Daily Health Policy Report

Wednesday, July 25, 2012

Last updated: Wed, Jul 25

KHN Original Reporting & Guest Opinion

Health Reform

Administration News

Capitol Hill Watch

Campaign 2012

International AIDS Conference

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

13 States Cut Medicaid To Balance Budget

Kaiser Health News staff writers Phil Galewitz and Matthew Fleming, working in collaboration with USA Today, report: "Thirteen states are moving to cut Medicaid by reducing benefits, paying health providers less or tightening eligibility, even as the federal government prepares to expand the insurance program for the poor to as many as 17 million more people" (Galewitz and Fleming, 7/24). Read the story. Also, check out the related story and chart.

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Phill Wilson: 'Advances Have Not Benefited All Populations Equally' (Video)

In this Kaiser Health News video, Wilson, the founder and executive director of the Black AIDS Institute, tells Joanne Silberner that the AIDS epidemic can be combatted by making policy choices based on science and by ensuring that the health law's essential benefits package provides for both HIV/AIDS treatment and prevention (7/24). Read the transcript or watch the video.

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Capsules: CBO Reports On Impact Of Medicaid Health Law Repeal Effort; GAO: Proposed Rule May Leave Some Children Ineligible For Subsidies; Minnesota Wants Outside Audit Of Medicaid HMOs; When Going Back To The Hospital Is Good News

Now on Kaiser Health News' blog, Julie Appleby details new Congressional Budget Office health law estimates: "Federal spending under the health care law is likely to be $84 billion lower over the next 11 years than previously projected now that states can opt out of the law’s Medicaid expansion, according to a Congressional Budget Office analysis released Tuesday" (Appleby, 7/24).

Appleby also reports on news from the Government Accountability Office: "While most uninsured children will qualify for coverage under the federal health law, a small percentage — 6.6 percent of the total, or at least 460,000 — may be shut out because of how the government proposes to define 'affordable' coverage, says a report from the U.S. Government Accountability Office" (Appleby, 7/23).

Also on the blog, Minnesota Public Radio's Elizabeth Stawicki, working in collaboration with Kaiser Health News and NPR, reports: "The Minnesota Department of Human Services announced Monday that it is seeking bids for an outside audit of Medicaid payment rates for fiscal years 2003 through 2011. The move follows months of controversy over whether the state's contracts have been too generous" (Stawicki, 7/24).

Finally, Jordan Rau reports: "No one wants to be readmitted to a hospital, but it does beat one alternative: death. As Medicare prepares to start punishing hospitals with higher than expected readmission rates, new government data show that some hospitals with high readmissions are actually doing a better job than most in keeping Medicare  patients alive" (Rau, 7/24). Check out what else is on the blog.

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Political Cartoon: 'Full Tilt'

Kaiser Health News provides a fresh take on health policy developments with "Full Tilt" by Steve Artley.

Meanwhile, here's today's health policy haiku:


Readmissions. The
problem's fix could be simple:
Home health referrals.
-Taken from a reader's comments

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

CBO Estimates Impact Of High Court Decision On Health Law Costs, Coverage Expansion

The Congressional Budget Office projected the court's decision allowing states to opt out of the Medicaid expansion would decrease costs to the federal government, but result in three million fewer Americans gaining coverage.

The New York Times: Court's Ruling May Blunt Reach Of The Health Law
The Congressional Budget Office said Tuesday that the Supreme Court decision on President Obama's health care overhaul would probably lead to an increase in the number of uninsured and a modest reduction in the cost to the federal government when compared with estimates before the court ruling (Pear, 7/24).

The Wall Street Journal: Report Gauges Court's Effect On Health Law
Three million fewer Americans will gain health insurance as part of the health-care overhaul because the Supreme Court loosened the law's requirement that states expand Medicaid coverage, the Congressional Budget Office said Tuesday (Radnofsky, 7/24).

Los Angeles Times: Supreme Court Decision Scales Back Cost, Coverage Of Health Law
Fewer Americans will likely get health insurance over the next decade under President Obama's healthcare law as a result of the Supreme Court's decision to limit it, according to a new analysis of the landmark ruling. At the same time, the court's decision to allow states to opt out of a major expansion of the government Medicaid insurance program for the poor could also save taxpayers $84 billion by 2022, the nonpartisan Congressional Budget Office estimates (Levey, 7/24).

The Associated Press: Budget Office: Obama's Health Law Reduces Deficit
President Barack Obama's health care overhaul will shrink rather than increase the nation's huge federal deficits over the next decade, Congress' nonpartisan budget scorekeepers said Tuesday, supporting Obama's contention in a major election-year dispute with Republicans. About 3 million fewer uninsured people will gain health coverage because of last month's Supreme Court ruling granting states more leeway, and that will cut the federal costs by $84 billion, the Congressional Budget Office said in the biggest changes from earlier estimates (Taylor and Alonso-Zaldivar, 7/24).

Kaiser Health News: Capsules: CBO Reports On Impact Of Medicaid Ruling, Health Law Repeal Effort
Federal spending under the health care law is likely to be $84 billion lower over the next 11 years than previously projected now that states can opt out of the law's Medicaid expansion, according to a Congressional Budget Office analysis released Tuesday (Appleby, 7/24).

Politico: Health Care Law Now Cheaper, Won’t Cover As Many People
President Barack Obama's health care law just got cheaper — to the tune of $84 billion over 11 years, according to the Congressional Budget Office. That's because the Supreme Court's June ruling on the law allowed states to opt out of a costly Medicaid expansion, and in a new report released Tuesday, CBO anticipates that some of them will do just that. As a result, about 3 million more people will remain uninsured, Capitol Hill's official bean counters said (Allen and DoBias, 7/25).

The Washington Post: CBO: Court Ruling Cuts Cost Of Health-Care Law, But Leaves 3 Million More Uninsured
President Obama's signature health-care initiative will cost a bit less than expected as a result of last month's Supreme Court ruling, but the decision is also likely to leave millions more people without access to insurance, congressional budget analysts said Tuesday (Montgomery, 7/24).

Reuters: CBO Says Healthcare Ruling Could Save $84 Billion
Last month's Supreme Court ruling that upheld President Barack Obama's 2010 healthcare law could save the U.S. government some $84 billion over 11 years, the non-partisan Congressional Budget Office said on Tuesday. … The CBO also estimated that 3 million uninsured people who would have received Medicaid coverage under the law before the ruling now will remain with no insurance (Smith, 7/24).

The Fiscal Times:  CBO:  Supreme Court Decision Lowers Obamacare Costs
The Supreme Court's decision upholding the Affordable Care Act but giving states the right to opt out of the law's Medicaid expansion will save the federal government an additional $84 billion over the next decade, the Congressional Budget Office estimated Tuesday.  The report said the increased cost of subsidizing people sent to the state-based insurance exchanges because they can't get expanded Medicaid coverage will be more than offset by the decrease in federal subsidies that will no longer be sent to states that opt out of expanding Medicaid coverage (Goozner, 7/24).

National Journal:  CBO Score Of Health Care Law Delivers No Big Wins
The CBO offered a fresh analysis of the 10-year cost of the health care law on Tuesday in the wake of the Supreme Court's ruling that states could opt out of expanding Medicaid to low-income adult populations without losing all of their other federal Medicaid funds. The congressional analysts found that the health care law is $84 billion cheaper and that 4 million fewer Americans will get health insurance, as states opt not to expand their Medicaid programs. ... They also found House Republican’s latest repeal bill would worsen the federal deficit by $109 billion over 10 years (McCarthy, 7/24).

CQ Healthbeat:  New CBO Numbers On Health Law Paint A Mainly Pleasing Picture For The White House
New independent congressional analyses of the health care law, released Tuesday, underscore the takeaway that the Obama administration fared far better in the Supreme Court’s June 28 ruling than many, if not most, observers predicted it would.  The latest take from the Congressional Budget Office and Joint Committee on Taxation: The ruling leaves intact much of the law's unprecedented expansion of insurance coverage. And getting rid of the law would make deficit spending worse rather than improve the nation's fiscal outlook, according to the analysts (Reichard, 7/24).

Boston Globe: Health Care Law's Coverage, Cost Shrink After Ruling, CBO Says
The Congressional Budget Office on Tuesday reduced its coverage and cost estimates for the national health care law to reflect last month’s Supreme Court ruling on the law. … Because the expansion is no longer mandatory, the CBO said, about 3 million fewer people than originally estimated will have health insurance by 2022. With fewer people receiving government-subsidized coverage, the net cost of the Affordable Care Act between 2012 and 2022 will be $84 billion less than anticipated, the CBO estimated. The cost reduction from $1.25 trillion to $1.17 trillion represents a 7-percent drop (Borchers, 7/24).

Market Watch: Health-Law Costs Dip, Repeal Adds Deficit: Studies
Adjustments to President Barack Obama’s health-care overhaul as a result of the recent Supreme Court ruling upholding the landmark law will result in some cost savings, and a proposed repeal of the legislation would add to the deficit. Those are findings from the Congressional Budget Office, which released two reports Tuesday examining the consequences of the Supreme Court upholding what is officially known as the Affordable Care Act, as well as the costs of the House’s July 11 measure to repeal what been called "Obamacare" (Britt, 7/24).

Roll Call: Deficit Complicates Health Care Repeal Goal
Congressional Republicans’ goal of repealing the Affordable Care Act continues to run afoul of their efforts to reduce the deficit, at least according to the judgment of the nonpartisan Congressional Budget Office. The CBO said Tuesday that President Barack Obama’s signature health care law will cut the deficit by $109 billion over the next decade and is $84 billion cheaper after a Supreme Court ruling in June gave states more flexibility to nix an expansion of Medicaid. The estimate cheered Democrats, who have sparred repeatedly with Republicans over whether the law cuts the deficit (Dennis, Newhauser, and Strong, 7/25).

Modern Healthcare: Dems Cite CBO Figures On Repeal Costs; GOP Lawmaker Zeroes In On Subsidies
Provider groups and lawmakers focused on different elements of the Congressional Budget Office's new projections about the 2010 healthcare law to underscore or advance their respective policy positions. Democrats emphasized one report from the CBO that concluded repealing the Patient Protection and Affordable Care Act—which the House of Representatives approved in a July 11 vote—would increase federal deficits by $109 billion between 2013 and 2022 (Zigmond, 7/24).

Marketplace:  Who Gets Medicaid And Who Doesn't?
The Congressional Budget Office has been crunching some numbers on the Affordable Healthcare Act. Today it said the recent Supreme Court ruling upholding the law, but changing its Medicaid requirements, will save the government around $84 billion over 11 years. It also noted that repealing the law would increase the deficit by more than $100 billion.  We're going to be hearing a lot about Medicaid over the coming months, so we thought it would be a good time to look at the program -- what it is, and who uses it (Gorenstein, 7/24).

In other news related to Medicaid -

Kaiser Health News: 13 States Cut Medicaid To Balance Budget
Thirteen states are moving to cut Medicaid by reducing benefits, paying health providers less or tightening eligibility, even as the federal government prepares to expand the insurance program for the poor to as many as 17 million more people (Galewitz and Fleming, 7/24).

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GAO: IRS Rule Could Leave Some Kids Ineligible For Health Insurance Subsidies

The report concludes that some children would fall through the cracks because of the definition of affordable health insurance that the IRS used in a rule implementing the health care law.

CQ Healthbeat:  GAO Puts Pressure On IRS To Change Definition Of Affordable Health Insurance
Many children may remain uninsured under a definition of affordable health insurance that the IRS used in a rule implementing the health care law, according to Government Accountability Office report released Tuesday.  Under the law, in 2014, people will be eligible for tax credits, based on their income, to subsidize the cost of their health insurance in the new exchange markets. People will not be entitled to the credits if they are eligible for Medicaid, the Children’s Health Insurance Program or affordable health insurance.  But a big question has arisen about how affordable health insurance should be defined. Did the law's authors mean health insurance covering an entire family, or just individual coverage for the parent or other family member who is employed (Adams, 7/24)?

Kaiser Health News: GAO: Proposed Rule May Leave Some Children Ineligible For Subsidies
While most uninsured children will qualify for coverage under the federal health law, a small percentage — 6.6 percent of the total, or at least 460,000 — may be shut out because of how the government proposes to define 'affordable' coverage, says a report from the U.S. Government Accountability Office (Appleby, 7/23).

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Administration News

Health Care, Housing Subsidies Take $1 Trillion Bite Out Of Federal Budget

Two studies look at the burden posed by health care costs, both to the federal government and to households across America.

The Associated Press: Health, Housing Get Greatest Federal Subsidies
A study of federal subsidies of various sectors of the economy released Tuesday says that health care and housing combined to reap almost $1 trillion in support in the most recent year for which data was available. The study funded by the Pew Charitable Trusts said that taxpayers subsidized health care by $743 billion in 2010, while a set of generous tax breaks was the main driver in $227 billion worth of subsidies for the housing industry (Taylor, 7/24).

Milwaukee Journal Sentinel: Health Cost Crisis Called 'Close To Cliff'
In most years, the country gets a little bit richer. In the last decade, nearly all of the gains -- more than 90% of economic growth -- went toward offsetting the growth in health care spending. The estimate, based on research by Michael Chernew, a health economist at Harvard University, is for 2000 through 2009, a period marked by sluggish growth overall. But it illustrates the growing burden that health care costs place on households as they struggle to get ahead (Boulton, 7/24).

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Capitol Hill Watch

House Unlikely To Seek Health Law Defunding In Bill To Fund Government

Politico reports that Speaker John Boehner has hinted that the House will not seek to end health law funding in the bill that Congress is expected to pass to keep the government running.

Politico: House Push To Defund Health Care Law Unlikely
The House's top Republican hinted he wouldn't push to defund the health care law in a short-term government funding resolution that's expected to come up this fall. Speaker John Boehner (R-Ohio) said that the House will "have agreement with the Senate" on a continuing resolution to fund the government after Sept. 30. The Senate, run by Democrats, won't agree to defund the health care law they labored to pass (Sherman, 7/24).

Meanwhile, another item on the congressional agenda is dealing with a scheduled Medicare pay cut for doctors.

Medscape:  1-Year Medicare 'Doc Fix' Looks To Avoid 'Fiscal Cliff'
A bill introduced by Rep. Michael Burgess, MD (R-TX), gives Congress a quick-and-dirty option for averting a 27% cut in Medicare pay for physicians in January by — in lawmaker parlance — kicking the can down the road for another year.  Of the 3 bills floated so far this year to deal with the Medicare reimbursement crisis, the legislation from Dr. Burgess appears to be the most passable. His so-called "doc fix," introduced July 18, would freeze Medicare rates at their current level through 2013, thereby postponing the cut until January 1, 2014 (Lowes, 7/24).

Some lawmakers are raising questions about Americans' privacy, including in regard to their health records.

Boston Globe: Data Brokers Stir Privacy Concerns From Congress
Concerned about the growing reach of data brokers into the day-to-day lives of Americans, members of Congress, including Representative Edward Markey of Massachusetts, are demanding answers from ... some of the country's biggest collectors of personal data as part of a fact-finding process that could lead to regulating the lucrative industry. … In letters to nine ... data brokers, the bipartisan group of eight elected officials noted the rising concerns over how the data is being amassed — from age, race, marital status and education level to political leanings, buying habits, and health conditions of an individual (Calvan, 7/24).

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Campaign 2012

Fact-Checking Obama's Criticism Of The Romney Medicare Plan

The Washington Post analyzes recent comments made by President Barack Obama about Medicare. Also, during a campaign appearance, Obama highlighted his differences with GOP presidential hopeful Mitt Romney regarding Planned Parenthood.

The Washington Post's Fact Checker: Obama Uses Out-Of-Date Data To Criticize Romney's Medicare Plan
On a campaign trip to Florida last week, President Obama — no surprise! — brought up the subject of Medicare. This is a highly emotional and difficult subject to understand. There's a reason why we suggested last year that readers would be best advised to mute the sound if any ad concerning Medicare aired — for either party. Let's look more deeply at the president's remarks (Kessler, 7/24).

Politico: Obama Gets Personal On Planned Parenthood
President Barack Obama got personal with his stump speech Tuesday. "Mr. Romney wants to get rid of funding for Planned Parenthood. I think that's a bad idea," Obama said to about 950 donors at the Oregon Convention Center as he highlighted differences with Mitt Romney. "I've got two daughters. I want them to control their own health care choices" (Samuelsohn, 7/24).

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International AIDS Conference

Obama Skips AIDS Conference; Disease Weighs Heavily On Black Community

A roundup of news coverage from the international AIDS conference being held in Washington.

Bloomberg: Obama Skipping AIDS Conference For Campaign Draws Activists' Ire
For all the dignitaries on the schedule at the International AIDS Conference this week in Washington, including Secretary of State Hillary Clinton, Microsoft Corp. co-founder Bill Gates and former President Bill Clinton, it's the absence of one that has activists talking. With the conference being held in the U.S. for the first time in 22 years, President Barack Obama is out of town campaigning and raising money for his re-election. His only presence is a 50-second cameo in a three-minute video welcoming delegates (Andersen Brower, 7/25).

Medpage Today: Activists Bring AIDS Message To White House
Protest is a common thread at International AIDS Conferences, and this year's was no different as thousands marched on the White House. Chanting protesters blocked streets from the Washington Convention Center to Lafayette Park to demand, among other things, a "Robin Hood" tax on financial transactions in the U.S. to fund additional AIDS research and programs (Petrochko, 7/24).

NPR: Black Teens Are Getting The Message On HIV, But Risks Are Still There
The HIV epidemic among African-Americans is getting deserved new attention at the 19th International AIDS Conference in Washington, D.C. And the news isn't all bad. New data from the U.S. Centers for Disease Control and Prevention show that black high school students are engaging in risky sexual behavior far less often than they were 20 years ago (Knox, 7/24).

Los Angeles Times: 2012 AIDS Meeting: Early Treatment Is Key, Experts Say
Treat HIV now, don't delay: That's the new advice from the International Antiviral Society-USA,  in a shift from earlier recommendations that called for waiting until a patient's immune system showed serious damage (Loury, 7/24).

Kaiser Health News: Phill Wilson: 'Advances Have Not Benefitted All Populations Equally' (Video)
In this Kaiser Health News video, Wilson, the founder and executive director of the Black AIDS Institute, tells Joanne Silberner that the AIDS epidemic can be combatted by making policy choices based on science and by ensuring that the health law's essential benefits package provides for both HIV/AIDS treatment and prevention (7/24).

ABC News: AIDS Conference Turns Focus To The Future
After stirring up enthusiasm and hope that the end of the AIDS epidemic may finally be possible, scientists, policymakers and others at the International AIDS Conference today turned their focus to the challenges -- and potential solutions -- that lie ahead in the fight against HIV. There remain more than 50,000 new HIV infections each year in the United States, and new data from the HIV Prevention Trials Network presented this week showed that the rate of HIV among black gay men under age 30 is nearly 6 percent -- a rate as high as that in Sub-Saharan countries in Africa most affected by the virus. "In the U.S., the burden of HIV is not shared equally by population or region," said assistant Health and Human Services (HHS) secretary Dr. Howard Koh (Duwell, 7/25).

McClatchy Newspapers: Researchers: With No AIDS Cure, Treatment For HIV Is Best Medicine
Eight years ago, Waldon Adams tested HIV-positive. Four years ago, he developed symptoms of AIDS, which meant bouts of pneumonia and weeks-long stays in hospitals and nursing homes. Now, Adams, 51, is healthy enough to run marathons. "When they found out I was going to run a marathon, I made the news," said Adams, who receives treatment and support at Whitman-Walker Health, a clinic in Washington that's helped people with HIV and AIDS in the nation’s capital for nearly three decades. Adams isn't cured. However, he's an example of what's possible with current treatments for HIV and AIDS (Tate and Mohamed, 7/24).

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State Watch

Medicaid News: Conn. Proposal To Restrict Eligibility Rankles Lawmakers

A proposal in Connecticut to tighten eligibility for 13,000 low-income adults to receive Medicaid has divided lawmakers in the state, which wants the federal government to allow temporary restrictions on who can be enrolled in the program.

CT Mirror: Proposed Cutbacks In Health Care For Poor Hangs In Political Limbo
A controversial plan that could end state health assistance for more than 13,000 of Connecticut's poorest residents fell into political limbo late Tuesday afternoon. After a day-long meeting, two panels of state lawmakers balked -- at least for now -- at giving Gov. Dannel P. Malloy's administration the go-ahead to set into motion a plan that could limit who in Connecticut can receive Medicaid, government's health program for the poor. The administration wants the federal government to allow Connecticut to impose two temporary restrictions on the Medicaid for Low Income Adults program, known as LIA (Phaneuf, 7/24).

The Associated Press/Houston Chronicle: Poor Adults Oppose Conn. Medicaid Rules Changes
Poor adults who rely on a state insurance program for medical care and advocates for the needy urged state legislators on Tuesday to oppose a plan by Connecticut's Department of Social Services that would tighten eligibility rules. Sheldon Toubman, staff attorney at New Haven Legal Assistance, told the General Assembly's Appropriations and Human Services Committees that the state's application seeking federal approval to change its eligibility rules is a "serious mistake." He predicted thousands of people, especially those 19-26 years old, will ultimately end up without any health coverage (Haigh, 7/24).

In other state Medicaid news --

Georgia Health News: List Shows Provider Tax's Bottom Line For Hospitals
The state's Medicaid agency has released an updated list of hospital "winners and losers" under the Georgia hospital provider tax. The hospital levy has helped Georgia raise money for its Medicaid program, which along with PeachCare serves 1.7 million Georgians. Generally, a hospital pays 1.45 percent of its net patient revenue in tax. The state, at the same time, offsets this expense through an increase of 11.88 percent in hospital Medicaid payments. In fiscal 2011, the state collected $215 million in fees, which were used to draw down an added $590 million in federal funds, used for paying Medicaid providers, according to the state Department of Community Health (Miller, 7/24).

California Healthline: Timeline Delineates Duals Project Tasks
The state Department of Health Care Services has released a timeline of deadlines and target dates for its Coordinated Care Initiative, also known as the duals demonstration project. Eventually, the duals project hopes to move about one million Californians dually eligible for Medi-Cal and Medicare benefits into Medi-Cal managed care plans. The idea, state officials have said, is to provide better, more integrated care by pooling the funding sources from two disparate programs. Coordinated care could provide stronger case management, offer needed services and save state and federal dollars. The pilot program in eight counties, beginning in March, 2013, will serve about 700,000 of the state's dual eligible (Gorn, 7/24).

Kaiser Health News: Capsules: Minnesota Wants Outside Audit Of Medicaid HMOs
The Minnesota Department of Human Services announced Monday that it is seeking bids for an outside audit of Medicaid payment rates for fiscal years 2003 through 2011. The move follows months of controversy over whether the state's contracts have been too generous (Stawicki, 7/24).

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S.D. Can Force Doctors To Warn Of Suicide Risk Before Performing Abortion

Reversing an earlier ruling, a South Dakota federal appeals court has ruled the state can require doctors to warn women before an abortion that they stand a greater risk of suicide.

The Associated Press: Appeals Court Upholds SD Abortion Suicide Advisory
South Dakota can require doctors to warn women seeking abortions that they face an increased risk of suicide if they go through with the procedure, a federal appeals court ruled Tuesday. The 8th Circuit Court of Appeals upheld the portion of the 2005 South Dakota law dealing with the suicide advisory 7-4 (Eaton, 7/24).

Reuters: Appeals Court Upholds South Dakota Abortion Law's Suicide Advisory
A federal appeals court on Tuesday upheld a South Dakota law requiring doctors to advise women seeking abortions that they face an increased risk of suicide after the procedure. The 7-4 ruling by the full 8th Circuit Court of Appeals reversed a decision by a three-judge appellate panel in September 2011 that had ruled unconstitutional the suicide advisory provision in South Dakota's 2005 law (Bailey, 7/24).

A defunding of Planned Parenthood in North Carolina has turned into a boon for the group's federal funding in that state --

McClatchy Newspapers: Federal Grant Thwarts GOP-Led Effort To Close North Carolina Planned Parenthood Clinic
One of the battles won by the conservatives who took over the North Carolina Legislature this session was stripping Planned Parenthood of its funding. But it is turning out to be a short-lived victory. The women's health organization has successfully applied for federal funds and will soon receive more than three times the amount Republican lawmakers had withheld. "We've weathered these increasing attacks on women's health care access the past couple of years," Paige Johnson, vice president of external and governmental affairs for Planned Parenthood of Central North Carolina, said Tuesday. "Now we're able to do more for our patients" (Jarvis, 7/24).

And some Arizona doctors are suing to stop abortion restrictions --

Bloomberg: Arizona Doctors Seek to Block Law Banning Some Abortions
The Center for Reproductive Rights is urging a judge to block an Arizona law, set to take effect Aug. 2, that makes it a crime for physicians to perform abortions after 20 weeks of pregnancy. U.S. District Judge James Teilborg in Phoenix is to hear arguments today on a request by three doctors for an order preventing that part of the statute from being enforced while they seek a ruling that it's preempted by the U.S. Supreme Court’s 1973 Roe v. Wade decision. The doctors are backed by lawyers at the reproductive rights group and the American Civil Liberties Union (Pettersson and Hermann, 7/25).

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State Roundup: La. Lawmakers Angry They Didn't Get To Decide On Health Cuts

A selection of health policy stories from Louisiana, New Jersey, California, Virginia, Massachusetts and Minnesota.

The Associated Press/CBS News: La. Lawmakers Criticize Few Details In Health Cuts
Louisiana lawmakers bristled Monday about getting few details and no ability to decide the $523 million in budget cuts Gov. Bobby Jindal's administration has made to health care programs, largely to LSU's safety net health care facilities. Several complained the governor's top leaders weren't explaining the gravity of the slashing and the implications on the LSU network of public hospitals and clinics that care for the poor and uninsured in a state where one in five residents don't have health insurance (7/24).

The New York Times: Court Exempts Judges From New Jersey's Curbs On Benefits
New Jersey judges and justices are constitutionally protected from a new law requiring state employees to contribute more toward their health and retirement benefits, the New Jersey Supreme Court ruled on Tuesday, damaging one of Gov. Chris Christie’s signature legislative victories and creating the awkward spectacle of judges taking action to preserve their own compensation (Yee, 7/24).

The Associated Press/Wall Street Journal: Court Sides With Judges
New Jersey's Supreme Court dealt a partial defeat to one of Gov. Chris Christie's signature legislative accomplishments Tuesday when it ruled that the state's judges don't have to contribute more to their pensions and health benefits. A leading state lawmaker immediately said the battle over the matter would continue (7/24).

Reuters: Near-Bankrupt San Bernardino Targets Bonds, Retiree Health
San Bernardino, the third California city planning to file for bankruptcy since June, would default on debt, freeze vacant jobs and quit paying into a retiree health fund under a three-month proposal to be submitted to the city council on Tuesday. The city is preparing a longer interim plan to make it through its expected bankruptcy period, when it will financially regroup under court protection from a financial hole created by a combination of the bad economy and poor management (Henderson, 7/24).

San Francisco Chronicle: Health Care Costs Still A Struggle
Despite rising health care costs, the percentage of California voters who struggle to pay for health care hasn't changed in five years, according to a Field Poll released Wednesday. The survey of about 1,000 registered voters over 12 days in June and July found that 53 percent of respondents say it is hard to pay for health care, and 44 percent say it is not. A similar poll conducted five years ago found nearly identical results (Lagos, 7/25).

Sacramento Bee: Health Care Costs Remain A Concern, California Poll Reveals
The promise of coming guaranteed access to health benefits seems of little comfort to the majority of Californians who, in a new study, reported trouble affording health care and anxiety over potential financial hardship due to the steep cost of care. A new Field Poll of 997 registered California voters showed 53 percent had difficulty paying their health care bills. Almost half, 46 percent, said they've simply delayed seeking treatment in the past year due to the cost. What's clear is that progress made since the federal Affordable Care Act was adopted in 2010 has done little so far to ease what pollsters called the "high level of concern" people feel about risks inherent in the health care system (Craft, 7/25).

Los Angeles Times: UCLA Doctors To Oversee 11 CVS In-Store Clinics
Pharmacy giant CVS Caremark Corp. and UCLA Health System are teaming up to treat patients in 11 in-store clinics in Los Angeles County as one remedy to a growing shortage of primary care physicians (Terhune, 7/25).

The Associated Press/Washington Post: Inmates At Va. Women's Prison Allege Shoddy Health Care Amounts To Cruel And Unusual Punishment
Medical care at a Virginia women's prison is so deficient that it violates the U.S. Constitution's ban on cruel and unusual punishment, five inmates claim in a lawsuit filed Tuesday (7/24).

KQED: Carrying Condoms Brings Arrest Risk For Sex Workers
Police officers in San Francisco and Los Angeles may be undermining public health efforts to prevent the spread of HIV among sex workers. … Researchers interviewed more than 300 people, including current and former sex workers in four major U.S. cities -- San Francisco, L.A., Washington, DC and New York. They found that police officers were either confiscating or taking photographs of sex workers' condoms as evidence of prostitution, putting sex workers at risk (Tran, 7/24).

Boston Globe: Coakley Asks Supreme Court To Sink DOMA
[Massachusetts Attorney General Martha] Coakley had also argued that DOMA unlawfully dictated the way the state could administer federally funded programs, forcing Massachusetts to discriminate against the type of marriages that it already approved. According to the federal act, for instance, under some circumstances, gay couples could be denied Medicaid and the state could not bury the same-sex spouse of a war veteran in federally funded cemeteries (Valencia, 7/24).

California Healthline: Two Yamada Bills Signed Into Law
Gov. Jerry Brown (D) yesterday signed a bill to protect seniors in county-run nursing homes during state emergencies. One day earlier, he signed another senior-protection bill, this one to make sure veterans get clearer updates on the cost of their care. Assembly member Mariko Yamada (D-Davis) authored both bills. … The [second] Yamada bill, AB 1823, was signed by the governor on Monday. It makes sure that those living in veteran's homes receive clear notification of the costs of care in that nursing home. Residents currently do get a quarterly report of costs, but it can look a little misleading, Yamada said (Gorn, 7/25).

Minneapolis Star Tribune: Uninsured Kids Have Minnesota Sliding Down List
Minnesota has slipped three rungs in a high-profile ranking of child-friendly states, largely because of its growing number of uninsured children. The 2012 Kids Count data book, released Wednesday by the Annie E. Casey Foundation, still ranks Minnesota as fifth-best for children, based on 16 measures of education, the economy, family demographics and health care. But this is the first time in 10 years that the state has ranked lower than No. 3 (Olson, 7/24).

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Editorials and Opinions

Viewpoints: 'No Cash, No Insurance, No Live'; Medicaid Expansion Is A Good Option; Eradicating Polio

Des Moines Register: A Modest Proposal For U.S. Health Care
With all the talk about health care recently, I'm surprised that no one has challenged the crazy idea that hospitals should treat people who can't pay. This is a free market nation, dammit! The home of "No Shirt, No Shoes, No Dice" in store windows should have "No Cash, No Insurance, No Live" on our hospital doors (Mike Draper, 7/24).

Bloomberg: States Will Not Turn Down Obamacare's Medicaid Expansion
If state governments become politically unable to drop expanded Medicaid, it will only be because the state's residents consider the program a good use of taxpayer money. That hardly seems like a big risk. But if any people are really concerned, they should vote for Mitt Romney, who ran for governor in 2002 with the position that the federal government should take on a larger share of Medicaid costs in order to relieve state budgets. He is sure to stand in the way of any efforts, Republican or Democratic, to shift Medicaid costs to the states (Josh Barro, 7/24).

The Dallas Morning News: Legislators Must First Retire Medicaid Debt
Rectifying Medicaid's problem before taking care of other needs probably won't please superintendents, teachers and parents. Texas' public schools took a serious hit in last year's Legislature, to the tune of at least $4 billion. ... But the state's health budget comes first. Texas can't cut corners on its Medicaid payments (Carl P. Leubsdorf, 7/24).

The Wall Street Journal: How To Eradicate Polio Once And For All
Earlier this year, the World Health Organization (WHO) removed India from the list of polio-endemic countries, a victory that involved 2.4 million volunteers administering vaccines to nearly 172 million children. Only three endemic countries remain—Pakistan, Afghanistan and Nigeria—and the 24-year global effort to eradicate the disease is now within striking distance of its goal. But the entire campaign could come undone if obstacles to vaccination stall further progress (Jay Winsten and Emily Serazin, 7/24).

The Wall Street Journal: The Tax Cliff Endangers Seniors
Most people know that the U.S. government is rapidly approaching the edge of a fiscal cliff that will raise taxes for millions of Americans—at every income level and age. What is less known is that seniors, many of whom depend on investment income to fund their retirement, will be hurt the most (Lewis Hay III, 7/24).

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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.