health care system this year due to the Affordable Care Act. With greater access to health care, there is an increased need to ensure care remains high quality, affordable, and centered around the needs of patients and families. One opportunity for addressing these challenges is through systems engineering, which includes a range of tools to improve efficiency and reliability. These tools have produced substantial benefits in other industries, from manufacturing to aviation, and hold similar promise for health care (Christine K. Cassel and Robert S. Saunders, 7/14).

The New York Times: A Defense Of Reproductive Rights
Facing a torrent of state laws restricting access to safe and legal abortions, supporters of a woman’s right to make her own childbearing decisions have been forced to play a defensive game — trying to block enactment of the laws, and, when that doesn’t work, challenging them in court. An important hearing of the Senate Judiciary Committee on Tuesday could begin to move the dynamics of the fight in a positive direction (7/14). 

Los Angeles Times: Who Gains From Those Drug Discount Deals? (Spoiler: Drug Companies)
The pharmaceutical industry has been bragging for nearly a decade now about its efforts to help cash-strapped patients pay for expensive prescription drugs. "An important safety net," the industry says, that has "already helped millions of Americans get free or reduced-cost prescription medicines." It's all about good works and helping the patients, Big Pharma says of these patient assistance programs (Michael Hiltzik, 7/14).

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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.