Daily Health Policy Report

Wednesday, July 16, 2014

Last updated: Wed, Jul 16

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch

Health Care Marketplace

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Senate Democrats Launch Fight To Reverse Supreme Court, State Abortion Restrictions

Kaiser Health News staff writer Julie Rovner reports: “Most of the momentum in fights over birth control and abortion has been in the direction of opponents of late. But you wouldn’t know that by watching the U.S. Senate. Democrats who control the chamber have scheduled a vote for Wednesday on a bill that would effectively reverse the Supreme Court’s Hobby Lobby ruling regarding contraceptive requirements in the Affordable Care Act. And on Tuesday the Judiciary Committee heard testimony on a separate, sweeping measure that would invalidate many state abortion restrictions” (Rovner, 7/15). Read the story

This Story: Print | Link to | Top

A Small Business Owner Enters The Insurance Marketplace

Kaiser Health News staff writer Heidi de Marco reports: “Alongside one of this city’s canals, blocks from the beach, Sandra Lopez is finally living her idea of the American dream. In 1996, six years after crossing the border from Mexico without papers, she began working at Las Fajitas, a popular Mexican restaurant as a cashier and cook. With the help of her boss, she received a work visa in 2001. Eleven years after that, she bought the business – a bustling establishment where Lopez knows most customers by name. Mexican lanterns hang from the ceiling, and cheers from a soccer match on TV fill the room' (de Marco, 7/15). Read the story and watch the accompanying video.

This Story: Print | Link to | Top

California Releases Proposal For Clearing Medicaid Backlog

Reporting for Kaiser Health News, Helen Shen writes: “Responding to inquiries from federal officials, the California health department has released a plan it says will dramatically slash its backlog of Medi-Cal applications within six weeks. For months, the state has labored under the largest such pile-up in the country, with 900,000 pending cases reported in May—the combined result of unexpectedly high application numbers and bug-ridden computer systems” (Shen, 7/16). Read the story

This Story: Print | Link to | Top

Detroit's Maternal Death Rate Is Triple The Nation's

The Detroit News' Karen Bouffard, working in partnership with Kaiser Health News, reports: "Detroit women are dying from pregnancy-related causes at a rate three times greater than for the nation. Experts blame the same combination of medical conditions and social toxins that kills Detroit babies at a frequency that is the worst of America’s big cities, and even some Third World countries" (Bouffard, 7/15). Read the story.

This Story: Print | Link to | Top

Texas Sees Increased Medicaid Sign-ups

The Texas Tribune's Eli Okun, working in partnership with Kaiser Health News, reports: "More than 80,000 additional Texans have enrolled in Medicaid or the Children’s Health Insurance Program since the rollout of the Affordable Care Act last fall despite Republican state leaders’ decision not to expand eligibility to poor adults, according to federal figures. The 80,435 new enrollees as of May — mostly Texans who already qualified for coverage but did not previously seek it — represent a 1.8 percent increase over pre-Obamacare figures. That places Texas, which has the nation’s highest uninsured rate, in the middle of the pack among states that chose not to expand access to those programs to everyone under 138 percent of the federal poverty line under the president's signature health law. The expansion, a key tenet of Obamacare, was deemed optional by the U.S. Supreme Court" (Okun, 7/15). Read the story.

This Story: Print | Link to | Top

Political Cartoon: Wait A Minute, Mr. Postman?'

Kaiser Health News provides a fresh take on health policy developments with "Wait A Minute, Mr. Postman?" by Mike Luckovich.

Meanwhile, here's today's haiku:

THERE SHOULD BE MORE TO LEGISLATION THAN A NAME

Time spent naming bills
on the fast road to nowhere
could be better spent.
-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.

This Story: Print | Link to | Top

Health Reform

CBO: Slowed Federal Health Spending Yields Savings

Federal spending on health care has slowed sharply, partly as a result of the federal health care law, reports the Congressional Budget Office. But the changes are not sufficient to resolve the nation's long-term debt, the report finds.

The New York Times: Budget Office Lowers Its Estimate On Federal Spending For Health Care
The growth of federal spending on health care will continue to decline as a proportion of the overall economy in the coming decades, in part because of cost controls mandated by President Obama’s health care law, the nonpartisan Congressional Budget Office said on Tuesday. The budget office said in its annual 25-year forecast that federal spending on major health care programs would amount to 8 percent of gross domestic product by 2039, one-tenth of a percentage point lower than its previous projection (Joachim, 7/15).

The Washington Post: CBO: Slowing Health-Care Costs Yield Big Savings, But Not Enough To Bring Down Our Big Debt
The fastest-growing part of the federal budget -- spending on health-care programs -- has slowed sharply in recent years. And while no one knows quite why that's happening, the Congressional Budget Office is predicting substantial savings. For the 10-year period beginning in 2010, the estimated cost of Medicare and Medicaid -- the government health programs for the elderly and the poor -- has dropped by $1.23 trillion, according to revised CBO projections. In its latest look at the nation's long-term finances, released Tuesday, CBO predicts that the savings will grow by 2039 to 1.5 percent of the economy -- or, in today's dollars, roughly $250 billion a year (Montgomery, 7/15).

The Wall Street Journal: CBO Sees Medicare's Financial Picture Improving
The biggest Medicare program is expected to remain financially solvent through 2030, five years longer than previously expected, according to a government estimate released Tuesday that predicts the program's health-care costs will grow more slowly than they did before the recession. The report by the Congressional Budget Office said Medicare's financial picture had improved sharply since its February forecast, when the nonpartisan budget scorekeeper projected that the portion of the government-run health program that provides hospital coverage for seniors and the disabled would exhaust its reserves in 2025 (Paletta, 7/15).

The Hill: CBO Says US Deficit Levels Are Unsustainable
Washington’s failure to contain entitlement spending is biting into the nation’s long-term fiscal outlook, the Congressional Budget Office warned in a Tuesday report that found the nation’s debt would jump to 106 percent of gross domestic product (GDP) in 2039. The CBO said the rising costs of entitlement programs like Medicare and Social Security as the U.S. population continues to age are the drivers of U.S. debt (Becker, 7/15).

The Hill: O-Care Controls Will Curb Health Spending
A new report from the Congressional Budget Office says cost control measures in ObamaCare will help reduce the growth in federal healthcare spending over the next 25 years. The report says federal healthcare spending will be equal to 8 percent of GDP by 2039, down from a projection last year of 8.1 percent. The savings would amount to $250 billion in today’s dollars, CBO found (Al-Faruque, 7/15).

This Story: Print | Link to | Top

California Vows To Cut Medi-Cal Backlog To 350,000

Responding to federal pressure, state officials said they would slash the number of waiting applicants nearly in half over the next six weeks. Kansas, meanwhile, promised to fix its computers so they can communicate with the federal system.

Los Angeles Times: Obamacare: California Details Plan To Cut Medi-Cal Backlog To 350,000
California will reduce the number of Medi-Cal applications it has pending under Obamacare by nearly half within six weeks, state officials pledged Monday. In a letter to the federal government's Center for Medicare and Medicaid Services (CMS), the director of California's Department of Health Care Services, Toby Douglas, noted that the number of pending applications for the healthcare program for the poor had declined from 900,000 in March to 600,000 by the end of June -- and said that the state's continued efforts to push through the backlog would reduce the number to "approximately 350,000 within six weeks" (Brown, 7/15).

Kaiser Health News: California Releases Proposal For Clearing Medicaid Backlog
Responding to inquiries from federal officials, the California health department has released a plan it says will dramatically slash its backlog of Medi-Cal applications within six weeks. For months, the state has labored under the largest such pile-up in the country, with 900,000 pending cases reported in May—the combined result of unexpectedly high application numbers and bug-ridden computer systems (Shen, 7/16).

Kansas Health Institute News Service: Kansas Responds To CMS Enrollment Concerns
A spokesman for the Kansas Department of Health and Environment said he expects the agency’s computer system to be fully compatible with the Centers for Medicare and Medicaid Services system by Aug. 15. KDHE Chief Information Officer Glen Yancey shared the prediction Monday in a letter sent to CMS headquarters in Baltimore. The letter was in response to CMS officials last month directing officials in six states, including Kansas, to submit plans for correcting delays in determining eligibility in their respective Medicaid programs, primarily for pregnant women, children, and people with disabilities (Ranney, 7/15).

This Story: Print | Link to | Top

Texas Medicaid Rolls Grow Even Without Expansion

More than 80,000 Texans have enrolled in Medicaid or the Children's Health Insurance Program since the rollout of the Affordable Care Act last fall, despite the state's decision not to participate in the health law's expansion of eligibility. Enrollment and marketplace developments in Colorado and Maryland are also tracked.

The Texas Tribune: Texas Sees Rise In Medicaid Sign-Ups
More than 80,000 additional Texans have enrolled in Medicaid or the Children's Health Insurance Program since the rollout of the Affordable Care Act last fall despite Republican state leaders' decision not to expand eligibility to poor adults, according to federal figures. The 80,435 new enrollees as of May — mostly Texans who already qualified for coverage but did not previously seek it — represent a 1.8 percent increase over pre-Obamacare figures (Okun, 7/15).

Houston Chronicle: Even Without Expansion, Texas Medicaid Rolls Rise
[Rosa] Ruiz' children are among a flood of Texans who joined the Medicaid rolls this year after long being eligible without knowing it. A new report shows the number of state residents on Medicaid or the Children's Health Insurance Program, or CHIP, grew by more than 80,000 between last summer and this May, a 1.8 percent spike, despite the Legislature's decision to reject the expansion of Medicaid under the federal Affordable Care Act. Overall, 4.52 million Texans now are on one of the federal programs, according to the report from the national Centers for Medicare & Medicaid Services. Most are children (Rosenthal, 7/15).

Health News Colorado: Double-Enrollment Snafu: Who's On The Hook For 'Million Dollar' Claims?
Colorado's Medicaid and health exchange managers simultaneously enrolled about 3,000 people in both public and private health insurance, creating confusion over who will pay claims that could approach $1 million per person for high-cost patients. The problem is also beginning to emerge around the country, and Colorado officials used the weekend meeting of the National Governor's Association in Tennessee to plead for help from federal health officials to halt the potentially costly double enrollments. Colorado's Medicaid Director Sue Birch tried to downplay the problem during a health exchange board meeting on Monday. She said she has identified the people who are double enrolled, is "minimizing the financial magnitude" of the problem and is ensuring that patients are getting care (McCrimmon, 7/15).

The Associated Press: Md. Officials Provide Update On Health Exchange
A computer glitch with Connecticut's health exchange will be corrected in the version Maryland will be using as the state revamps its own troubled website with Connecticut's technology, Maryland’s information technology secretary assured lawmakers Tuesday. As Maryland faces a tight timeline before the next enrollment period begins in four months, Isabel FitzGerald told a legislative oversight panel that the state is on schedule to have its own flawed website fixed with the new technology in time for the next open enrollment period in November (7/15).

This Story: Print | Link to | Top

Study Finds No Sign That Health Law Has Created Crush Of Medical Demand

The industry study finds that visits to doctors are down slightly over 2013. Another study looks at how nurses could do more in managing chronic illnesses to relieve stress on doctors.

NBC News: The Obamacare Surge? No Sign Of Pent-Up Doctor Demand Yet
Remember all those predictions that Obamacare was going to create a crush of pent-up medical demand? All these millions of newly insured people were not only going to pack doctors' offices, but they were all going to be sick with all sorts of untreated illnesses like diabetes and clogged arteries? That doesn't seem to have happened, according to a new report. In fact, visits appear to be down slightly over 2013, before 9 million people or more gained fresh insurance under the 2010 Affordable Care Act, the team at Athenahealth found (Fox, 7/15).

Reuters: Nurses Could Manage Chronic Care On Doctors’ Orders
Expanding the role of nurses in managing chronic conditions such as diabetes, high blood pressure and high cholesterol could be an effective way to handle the shortage of primary care physicians, according to a new study. "The idea was to see if we could have nurses, who are the nation's largest healthcare workforce, assume additional roles which they already do in hospitals, but they don't necessarily do that much in outpatient settings," said lead author Ryan Shaw. A registered nurse and health services researcher at the Veterans Affairs Medical Center in Durham, North Carolina, Shaw told Reuters Health the Affordable Care Act is only worsening the shortage of primary care doctors by increasing demand for health care (Lehman, 7/15).

Meanwhile, here's a look at how the health law is affecting one business owner -

Kaiser Health News: A Small Business Owner Enters The Insurance Marketplace
Alongside one of this city's canals, blocks from the beach, Sandra Lopez is finally living her idea of the American dream. In 1996, six years after crossing the border from Mexico without papers, she began working at Las Fajitas, a popular Mexican restaurant as a cashier and cook. With the help of her boss, she received a work visa in 2001. Eleven years after that, she bought the business – a bustling establishment where Lopez knows most customers by name. ... For years, she felt she couldn’t afford health insurance for herself, let alone her half dozen employees: "How can I offer them something I don’t even have?" (de Marco, 7/15).

This Story: Print | Link to | Top

Capitol Hill Watch

House GOP Launches Effort Today To Sue Obama On Health Law

Despite many confrontations with the White House, Republicans have decided the best strategy is to focus this legal challenge on actions President Barack Obama has taken on the health law.

Politico: Behind The GOP Focus On Obamacare
There is no shortage of actions that House Republicans see as illegal overreach by President Barack Obama. ... But instead of a multipronged legal assault against the Obama White House in the middle of an election year, Speaker John Boehner is training his fire on the issue that has most animated the GOP since it took control of the House in 2011: Obamacare. Republicans are betting they can translate their success in making the law politically potent into a legal victory (Sherman and French, 7/15).

Politico: 5 Questions About John Boehner's Lawsuit Against Barack Obama
The GOP-led House is set to take its first big step Wednesday toward launching a high-profile lawsuit charging President Barack Obama with failing to carry out his constitutional duty to enforce the law. ... The House Rules Committee will debate the merits of the potential lawsuit at a hearing Wednesday morning. ... Here is POLITICO’s look at the legal questions surrounding the lawsuit (Gerstein, 7/15).

This Story: Print | Link to | Top

Senate Dems Aim To Reverse Hobby Lobby Decision, Undermine State Abortion Restrictions

Democrats have scheduled a Senate vote Wednesday on legislation offered to respond to the Supreme Court's recent ruling. And, on Tuesday, the Senate Judiciary Committee heard testimony about another measure that would void some state abortion restrictions.   

Los Angeles Times: Senate Democrats Move To Prevent State Restrictions On Abortion
Democrats say the bill would prevent states from singling out abortions and protect women’s reproductive rights. The Women’s Health Protection Act comes in response to the recent push in some states to impose new limits on the practice. These restrictions include requiring that doctors who perform abortions have admitting privileges at nearby hospitals, curtailing training for abortion services and limiting the remote prescription of drugs to end a pregnancy without a doctor’s visit (Levine, 7/15).

Kaiser Health News: Senate Democrats Launch Fight To Reverse Supreme Court, State Abortion Restrictions
Most of the momentum in fights over birth control and abortion has been in the direction of opponents of late. But you wouldn’t know that by watching the U.S. Senate. Democrats who control the chamber have scheduled a vote for Wednesday on a bill that would effectively reverse the Supreme Court’s Hobby Lobby ruling regarding contraceptive requirements in the Affordable Care Act. And on Tuesday the Judiciary Committee heard testimony on a separate, sweeping measure that would invalidate many state abortion restrictions (Rovner, 7/15). 

Associated Press: Dems Seek Political Edge in Contraception Ruling
Democrats see a political winner in the stinging defeat they suffered when the Supreme Court ruled that businesses with religious objections may deny coverage for contraceptives under President Barack Obama's health care law. A four-term senator — Washington state's Patty Murray — and a vulnerable freshman — Mark Udall of Colorado — have pushed legislation that would counter last month's court ruling and reinstate free contraception for women who are on health insurance plans of objecting companies. The Senate was expected to vote Wednesday on moving ahead on the bill, which backers have dubbed the "Not My Boss' Business Act." Republicans who have endorsed the court's decision as upholding the constitutional right of religious freedom are expected to block the measure. (Cassata, 7/16).

CBS News: Republicans Pounce on Democrats’ Bill To Reverse Hobby Lobby Ruling
Senate Republicans sent a message to their Democratic counterparts: you won't be the only party ready to respond in the wake of a Supreme Court decision on contraception coverage. Sen. Kelly Ayotte, R-N.H., denounced her Democratic colleagues Tuesday for what she calls a "misrepresentations" of a recent Supreme Court rulingthat closely-held companies like Hobby Lobby don't have to follow the Obamacare mandate requiring large firms to help pay for their employees' birth control. In response, she said, Republicans will be introducing a bill that "will make very clear that women have the same rights today to access contraception as they did before Obamacare was passed and before the Hobby Lobby decision" (Kaplan, 7/15).

CQ Healthbeat: State Abortion Restrictions Roil Senate Judiciary Hearing
At a contentious Tuesday hearing on a bill that would overturn state laws deemed restrictive enough that they interfere with access to abortion, about all that Democrats and Republicans found any agreement on were tactics. Each side accused the other of playing politics, pushing policies that endanger the health of women and trying to subvert the Constitution. Opponents on the issue also largely agree on the facts surrounding the bill, although they differ wildly in their interpretation of them. And while the legislation is unlikely to make it into law this year given opposition from House Republicans, the hearing enabled both sides to air their views on a relatively new development in abortion policy in advance of the mid-term elections. The past several years have seen the emergence of hundreds of state laws affecting abortion providers, including waiting period and ultrasound requirement statutes, as well as requirements that abortion clinics have configurations and capabilities similar to hospitals or surgical clinics (Margetta, 7/15).

This Story: Print | Link to | Top

Health Care Marketplace

More Insurers Want You To See A Doctor Virtually

Insurers like WellPoint and Aetna are offering patients the option of e-visits with doctors as a way to cut costs, but some see problems with that, reports Bloomberg. Other media outlets explore the controversy over Sovaldi, an expensive new drug for hepatitis C.

Bloomberg: More Docs Are A Click Away, But Some Say It’s Not A Healthy Trend
Health insurers want you to see the doctor, just not in an office or hospital. To cut medical costs and diagnose minor ailments, WellPoint and Aetna, among other health insurers, are letting millions of patients get seen online first. In a major expansion of telemedicine, WellPoint this month started offering 4 million patients the ability to have e-visits with doctors, while Aetna says it will boost online access to 8 million people next year from 3 million now. The insurers are joining with companies such as Teladoc, MDLive and American Well that offer virtual visits with doctors who, in some states, can prescribe drugs for anything from sinus infections to back pain (French, 7/14).

The Washington Post’s Wonkblog: How do You Pay For A Drug That Costs $84,000? 
There's a new $84,000 treatment for hepatitis C that's giving new hope to patients. But it's also giving a health-care system strained by limited resources a strong reality check. Since Gilead Sciences unveiled Sovaldi more than six months ago, its $84,000 price tag has ignited a conversation in the health policy world about how to make life-saving medicines more affordable without hurting drugmakers' incentives to develop the treatments in the first place (Millman, 7/15).

The Hill: 4 in 5 Say $1,000-a-Pill Drug Cost ‘Unacceptable’
Eighty-two percent in a new poll say the cost of a $1,000-a-pill medicine which has sparked congressional scrutiny is “unacceptable” and expressed concerns the specialty drug could harm innovation in the pharmaceutical industry. In the survey by the Morning Consult released Tuesday, only 18 percent agreed that the cost was “acceptable and what we have to pay for innovative, life saving drug treatments" (Al-Faruqe, 7/15).

Meanwhile, Walgreen weighs purchase of overseas chain -

The Wall Street Journal: Walgreen Weighs Riding Tax-Inversion Wave
Walgreen Co.'s first pharmacy opened 113 years ago inside a hotel on Chicago's South Side and this year, the chain will derive nearly all its sales and most of its profits from its 8,700 U.S. locations. But Walgreen is currently thinking about leaving American shores, as part a plan to buy the rest of Alliance Boots GmbH, which operates a U.K. drugstore chain and is based in Switzerland. The move could help Walgreen lower its U.S. tax bill saving the company hundreds of millions of dollars a year—money that wouldn't flow into the U.S. Treasury (Ziobro, 7/15).

And the Nemours Foundation settles lawsuits against insurers -

The Associated Press: Nemours Settles 2 United Health Lawsuits
The foundation that owns the Alfred I. du Pont Hospital for Children in Delaware and various pediatric practices in the region has settled lawsuits against two United Healthcare entities for unpaid bills. Federal court documents filed this week indicate that the Nemours Foundation has settled lawsuits against United Healthcare of the Mid-Atlantic and United Healthcare Community Plan of New Jersey. A third lawsuit against United Healthcare of Pennsylvania remains pending (7/15).

This Story: Print | Link to | Top

State Watch

North Carolina Lawmakers Move Closer On State Medicaid Funding

Senate negotiators have backed away from proposed cuts in eligibility for many aged, blind and disabled people.

North Carolina Health News: Budget Negotiators Move Closer On Medicaid
Senate leaders moved a little closer to the House’s budget position on Medicaid funding Tuesday during a public budget conference committee at the General Assembly in Raleigh. For weeks, the two chambers of the legislature have been far apart on funding for the nearly $4 billion program that provides health care for low-income children and their parents, people with disabilities and poor elderly. At Tuesday’s meeting, lead Senate negotiator Harry Brown (R-Jacksonville) told House committee members that the Senate was willing to scrap an earlier proposal to cut eligibility for many aged, blind and disabled people. The concession keeps funding at current levels for those beneficiaries, he said (Hoban, 7/15).

Charlotte Observer:  NC Senate Moves Closer To House Positions In Budget Talks
Republican senators said Tuesday they would give teachers 8 percent rather than 11 percent raises and cut fewer elderly people from Medicaid in their latest state budget offer that moves Senate positions on contentious items closer to House preferences. The new Senate proposal was the first major move in about a week toward finalizing a revised $21 billion state budget that is more than two weeks overdue. The Senate wanted average 11 percent raises for teachers that would come with major cuts to teacher assistants and elderly and disabled Medicaid beneficiaries. The House wanted more modest raises of 6 percent for teachers that would avoid the steep reductions in teacher assistants and Medicaid (Bonner, 7/15).

Raleigh News & Observer: NC Senate Moves Closer To House Positions In Budget Talks
Republican senators said Tuesday they would give teachers 8 percent rather than 11 percent raises and cut fewer elderly people from Medicaid in their latest state budget offer that moves Senate positions on contentious items closer to House preferences. The new Senate proposal was the first major move in about a week toward finalizing a revised $21 billion state budget that is more than two weeks overdue (Bonner, 7/15).

Raleigh News & Observer: NC House, Senate Nearing Agreement On Medicaid Management
The state House and Senate are moving closer to agreeing on a Medicaid plan that will require doctors and hospitals to put skin in the game when it comes to managing the state’s $13 billion Medicaid program. Sen. Ralph Hise, the chamber’s Medicaid expert, said the Senate will introduce a plan Wednesday to reward providers for meeting patient health goals and penalize them financially for cost overruns. The House has been pushing a similar measure (Neff, 7/15).

Meanwhile, a class action lawsuit if filed against New York's Medicaid program -

The New York Times: Medicaid Home Care Cuts Are Unjust, Lawsuit Says
A federal class action lawsuit filed late Tuesday accuses New York State health officials of denying or slashing Medicaid home care services to chronically ill and disabled people without proper notice, the chance to appeal or even an explanation, protections required by law (Bernstein, 7/15).

This Story: Print | Link to | Top

L.A. County Supervisors OK Full Implementation Of State Law That Allows Court-Ordered Mental Health Care

The statutes, known as Laura's Law in California, have become popular in various states after the recent wave of mass shootings.  

Los Angeles Times: L.A. County To Expand Laura’s Law Mental-Illness Treatment Program
Los Angeles County leaders voted Tuesday to fully implement Laura's Law, a state statute that gives counties the option to pursue court-ordered outpatient treatment for people with serious mental illness. Praised by advocates who say it offers a new tool to family members of adults with severe untreated mental illness, the law was recently adopted by San Francisco and Orange counties (Sewell, 7/15).

The Wall Street Journal: Los Angeles County Approves Involuntary Mental-Health Care
The county's Board of Supervisors voted Tuesday to adopt a law allowing court-ordered involuntary mental health treatment for people with serious mental illness and a history of evading treatment. Such laws, though divisive, have become more popular nationwide in the aftermath of recent mass shootings, when some have argued that mandated mental health treatment might have prevented them (Phillips, 7/15).

In related news -

Los Angeles Times: D.A. Jackie Lacey Calls Jailing Of Mentally Ill A ‘Moral Question’
Los Angeles County Dist. Atty. Jackie Lacey told county supervisors Tuesday that gaps in services and communication breakdowns between agencies have resulted in more mentally ill people being sent to jail. Lacey, who is heading up a group of leaders from different agencies focused on expanding diversion programs, called the issue a "moral question" (Sewell, 7/15). 

This Story: Print | Link to | Top

State Highlights: Health Insurance Changes Catch Detroit Teachers Off Guard

A selection of health policy stories from Michigan, Tennessee, California, Wisconsin, New York and North Carolina.

Detroit Free Press: Detroit Teachers Union Challenges Health Insurance Changes
Teachers union officials in Detroit say recent changes to medical insurance caught union members off guard and violate a collective-bargaining agreement. District officials say the new insurance plans, which take effect Aug. 1, are expected to save the financially troubled Detroit Public Schools more than $13 million annually. The changes were necessary and allowable under emergency manager law, a district spokeswoman said. The changes eliminate a more expensive Blue Cross Blue Shield PPO option and require members to sign up for one of two Health Alliance Plan HMO plans: One that requires people to use Henry Ford Health System doctors, or a more expensive premium plan that lets people chose any HAP provider (Zaniewski, 7/15).

The San Francisco Chronicle: S.F. Supervisors Pass Budget, Easily And Early
In a vote that was void of the controversy of last year, board members also unanimously approved 2015 health care rates for city workers, a package that will cut Kaiser members' rates by 2 percent, keep rates for Blue Shield static and reduce the rates for employees covered by the city self-funded plan by 18 percent. Supervisors in 2013 threatened to reject health care rates, saying Kaiser hadn't done enough to justify a 5.25 percent increase (Lagos, 7/15).

The Tennessean: United Cuts Providers For Medicare, Medicaid Patients
United [Healthcare]is cutting 500 Tennessee physicians from its Medicare Advantage network, and an additional, undisclosed amount from its TennCare product in 2014. According to the Tennessee Medical Association, these doctors were not cut because of performance issues or poor conduct, but unrelated network changes. United has made similar network changes in states besides Tennessee. United is not doing this out of the blue. Reimbursement rates for Medicare and Medicaid members are declining. Major insurance companies like United are looking for ways to keep costs down and to negotiate quality incentives with doctors (DuBois, 7/15).

The Milwaukee Journal Sentinel: Losses Mounting At Wheaton Franciscan-St. Joseph
A decline in the number of patients, combined with an increase in the percentage covered by government health programs, has resulted in huge losses at the Wheaton Franciscan-St. Joseph Campus and given the hospital little or no hope of breaking even in future years. The hospital is one of two that serve Milwaukee's lowest-income neighborhoods, and both now are consistently losing money. Wheaton Franciscan-St. Joseph, on the city's west side, is expected to post a loss of more than $30 million for the fiscal year that ended June 30, after losing $14.8 million in its 2013 fiscal year (Boulton, 7/15).

The New York Times: At NewYork-Presbyterian Hospital, Its Ex-C.E.O. Finds Lucrative Work
When Dr. Herbert Pardes retired as president and chief executive of NewYork-Presbyterian Hospital in 2011, the institution honored him at its annual “Cabaret” fund-raiser. More than 1,000 guests dined on wild mushroom soup catered by the restaurateur Danny Meyer and listened to Kelli O’Hara, a star of “South Pacific,” serenade them with Rodgers and Hammerstein, Sondheim and Berlin. But there were more thanks to come. The next year, Dr. Pardes earned $5.6 million ... Three years after retirement, Dr. Pardes is still employed by the hospital (Hartocollis, 7/15).

Bloomberg: Sterilized Women Would Get Reparations Extension in N.C.
A Democratic legislator in North Carolina is fighting to give people forcibly sterilized by the state four decades ago more time to file for compensation under a 2013 law that gave them a year to come forward. Fewer than half the estimated 1,800 living sterilization victims, most of them poor, black women, filed claims by the June 30 deadline. The state is closing the door on the rest, a stance that undermines the first and only eugenics reparations in the U.S., said Representative Larry Hall, a 58-year-old who represents Durham. North Carolina’s decision to pay sterilization victims, more than a decade in the making, exemplifies challenges faced by states trying to address their misdeeds of the past. In the U.S. South, legislators have resisted eugenics compensation for fear of setting a precedent for reparations for slavery and civil-rights violations (Newkirk, 7/16).

This Story: Print | Link to | Top

Editorials and Opinions

Viewpoints: Lower Health Spending Is Welcome News; Media Bias Against Health Law Success

The New York Times' The Upshot: Expected Health Spending Declines — Again
The last few years have seen a puzzling and welcome new trend in health care spending: Instead of going up and up, increases have slowed way down. Since health care costs are growing more slowly than they have in decades, they're making budget forecasts look better and better (Margot Sanger-Katz, 7/15).

The Wall Street Journal: The Hobby Lobby Decision And Its Distortions
In the days since the Supreme Court's June 30 Burwell v. Hobby Lobby decision, we have been troubled by those who seem eager to misrepresent both the facts of the case and the impact of its ruling on women—all to divide Americans and score political points in a tough election year. The biggest distortion: the #NotMyBossBusiness campaign on Twitter, which falsely suggests that under the ruling employers can deny their employees access to birth control (Sens. Kelly Ayotte, R-N.H.,  and Deb Fischer, R-Neb., 7/15).

JAMA Internal Medicine: The Supreme Court Decision In The Hobby Lobby Case
A large, family-owned company, Hobby Lobby, objected to including contraceptive coverage—specifically, intrauterine devices and emergency contraception—in their employees' health insurance because the owners viewed these forms of birth control as "abortions." But, consistent with a disturbing trend among courts and legislatures to misstate or misuse scientific information in the context of women's reproductive rights and health, the Supreme Court's decision ignored the well-accepted distinction between contraception and abortion. Writing for the majority, Justice Alito disallowed any inquiry into whether the company owners’ definition of abortion or views on complicity were reasonable (R. Alta Charo, 7/14).

The Washington Post: Obamacare Doesn't Cover Media Bias. No Wonder It's Not More Popular.
The Affordable Care Act — also known as the ACA, Obamacare, the Devil's Spawn, depending on your orientation — pretty clearly appears to be doing what it's supposed to be doing: covering the uninsured and controlling costs. Yet it certainly doesn't seem to be getting' the love from the press at anything like the rate that it got bashed after its lame rollout. Analysts at the Urban Institute have been tracking the share of the adult population without coverage and in a particularly useful way: by comparing states with and without the Medicaid expansion. While the ACA is of course in effect in all states, 21 states have thus far decided not to take advantage of the Medicaid expansion offered by the law. Thus, we have a sort of natural experiment (Jared Bernstein, 7/15). 

The Wall Street Journal: What's Trending In Health Care? Conservative Ideas.
Conservative criticism of the Affordable Care Act has created the impression that liberal, "big government" ideas are driving the health-care system. But plenty of ideas that conservatives like are taking hold in health care as well (Drew Altman, 7/15). 

Bloomberg: Obamacare Isn't Hurting Democrats
Democrats received a bit of good news in two Marist/NBC Senate polls today showing Mark Udall in Colorado and Gary Peters in Michigan holding solid, though not especially large, leads. Throw these results into the polling averages, and Democrats appear to be ahead in both states. Neither race is a must-win for Republicans to get to a 51-seat Senate majority. However, the more live targets, the better the chances for Republicans to get the six seats they need (Jonathan Bernstein, 7/15).

The Chicago Tribune: An Unwelcome Surprise From The Cook County Health System
CountyCare — that's Cook County's attempt to leverage federal dollars through a Medicaid managed care program — is in a heap of trouble. Expenses outstripped revenues by $21 million in the first six months of the county's fiscal year, through May 31. The shortfall is expected to grow to $63.5 million by the end of the fiscal year, Nov. 30. That's driving a projected $85.9 million shortfall in the 2014 Cook County budget (7/14).

The Washington Post's Post Partisan: Boehner's 'Political Stunt' Will Lead To Obama's Impeachment
The speaker is planning to sue the president because he allegedly "created his own law" by waiving the employer mandate under the Affordable Care Act. Many in this town believe that Boehner's litigiousness is part of a larger strategy to keep his raucous caucus at bay on impeachment of Obama. ... Politically, the Boehner suit is a fool’s errand because it won’t do what he wants it do. Rather than tamp down talk of impeaching Obama, it will lead to an increased clamor for it (Jonathan Capehart, 7/15).

Bloomberg: Doctors For The 1 Percent
While health wonks have been focused on the effects of Obamacare, another change has been happening, intertwined with the new law but worth thinking about separately: How is growing income inequality affecting the delivery of health care? And is that change for the better? ... It's unclear how far the U.S. health-care system will move in that direction. The slice of the population that's willing and able to pay for specialty care in cash is small; the share of physicians in cash-only practices was just 6 percent last year. But that's double the level from 2011. And if the income gap keeps growing, so will the number of doctors who can find enough cash-only patients to stop taking insurance (Christopher Flavelle, 7/14).

Los Angeles Times: An Overdue Response To The Frenzy Of State Restrictions On Abortion
In the last few years, state legislators around the country have been busy with an onslaught of antiabortion legislation aimed at making it impossible for women to exercise what is still (despite the opposition's best efforts) a right guaranteed by the U.S. Constitution. And while it's unclear exactly why there has been such a frenzy of activity — conservative victories in 2010? Reignition of the culture wars sparked by the Affordable Care Act's contraceptive mandate? — we do know that more than four times as many bills aimed at limiting abortion access (93) were passed between 2011 and 2013 than had been passed in the previous decade (22) (Robin Abcarian, 7/15).

Charlotte Observer: A Prescription For Saving Lives
Deaths from unintentional poisoning – mostly prescription drug abuse – have jumped nearly 300 percent over the past decade in North Carolina, according a report. From 1999 to 2012, deaths from the most addictive prescription drugs spiked 400 percent. Today, more North Carolinians die from prescription drug overdoses than from heroin, cocaine and alcohol overdoses combined, and about the same number die from it as do in traffic accidents. The analysis – from the General Assembly’s Program Evaluation Division – found several flaws with the way North Carolina monitors and tries to prevent this tragic situation. Its recommendations for improving the system now sit in a legislative committee, stalled while lawmakers negotiate over teacher pay and Medicaid spending (7/15).

This Story: Print | Link to | Top


EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
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.