Daily Health Policy Report

Thursday, July 19, 2012

Last updated: Thu, Jul 19

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch

Campaign 2012

Coverage & Access


Health Care Marketplace

Health Information Technology

State Watch

Weekend Reading

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Q & A: Upfront Payment For Medical Problems (Video)

Kaiser Health News consumer columnist Michelle Andrews answers a question about providers requesting advance payment for medical tests and other services (7/18). Watch the video.

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Capsules: Bill Frist To GOP Governors: Get Cracking On Exchanges

Kaiser Health News: Capsules: Bill Frist To GOP Governors: Get Cracking On Exchanges
Now on Kaiser Health News' blog, Marilyn Werber Serafini writes: "A former GOP power player is urging Republicans to rethink their rejection of the health law and to implement state insurance exchanges – and to do it now" (Werber Serafini, 7/18). Check out what else is on the blog.

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Political Cartoon: 'Unnecessary Procedures'

Kaiser Health News provides a fresh take on health policy developments with "Unnecessary Procedures" by Adam Zyglis.

And here's today's health policy haiku:


Carrot is OK
but not the stick, says SCOTUS.
What will the states do?

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

Polling Indicates Americans Still Divided On Health Law

An NPR poll shows that a slight majority - 51 percent - favored amending rather than doing away with the health law. A Quinnipiac poll in Virginia found that 50 percent of respondents said Congress should repeal the overhaul.

NPR: A Majority Of Voters In NPR Poll Favor Amending, Not Repealing, Health Care Act
A new poll done for NPR by a bipartisan polling team shows the Affordable Care Act still stirring deep political division in the weeks after the Supreme Court upheld the law's constitutionality. But while much of the country remains strongly opposed to the law popularly known as Obamacare, a bare majority (51 percent) favors the idea of amending rather than repealing it (Elving, 7/18).

The Associated Press/Richmond Times-Dispatch: Majority In Va. Backs Tax Boost For Big Earners, Poll Finds
A new statewide poll in Virginia shows a clear majority support President Barack Obama's proposal to let tax breaks lapse for those earning more than $250,000 annually, but half still want his healthcare law repealed. The Quinnipiac University poll's survey released today shows 59 percent of those surveyed would approve of higher taxes for households earning $250,000 or more if it will help reduce the nation's budget deficit. Thirty-six percent oppose it, and 4 percent were undecided. Fifty percent said Congress should repeal the Affordable Care Act while 43 percent want to let it stand, and 6 percent were undecided. Respondents were evenly split over whether they supported the Supreme Court ruling upholding the law, but 63 percent said it wouldn't influence them to vote for or against Obama (7/19).

Meanwhile -

The Hill: Former CMS Chief: Leaders In Washington ‘Bend The Truth And Rewrite Facts’
President Obama's former Medicare chief blasted critics of the healthcare law for "irresponsible, cruel, baseless rhetoric" and said Washington leaders "bend the truth and rewrite facts" out of convenience. Don Berwick resigned his position as head of the Center for Medicare and Medicaid Services (CMS) in late 2011 after Republicans in the Senate refused to allow his confirmation to proceed. In a recent address to Harvard graduates, Berwick condemned Washington for "careless games" when it comes to healthcare (Viebeck, 7/18).

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Frist Urges State Leaders To Move Quickly On State-Based Exchanges

In an op-ed published Wednesday in "The Week," former Senate Majority Leader Bill Frist, R-Tenn., who is also a surgeon, suggested that GOP governors rethink their rejection of the online insurance markets called for in the health law. (Frist  is a member of The Kaiser Family Foundation board. KHN is an editorially independent project of the Foundation.)

Kaiser Health News: Capsules: Bill Frist To GOP Governors: Get Cracking On Exchanges
A former GOP power player is urging Republicans to rethink their rejection of the health law and to implement state insurance exchanges – and to do it now (Werber Serafini, 7/18).

Los Angeles Times: Bill Frist Calls For GOP To Get Over Opposition To Healthcare Law
As Republicans continue to fight implementation of President Obama's healthcare law, one former party leader is urging them to get over it and embrace a central pillar of the new law. In an op-ed published Wednesday in "The Week," a weekly news magazine, former Senate Majority Leader Bill Frist, a surgeon from Tennessee, said state leaders in both parties should move quickly to establish state-based insurance exchanges where consumers who don't get insurance through an employer will be able to shop for health insurance plans (Levey, 7/18).

Also, news outlets report on insurance co-ops and essential health benefits, as well as on the latest developments regarding accountable care organizations -  

CQ Healthbeat:  Utah Co-Op Shrugs Off The Skeptics
"These new private, nonprofit insurers will be run by consumers and are designed to offer individuals and small businesses more affordable, consumer-friendly and high-quality health insurance options," Marilyn Tavenner, Centers for Medicare and Medicaid Services acting administrator, said in announcing the loan to Aarches Community Health Care to be headquartered in the Salt Lake City area (Reichard, 7/18).

Modern Healthcare: CMS Names 15 Advance Payment ACOs
Fifteen of the latest Medicare accountable care organizations will receive upfront payments to help with startup costs, the CMS announced. The 15 small ACOs were among the 89 ACOs announced earlier this month as the most recent additions to Medicare's experiment with the emerging payment model (Evans, 7/18).

Modern Healthcare: HHS' Final Rule Sets Data-Reporting Standards For Benchmark Plans
HHS issued a final rule establishing data-reporting standards for health plans that will serve as benchmarks for defining each state's essential health benefits under the healthcare reform law.  The regulations specifically apply to the largest three small-group plans in each state. The rule also established the National Committee for Quality Assurance and URAC as interim accrediting bodies to determine whether plans satisfy the requirements (Blesch, 7/18).

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Maine Governor's Medicaid Plan Could Lead To 'Direct Confrontation' With Feds

Gov. Paul LePage views the recent Supreme Court health law decision as license to make deep cuts to Maine's Medicaid rolls. Meanwhile, in news related to the Medicaid expansion, Arkansas officials estimate future savings of $372 million if it proceeds with the expansion.

The New York Times: Maine Debate Hints At Rift On Medicaid After Ruling
As some Republican governors declare that they will not expand Medicaid under the national health care law, Gov. Paul R. LePage is going a step further. In what could lead to a direct confrontation with the Obama administration, he is planning to cut thousands of people from Maine's Medicaid rolls, arguing that the recent Supreme Court ruling on the law gives him license to do so (Goodnough and Pear, 7/18).

The Associated Press/CBS News: Ark. DHS: $372M In Savings From Medicaid Expansion
Arkansas would save $372 million over the next several years if it goes forward with an expansion of Medicaid under the federal health care law after the savings from the law and new state tax revenue are factored in, state officials said Tuesday. The Arkansas Department of Human Services released the new numbers as Gov. Mike Beebe weighs whether to agree to the expansion (7/18).

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NY Times Finds Satisfaction With Supreme Court Falls After Health Ruling; Scalia Denies 'Falling Out' With Roberts

Scalia says press reports of a clash between him and the chief justice on the health law ruling are wrong.

The New York Times: Public's Opinion Of Supreme Court Drops After Health Care Law Decision
The American public's satisfaction with the Supreme Court, which had already been low by historical standards in recent polls, dropped further in the wake of the court's 5-to-4 ruling last month upholding President Obama's health care overhaul law (Liptak and Kopicki, 7/18).

The Associated Press: Scalia Says No 'Falling Out' With Roberts
Justice Antonin Scalia said Wednesday he hasn't had a "falling out" with Chief Justice John Roberts over the Supreme Court's landmark 5-4 decision validating much of President Barack Obama's health care overhaul. In an interview on CNN's "Piers Morgan Tonight," the justice said despite reports that he and Roberts had clashed, there is not a personal feud going on between the court's two leading conservatives (Holland, 7/18).

USA Today's The Oval: Scalia: No 'Falling Out' With Roberts After Obamacare Ruling
"You shouldn't believe what you read about the court in the newspapers," Scalia told Morgan. "No, I haven't had a falling out with Justice Roberts" (Madhani, 7/19).

Politico: Scalia Says He's Not Feuding With Roberts
Justice Antonin Scalia is shedding little light on the Supreme Court's deliberations over President Barack Obama's health care law, but the court's longest-serving justice did deny in an interview aired Wednesday night. ... While Scalia offered no warm words for Roberts, the Reagan-appointed justice and conservative legal mind denied in general terms that his colleagues are prone to personal infighting. "There are clashes on legal questions but not personally," Scalia said. "The press likes to paint us as nine scorpions in a bottle. That’s just not the case" (Gerstein, 7/19). 

Reuters: Scalia Says No Fallout With Roberts Over Health Care Decision
U.S. Supreme Court Justice Antonin Scalia said there was no bad blood between himself and Chief Justice John Roberts, who stunned conservatives by voting to uphold President Barack Obama's health care law. In a rare interview that aired on Wednesday night, Scalia also told CNN he had "no regrets" over the court's 5-4 decision that swung the 2000 presidential election to Republican George W. Bush (7/18).

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Capitol Hill Watch

House Subcommittee Approves Spending Bill That Deletes Health Law Funding

The measure, which is part of the GOP plan to defund the health overhaul, also deletes all federal funding for Planned Parenthood and the Agency for Healthcare Research and Quality.

Politico: Health-Care Reform: Subcommittee Follows Up On Plan To Defund
Republicans on a House Appropriations subcommittee beat back Democratic efforts Wednesday to protect the health reform law, winning passage of a spending bill that would defund the Affordable Care Act, eliminate a decades-old health research agency and slash the budget for other health programs. The subcommittee approved the Labor-Health and Human Services appropriations bill on a mostly party-line vote of 8-6. The vote came only after Republicans defeated an attempt by one of their own, Rep. Cynthia Lummis (R-Wyo.), to chop an additional $8.6 billion from the bill, cutting it by 5.5 percent across the board (Cheney, 7/18).

National Journal:  Republicans Approve Bill To Gut Spending On Health Law
House Republicans on Wednesday backed a health care spending bill that cuts all federal funding for Planned Parenthood, an agency focused on improving health quality, and Democrats' signature health reform law, sending the legislation to full committee.  The House Labor-Health and Human Services Appropriations Subcommittee approved the fiscal 2013 L-HHS bill on a largely party-line vote…The bill cuts funding for labor and health programs to $150 billion, a drop of $6.8 billion from what they got in 2012. It is $2 billion lower than what the programs received in 2009 (McCarthy, 7/18).

In addition, the possible impact of upcoming scheduled automatic spending cuts is taking shape -

Politico: Domestic Programs Brace For Sequester's Ax
[Rep. Ed] Markey obtained one of the early detailed answers from the Obama administration about the budget pain of the automatic cuts — formally called a sequester — in a letter released last week from the Department of Health and Human Services. Among those cuts: the elimination of 2,300 National Institutes of Health research grants; nearly 100,000 children losing Head Start services; and no more child care assistance for 80,000 kids. Not to mention 12,150 fewer patients with access to AIDS Drug Assistance Program benefits and 169,000 people who would not get access to substance-abuse treatment programs (Kim, 7/18).

And ideas on how to replace the current Medicare payment formula continue to bounce around Capitol Hill -

CQ Healthbeat:  From the CQ Newsroom: Progress Seen in House on Medicare Payment Rates, But Extension Likely
House lawmakers on Wednesday praised ideas to replace the current Medicare physician payment formula but acknowledged that anything more than an extension of rates is unlikely to happen this year… The hearing was similar to several held by the Senate Finance Committee this year, with witnesses from the private sector sharing their experiences in trying to move away from a traditional fee-for-service physician reimbursement system.  But lawmakers said they must be realistic about the schedule for the rest of this year. The best possible outcome for now, several said, may be a long-term payment patch to provide more time to work out a replacement – the same goal they reached for, and missed, last year (Ethridge, 7/19).

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Campaign 2012

Economy Dominates Voter Concerns, While Health Law Bubbles On Back Burner

Though the economy seems to be trumping the health law on the campaign trail, the overhaul is one of the flashpoints in what the New York Times describes as a "philosophic clash" over the role of the federal government. Meanwhile, President Barack Obama, campaigning in Florida, is expected to talk Medicare. In the background, Vice President Joseph Biden says Obama expected the political backlash triggered by the health law.

The New York Times: Economic Fears Hurting Obama, Poll Indicates
But the Times/CBS poll nonetheless underscores a national trendline in which the economy remains the dominant force in the campaign, regardless of outside events like the Supreme Court ruling on Mr. Obama's health care law or the daily sticks-and-stones of the trail (Rutenberg and Connelly, 7/18).

The New York Times: Campaign Memo: Philosophic Clash Over Government's Role Highlights Parties' Divide
At its core, the president's argument is that the every-man-for-himself ethos he attributes to his opponents does not work. Instead, he advances a we're-in-this-together creed born out of his days as a community activist. … Mr. Romney, for his part, has also been a believer in activist government at times, certainly when he was governor of Massachusetts and enacted a pioneering plan to expand health care coverage. But the lifelong entrepreneur in him hears words like Mr. Obama's as a repudiation of the storied American tradition of rugged individualism and the self-made man (Baker, 7/18).

The Associated Press: In Florida, Obama Aims To Keep Pressure On Romney
Obama is expected to make a pitch to seniors in West Palm Beach, where he'll visit Century Village, a condominium complex home to thousands of retirees, long a bastion of reliable Democratic voters. Obama and Democrats have warned that Romney would seek to implement a budget plan authored by Rep. Paul Ryan, R-Wis., that includes an overhaul of Medicare that would change it into a voucher-like program for those who retire in 10 years (Thomas, 7/19).

Politico: Biden: Obama Knew Health Care Would Cost Him
Vice President Biden said Wednesday that President Obama was fully aware of the political backlash that passing health care reform would cause — but did it anyway. "Every single time he's made a decision — and I'm not exaggerating to you — he sits there, knows the pain it's gonna cost him politically," Biden said on a call with Obama campaign volunteers (Tau, 7/18).

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Coverage & Access

Postal Service Expects To Miss Health Benefits Payment

The annual $5.5 billion payment, due Aug. 1, is to a health benefits fund for future retirees. The Postal Service is warning that it will defaut without congressional action. 

The New York Times: Postal Service Set To Default On Billions In Health Fund Payments
The Postal Service, faced with continuing financial losses because of a drop in mail volume, expects to default for the first time on its annual payment for future retiree health benefits. ... Missing the health care payment will not cause immediate disaster, nor will it affect current retiree benefits. The Postal Service will still be able to pay its employees and buy fuel for its trucks to deliver mail on time, postal officials said (Nixon, 7/18).

The Wall Street Journal: Post Office Might Miss Retirees' Payment
The Postal Service repeated on Wednesday that without congressional action, it will default—a first in its long history, a spokesman said—on a legally required annual $5.5 billion payment, due Aug. 1, into a health-benefits fund for future retirees. Action in Congress isn't likely, as the House prepares to leave for its August recess (Levitz, 7/18).

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Survey: Medicare Beneficiaries Happier With Coverage Than Younger People On Private Plans

The poll results, published in Health Affairs, found that 8 percent of seniors said their coverage was "fair" or "poor" while 20 percent of those with a plan offered through work said that.

Los Angeles Times: Survey: Medicare Patients Happier Than Those With Private Coverage
Elderly Americans on Medicare are substantially happier with their insurance coverage than their younger counterparts who rely on commercial insurance, according to a new national survey. Only 8 percent of Medicare beneficiaries 65 or over rated their coverage "fair" or "poor," the nonprofit Commonwealth Fund found. By comparison, 20 percent of those with employer-based coverage gave their insurance plan low marks (Levey, 7/18).

National Journal:  Seniors Prefer Medicare To Private Plans, Study Says
Seniors enrolled in the traditional Medicare program were happier and spent less out-of-pocket than their peers who chose private Medicare Advantage plans, according to a study published in the journal Health Affairs.  The study found that traditional Medicare costs less not just for the government but for beneficiaries, data that is sure to emerge in the next discussions about whether Medicare should be converted from a government-run insurance program to a private voucher system, a proposal championed by congressional Republicans and GOP presidential hopeful Mitt Romney (Sanger-Katz, 7/18).

Politico Pro: Medicare Patients Report Fewer Cost Issues
Medicare beneficiaries report higher satisfaction with their insurance than people on private plans, according to the Commonwealth Fund. In a new study posted online by Health Affairs Wednesday, Commonwealth found that 20 percent of adults surveyed who received insurance through their employers said their coverage was either fair or poor. Just 8 percent of adults on Medicare had the same poor assessment of their insurance. Those in the individual market fared the worst -- about a third said their insurance was just fair or poor (Smith, 7/18).

And on the dual eligibles' front --

Modern Healthcare: CMS Won't Expand Dual-Eligibles Pilot Program
The CMS will keep enrollment in a coming national pilot project for dual-eligible beneficiaries below 2 million people, or more than a million fewer than states have proposed. Melanie Bella, director of the Medicare-Medicaid Coordination Office at the CMS, addressed the expected size of the pilot program at a Senate Aging Committee hearing on the controversy that has arisen around it (Daly, 6/18).

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Health Care Marketplace

Documentary Film Provides Glimpse Into The World Of Public Hospitals

PBS NewsHour: New Documentary Explores Challenge To Public Hospitals In Serving Uninsured
The daily life of a large, under-resourced, urban public hospital, a new documentary offers no experts and no statistics, just a rare fly-on-the-wall look inside an overwhelmed and at times overwhelming system and its impact on patients and staff (Brown, 7/18).

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Health Information Technology

EHR Adoption By Doctors Reaches 55 Percent

Medscape:  EHR Adoption By Physicians Hit 55% In 2011, CDC Says
Physician adoption of the electronic health record (EHR) may be at — or even past — the proverbial tipping point, or so suggests a government study released yesterday that is a litany of progress.  In 2011, 55% of physicians reported having adopted an EHR, and of those, 85% said they were either somewhat or very satisfied with the technology, according to the report from the US Centers for Disease Control and Prevention (CDC). Roughly 3 in 4 physicians using EHRs said the software enhanced overall patient care. And 71% of digital physicians would buy their EHR program again (Lowes, 7/18).

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State Watch

Mich. Gov. Urged To Set Up Exchange By Executive Order; Oregon Plans Campaign To Urge People To Buy Insurance

The health law's insurance exchanges make news in Michigan, where the governor won't get House approval to start work on the marketplace, and in Oregon, where the exchange board eyes a communication campaign to help insure people.

The Associated Press/CBS News: Michigan House Won't Take Up Health Exchange
A rift among Michigan's Republican lawmakers means Gov. Rick Snyder won't get the House approval he wants Wednesday to start work on a website for purchasing health insurance that's required under the federal health care law. House Speaker Jase Bolger's spokesman, Ari Adler, told The Associated Press on Tuesday that the Republican caucus remains divided and won't be ready to act on the health insurance exchange when lawmakers return Wednesday after a five-week break (7/18).

Detroit Free Press: Michigan Health Reform Group Wants Gov. Rick Snyder To Issue Executive Order
A health care reform organization Wednesday called on Michigan Gov. Rick Snyder to issue an executive order to create a state health insurance exchange, one day after a top Republican leader said the state needs more time to set up the program. Michigan Consumers for Healthcare, a Lansing nonprofit with 155 member groups, issued a statement encouraging Snyder to give his own go-ahead for an exchange -- a largely Web-based program for comparing and buying insurance. "The delay of health exchange legislation that has been created by needless obstruction by a handful of misguided politicians has put Michigan consumers in a weak position with respect to establishing a state-based health exchange," its statement said (Anstett, 7/19).

The Lund Report: Health Insurance Exchange Board Hammers Out Choice, Communication Issue
The Health Insurance Exchange Board intends to launch an aggressive communication campaign next summer and encourage people to purchase insurance so they can avoid paying a penalty starting in January 2014 when the Affordable Care Act kicks in. Each insurer will be limited to three health plan options in the individual and small group market, which should avoid confusion, Rocky King, executive director, told the exchange board last week. Massachusetts learned that lesson the hard way, he said, and ended up dropping plans after implementing a statewide insurance mandate (McCurdy, 7/18).

Health Policy Solutions (a Colo. news service): Latinos Could Benefit Most From Health Law
Latinos, who are uninsured at disproportionately high rates in Colorado, could gain the most as health reform takes hold. That’s what happened in Massachusetts, which in 2006 became the first state in the nation to require health coverage for all individuals and to implement a health insurance exchange. … In Colorado, about one-third of Hispanics are uninsured, according to the Colorado Health Access Survey’s (CHAS) latest results from 2011. The survey found that Hispanics were more likely to be uninsured than Anglos or African Americans. ... About 21 percent of Colorado’s 5.1 million people are Latino, according to U.S. Census data (McCrimmon, 7/18).

Meanwhile, ACOs take shape in various state markets --

Modern Healthcare: Cigna Announces New ACO Agreements
Cigna has announced new accountable care initiatives in several states. In California, the agreement with the Palo Alto Medical Foundation, an affiliate of Sutter Health, will include as many as 21,000 patients. Cigna's agreement with New West Physicians in Denver will cover about 7,800 patients, according to a news release from the Bloomfield, Conn.-based insurer (Evans, 7/18).

Modern Healthcare: N.C. Blues, Wilmington Health Partner For ACO
Blue Cross and Blue Shield of North Carolina said it has formed an accountable care organization with Wilmington Health, a multispecialty physician group practice in southeastern North Carolina. The Chapel Hill, N.C.-based insurer said in a news release that the ACO's development will include the launch of a new oncology program that will aim to improve outcomes by ensuring that patients receive treatments that follow evidence-based research (Lee, 7/18).

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States Draw Stark Lines On Abortion With Lawsuits And Legislation

State laws -- 40 of them in 15 states -- are making it harder to get an abortion in the U.S., according to a new report. Meanwhile, a House panel approves new measure to curb abortion in the District of Columbia.

Reuters: New State Laws Make Getting Abortions Tougher In U.S.: Report
American women face increasing legal obstacles to obtaining abortions as more states pass laws restricting access, some so stringent they approach a ban on the procedure, according to a report issued on Wednesday by the Center for Reproductive Rights. The New York-based advocacy group cited nearly 40 laws enacted across 15 states this year having the potential to restrict women's access to reproductive health care, nearly 40 years after the U.S. Supreme Court's decision in Roe v. Wade made the controversial procedure legal (Le Coz, 7/18).

Roll Call: House Committee Approves Ban On D.C. Abortions After 20 Weeks
The House Judiciary Committee approved a bill today that would ban abortions after 20 weeks in the District of Columbia. The party-line vote of 18-14 came as no surprise: The National Right to Life Committee calls the bill its No. 1 legislative priority for passage in the 112th Congress, and the Republican majority by and large holds anti-abortion positions. What was surprising, D.C. Del. Eleanor Holmes Norton (D) said, was that Republicans seemed almost reluctant to speak about why the bill was D.C.-specific (Dumain, 7/18).

The Washington Post: House Panel Approves Ban On D.C. Abortions After 20 Weeks
The bill would likely command majority support if it comes to a House floor vote, though its ultimate fate is unclear. It is unlikely to come up for stand-alone consideration in the Democratic-controlled Senate. But Senate Republicans could seek to attach it to other legislation (Pershing, 7/18).

The Texas Tribune offers several interactive maps focusing on women's reproductive health issues. 

Texas Tribune: Interactive: State Family Planning Contractors
Since budget cuts took effect last September, the Department of State Health Services has implemented the Legislature’s order to reduce family planning funding through its department by two-thirds, from $111 million during the last biennium to $37.9 million in this one. A funding priority system that gives most money to federally qualified and comprehensive health clinics has left many specialty reproductive health providers in a lurch (Murphy, 7/19).

Texas Tribune: Interactive Map: Women's Health Program Providers
In conjunction with the Fertile Ground series, we've updated the state's list of Women's Health Program providers. Since the last iteration of this map in February, Gov. Rick Perry has rejected Medicaid funds to continue the program as a federal-state partnership. Anti-abortion proponents are trying to exclude abortion affiliates like Planned Parenthood from participating, but a court injunction will keep them in the program while a lawsuit moves through the court (Aaronson, 7/19).

Philadelphia Inquirer: Abington Health, Holy Redeemer Call Off Merger
Abington Health and Holy Redeemer Health System called off their plans for a merger Wednesday, amid intense pressure from activists who opposed the plan because it would have meant an end to abortions, which Abington has been performing. The two institutions released a brief joint statement Wednesday afternoon, saying that officials were disappointed but that their decision was "in the best interests of both organizations." … The merger, announced just three weeks ago, was officially termed a "partnership" between Abington and the Catholic-run Redeemer. It had been sought in the belief that a larger, more efficient institution would be better equipped to cope with the federal health care overhaul (Avril, 7/19).

And in related news --

CQ Healthbeat: One Lawsuit Dismissed And Another Filed In HHS Contraception Fight
A federal judge has dismissed a lawsuit filed by seven state attorneys general challenging a Health and Human Services rule on contraception, but the legal battle isn't letting up. An evangelical Christian liberal arts college filed a new suit in the District of Columbia on Wednesday, joining a similar action by Catholic University (Norman, 7/18).

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State Roundup: Fla. Counties May Reconsider Medicaid Lawsuit Against State; Accessing Dental Care In Georgia

A selection of health policy stories from Minnesota, Florida, Oregon, California, Massachusetts and Georgia.

Minnesota Public Radio: Health Care Spending Slows In Minn.
The state Health Department reports the rate of health care spending in Minnesota has slowed to its lowest point since 1997. Health care costs are still rising, but at a much slower pace -- 2.2 percent between 2009 and 2010. State Health Economist Stefan Gildemeister said the recession was a major factor in why Minnesotans spent less on health care. He said many lost their insurance when they lost their jobs and others who kept their jobs were more cautious (Stawicki, 7/18).

Minneapolis Star Tribune: Minnesota's Health Care Spending Slows
Health care spending in Minnesota rose just 2.2 percent in 2010 -- the slowest annual growth rate since 1997, the Minnesota Department of Health reported Wednesday. Lingering effects of the 2008-09 recession probably explain much of the slowdown, as Minnesotans delayed routine and acute care, according to Health Commissioner Ed Ehlinger. In addition, surveys indicate that many people lost employer health coverage (Walsh and Crosby, 7/18).

The Associated Press/Miami Herald: Fla. Reduces Counties’ Medicaid Bills By $171.4M
Florida's counties may reconsider a lawsuit over disputed Medicaid fees because the state has slashed $171.4 million from their bills, a spokeswoman for their statewide association said Wednesday. That cut the disputed amount by more than half -- from $316 million to $146.4 million. (Kaczor, 7/18).

The Lund Report: CDC Grant Program Focuses On Improving The Health Of People With Disabilities
Oregon was one of 18 states to receive the grant awards announced earlier this year, but has actually received funding from the CDC for projects on disability and health since 1994, said Conne-Ward Cameron of the CDC's Center on Birth Defects and Disabilities, who echoed Andresen's sentiment that Oregon's work in this area has been particularly strong. …The current three-year grant, which kicked in at the beginning of this month and will end in 2015, requires states to demonstrate that people with disabilities are included in a mainstream public health program, that they receive preventive health care screening and are included in state-based emergency planning exercises (McCurdy, 7/19).

KQED: For Those Needing Stronger Pain Medications, Bill Spells Relief
A bill that would make it easier for patients to get strong pain medications through their health insurance is making its way through the state legislature. California Watch reporter Christina Jewett says a patient advocacy nonprofit called For Grace is lobbying for the bill, but the group has some powerful supporters (7/18).

San Francisco Chronicle: S.F. Hospital Pact Wins 2-Week Delay
California Pacific Medical Center peered over the brink late Tuesday night and took a step back. Faced with the possibility of receiving a fatal blow to its $2.5 billion proposal to overhaul its medical facilities in San Francisco, the Sutter Health-affiliated medical group requested -- and ultimately got -- a two-week postponement of a vote that it was expected to lose on the environmental impact study for its long-range development plans. The Board of Supervisors unanimously decided, after a six-hour hearing, to grant the reprieve until July 31 after a Sutter Health official pledged to take substantive steps to jump-start stalled negotiations on a range of concerns over California Pacific Medical Center's development plans, including building two seismically safe hospitals (Coté, 7/18).

Boston Globe: UMass Medical School To Manage Health Care At N.C. Federal Prison
The Federal Bureau of Prisons has awarded the University of Massachusetts Medical School a contract to manage comprehensive medical services to about 4,900 inmates at the Federal Medical Center located in Butner, N.C., UMass Medical School said. The agreement, valued at $24.7 million for the first year, represents its largest federal correctional health contract to date, the Worcester school said (Reidy, 7/19).

CommonHealth/WBUR: Uncertain Fate Of Law That Prompted Health Insurance Rebates
There’s lovely news in the mail this summer for many Massachusetts residents: The day-brightening surprise of opening an envelope and finding a check for $100 or $200, (Or $104.94, as one happy blogger posted) — a rebate on health insurance. But the state law that prompted those rebates is up for renewal, and its fate is uncertain (Goldberg, 7/18).

Georgia Health News: How Do We Increase Access To Dental Care?
More than a decade ago, the first U.S. Surgeon General's Report on oral health outlined a "silent epidemic" of dental and oral diseases in the nation. Dental problems affected large numbers of children and adults, and were also linked to major health conditions, said the landmark report, released in 2000. Dr. David Satcher, who was surgeon general at the time and produced the report, said poor Americans and children were especially vulnerable, and that members of racial and ethnic groups had a disproportionate level of oral health problems. Satcher, reflecting on that data 12 years later, says progress has been made in improving access to dental care, including in Georgia (Miller, 7/18).

Minneapolis Star Tribune: Making Decisions For Loved One's Final Days
Sue Schettle has spent the past three years coordinating an ambitious campaign to help Minnesotans make better end-of-life medical choices. … The campaign has enlisted doctors, hospitals, insurers and thousands of patients in the Twin Cities, with fingers stretching to outstate Minnesota and into Wisconsin. Now community and faith groups are joining the effort, and the project has generated a five-part public television series broadcast more than 70 times (Wolfe, 7/19).

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Weekend Reading

Longer Looks: Physicians And Assisted Suicide; Avoid Getting Sick In July

KHN's Matthew Fleming selected these interesting articles from around the Web for weekend reading options.

ABC News: Assisted Dying: Experts Debate Doctor's Role
Peggy Sutherland was ready to die. The morphine oozing from a pump in her spine was no match for the pain of lung cancer, which had evaded treatment and invaded her ribs. … Sutherland, 68, decided to use Oregon's "Death With Dignity Act," which allows terminally-ill residents to end their lives after a 15-day requisite waiting period by self-administering a lethal prescription drug. ... But not all doctors are on board with the law. In the 15 years since Oregon legalized physician-assisted dying, only Washington and Montana have followed suit, a resistance some experts blame on the medical community (Katie Moisse, 7/13).

The Daily Beast: When Chemo Causes Cancer
Clutching George Stephanopolos's hand on the sofa next to her, (Good Morning American anchor Robin) Roberts announced that she has myelodysplastic syndrome (MDS), a relatively rare blood disease that Roberts herself said she'd never heard of until she was diagnosed with it. Likely even more unfamiliar for many viewers than the name of her condition was Robert's startling remark that cancer treatment can result in other serious health problems,  including different forms of cancer,  several years after the initial cancer is in remission.  But in the medical world, it has been known for decades that cancer treatment carries with it the risk of causing another kind of cancer to develop (Casey Schwartz, 7/12). 

The Atlantic:  Spray Tanning May Cause Cancer, Too -- Ask For A Nose Filter
The chemical responsible for the 'faux glow' given by 'spray-on' tanners, may cause genetic mutations and DNA damage. One of the biggest concerns is the absorption of dihydroxyacetone, or DHA, into the bloodstream through the mucous membranes. ... The FDA advises consumers to request protection for their eyes and mucous membranes and prevent inhalation. These preventive measures include the use of protective undergarments, nose filters, lip balm, and eyewear (Charlotte Lobuono, 7/13).

The New York Times: Don't Get Sick In July
It's one of those secrets you normally don’t learn in nursing school: "Don't go to the hospital in July." That's the month when medical residents, newly graduated from medical school, start learning how to be doctors, and they learn by taking care of patients. And learning means making mistakes. There's disagreement in the medical literature about whether a so-called July Effect, where medical error rates increase in the summer, actually exists. ... From what I've experienced as a clinical nurse, whether or not the July Effect is statistically validated as a cause of fatal hospital errors, it is undeniably real in terms of adequacy and quality of care delivery. Any nurse who has worked in a teaching hospital is likely to have found July an especially difficult month because, returning to Dr. Young's football metaphor, the first-year residents are calling the plays, but they have little real knowledge of the game (Theresa Brown, 7/14).

Salon: My Slide Back To Painkillers
We judge each other's tolerance for pain. We tell ourselves that pain makes us stronger, that it sharpens our character, that it demonstrates our will. We expect high-paid athletes to play hurt. We debate whether women should use drugs during labor. We wonder if we rely too much on over-the-counter medications for the ordinary aches and pains of life. ... When pain derailed my life more than a decade ago, I did not stop to attend to it. I popped a pill prescribed by my doctor and kept going, which eventually landed me in detox with a full-blown addiction to OxyContin. Eleven years later, I find myself wondering what it means to stay "sober." I suffer from migraines, the variant known as cluster headaches — also known as "suicide headaches" — and as I lie in dark rooms, waiting for the headaches to pass, the question I ask myself is this: How much pain can I tolerate? Or really: How much should I tolerate? (Lorraine Berry, 7/16). 

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Editorials and Opinions

Viewpoints: Researchers See Potential To Control HIV Pandemic; The 'Ceaseless Attacks' On Women's Reproductive Health

New England Journal of Medicine: The Beginning Of The End Of AIDS?
We are at a moment of extraordinary optimism in the response to the human immunodeficiency virus (HIV). A series of scientific breakthroughs ... have the potential to markedly expand the available preventive tools. There is evidence of the first cure of an HIV-infected person. And most important, the finding that early initiation of antiretroviral therapy can both improve individual patient outcomes and reduce the risk of HIV transmission to sexual partners by 96% has led many to assert what had so long seemed impossible: that control of the HIV pandemic may be achievable (Dr. Diane Havlir and Dr. Chris Beyrer, 7/19).

The New York Times: A Ruling Protecting Women's Health
A federal judge in Nebraska made the right call on Tuesday when he dismissed a lawsuit filed by seven state attorneys general against the requirement in the new health care law that most employers provide insurance coverage for contraception (7/18).

Los Angeles Times: The War On Abortion Rights
In California, where limiting access to abortion and other reproductive services would be practically unthinkable, it can be easy to ignore the ceaseless attacks on women's reproductive rights elsewhere. But an aggressive campaign to curtail those rights is being waged across the country as opponents seize every opportunity to deny women long-established constitutional protections (7/18).

The Wall Street Journal: An Evangelical-Catholic Stance On Liberty
On Wednesday, represented by the Becket Fund for Religious Liberty, the trustees of Wheaton College joined The Catholic University of America in filing a lawsuit against the Department of Health and Human Services. They did so because the HHS mandate requiring the college to provide and subsidize insurance coverage for abortion-inducing drugs violates the conscience of the school and its members, and denies their First Amendment freedom of religion (Philip Ryken and John Garvey, 7/18).

The New York Times: More Myths Of Obamacare
If only I'd checked with you first, Times readers, I could have expanded my list of fallacies about the Affordable Care Act. Thanks to your comments and emails on my column, I’ve noted a few more enduring myths that seem worthy of debunking (Bill Keller, 7/18). 

Philadelphia Inquirer: Language Is Loser In 'Obamacare' Ruling
It was [Paul Clement's] easy grasp of the subject that made his baseline declaration about Chief Justice John Roberts' majority opinion in President Obama's health care law all the more jarring. "The individual mandate was struck down," he declared to the audience of 200 or so lawyers. If so, that would certainly come as a surprise to the White House and to Democratic leaders on Capitol Hill, who have hailed the wisdom of Roberts decision to essentially uphold the law that they enacted. Yet Clement's assertion wasn't quite as out there as it seemed (Chris Mondics, 7/19).

Minnesota Public Radio: The Danger Of A Supreme Court That Can Find A 'Rational Basis' For Any Mandate
What is most shocking about last month's ruling on the Affordable Care Act is not that the law was upheld but that any justices voted to uphold it. Lost in all the intrigue surrounding why Chief Justice John Roberts voted the way he did is that four other justices would have upheld the law's individual mandate — the requirement that all Americans purchase health insurance — under a view of the federal government's authority so sweeping that it would eliminate the Framers' carefully constructed plan of enumerated federal powers. When the U.S. Supreme Court is one vote away from abandoning a basic safeguard for liberty, you know how precarious our system of federalism has become (Anthony Sanders, 7/19).

The Hill: Continuing On The Path Toward Health Care Reform
While it was important to settle the questions surrounding the ACA – after all, no industry likes uncertainty – the train had already left the station. The only question was how fast it would reach its destination, and we in the healthcare industry couldn't sit on our hands waiting to find out. As the adage says, "If you don't create change, change will create you." Many health care organizations – including Cleveland Clinic – set about creating change several years ago, addressing issues of patient access, cost and quality (Dr. Delos M. "Toby" Cosgrove, 7/18).

Boston Globe: State Needs To Take Stock Before Expanding Health Payment Methods Employers Are Rejecting
The health care legislation under consideration in the State House has ambitious goals — to cap spending and change the way providers are paid. The bills encourage health insurance plans to move to a variety of payment methods that share the same focus: they would require providers to be held financially responsible for the health outcomes of their patients; they promote coordination of care; and they discourage redundant care. ... The problem, and what the legislation doesn't recognize, is that fewer — not more — employers are offering these types of insurance plans (Eric Beyer, 7/18).

Health Policy Solutions (a Colo. news service): Living Outside The Affordable Care Act Tent
It should be no surprise then that we do not focus on whether patients are citizens or undocumented immigrants when they enter our clinic. We believe that everyone in our community needs and deserves high quality health care services. Unfortunately, the health care reform law leaves undocumented immigrants largely outside of the discussion. We understand the political reality of today, where Congress is gridlocked on the issue of immigration.  Despite this impasse, the recent Supreme Court decision advances the idea that we are a nation that cares for its sick, and that the time has come for us to expand our definition of "we" to fully reflect our neighbors and our communities (Jim Garcia, 7/18).

Journal of the American Medical Association: How Can We Spur Organizational Innovation To Fix US Health Care?
Why is it so hard to improve the delivery system or to reform the outdated structure of Medicare? In large part it's because of the way we have chosen to solve the challenge of getting a vibrant private-sector market to achieve social goals, such as providing insurance for many essentially uninsurable people or delivering a basic package of care to people who don't have the money to pay for it. To address this challenge, we've primarily been using a central planning strategy. And it is fundamentally flawed (Stuart Butler, 7/18).

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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.