Daily Health Policy Report

Monday, July 29, 2013

Last updated: Mon, Jul 29

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch


Health Care Fraud & Abuse

Women's Health

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Obamacare Canvassers Seek Out Florida's Uninsured

Kaiser Health News staff writer Phil Galewitz reports: "Tammy Spencer did a double take when she read the address on her paper and looked at the house in front of her. Spencer, a volunteer with the nonprofit Enroll America, was spending a hot and humid Saturday morning knocking on doors in this mostly posh South Florida city looking for people without health coverage. She wanted to let them know about new online insurance marketplaces that open for enrollment Oct. 1" (Galewitz, 7/29). Read the story.

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Maryland Regulators Slash Rates For Obamacare Insurance Policies

Kaiser Health News staff writer Jay Hancock reports: "Citing what they called flawed data and unreasonable assumptions, Maryland insurance regulators on Friday sharply reduced prices for health plans that will be sold to individuals and families through the state's insurance marketplace starting Oct. 1" (7/26). Read the story.

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Political Cartoon: 'Impatient Or Inpatient?'

Kaiser Health News provides a fresh take on health policy developments with "Impatient Or Inpatient?" by Daryl Cagle.

Meanwhile, here is today's health policy haiku:


Taking it to the
 -- the enrollment push starts.
Who's gonna sign up?

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

Selling Of Obamacare Begins In Earnest

President Barack Obama tells the New York Times that his plan to build support for the health law is simply to implement it. Meanwhile, high level aides and supporters meet to craft a new message, while volunteers for the nonprofit Enroll America fan out across the country to tell the uninsured about new coverage options.

The New York Times: Obama Intends To Let Health Care Law Prove Critics Wrong By Succeeding
President Obama waved aside persistent Republican criticism of his signature health care law last week, saying in a New York Times interview that the overhaul would become vastly more popular once "all the nightmare scenarios" from his adversaries proved wrong. The president accused Republicans of "all kinds of distortions" about the legislation. He said bluntly that his administration had a simple plan to build support for the law, which continues to be viewed with suspicion by large numbers of Americans. "We're going to implement it," he said (Shear and Calmes, 7/27).

Politico: Obama Aides, Supporters Huddle To Agree On Obamacare Message
While President Obama was on the road talking about the economy this week, top aides and supporters were huddling for a major strategy session to coordinate a new, more aggressive message on Obamacare. Meeting Wednesday at Democratic National Committee headquarters over an Obamacare message testing poll taken by the Service Employees International Union, they hashed out a simple strategy, but one they agreed needs to quickly become unanimous among them and other Obama supporters. Republicans are winning the rhetorical and political argument because they're the only ones keeping focus on the parts of the law they feel are vulnerable (Novere, 7/26).

Kaiser Health News: Obamacare Canvassers Seek Florida's Uninsured
Tammy Spencer did a double take when she read the address on her paper and looked at the house in front of her. Spencer, a volunteer with the nonprofit Enroll America, was spending a hot and humid Saturday morning knocking on doors in this mostly posh South Florida city looking for people without health coverage. She wanted to let them know about new online insurance marketplaces that open for enrollment Oct. 1 (Galewitz, 7/29).

Reuters: Obamacare's Foot Soldiers Train To Enroll The Masses
Nahla Kayali is a foot soldier for Obamacare. She is among the first wave of 2,000 community organizers in California getting trained to persuade more than 1 million uninsured people in the state to sign up for subsidized health coverage under President Barack Obama's reform law (Bernstein, 7/26).

The Washington Post: Obamacare Spurs Creation Of Thousands Of New Jobs To Explain Law
Amid a torrent of speculation about the impact of Obamacare on the economy, one thing seems clear: The law is spurring a raft of new jobs in call centers, IT companies and community organizations designed to help Americans understand the complex health law and navigate the new insurance marketplaces (Kim, 7/26).

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Maryland Regulators Approve Premium Rates Much Lower Than Insurers Sought

The Maryland insurance commissioner Therese M. Goldsmith approved premium increases Friday for nine insurance companies who applied to sell plans to individuals through a state exchange, which was established by the health law. 

The Washington Post: Maryland Issues Insurance Rates That Are Among Lowest In U.S.
The Maryland Insurance Administration approved premiums at levels as much as 33 percent below what had been requested by insurance carriers. For a 21-year-old non-smoker, for example, options start as low as $93 a month. Insurance Commissioner Therese Goldsmith reduced the premium rates proposed by every insurance carrier in the individual market, including some by more than 50 percent, according to an analysis by Maryland officials who will be operating the marketplace (Sun, 7/26).

Kaiser Health News: Maryland Regulators Slash Rates For Obamacare Insurance Policies
Citing what they called flawed data and unreasonable assumptions, Maryland insurance regulators on Friday sharply reduced prices for health plans that will be sold to individuals and families through the state's insurance marketplace starting Oct. 1 (7/26).

Baltimore Sun: Premiums To Go Up As Much As 25 Percent Under Health Reform
Marylanders who buy health insurance on a state exchange under health reform could see their premiums jump as much as 25 percent under rates approved by state regulators, but those increases are less than insurers sought. Maryland Insurance Commissioner Therese M. Goldsmith approved premium increases Friday for nine insurance companies who applied to sell plans to individuals through a state exchange, called Maryland Health Connection, established under health reform (Walker, 7/26).

The Associated Press: Md. Insurance Official Approves Health Care Rates
Newly approved rates for health plans that will be sold in the individual market through Maryland's new health benefit exchange will have some of the lowest costs among the 12 states that have either proposed or approved rates, the state's insurance commissioner said Friday. Insurance Commissioner Therese Goldsmith approved the rates after reviewing proposals from insurance companies and considering public comments (Witte, 7/26).

Still, news outlets report that rates vary among states and political spinning continues  -

USA Today: State Health Exchange Rates Vary, But Lower Than Expected
As state health exchanges continue to announce lower-than-expected rates for health insurance, experts say both state and regional issues play a part in how much a consumer will pay for insurance beginning in January (Kennedy, 7/28).

The Associated Press: Health Care Battle Fraught With Partisan Numbers
In the raging federal health care debate, numbers are turning out to be some of the most partisan tools available to Democrats, Republicans and everyone with a stake in the game. Indiana residents have gotten a rare look at the spinning of statistics and price tags that happens regularly in government as Gov. Mike Pence's point man on federal health care estimated that residents would pay 72 percent more for health insurance through the insurance exchange being built (LoBianco, 7/28).

And in Minnesota -

MPR News: State Officials Ask Insurers To Reveal Premium Details Early
Two state government agencies are asking companies selling health plans on the new online insurance exchange, MNsure, to give Minnesotans an early peak at how much policies will cost when they go into effect. Right now, the rates are kept secret until their effective date — Oct. 1 — the same day MNsure goes live to help Minnesotans compare and enroll in those policies. But Minnesota's commerce and health departments are asking the plans to change the effective date so the rates can be revealed about a month early, on Sept. 6. The state commerce and health departments say releasing the rates before MNsure goes live would give consumers and small businesses more time to understand their options (Stawicki, 7/26).

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Mississippi, Nevada Wrestle With The Development Of Their Health Exchanges

In other state and local health law implementation news, the health law may prove key to Detroit's efforts to manuever its bankruptcy process. Also, opponents in many states focus on limiting what they see as "the long arm of Washington."

Politico: Mississippi Insurance Commissioner's ACA Plan
After suffering through a high-profile intraparty squabble with the governor and averting a near disaster for the state’s insurance marketplace, Mississippi Insurance Commissioner Mike Chaney is giving another go at running an Obamacare exchange. This time, the Republican commissioner is looking to run just the state's exchange for small businesses while letting the feds oversee the new insurance marketplace for individuals — an option the Department of Health and Human Services only recently made available to states reluctant to do the entire lift (Millman, 7/29).

The Associated Press: Nevada's Insurance Exchange Work In Progress
Nevada's health insurance exchange won't have all the bells and whistles initially hoped for when it launches Oct. 1. But state officials said the glitches should be minimal for consumers and the all kinks worked out by early next year. CJ Bawden, spokesman for the Silver State Health Insurance Exchange that was created by the 2011 Legislature to set up Nevada's online health insurance marketplace, said there are some "nice to haves" that won't be available when enrollment begins (Chereb, 7/28).

The New York Times: Detroit Looks To Health Law To Ease Costs
As Detroit enters the federal bankruptcy process, the city is proposing a controversial plan for paring some of the $5.7 billion it owes in retiree health costs: pushing many of those too young to qualify for Medicare out of city-run coverage and into the new insurance markets that will soon be operating under the Obama health care law (Davey and Goodnough, 7/28).

Politico: States Seek To Nullify Obama Efforts
Infuriated by what they see as the long arm of Washington reaching into their business, states are increasingly telling the feds: Keep out! Bills that would negate a variety of federal laws have popped up this year in the vast majority of states — with the amount of anti-federal legislation sharply on the rise during the Obama administration, according to experts (Kopan, 7/28).

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Capitol Hill Watch

This Week On Capitol Hill: Repeal Vote Number 40

The House of Representatives will consider a bill that would prevent the Internal Revenue Service from implementing the law. Specifically, it states that neither the Treasury secretary nor any designee of the Treasury secretary may implement any part of the Affordable Care Act.

USA Today: GOP Seizes On IRS Scandal To Press Agenda
The House of Representatives will vote on 10 bills this week all inspired by a single scandal: The Internal Revenue Service treatment of political groups seeking tax-exempt status. ... But the bills aren't exclusive to the IRS, and some are part of a long-standing GOP agenda to roll back the size of government. At the top of the list is a bill to partially repeal the 2009 health care law. The vote on the Keep the IRS Off Your Health Care Act is the 40th attempt by House Republicans to repeal, change or defund the health care law. Another bill would require congressional approval of all new government regulations -- a proposal critics say would handcuff the government's ability to enforce health and safety laws (Korte, 7/28).

The Hill: Week Ahead: ObamaCare Repeal Vote No. 40 Looms In House
The House this week will vote for the 40th time to repeal part of ObamaCare. This time, it’s a bill to prevent the IRS from implementing the law. The bill, sponsored by Rep. Tom Price (R-Ga.), is short and simple: It states that neither the Treasury secretary nor any designee of the Treasury secretary may implement any part of the Affordable Care Act (Baker, 7/29).

In other news from Capitol Hill -

Politico: 3 Wrap Up Senate Careers, Guarding ACA Legacy
Three Democratic senators have spent years of their Capitol Hill careers trying to pass a health care law that would cover millions of uninsured Americans. But by the time that crowning achievement, now known as Obamacare, gets through its first year, all three will have left office. Sens. Tom Harkin of Iowa, Jay Rockefeller of West Virginia and Max Baucus of Montana — Senate committee chairmen who helped write the law and push it through the Senate — are all retiring at the end of 2014. All are devoting at least a portion of their remaining time in office trying to protect the president’s legacy legislation from political opponents — and make the law work (Haberkorn, 7/28).

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Effort To Defund Health Law Complicates Budget Talks

The Wall Street Journal reports that Obama administration officials are stepping up meetings with Senate Republicans in hopes of avoiding a deadline clash over federal spending this fall. One of the flashpoints is the Republican demand to defund Obamacare as part of any deal.

The Wall Street Journal: Grand Bargain Eludes Budget Negotiations
Top White House officials are stepping up meetings with Senate Republicans in hopes of averting a deadline-driven clash over federal spending this fall, according to people familiar with the sessions. But the two sides remain far apart on basic questions of whether to raise tax revenue and how to rein in the cost of Medicare (Nicholas and Peterson, 7/28).

The Wall Street Journal: Lew Urges Congress To Raise Debt Limit
Senior Republican lawmaker Peter King of New York addressed the debt ceiling fight in the context of a policy split in the GOP, saying, "We should not be closing the government down under any circumstances." He said that although Republicans should try to de-fund the healthcare act called Obamacare, they should not "threaten" to "bring down the government" over it (Mundy, 7/28).

Politico: No Shutdown Over Obamacare, Lee Says
Sen. Mike Lee says the government will inevitably get funded regardless of his efforts to limit funding for Obamacare. Pressed repeatedly on "Fox News Sunday" by host Chris Wallace on whether he's prepared to shut down the government over defunding the new health care law, Lee said that's an unlikely conclusion. ... "We all know the government is going to get funded. The only question is whether the government gets funded with Obamacare or without," Lee said on Sunday (Everett, 7/28).

The Hill: Lee Downplays ObamaCare Shutdown Threat: Government 'Going To Get Funded'
Sen. Mike Lee (R-Utah) on Sunday defended his efforts to block any funding bill that provides money to roll out the president's healthcare reforms and downplayed the chances those efforts could shutdown the government. "We all know the government is going to get funded, the only question is if the government gets funded with ObamaCare or without it," said Lee on "Fox News Sunday" (Schroeder, 7/28).

Fox News: White House Doubles Down On Vow Obama Won't Agree To More Spending Cuts
The Obama administration dug in Sunday on its vow to reject proposed spending cuts by congressional Republicans in upcoming budget talks but declined to say whether the president would veto their proposals or allow a government shutdown. Treasury Secretary Jack Lew told "Fox News Sunday" that President Obama will neither sign government funding bills that slash domestic spending nor negotiate with Republicans over spending cuts to raise the federal debt limit. … Some conservatives are making a last stand against Obama's new health care law, which includes plans not to fund ObamaCare in the continuing resolution (7/28).

Fox News: Democrats, Republicans Hint At Shutdown Before Budget Talks Involving ObamaCare, Sequester
The routine Capitol Hill negotiations in which Democrats and Republicans try to reach a short-term deal to fund the federal government after September is expected to be especially complex this year as both sides hint they will allow a government shutdown over such key issues as sequestration and ObamaCare. Republicans essentially have tried to dismantle the president's signature health-care legislation since he signed it into law in 2010, including 38 related votes in the GOP-led House. And Republicans say defunding it next year is their last, best chance (7/27).

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Fewer Doctors Treating Medicare Patients, CMS Says

Amid payment rates and rules they dislike, more doctors are opting to not treat Medicare patients, say the Centers for Medicare & Medicaid Services. In the meantime, health care providers ready different models to change how Medicare pays doctors.

The Wall Street Journal: More Doctors Steer Clear Of Medicare
Fewer American doctors are treating patients enrolled in the Medicare health program for seniors, reflecting frustration with its payment rates and pushback against mounting rules, according to health experts. The number of doctors who opted out of Medicare last year, while a small proportion of the nation's health professionals, nearly tripled from three years earlier, according to the Centers for Medicare and Medicaid Services, the government agency that administers the program. Other doctors are limiting the number of Medicare patients they treat even if they don't formally opt out of the system (Beck, 7/28).

CQ HealthBeat: Alternative Methods For Medicare Payment At The Heart Of 'Doc Fix' Bill
Health care providers are ready with a variety of payment models they say have already worked in the private sector and should be recognized under the Medicare physician payment system created in a House bill. Under the House bill that would replace Medicare's current physician payment formula, physicians would be allowed to enter into alternative payment models -- some already in progress and some yet to be created (Ethridge, 7/26).

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Health Care Fraud & Abuse

U.S. Bans New Home Health, Ambulance Providers In Three High-Fraud Cities From Medicare, Medicaid

Federal officials are temporarily banning certain types of home health and ambulance providers in three major, high-fraud cities from enrolling in Medicare or Medicaid.

The Associated Press/Washington Post: Feds Ban Some Types Of Medicare Providers From Enrolling In Miami, Chicago, Houston
For the first time in history, federal health officials said Friday they will ban certain types of Medicare and Medicaid providers in three high-fraud cities from enrolling in the taxpayer-funded programs for the poor as part of an effort to prevent scams (7/26).

Reuters: U.S. Bans New Home Health, Ambulance Providers In Three Regions
The U.S. government on Friday said it would temporarily ban new home health providers and ambulance suppliers from enrolling in Medicare, Medicaid and the Children's Health Insurance Program in three areas of the country, citing the risk of fraud. The Centers for Medicare & Medicaid Services (CMS) said the bans will apply to home health agencies in the Miami, Florida and Chicago, Illinois metropolitan areas as well as ambulance suppliers in the Houston, Texas area (7/26).

In the meantime, The Fiscal Times looks at problems at assisted living facilities --

Fiscal Times: Abuse And Neglect In Assisted Living Facilities
You've seen the sales pitches about America’s assisted living facilities. Seniors can flourish in bright, cheery alternatives to nursing homes and live out their golden years securely, monitored by medical professionals who tend to their every need. The business of assisted living paints a depressingly different picture, according to a provocative new documentary from PBS Frontline airing this Tuesday night, accompanied by a series from ProPublica that is being published this week. Nearly 750,000 American seniors live in assisted living facilities today -- but instead of being cared for, many are abused and neglected, according to a year-long investigation (Mackey, 7/29).

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Women's Health

Federal Appeals Court Rejects Company's Contraception Coverage Challenge

The court's divided decision makes it more likely the Supreme Court will have to decide if companies making a secular product have to provide contraception coverage to their employees -- a major tenet of the 2010 health care law.

The Washington Post: Contraceptive Mandate Divides Appeals Courts 
A federal appeals court ruling on Friday increased the chances that the Supreme Court in its coming term will need to settle whether secular, for-profit corporations must provide contraceptive coverage to employees despite the owners' religious objections. A divided panel of the U.S. Court of Appeals for the 3rd Circuit ruled that a Pennsylvania cabinet-making company owned by a Mennonite family must comply with the contraceptive mandate contained in the Affordable Care Act (Barnes, 7/26).

The Wall Street Journal's Law Blog: Appeals Court: For-Profit Companies Don't Have Religious Rights
Companies can be prosecuted like in-the-flesh people and they have First Amendment rights to free speech. But the next "corporate personhood" question the Supreme Court will likely confront is whether for-profit companies also enjoy religious rights. Federal courts are fractured on the issue (Palazzolo, 7/26).

Reuters: U.S. Court Rejects Firm's Challenge To Obamacare Contraception Mandate
A divided federal appeals court on Friday rejected a Pennsylvania cabinet maker's religion-based challenge to the 2010 health care law's requirement that larger companies provide workers with health insurance covering birth control. The decision created a split among federal appeals courts, boosting the chance that the U.S. Supreme Court may step in to resolve the dispute over challenges to the provision in the Patient Protection and Affordable Care Act, known as Obamacare (Stempel, 7/26).

The Associated Press: Court Rejects Pa. Firm's Health Care Law Challenge
A federal appeals court ruled Friday against the Mennonite owners of a central Pennsylvania furniture manufacturing company who claimed new health insurance requirements that they pay for employees' contraceptive services violated their First Amendment rights. The 2-1 decision issued by a three-judge panel of the 3rd U.S. Circuit Court of Appeals upholds a lower court decision that Conestoga Wood Specialties Corp. does not qualify for the exemption because it is a for-profit company making a secular product with no formal ties to a church or other religious group (Loviglio, 7/26).

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Proposed Abortion Ban Breeds New Generation Of GOP Leaders

A new generation of Republican leaders band together under the abortion-issue umbrella.

The New York Times: G.O.P. Senators See An Upside In A Problematic Issue: Abortion
It reads like a who's who of the next generation of Republican Party leaders: Marco Rubio, Ted Cruz, Rob Portman. But what is bringing all these marquee political names together is not the Iowa State Fair or a Tea Party rally on the National Mall. Rather, they are all talking discreetly about how to advance a bill in the Senate to ban abortion at 20 weeks after fertilization (Peters, 7/27).

The issue is also playing in Virginia's gubernatorial race --

Politico: Abortion Key For Virginia Voters, NARAL Poll Shows
Highlighting Ken Cuccinelli's strident opposition to abortion will help drive female voters who might otherwise stay home to the polls in the off-year Virginia governor's race, according to a Democratic poll conducted last month for the abortion rights group NARAL Pro-Choice America. A statewide survey by Greenberg Quinlan Rosner Research, shared first with Politico, focused on which messages might get women who voted in the 2008 or 2012 presidential elections, but not for governor in 2009, to show up (Hohmann, 7/29).

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State Watch

State Highlights: Mass. Insurers Back Out Of Disabled Adults Experiment

A selection of health policy stories from Massachusetts and California.

Boston Globe: Health Plan For Disabled Adults Cut Back In Mass.
Massachusetts health insurers' reluctance to join a national experiment to improve care for disabled lower-income adults has forced the state to scale back the program even before it starts. Massachusetts is among the first states to roll out the national program, but half the insurers that were expected to participate backed out because they feared losing money. That will mean fewer options for patients when enrollment opens for the voluntary "One Care" program in October (Conaboy, 7/29).

Boston Globe: The New 21st Century House Call
Keeping track of health measurements at home is pretty simple: Step onto a scale in the bathroom, take a glucose measurement on the way out the door, or strap on a blood pressure cuff while watching television. Now, doctors increasingly want access to those at-home measurements in an effort to keep patients healthier and reduce health care costs. Boston's Partners HealthCare last month launched a system that allows patients to upload information from their medical devices, often wirelessly, directly into their electronic records in doctors’ offices. Patients can use glucometers, blood pressure cuffs, bathroom scales, and pulse oximeters (which measure blood oxygen levels) at home, to take regular measurements and send them to their doctors (Sathian, 7/29).

Los Angeles Times: Burbank Police Department Honored For Mental Health Program
The Burbank Police Department's mental health evaluation team is one of six local law enforcement agencies to be honored for its efforts by the state attorney general. When established roughly a year ago, the Burbank evaluation team was tasked with responding to an uptick in mental health calls citywide, which had jumped from 293 calls in 2008 to 567 last year, officials said (Tchekmedyian, 7/28).

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Editorials and Opinions

Viewpoints: Rove Warns Against Government Shutdown; 'Despicable' GOP Tactics; Medicare Database A Tool To Control Costs

Fox News: Republicans Must Resist Game Of Chicken With President Over Obamacare
President Obama would love nothing more than Republicans’ providing him a bully pulpit and big stick with which he can beat them daily through the 2014 midterm elections.  That’s what the Republicans would give Mr. Obama if they shut down the government by trying to defund Obamacare in the Continuing Resolution (CR) to fund the federal government after October 1. That’s because the Continuing Resolution only affects discretionary spending.  Virtually all of Obamacare costs are mandatory spending, unaffected by what’s in the CR (Karl Rove, 7/26).

Bloomberg: Drop The Disastrous Plan To Defund Obamacare
Conservatives on Capitol Hill think they have a chance to strike a mortal blow against President Barack Obama’s health-care overhaul this fall. If their plan goes forward, however, it will backfire. The plan is to oppose any bill to fund the government or increase the debt limit that also provides money for putting the health-care law in place (Ramesh Ponnuru, 7/26).

The New York Times: The War Over Health Care Exchanges
Federal and state governments are entering the home stretch in the race to carry out the most important health care reform in more than four decades. The most pressing task is to establish new health care exchanges, the electronic marketplaces in which consumers will be able to compare and buy insurance plans just as they buy airplane tickets or rent cars on the Internet. ... To their shame and discredit, Republicans are trying to block efforts to inform people about the law and are using scare tactics to keep them from enrolling. ... Their tactics are despicable (7/26).

Roll Call: Open Exchanges To The Poor In States That Opt Out Of Medicaid
Passage of the Affordable Care Act has positioned the United States to establish a national floor of insurance coverage for nearly all Americans, using an approach that combines employer coverage with Medicaid for the poor and a subsidized health insurance marketplace (exchanges) for people who have neither. Several unexpected twists threaten to derail this effort. The question is how to devise a solution (Sara Rosenbaum and Patricia Gabow, 7/26).

Politico: Give The Public Access To The Medicare Database
For no compelling reason, a commanding tool for trying to contain health care costs is lying unused. That sidelined powerhouse is the Medicare claims database, which holds a record of all payments from taxpayers to physicians and other providers for seniors’ health care (Sen. Chuck Grassley and Sen. Ron Wyden, 7/28).

The Wall Street Journal: The Affordable Care Act's Rate-Setting Won't Work
Although I've been critical of many components of the law, there is still much to applaud. Accountable Care Organizations could eliminate duplicative services and prevent medical errors while seeking to reduce costs for individuals, particularly if their creation ultimately leads to the end of fee-for-service medicine, as I believe it will. In addition, the Health Insurance Marketplace exchange systems, once implemented, will provide individuals with competitive plan options based on price, services, quality and other factors. Even more important, the exchanges will make the process of securing health insurance much easier and more transparent for millions who don't currently have it. … That said, the law still has its flaws, and American lawmakers and citizens have both an opportunity and responsibility to fix them. One major problem is the so-called Independent Payment Advisory Board (Howard Dean, 7/28). 

The Washington Post: Mr. Obama Should Not Ignore Entitlements 
But that’s a far cry from leveling with the public about the fact that Social Security, Medicare and the rest are crowding out other domestic priorities — including those that the president emphasized in his speeches — and that these programs are at the heart of the country’s long-term fiscal challenges, which have still not been addressed even as the deficit has declined in the short term (7/27).

The Hill: Opinion: GOP Gets It Wrong On Health Law
Eighty-three percent of Americans, according to last week’s NBC/Wall Street Journal poll, disapprove of Congress. That was the highest level in the history of the poll. The anger is so deep now that 57 percent want the entire Congress thrown out (Juan Williams, 7/29).

The New York Times: News Analysis: The Hype Over Hospital Rankings
Last week U.S. News and World Report released its annual list of “Best Hospitals.” Web sites are being updated to celebrate victories. (Johns Hopkins ranks No. 1!) ... For American hospitals large and small, it clearly pays to advertise, particularly in these tough economic times and with the Affordable Care Act poised to throw tens of millions of newly insured patients into the market. ... Some critics decry the glut of hospital self-promotion as not just wasteful and costly, but also potentially dangerous (Elizabeth Rosenthal, 7/27).

Earlier from KHN: Hospital Ratings Are In The Eye Of The Beholder

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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.