Daily Health Policy Report

Tuesday, July 23, 2013

Last updated: Tue, Jul 23

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch

Health Care Marketplace


State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Insuring Your Health: Patient Advocates Seek A Gentle Transition From High Risk Pools To New Exchange Plans

Kaiser Health News consumer columnist Michelle Andrews writes: "State high-risk insurance pools around the country provide coverage to approximately 220,000 people who have medical problems and are often turned down for traditional policies" (Andrews, 7/23). Read the story.

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Political Cartoon: 'The Doctor Is In?'

Kaiser Health News provides a fresh take on health policy developments with "The Doctor Is In?" by Bob Englehart.

Meanwhile, here is today's health policy haiku:


Change happens, slowly.
So quit complaining and work
In Mississippi.

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

Star Power Enlisted To Spread The Word About Health Law

The Obama administration is using the help of celebrities, including comedian Amy Poehler, actor Kal Penn and singer Jennifer Hudson, to educate young Americans about new insurance options under the law.

Los Angeles Times: White House Enlisting Entertainers To Help Implement Healthcare Law
Stepping up efforts to enroll young Americans in health insurance this fall, the Obama administration is enlisting the help of actors and entertainment industry officials to educate twentysomething consumers about the need to get covered. Senior administration officials met Monday morning with a group of entertainers to talk about media campaigns to reach young Americans about the Affordable Care Act, according to a White House official (Levey, 7/22).

The Washington Post: Health-Care Enrollment Effort Gets Some Star Power
Comedian Amy Poehler, actor Kal Penn and singer Jennifer Hudson attended a closed-door White House meeting Monday, hosted by senior advisor Valerie Jarrett and other top White House officials, according to a White House official (Kliff, 7/22).

Fox News: Obama Enlisting Celebrities To Promote ObamaCare
President Obama is enrolling some star power to promote ObamaCare amid public doubts and embarrassing setbacks to his signature health care law. Obama stopped by a private White House meeting Monday with celebrities including singer Jennifer Hudson and actors Amy Poehler, Michael Cera and Kal Penn. The White House said the artists expressed interest in helping spread the word about the health insurance marketplaces opening Oct. 1. Insurers need healthy young customers to help offset the costs of older, sicker consumers (7/23).

CNN: Obama Meets With Celebs Who Want To Promote Obamacare
President Barack Obama, hoping to pitch his signature health care law to younger Americans, will get some help from a cadre of Hollywood stars who have volunteered to help promote Obamacare's insurance exchanges that open on October 1. At a meeting at the White House Monday, a group that included singer Jennifer Hudson and actors Kal Penn and Amy Poehler heard Obama extol the benefits his health care law offers young people, whose participation in the exchanges is seen as essential for their long-term viability (7/22).

Reuters: White House Finds The Funny In 'Obamacare' Pitch To Youth
What's so funny about President Barack Obama's healthcare reform law? A website known for viral comedy videos popular with Americans under 30 - Funny or Die - has a few ideas and is enlisting celebrities to make something that catches the attention of a key demographic the White House needs to sign up for Obamacare (Rampton, 7/22).

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Obama Seeks To Mobilize Grass Roots To Help Advance Health Law

Presdient Barack Obama spoke to the group Organizing for Action and said the role of these volunteers in terms of putting the new health care plan in place and advancing other second-term initiatives is critical -- especially as the August congressional recess approaches.

The Associated Press/Washington Post: Obama, Democratic Leaders To Urge Supporters To Speak Up As Lawmakers Prep For August Recess
Lawmakers in barely a week will fan out across the country, returning to their home districts for the annual summer break. At town hall meetings and picnics and public events, they’ll hear firsthand from constituents — most of whom, polls show, have had it with Washington and incessant partisan fighting. With a tough path ahead for Obama’s major goals — including an immigration overhaul, the economy and the rollout of his health care law — his supporters want to ensure that lawmakers of both parties return to Washington with a mandate to work with Obama. So, OFA, with a presidential assist, is seeking to get activists energized and ready to speak up (7/22).

USA Today: Obama Urges Volunteers To Help Him Pass Agenda
Speaking Monday night to Organizing For Action, a group of volunteers created from the remnants of his 2008 and 2012 campaigns, Obama said he needs them to stay active and pressure Congress into helping him deliver on his agenda. Among the items he cited: Getting an immigration bill through the Republican-run House, putting the new health care plan in place later this year, and pursuing climate change legislation. Obama told OFA members they have already been working as hard now as they did during his successful presidential campaigns (Jackson, 7/22).

Politico: OFA Embraces Tea Party Blueprint For August Push
OFA’s preparing a range of under-the-national-radar tactics in conjunction with heading for town halls. Rallies, flyering and district office demonstrations will be aimed at drawing the same sort of local attention that tea party groups managed four years ago, hoping to spook members of Congress worried about the 2014 midterms. … They’ll begin August 4, marking the president’s birthday with a day of events organized to promote the benefits of Obamacare. That kickoff will be followed by weeks of events across the country, each centered around designated “national days of action” pushing for federal and state moves on climate change, gay marriage, gun control, immigration reform — and, in targeted states like Texas, reproductive and women’s rights (Dovere, 7/23).

The Washington Post’s Post Politics: OFA's Effectiveness Contingent On 'Action August'
As Organizing For Action (OFA) meets in Washington, D.C. Monday night, the non-profit tied to President Obama is gearing up for a major advocacy push in August aimed at marshaling support for both the president’s health-care law and immigration reform initiative (Tam and Eilperin, 7/22).

The Hill: Enroll America Chief Urges Texans To Embrace Obamacare
The head of a major Obamacare enrollment group urged Texans to embrace their new benefits under healthcare reform as a means to stay "healthy and financially secure." Enroll America President Anne Filipic noted in an op-ed piece that Dallas County has one of the highest concentrations of uninsured patients in the United States, which leads to higher costs for all residents (Viebeck, 7/22).

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Polls: Most Don't Support Health Law Repeal; Doctors, Too, Are Uninformed

A majority of Americans don't want Congress to repeal the health law but believe its implementation is going poorly, according to a United Technologies/National Journal Congressional Connection poll. Meanwhile, a survey of physicians concludes they are unfamiliar with how the overhaul will work.

National Journal: Poll: Most Americans Don't Want Congress To Repeal Obamacare
Americans aren't ready to repeal Obamacare. But that doesn’t mean they think its implementation is going well. A majority of adults don't want to repeal the Affordable Care Act, according to the latest United Technologies/National Journal Congressional Connection Poll, preferring instead to either spend more on its implementation or wait to see if changes are needed later. But based on recent news that the White House is delaying its employer health insurance mandate, the public appears convinced that the law’s implementation is going poorly (Roarty, 7/22).

NBC News: Even Doctors Are Clueless On Obamacare, Poll
The doctor is ... skeptical about the Affordable Care Act. And clueless, too. A new survey shows that an overwhelming percentage of physicians don't believe that their states' new health insurance exchanges will meet the Oct. 1 deadline for those key Obamacare marketplaces to begin enrolling the uninsured. Just 11 percent of doctors believe those exchanges will be open for business that day. But those doctors, by a wide margin, also said they are "not at all familiar" with how a number of important aspects of those exchanges and plans offered on them will work—aspects that will directly affect their bottom lines (Mangan, 7/22).

And Boston's WBUR offers a soap opera to make the measure more digestible -

WBUR: CommonHealth: A Radio Drama To Explain Obamacare (Audio)
A recent Kaiser Family Foundation poll found that more than 40 percent of Americans do not know if the Affordable Care Act is indeed a law. In Massachusetts, we may have a different problem. Many residents assume that the state’s older health reform law has already done everything that the ACA, or Obamacare, is supposed to do. But in fact, come October 1st, when Obamacare really kicks in, it will affect Massachusetts in a variety of ways. So, our Commonhealth team has come up with a way to make the complex news a little more digestible: a soap opera (7/22).

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Illinois Gov. Quinn Signs Medicaid Expansion Into Law

News outlets report on other developments related to state decisions about whether to expand the federal-state program for the poor in Idaho, West Virginia and California.

The Associated Press: Gov. Quinn Signs Medicaid Expansion Into Law
Illinois became the latest state Monday to implement a central part of President Barack Obama's health care law by expanding Medicaid to cover low-income adults who don't have children at home. Gov. Pat Quinn signed the state legislation into law, which will allow an estimated 342,000 Illinois residents to enroll by 2017 (Tareen, 7/22).

Chicago Tribune: Medicaid Coverage To Expand In Illinois
About 342,000 low-income Illinoisans will be newly eligible for government-sponsored health insurance through Medicaid starting in January as part of legislation signed into law Monday by Gov. Pat Quinn. The expansion of the state-administered Medicaid program, one of the central components of President Barack Obama's 2010 health care overhaul law, will be financed fully by the federal government for the first three years, then gradually decline to 90 percent by 2020 (Frost and Pearson, 7/23).

The Associated Press: H&W Prepares For Medicaid Expansion – Just In Case
Idaho has so far balked at expanding Medicaid coverage for more low-income residents, part of President Barack Obama's insurance overhaul left optional for states by the U.S. Supreme Court. But the Idaho Department of Health and Welfare doesn't want to get caught flat-footed, just in case lawmakers and Gov. C.L. "Butch" Otter decide otherwise (Miller, 7/22).

The Associated Press: Some W.Va. Lawmakers Wary Of Expanding Medicaid
Several members of a House-Senate oversight committee questioned West Virginia's decision to expand Medicaid under the federal health care overhaul on Monday, after fielding details from the financial analysis that helped prompt Gov. Earl Ray Tomblin to choose that course in May. Conducted by CCRC Actuaries with the help of specialists, the study estimates that 91,500 low-income West Virginia would gain coverage starting next year, by increasing the income threshold for enrolling in Medicaid (Messina, 7/22).

California Healthline: New Campaign For Medi-Cal Enrollment
The enrollment-assistance plan, called CaliforniaHealth+, is a major effort of the California Primary Care Association. It directs people to newly established help desks at community health centers across the state. It's designed to publicize the benefits of Medi-Cal expansion for the estimated 3.9 million Californians who are either newly eligible or are currently eligible but not enrolled. In addition, the centers will direct eligible people to the state's health benefit exchange, Covered California. But the main focus of the CaliforniaHealth+ campaign is the Medi-Cal expansion population, according to Carmela Castellano-Garcia, president and CEO of CPCA (Gorn, 7/22).

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Minnesota Approves Additional Federal Funds For Its New Health Exchange

The state is seeking another $40 million for operation costs. Meanwhile, in Illinois, the Quinn administration filed plans to award the contract to build the state's online insurance marketplace.  

MPR News: Minn. Seeking Another $40M For MNsure
Minnesota will seek another $40 million in federal money to operate the new online insurance marketplace, MNsure in 2014. The state's received about $110 million in federal funds so far to design, plan and hire staff for MNsure, which is expected to serve as an online gateway to health coverage for more than a million Minnesotans (Stawicki, 7/22).

Crain's Chicago Business: Quinn Taps Canadian IT Firm To Build Health Insurance Exchange
The Quinn administration has filed plans to award a $66.5 million contract to build the state's online health insurance exchange to CGI Technologies and Solutions Inc., apparently beating out four other bidders. The federal government will initially set up the online exchange for Illinois, where an estimated 486,000 individuals and small businesses are expected to compare and buy health plans in its first year. Enrollment begins Oct. 1, for coverage mandated under the Affordable Care Act to begin Jan. 1. CGI, a Montreal-based IT firm, will help conduct preliminary work for the exchange and provide IT services to the Illinois Department of Insurance, but the bulk of the company's work would come in 2015 if the state Legislature approves a law to create a state-based exchange (Schorsch, 7/22).

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Birth Control Coverage Rule Not So Simple

Politico: ACA's Confusing Birth Control Rules
Listen to the political rhetoric around the contraception mandate, and you might think that employers must provide women with free birth control of every kind. It’s not quite that simple. Employer plans don’t have to cover every type of birth control approved by the Food and Drug Administration — they have to cover some. They can often charge a co-pay for some brands or products as long as they offer others for free. And a woman may not know precisely which category her specific prescription falls into until the pharmacy rings it up (Cunningham, 7/23).

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Capitol Hill Watch

Abortion Is Energizing Both Parties On Capitol Hill

Roll Call reports that even though no legislation is expected to pass this year on abortion, the issue is galvanizing partisans. Also in congressional news, outlets look at GOP efforts to end funding for the Agency for Healthcare Research and Quality and an effort to improve VA health records.

Roll Call: Abortion Energizes Parties, Even Without Passage
Congress is unlikely to pass any legislation making changes to abortion this year, but that hasn't stopped both sides from taking legislative steps aimed at energizing their core constituencies. The House Appropriations Committee included a ban on abortion coverage in the new health insurance marketplaces in the fiscal 2014 financial services spending bill approved on July 17 (Adams, 7/22).

CQ HealthBeat: Lobbyists Brace For New Attempt To Zero Out AHRQ
Medical research lobbyists are bracing for a new attempt by Republican appropriators to end funding for the Agency for Healthcare Research and Quality when a House appropriations subcommittee meets on Thursday to mark up a Labor-HHS-Education spending bill (Reichard, 7/22).

The Associated Press: Vt.'s US Rep. Says Vets Need Better Health Records
U.S. Rep. Peter Welch said Monday he is co-sponsoring a bill that would require the Department of Veterans Affairs and the Defense Department to find a better way to share health information so veterans can have better access to their military health records. Delays in accessing the records can sometimes cause delays in getting VA benefits, said Welch, a Vermont Democrat (Ring, 7/22).

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Health Care Marketplace

Health Benefits -- Who Gets What?

The Wall Street Journal's Real Time Economics: Who Gets Health Benefits?
Bigger businesses are better bets for offering employee benefits than smaller ones. The latest report from the Labor Department on benefits such as health insurance, retirement plans and paid vacations or sick leave found that 88 percent of employees at private-sector establishments with a workforce of 500 or more were likely to have access to health care benefits. That percentage declined along with the size of the workforce. At enterprises with between 50 and 99 employees, 69 percent of workers had access to such benefits. The same trend largely held true for state and local government employers. The Labor Department's annual report on employee benefits, issued last week, gives a snapshot of how many workers are offered -- and participate in -- employer-sponsored programs for insurance and retirement (Cronin, 7/22).

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Medical Groups Oppose Efforts To Loosen Regs For Medical Imaging And Radiation Therapy Equipment

The organizations, which have sent letters to the Centers for Medicare & Medicaid Services, are concerned that this step would lead to lax standards. 

The Hill: Medical Groups Resist Possible Standards Loosening
Medical trade groups are resisting a potential change to regulations on medical imaging and radiation therapy equipment that they worry would lead to lax standards. In recent weeks, organizations have sent letters to the Centers for Medicare and Medicaid Services (CMS) urging the agency not to lower standards for the maintenance of devices that perform MRIs and other procedures (Hattem, 7/22).

Also in other oversight news, Bloomberg reports -

Bloomberg: Medical Device Hackers Find Government Ally To Pressure Industry
Although there are no known incidents of patients being harmed from hacking attacks against their medical devices, the potential for that is growing as more medical products feature wireless connections, according to Bill Maisel, deputy director for science at the FDA's Center for Devices and Radiological Health. ... The agency doesn't force device makers to respond directly to complainants, but it does require that companies reply to the FDA within 45 days of being notified of a complaint, Maisel said. That often means the companies will contact the complainants first to gather information to mitigate security threats, medical device makers such as Medtronic and Animas have hired hackers to probe their products (Robertson, 7/23).

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State Watch

Federal Judge Blocks North Dakota Fetal Heartbeat Abortion Law

The ban would prevent abortions in that state after a fetal heartbeat could be detected -- as early as six weeks into pregnancy, in some cases.

Los Angeles Times: Federal Judge Temporarily Blocks North Dakota Abortion Law
Under the law, which had been scheduled to go into effect Aug. 1, a woman could be prevented from seeking an abortion as early as six weeks into her pregnancy if a fetal heartbeat is detected. North Dakota passed the law at the end of March, part of a package of curbs in four laws that passed the Republican-controlled Legislature and were signed by GOP Gov. Jack Dalrymple (Muskal, 7/22).

Politico: Federal Judge Blocks North Dakota's Six-Week Abortion Ban
A federal judge has temporarily blocked a recent North Dakota law that would ban abortions as early as six weeks -- the earliest prohibition in the nation -- calling the measure "clearly unconstitutional" and a "troubling law" (Cheney, 7/22).

Reuters: Federal Judge Halts New North Dakota Abortion Law, For Now 
A federal judge on Monday temporarily blocked North Dakota's new abortion law, the most restrictive in the country because it prohibits ending a pregnancy once a fetal heartbeat can be detected, which can be as early as six weeks after conception. Banning abortions as early as six weeks, or before fetal viability between 24 and 26 weeks of gestation, would bar nearly 90 percent of the abortions performed at the Red River Women's Clinic, the state's only abortion clinic, said its director, Tammi Kromenaker (O’Brien, 7/22).

CNN: Judge Blocks North Dakota’s Restrictive Abortion Law
One of the most restrictive abortion laws in the U.S. was temporarily blocked from enforcement after a federal judge said Monday that North Dakota's pre-viability provisions were "invalid and unconstitutional." The state legislature had passed a law that would ban an abortion when a fetal heartbeat was detected–sometimes as early as six weeks into pregnancy. The legislation was set to go into effect August 1, but Judge Daniel Hovland granted a temporary injunction, after a Fargo women's clinic filed a lawsuit last month (7/22).

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State Highlights: DOJ Sues Fla. Over Keeping Children In Nursing Homes

A selection of health policy stories from Florida, Connecticut, California, Missouri, Virginia, Oregon, Maryland and North Carolina.

The Associated Press/Washington Post: Justice Dept. Sues Florida, Says State Keeps Disabled Children In Nursing Homes Unnecessarily
The U.S. Justice Department filed a lawsuit against Florida on Monday, accusing the state of unnecessarily institutionalizing about 200 disabled children in nursing homes and cutting services that would allow them to receive care at home (7/22).

CT Mirror: As Hospitals Buy Medical Practices, Patients Face Thousands Of Dollars In New Charges
At first, the $4,000 medical bill didn't worry Susan Ferro. She was certain it was a mistake. … But when Ferro called the doctor's office, she learned it wasn't a mistake. Since her 2010 biopsy, the radiology practice had been bought by Norwalk Hospital. And now, the same procedure, performed in the same place, was being treated differently: For billing purposes, it was considered an [inpatient] procedure, as if she'd been in a hospital. Instead of being covered by her insurance, the bill went to Ferro's deductible, leaving her with the cost. … Ferro's situation is the result of something known as a facility fee, a charge that's likely to become increasingly common as hospitals acquire physician practices or take ownership of the equipment doctors use (Becker, 7/22).

California Healthline: Pediatric Dental Coverage Revisited
How California children get dental coverage in the new health insurance exchange -- an issue discussed and decided last month -- comes back on the table this week and early next month. Covered California directors announced plans for offering pediatric dental coverage in stand-alone and bundled plans in June. Children's advocates and the state insurance commissioner are urging exchange officials to include another option -- dental coverage embedded in medical plans.  The Plan Management advisory committee -- one of three groups offering Covered California advice on setting up the new exchange -- meets today to discuss pediatric dental coverage. The Covered California board of directors scheduled a special session on the issue for Aug. 8 (Lauer, 7/22).

Reuters: Kids With Pediatricians Also Getting Care At Clinics
Even children who have pediatricians sometimes get care from retail medical clinics like the ones in large drugstore chains, according to a survey of parents near St. Louis. Almost a quarter of the parents surveyed while at a pediatrician's office had taken their children to retail health clinics, many saying they found it more convenient than going to their child's regular doctor (Seaman, 7/22).

The Associated Press/Washington Post: Va. Guardianship Case Tests Rights Of Adults With Disabilities To Choose Where, How They Live
A guardianship case for a Virginia woman with Down syndrome is testing the rights of adults with disabilities to choose how they live. The Washington Post reports that 29-year-old Margaret Jean "Jenny" Hatch has been fighting for nearly a year for the right to move in with friends who employed her at their thrift shop. Her parents want her to remain in a group home (7/22).

Los Angeles Times: Deputy Director Of State Mental Hospitals Takes Unexplained Leave
Seven days after being confirmed by the state Senate, the official responsible for day-to-day operations at California's mental hospitals and prison-based psychiatric programs has abruptly taken an extended -- and unexplained -- administrative leave with pay. Kathy Gaither, confirmed as deputy director of the fledgling Department of State Hospitals on July 8, will be out of the office for an "extended period of time" because of "unforeseen circumstances," according to a brief email sent to staffers July 15 by the department's acting director, Cliff Allenby (Romney, 7/22).

Richmond Times Dispatch: Bermuda Medical Center Fills Gap In Chesterfield
For residents of Winchester Greens, a mixed-use, mixed-income community in north Chesterfield, health care doesn't get any closer than a few steps away. Capital Area Health Network has opened Bermuda Medical Center, a federally supported health center in the town house and apartment community off Jefferson Davis Highway. … The Patient Protection and Affordable Care Act is providing billions of dollars for the operation, expansion and construction of health centers to help care for the millions of newly insured Americans who will seek places to get health care once the law’s provisions are fully implemented (Smith, 7/23).

Oregonian: Public Advisors Chart Plan For Portland-Area Oregon Health Plan Organization
Members of the community advisory council to the group Health Share of Oregon will meet in Milwaukie Aug. 2 to elect officers and adopt a strategic plan. The council provides a window into the operations of Health Share, a coordinated care organization serving Oregon Health Plan members in Clackamas, Multnomah and Washington counties. Members will vote on officers for the advisory council, as well as a strategic plan to address an upcoming benefits expansion for Oregon Health Plan members and other changes (Budnick, 7/22).

Baltimore Sun: Officials Promote Health Insurance Tax Credit To Small Businesses
State and local officials are trying to promote public awareness of a little-known federal tax credit to help small businesses cover some of the costs of providing health insurance to their workers. Maryland Comptroller Peter Franchot launched a campaign Monday to encourage small-business owners in Howard County to take advantage of the break (Mirabella, 7/22).

North Carolina Health News: First Look At The Final State HHS Budget
Lawmakers released their compromise state budget late Sunday night, a document that provides for $20.6 billion in state spending over the upcoming year. The 546-page document not only provides the amounts being budgeted for programs this coming year but also sets policies, changes the way departments are organized, cuts and adds jobs and creates new programs in the 71-pages of language that address health and human services (Hoban, 7/22).

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Editorials and Opinions

Viewpoints: It's Time For Congress To Talk About 'Death Panels;' Will Health Law Opponents Help Constituents Get Coverage?

Los Angeles Times: Bring Back The 'Death' Panel Bill
Probably nothing causes members of Congress more unease than having to talk about death. It's only been four years since healthcare reform became more about whether President Obama wanted to throw mama from a train via "death panels" than, well, how best to reform a broken healthcare system. Still, there are several representatives from both parties who want to discuss it (Daniel Rothberg, 7/22).

The Washington Post's The Plum Line: Republican's Dilemma: How Aggressively Should They Sabotage Obamacare?
I'm not talking about whether Republicans will continue arguing against Obamacare or calling for its repeal. Those are actual policy positions, and Republicans obviously are free to advocate for them (though at a certain point the endless repeal votes would seem to become counterproductive). I'm talking about whether Republican lawmakers will do the absolute minimum when it comes to making the law work for their own constituents — whether they will offer basic assistance navigating the law as it goes into effect (Greg Sargent, 7/22). 

Roll Call: Collaboration Needed To Address Prescription Drug Abuse And Access Issues
Partisanship usually gets the blame when Washington fails to muster an appropriate governmental response to the nation's challenges. But when it comes to confronting prescription drug abuse, the divide within the government is caused not by the culprit of partisan stripes but rather by departmental silos. That needs to change (Steven C. Anderson, 7/22).

The New Republic: Hoosier Hustle? Another Dubious Attack On Obamacare
Obamacare got some bad news late Thursday afternoon. State officials in Indiana announced that premiums for residents buying insurance on their own next year would be 72 percent higher than the premiums such people typically pay this year. They also announced that the typical cost for an individual plan next year would be $570, up from $255 this year. ... But, from the very beginning, there was something odd about the announcement. ... information suggested [Logan Harrison, chief deputy commissioner for the state insurance department,] hadn't been particularly forthright in his announcement—although, even now, it's not entirely clear what the Indiana numbers really show (Jonathan Cohn, 7/21).

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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.