Daily Health Policy Report

Wednesday, July 31, 2013

Last updated: Wed, Jul 31

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch


Health Care Marketplace

Women's Health

Public Health & Education

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

What To Say When Mom Or Dad Has Cancer

KUHF's Carrie Feibel, working in partnership with Kaiser Health News and NPR, reports: "At any one time, an estimated 2.9 million children have a parent who has, or has had, cancer. Dozens of studies show that many of these children experience worry and stress, but that good communication can ease their fears and isolation, even up to the point of a parent’s death. Still, figuring out what to tell the kids – and when – is not an easy decision, and many parents who have cancer get little to no advice from their doctors about how to handle it" (Feibel, 7/30). Read the story.

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Political Cartoon: 'Stand And Deliver?'

Kaiser Health News provides a fresh take on health policy developments with "Stand And Deliver?" by Chris Weyant.

Meanwhile, here is today's health policy haiku:

The Health Law And Intra-Party Fissure

For Republicans,
the push to defund causes
a family feud.

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: Employer Mandate Delay Estimated To Cost The Feds $12 Billion

The amount represents lost tax revenue and additional costs. The Congressional Budget Office also noted that about one million fewer people will get insurance from their employers in 2014 than they would have if the mandate had been implemented.

The Wall Street Journal: Delay In Employer Health Mandate Estimated To Cost $12 Billion
The Obama administration's move to delay a mandate on businesses to provide health coverage will mean $12 billion in lost tax revenue and additional costs, according to the Congressional Budget Office. ... Earlier this month, the Treasury Department said it was delaying for one year the enforcement of penalties that could be charged to employers with 50 or more people for not providing adequate health insurance in 2014 (Dooren, 7/30).

The Washington Post’s Wonk Blog: Obamacare Mandate Delay Costs $12 Billion, Cuts Insurance Coverage
The vast majority of that increase ($10 billion) reflects a reduction in the penalties that the government would have collected from employers who did not comply with the requirement to provide health insurance. The Congressional Budget Office, which released the new estimate Tuesday, also expects more Americans to access federal subsidies purchasing coverage on the new marketplaces (Kliff, 7/30).

Reuters: 'Obamacare' Mandate Delay Will Cost $12 Billion, Affect 1 Million Workers
"Of those who would otherwise have obtained employment-based coverage, roughly half will be uninsured (in 2014)," CBO said in a July 30 letter to Representative Paul Ryan, Republican chairman of the House of Representatives Budget Committee (Morgan, 7/30).

The Hill: CBO: ObamaCare Mandate Delay Will Cost Government $12 Billion
Republicans have hammered the Obama administration over the delay, arguing that it creates a double standard because the law's individual mandate still goes into effect next year. ... Although the delay in the employer mandate will make parts of the law more expensive, the CBO has said that taken as a whole, the law reduces the federal deficit (Baker, 7/30). 

The Associated Press/MPR News: Delay Of Employer Penalties Will Cost Gov’t $10B
The budget office said fewer than half million people will have to forgo coverage as a consequence of the delay in the so-called employer mandate. The delay " will have only a negligible effect on sources of insurance coverage," the report said. ... the impact on the bottom line does not appear to be major -- at least in terms of the federal budget (Alonso-Zaldivar, 7/31).

Bloomberg: Delay Of U.S. Health Law Mandate To Cost $12 Billion
The costs of the delay were offset by about $1 billion because of “small changes,” CBO said, including an increase in income tax collections from people who don’t get coverage at work. The value of employer-provided health insurance isn’t taxed, while workers who get higher pay to buy insurance on their own would have to pay income tax on that compensation (Wayne, 7/30).

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Ga. Seeks Delay For Approving Health Exchanges' Proposed Rates

The state insurance commissioner cited "massive rate increases" in the proposals from seven insurers seeking to do business on these online insurance marketplaces.

Atlanta Journal-Constitution: Insurance Chief's Claim: Health Care Law Will Inflate Rates
The state must approve or deny dozens of health plans to be sold on a new federally run insurance website, called an exchange, that is critical to the Affordable Care Act’s goal of insuring millions of Americans. The deadline to approve plans is Wednesday, but Hudgens is asking for a 30-day extension. ... Bill Custer, a Georgia State University health care expert who has reviewed the filings, said a 198 percent increase is nowhere near typical. "The majority of Georgians with individual coverage will not see rate increases anywhere near that amount and many will see rate decreases," Custer said. The U.S. Health and Human Services Department is reviewing Georgia’s request, a spokeswoman said Tuesday (Teegardin and Williams, 7/30).

Georgia Health News: State Seeks Delay On Rate Approval For Exchanges
The deadline for state regulators to approve the insurance rates for the exchanges is Wednesday. Hudgens told GHN on Tuesday that Georgia is the only state that has asked for a 30-day extension to continue to analyze the rate increases. "I was always skeptical of Obamacare," said Hudgens, a Republican (Miller, 7/30).

CQ HealthBeat: Georgia Wants Delay In Filing Rates For Federal Exchange
Georgia’s insurance commissioner has asked the secretary of Health and Human Services for more time to file premium rates for the new federal marketplace because insurers have proposed rate hikes of up to 198 percent for some individuals. Insurance Commissioner Ralph Hudgens faxed Secretary Kathleen Sebelius a letter on Monday, saying the health law is responsible for what he called massive rate increase demands from the seven insurers who want to do business in the new health law exchanges (Bunis, 7/30).

In other news related to premium rates -

CT Mirror: A Glimpse At Obamacare Insurance Rates And Assumptions Behind Them
You’ll still have to wait a bit to find out exactly what it will cost to buy a health plan through the state’s new insurance marketplace, known as Access Health CT. But on Tuesday, actuaries consulting for the marketplace’s board gave their take on the proposed premiums, offering a glimpse at the assumptions behind the pricing, the range of potential costs, and the complexity of setting and approving insurance rates for markets subject to major changes brought by the federal health reform law (Becker, 7/31).

Health News Florida: Premiums Rising 5-6% For Most Floridians
Florida's average increase in health-insurance premiums under the Affordable Care Act for 2014 will be in the range of just 5 to 6 percent, Office of Insurance Regulation officials said Tuesday. That is not out of line with past years, and the new law will require health policies to cover more than many do now (Gentry, 7/30).

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Ohio Lawmaker Introduces Medicaid Expansion Bill

In Michigan, a committee vote on the expansion could come today. Elsewhere, New Hampshire and Wisconsin are considering expansion of coverage to childless adults, among others.

Columbus Dispatch: Hoping To Jump-Start Process, Democrat Introduces Medicaid Expansion Bill
Frustrated by the inaction of state GOP leaders, a Democratic senator introduced another bill to expand Medicaid yesterday, this one including many Republican-sought changes to the health care program for poor and disabled Ohioans. The nudge likely won't spark legislative action soon but it did ignite another round of debate about how much progress has been made (Candisky, 7/31).

Cleveland Plain Dealer: Latest Ohio Medicaid Expansion Proposal Introduced
Democratic Sen. Capri Cafaro unveiled during a Tuesday news conference the latest legislative measure aimed at reforming and expanding Medicaid in Ohio. And while Cafaro's proposal included some new policy, the senator focused mostly on trying to dispel a central Republican complaint -- Medicaid expansion would siphon money from state coffers. Cafaro argues that expanding Medicaid would save Ohio billions (Blackwell, 7/30).

Detroit Free Press: Medicaid Expansion Vote In State Senate Committee Could Come Wednesday
A committee vote on expanding Medicaid to 470,000 additional Michiganders could happen as soon as Wednesday. The Senate Government Operations Committee heard three hours of testimony Tuesday, mostly from supporters of the plan to expand Medicaid to people who fall between 100 percent and 133 percent of the federal poverty level. ... But opponents of the expansion will get their turn Wednesday, when Republican Sens. Patrick Colbeck of Canton and Bruce Caswell of Hillsdale offer their bills that would provide health care for low-income residents, but without any federal money (Gray, 7/30).

Detroit News: Michigan Senate Committee Expected To Vote On Medicaid Expansion
It’s unclear how much support the bill will get from the Senate Republican caucus, which broke for the summer without bringing the issue to the floor because fewer than 50 percent of GOP senators supported the expansion (Bouffard, 7/30).

The Associated Press: Medicaid Panels Hear Insurance Options
Subsidizing private insurance to cover poor adults eligible for Medicaid would be difficult at the outset, New Hampshire's Insurance Department told a special commission studying Medicaid expansion on Tuesday. The nine-member commission is charged with recommending by Oct. 15 to lawmakers whether New Hampshire should expand Medicaid to an estimated 49,000 poor adults (Love, 7/30).

The Associated Press: 20 Wisconsin Counties Press For Medicaid Funds
Twenty Wisconsin counties want to circumvent the state and its rejection of the federal Medicaid expansion and deal directly with the federal government for low-income health care dollars.The counties have sent a letter to state health Secretary Kitty Rhoades asking that the state be only the conduit for the federal funds (7/30).

In Texas, a federal health law ban on asset tests for Medicaid eligibility has some worried about costs --

Texas Tribune: Medicaid Asset Test Ban Draws Concerns
With key components of the Affordable Care Act set to take effect in January, state officials are worried that one regulation -- the ban on asset evaluation in calculating Medicaid eligibility -- could increase costs and decrease efficiency in processing Medicaid applications. Texas is one of three states to examine applicants’ assets -- such as cars, bank accounts and homes -- in addition to their incomes in determining whether they qualify for Medicaid, the public health insurance program for low-income children and people with disabilities (Luthra, 7/31).

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Health Law Supporters And Opponents Focus On Moms

A surge of advertising and grassroots organizing targets mothers because women usually make the health-care decisions for families and use more health care than men, Bloomberg reports.

Bloomberg: Moms Center Of $500 Million Ad Blitz Over Obamacare Fate
Call them Doctor Moms. Women make about 80 percent of the health-care decisions for their families, and also utilize more health care than men.  That's why supporters and opponents of the Affordable Care Act have targeted mothers in a surge of advertising and grassroots organizing as a major piece of Obamacare readies to roll out Oct 1 (Armour, 7/31).

Meanwhile, HHS Secretary Kathleen Sebelius is taking the health care lobbying effort to red states.

Bloomberg: Sebelius Takes Pitch On Health Care Law To Republican States
The top two U.S. health officials are planning multiple trips in the coming months to states led by Republicans hostile to the Affordable Care Act, seeking success there for President Barack Obama's health-care overhaul despite opposition (Wayne, 7/30).

And in California, KQED reports on how the impending implementation is affecting stakeholders.

KQED's California Report: Oakland Hospital Prepares For Affordable Care Act 
Public hospitals like Oakland's Highland Hospital are the backbone of California's safety net system. They treat the complex and varied health needs of diverse populations, often while managing tight budgets. Guest host Mina Kim visits Highland Hospital's trauma room No. 9 to talk about some of the new challenges with Dr. Kathleen Clanon, associate chief medical officer for Alameda Health System that runs the hospital (Kim, 7/28).

KQED's California Report: Obamacare Already Paying Dividends for Some
As Matt Kragen prepares a dinner salad in his family’s kitchen, he makes sure he chops all of the vegetables just so. The 23-year-old is learning how to be a cook at a Japanese restaurant. ... Kragen can't afford to buy his own health insurance. But thanks to Obamacare, he's covered under his mom’s policy until he turns 26. ... Another group of people who've already benefited from Obamacare are adults with pre-existing conditions (Goldberg, 7/28).

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Data Hub Will Be Key To Health Law But Also Raises Privacy Concerns

Bloomberg examines the complications involved in building the hub that will connect the databases of seven federal agencies.

Bloomberg: Privacy Fears Loom For Affordable Care Act
The biggest overhaul of the U.S. health-care system in 50 years has spawned one of the most complex computer projects in the government's history. Dubbed the Hub, the $267 million computer system built by a unit of UnitedHealth Group Inc. (UNH) is one of the most important determiners of whether the Affordable Care Act succeeds. The hub ties together the databases of seven U.S. agencies, ranging from the Internal Revenue Service to the Peace Corps, to determine which Americans can buy medical coverage and get U.S. subsidies through the new government-run insurance exchanges (Wayne, 7/31).

And another news outlet looks at some of the troubles for doctors and hospitals with digital records.

California Healthline: Effort To Move Patient Data Online May Spur A More Efficient, Affordable Network
The sharing of health care data electronically is in its beginning stages and implementation of new record-keeping systems is creating some confusion among health professionals across the country. But that can be a good thing according to a number of health experts who gathered last week at a health information conference in Santa Rosa. "I'm glad that we've got a bunch of stuff that doesn't work as well as we'd like it to," said Mark Frisse, a professor at Vanderbilt University's School of Medicine in Tennessee. … Many electronic health records can't speak to each other to enable smooth and secure sharing of patient health information and the digital networks that connect these electronic systems -- health information exchanges -- are largely unable to accept data passed between providers, Frisse said (Hart, 7/30).

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Parsing Public Opinion About Obamacare -- And GOP Repeal Efforts

The Washington Post's Fact Checker finds a recent Obamacare poll by the U.S. Chamber of Commerce presented data "in a highly misleading way," while a memo by President Barack Obama's pollster asserts that GOP efforts to repeal the health law have the support of only about half of GOP voters.

The Washington Post's The Fact Checker: A Misleading 'Obamacare' Poll, Courtesy Of The Chamber Of Commerce And Harris Interactive
We have long warned readers about the perils of relying on data from opt-in Internet polls, especially those that make broad claims about estimating population values. We have given Pinocchios both to President Obama, for relying on an opt-in poll when he claimed that a majority of millionaires support the Buffett rule, and the National Rifle Association, for asserting that an opt-in poll reflected the views of the nation’s police. This is a yet another case, but with a wrinkle. Here, the polling company, Harris Interactive, and the sponsor, the U.S. Chamber of Commerce, presented the data in a highly misleading way — and then made false claims about the type of poll that had been conducted (Kessler, 7/31).

Politico: Joel Benenson: Weak Support For Obamacare Repeal
Republican efforts to repeal Obamacare have middling public support at best, including among GOPers and in states carried last year by Mitt Romney, a new Democratic polling memo states. The "interested parties" memo by President Barack Obama's pollster Joel Benenson, obtained by POLITICO, asserts that GOP efforts to repeal the president’s signature health care law barely have majority support of their own voters and that Republicans are embracing a political loser by continuing to fight implementation (Haberman, 7/30).

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Capitol Hill Watch

Push To Defund Health Law Triggering Fault Lines Among Republicans

The effort is gaining momentum among tea-party supporters and their Capitol Hill advocates, but some moderate GOP senators are taking a very different view.

The Wall Street Journal: Tea Party Pushes To Defund Obama's Health Care Law
A drive to cut off funding for President Barack Obama's health care law is gathering momentum among tea-party activists and their allies on Capitol Hill, but Republicans in Congress are divided over how hard to push the issue. House GOP leaders are planning to make opposition to the health care law a centerpiece of the party's message when they return to their districts for the August recess (Hook and King, 7/30).

Reuters: Senate Republicans Feud Over Defunding 'Obamacare'
A nasty, name-calling spat between Tea Party conservatives and older, more moderate Republican senators is playing out in public this week, fueling a battle over the best way to kill President Barack Obama's landmark health care law (Lawder and Cowan, 7/30).

Politico: John Boehner On Shutdown: Don't Go There
Speaker John Boehner will use a private party meeting Wednesday to lay out a new strategy to chip away at Obamacare, brushing back at House and Senate conservatives who have urged a government shutdown if the law is funded. Boehner (R-Ohio) will give a presentation saying that the House Republican leadership supports continuous votes to build "on the successful, targeted strikes against the law that took place in the House this month and resulted in significant Democratic defections, chipping away at the legislative coalition that keeps the president's health care law on the books," a GOP leadership aide said on Tuesday evening (Sherman, 7/30).

The Hill: McConnell Mum On Obamacare Shutdown Threat
Key players within the GOP are beginning to pick sides in the conflict over forcing a government shutdown to defund Obamacare. The two big exceptions -- Senate Minority Leader Mitch McConnell (R-Ky.) and Speaker John Boehner (R-Ohio) -- are no surprise (Baker and Viebeck, 7/30).

Politico: Ted Cruz Taunts Fellow Republicans In Obamacare Fight
Ted Cruz is taking his hardball tactics to a whole new level. The Texas freshman senator and his senior aides are unleashing a barrage of attacks on their fellow Republicans for refusing to support their plan to choke off Obamacare as a condition for funding the government. Cruz's chief of staff is lambasting fellow conservatives like Oklahoma's Tom Coburn for serving in the "surrender caucus." His top political strategist has compared Mitch McConnell to Barack Obama. And the senator himself has said many Republicans are "scared" to wage this fight (Raju and Everett, 7/31).

Politico: Ted Cruz: Shutdown Over Obamacare Wouldn't Be 'Disaster' For GOP
Texas Sen. Ted Cruz on Tuesday downplayed the long-term consequences of a government shutdown on the Republican Party, calling for a grassroots mobilization to pressure lawmakers to defund the Affordable Care Act. "I think the received wisdom that '95 was a disaster is completely wrong. I think it was important that Republicans stood for principle and it actually led to some serious solutions to the fiscal and economic challenges facing this country," Cruz said at an event hosted by the Heritage Foundation (Delreal, 7/30).

In the background, more talk of a "grand bargain" comes from the White House in an attempt to appeal to some House and Senate Republicans --

Los Angeles Times: Obama Offers New 'Grand Bargain' Of Corporate Tax Cuts And Jobs
President Obama on Tuesday offered what he billed as a new "grand bargain" proposal that would combine a cut in corporate tax rates sought by many Republicans with a jobs-creating program that would spend more money on roads and bridges around the country. … White House officials, however, have suggested they think the new idea might appeal to at least some moderate Republicans in the Senate, although they have less hope in the Republican-controlled House. In unveiling the new strategy at an Amazon distribution center, Obama tacitly acknowledged what lawmakers had assumed for months -- that the old "grand bargain" talks were dead. Those negotiations, aimed at reducing the long-term deficit by combining lower spending on Medicare and Social Security with tax increases, dragged on for months but failed to produce a plan both sides could support (Parsons, 7/30).

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Medicare Increase $1 In Price From The Past Three Years

The Obama administration cast the average monthly premium price increase as a matter of inches.

The Associated Press/Washington Post: Gov't.: Average Monthly Premium For Medicare Drug Plans Will Rise By $1 For 2012, To $31
The Obama administration says the average monthly premium for Medicare prescription drug plans will inch up by $1 next year, to $31. The increase comes after three stable years in which the average premium hovered around $30 a month (7/30).

USA Today: Medicare Premiums To Remain Stable In 2014
Medicare Part D premiums will average about $31 in 2014 — up from $30 for the past three years. The Part D deductible will fall from $325 to $310 in 2014. "There is continued very strong competition within the Part D plan," said Jonathan Blum, deputy administrator and director for the Center of Medicare. When the coverage gap program began, "there was lots of concern that filling in the doughnut hole would cause Part D costs to go up" (Kennedy, 7/30).

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Health Care Marketplace

Huge Hospital Merger In The Works

If approved, Community Health Systems will buy Health Management Associates, resulting in a chain of 206 for-profit hospitals.

The Associated Press: Community Health Plans $3.9B Acquisition
Community Health Systems Inc. plans to spend $3.9 billion to acquire Health Management Associates Inc. in a deal that would create a giant U.S. hospital chain just as the health care overhaul starts funneling millions of newly insured people into the health care system. But Community Health wants to buy its fellow hospital operator at a discount, with shareholders assuming some of the risk that the company faces from federal investigations (Murphy, 7/30).

The New York Times: Community Health Agrees To Buy H.M.A. For $3.6 Billion
Regulators have been investigating H.M.A.’s patient admission practices. (Community Health recently disclosed a subpoena from the Justice Department over a similar matter.) If approved, the deal would create a big for-profit hospital system with 206 hospitals in 29 states, many of which are in rural areas. It is the latest move by Community Health, which has struck 25 deals in the last six years (De La Merced, 7/30).

The Wall Street Journal: Community Health Strikes Deal To Merge 206 Hospitals
The combination would bring together two companies facing similar business and regulatory challenges. Both reported earnings this week that fell well short of analysts' expectations, results tied to declining patient volumes at their largely rural hospitals. Both also face continuing government investigations into aspects of their operations (Mathews, 7/30).

Modern Healthcare: Activist Shareholder Skeptical Of Community's Bid For HMA
Community Health Systems' ... billion bid to acquire Health Management Associates is facing a skeptical reaction from the hedge fund shareholder that had been pushing for a deal in the first place. Glenview Capital Management, the activist shareholder which has been agitating for a change of control at HMA since May, is pressing forward with the consent solicitation process to unseat HMA's current board of directors and bring in a new slate (Kutscher, 7/31).

Georgia Health News: National Hospital Merger To Be Felt In Georgia
The proposed $3.9 billion acquisition of Health Management Associates by Community Health Systems would unite five Georgia hospitals as part of a huge new chain. The deal reflects the hospital consolidation accelerating across the nation, ignited in part by the health reform law of 2010 (Miller, 7/30).

In other hospital news, Consumer Reports issues its own set of hospital ratings - 

Consumer Reports: Your Safer-Surgery Survival Guide
Surgery is scary. It usually involves having your body cut open, and sometimes things go wrong. … Perhaps scariest of all, though many hospitals now gather data on those problems, patients for the most part remain in the dark about surgical safety. Industry insiders have access to some of that information because hospitals track how well patients do and report results to state and national officials. … Our new surgery Ratings are part of an ongoing effort to shed light on hospital quality and to push the health care industry toward more transparency (7/30).

Reuters: For Surgery, Big And Famous Hospitals Aren't Always The Best
In the first effort of its kind, the nonprofit publisher of Consumer Reports magazine released ratings of 2,463 U.S. hospitals in all 50 states on Wednesday, based on the quality of surgical care. The group used two measures: the percentage of Medicare patients who died in the hospital during or after their surgery, and the percentage who stayed in the hospital longer than expected based on standards of care for their condition. Both are indicators of complications and overall quality of care, said Dr John Santa, medical director of Consumer Reports Health (Begley , 7/31).

NBC News: 'Top' Hospitals Aren’t Always Tops, New Report Finds
The top hospitals don't always live up to their reputations when it comes to handling surgery, according to a new report released on Wednesday. Consumer Reports used newly available federal government data to look at how patients fared after surgery at nearly 2,500 hospitals in 50 states. The report found some of the big-name hospitals did not always do well in preventing infections and other measures of quality care, while some busy urban hospitals that care for the poorest and sickest patients often did surprisingly well (Fox, 7/31).

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Aetna's Profits Rise After Managed Care Plan Purchase

The insurer's second quarter earnings increased 17 percent as it reaped enrollment and revenue gains from its acquisition of the managed health care company Coventry Health Care Inc. 

The Associated Press/Washington Post: Health Insurer Aetna's 2nd-Quarter Profit Rises 17 Percent, Helped by Coventry Acquisition
Aetna Inc.’s second-quarter earnings jumped 17 percent, and the health insurer raised its 2013 forecast as it reaped revenue and enrollment gains from its acquisition of fellow insurer Coventry Health Care. The Hartford, Conn., company said Tuesday that it earned $536 million, or $1.49 per share, in the three months that ended June 30. That's up from $457.6 million, or $1.32 per share, a year ago (7/30).

The Wall Street Journal: Aetna Earnings: Membership Keeps Growing
In May, Aetna acquired the managed-health-care company Coventry Health Care Inc. to bolster its presence in government-financed health care. The cash and stock deal, worth $5.7 billion when announced in August, added about 3.7 million medical members and 1.5 million Medicare Part D members. While Aetna's revenue has improved over the past year, its profit came under pressure as consumers started to return to former health-care usage patterns amid an improving U.S. economy (Warner, 7/30).

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Women's Health

U.S. Divide On Abortion Widens Along Regional Lines

Opposition to abortion has grown in parts of the South, while those in the Northeast and West Coast continue to be strong supporters of abortion rights, a study says. In the meantime, a judge in Indiana made permanent her order barring the state from denying Medicaid funds to Planned Parenthood.

Reuters: U.S. Differences On Abortion Widen Along Regional Lines: Survey
U.S. attitudes on abortion are split along regional lines, and opposition to legal abortion has grown in some parts of the South while Americans in the Northeast and on the West Coast still strongly favor abortion rights, according to a new study. While a little more than half of all Americans continue to favor abortion rights and two in five oppose them, the divide is reflected in legal and legislative battles over the issue this month in the two regions with the most opposition to legal abortion: the South Central and Midwestern states (Gillam, 7/30).

The Associated Press/Washington Post: Judge Ends Indiana's Failed Battle To Deny Medicaid Funds To Planned Parenthood Over Abortions
A judge on Tuesday made permanent her order barring Indiana from denying Medicaid funds to Planned Parenthood clinics, ending the state’s two-year legal fight. U.S. District Judge Tanya Walton Pratt issued the permanent injunction after the U.S. Supreme Court in May refused to hear Indiana’s appeal in the case. Days later, the Centers for Medicare and Medicaid Services issued an administrative ruling siding with Planned Parenthood (7/30).

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Public Health & Education

N.Y. Appellate Court Upholds Decision Blocking NYC's Big Soda Ban

The panel said the city board of health acted outside its authority in imposing the ban, which would have prevented restaurants, theaters and food carts from selling sodas and other sugary drinks in excess of 16 ounces. Mayor Michael Bloomberg said he planned to appeal the ruling.

The Wall Street Journal: Bloomberg Loses in Sugary Drinks Fight
A state appellate court on Tuesday unanimously affirmed an earlier decision to block New York City from banning the sale of large sugary drinks in restaurants and other venues, a blow to a public-health initiative that has been among the hallmarks of Mayor Michael Bloomberg's tenure at City Hall (Saul, 7/30).

Los Angeles Times: Appeals Court Rules NYC Ban On Large Sugary Drinks Is Unconstitutional
Dealing yet another blow to Mayor Michael Bloomberg's efforts to reduce obesity in New York City, a state appeals court upheld an March decision by a lower court that Bloomberg's sugary drink ban is unconstitutional. The court wrote that the city's Board of Health "failed to act within the bounds of its lawfully delegated authority," and as a result, the so-called soda ban is unlawful (Lopez, 7/30).

Medpage Today: NYC Soda Ban Continues To Fizzle
New York City's campaign against super-sized sugary drinks continues to fizzle, with an appellate court upholding an earlier ruling that the ban is unconstitutional. The New York State Supreme Court Appellate Division panel in New York City agreed with a lower court decision from March that the city's Board of Health acted outside of its authority when it imposed the limits, which would prevent fast food restaurants from selling sodas and other sugary drinks in excess of 16 ounces. The ban would have applied to stores regulated by the city health department, including chains such as Dunkin' Donuts and Subway, but grocery stores and bodegas would have been exempt (Fiore, 7/30).

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State Watch

State Highlights: Experts Cite 'Serious' Health Care Risks At Calif. Prison

A selection of health policy stories from California, Massachusetts, North Carolina and Minnesota.

Los Angeles Times: Court Experts Cite 'Serious' Health Care Risks At Corcoran Prison
Medical experts reporting to a federal court monitor say health care at the California state prison at Corcoran poses "an ongoing serious risk of harm to patients" that results in preventable deaths. The report, filed in federal court Monday, finds "serious patient care issues" within the general hospital at the prison, including life-threatening infections caused by unsanitary conditions, nurses who did not check vitals and doctors who repeatedly "cut and paste" the same patient notes (St. John, 7/30).

WBUR: With Higher Cigarette Taxes, Concerns About Smuggling
As of Wednesday, Massachusetts cigarette prices have increased $1 a pack, as part of the transportation finance bill passed by state lawmakers a week ago. Massachusetts now has the second-highest cigarette tax rate in the country -- a fact that's also raising concerns about a spike in cigarette smuggling. … But even if Massachusetts loses money, the tax still has its supporters. Casey Harvell, public policy director for the American Lung Association Massachusetts, says the price hike will encourage 25,000 smokers to quit, and prevent 27,000 children from taking up smoking in the first place (Lepiarz, 7/31).

North Carolina Health News: New Payment Plan Aims To Save N.C. Money For Psychiatric Care
Five years after North Carolina implemented a system in which the state and hospitals work together to provide beds for psychiatric patients, the General Assembly passed legislation this session intended to make that system more efficient. A provision in the state budget sets up a two-tiered system of paying hospitals for their inpatient psychiatric beds (Hoban, 7/31).

MPR News: State Grant Goes To Helping Low Income Latino Families Enroll In SNAP
Low income Latino families will get help signing up for food stamps thanks to a new state grant. The $20,000 grant to Neighborhood House will allow the St. Paul nonprofit to assist Spanish-speaking families who have trouble affording food. State officials say many low-income Latino families who are eligible for food stamps aren't enrolled in the food stamps program, officially called the Supplemental Nutrition Assistance Program, or SNAP. Often, people don't know how to sign up for the program, and are hampered by their inability to speak English, said Armando Camacho, president of Neighborhood House (Siple, 7/31).

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Editorials and Opinions

Viewpoints: GOP's Shutdown Vow; Peter Orszag Defends Rationale Behind Medicare Payment Board

Los Angeles Times: Sabotaging The Health Law
A dozen Republicans in the Senate have said they'd rather shut down the government than provide funding for the Patient Protection and Affordable Care Act, the 2010 healthcare reform law better known as Obamacare. Meanwhile, more than 60 Republicans in the House have called on their leadership to cut off all federal support for the law in the coming fiscal year. And they complain when President Obama doesn't hold up his end of the bargain? (7/30). 

The Washington Post: The GOP's Shutdown Showdown
The budget and appropriations processes have been a mess in recent years under both parties' control, and there was no expectation this year would be different. But this time the slow walk serves conservatives' singular purpose of undermining Obamacare. Because the appropriations won't be completed by Oct. 1, Congress will have to pass a temporary extension, or "continuing resolution." This kitchen-sink measure gives House Republicans the power to shut down the federal government if President Obama doesn't agree to their demands — particularly the repeal of health-care reform (Dana Milbank, 7/30).

The Wall Street Journal: How ObamaCare Hurts Patients
President Obama promised to mend the failings in the American health-care system, and yet for cancer treatment, ObamaCare is taking a rotten feature of the old system and making it worse. The Affordable Care Act expands a program called 340B, which siphons money from drug makers and insurers to subsidize certain hospitals. The program has been expanded as a way to offset some of the cuts that the law imposes on hospitals. One significant side effect: 340B is increasing the cost of cancer care—and harming its quality (Scott Gottlieb, 7/30). 

The Baltimore Sun: Maryland Shows Obamacare Can Be Affordable
Maryland regulators have released the details of the rates they have approved for the nine companies that want to sell policies on the state's new health insurance exchange as part of the Affordable Care Act, and the average rates for individuals buying coverage are expected to jump by as much as 25 percent. Another horror story about the train wreck of Obamacare? Hardly. That figure represents an apples-to-oranges comparison that says little about what health care will cost for any particular individual or family once the exchange starts selling policies this fall. The truth is that Maryland appears to have some of the lowest projected rates in the nation — a tribute to a well-regulated state health care system and officials who are determined to see the Affordable Care Act succeed, not fail (7/29).

The Washington Post's The Plum Line: The Conservative (Led) Boycott Of (Some) Health Insurance
You know, it's one thing to oppose a policy; that, of course, is perfectly legitimate. It's another to undermine its implementation by using whatever legislative or legal maneuvers are available to keep it from working, even if it imposes widespread costs in the meantime. Oh, and it's even worse to do that when you have no alternative policy. But now, the latest. As discussed last week, conservatives are now trying to talk people out of signing up for insurance through the exchanges (Jonathan Bernstein, 7/30). 

Bloomberg: Critics Are Wrong About the Medicare Payment Board
For Medicare, this has been a summer of good and bad news. On one hand, the program's costs continue to rise remarkably slowly. So far this fiscal year, they have gone up by only 2.7 percent in nominal terms, the Congressional Budget Office reports. On the other hand, opposition to the Independent Payment Advisory Board -- created as part of the Affordable Care Act -- continues to mount. And opponents continue to mischaracterize the whole point of the board (Peter Orszag, 7/30).

The Washington Post: Bringing Compounding Pharmacies Under Federal Regulation
A fungal meningitis infection last year that spread in contaminated vials of medicine distributed by the New England Compounding Center in Framingham, Mass., led to 749 people becoming ill and 61 deaths in 20 states. Without doubt, this outbreak could and should have been prevented. Now, Congress is making headway toward writing laws that would prevent similar occurrences. This is not the first time Congress has attempted to tackle the problems of so-called compounding pharmacies, lightly regulated firms that mix and ship medicines to hospitals and clinics, but previous efforts were frustrated by lawsuits and ultimately were ineffective. A legacy of the 2012 outbreak must be hard and fast rules that would prevent another disaster (7/30). 

The Wall Street Journal: The Other White Medicine
The friendly acquisition of U.S. pork producer Smithfield Foods by the Chinese conglomerate Shuanghui is producing some odd economic arguments against foreign investment. But you've got to hand it in particular to House Energy and Commerce Chairman Fred Upton for trying to make the other white meat into a medical emergency. In a letter to Smithfield CEO Larry Pope, Mr. Upton and five of his GOP colleagues claim that the sale "raises questions related to the safety and adequacy of the U.S. heparin supply." Heparin is an anticoagulant used to prevent blood clots during heart surgeries and in kidney patients prior to dialysis. About 12 million people annually are treated with the drug, whose active ingredients are derived from the membranes in pig intestines (7/30). 

Health Policy Solutions (a Colo. news service): The Perils Of Privatizing Health Care, American-Style
As health systems around the world grapple with the increasing costs of providing health care for their citizens, far too many are considering more extensive privatization of their systems to emulate the U.S. health care model.  This is a mistake not only from an economic perspective but also from a human rights and public health position (Donna Smith, 7/31).

San Francisco Chronicle: Pensions At Heart Of UC Hospitals Labor Dispute
At the University of California, our hospitals treat patients facing complex medical conditions that require specialty care of the highest standard. And Californians count on UC medical centers not only to meet, but to exceed, that standard (John Stobo, 7/31).

Fiscal Times: Will Killing The 'Doc Fix' Push More MDs From Medicare?
Beyond the headlines of the rocky roll-out of the Affordable Care Act, also known as Obamacare, is a much more dramatic story. Many in Congress want to axe the Sustainable Growth Rate that pays physicians for Medicare patients. If Congress succeeds in scrapping legislation that caps doctor payments for Medicare, it may replace it with a game-changing formula that represents a new paradigm for healthcare compensation. The SGR, hated by doctors and sidestepped by lawmakers on an annual basis, will automatically force a 24-percent cut in physician payments next year, unless Congress votes to abandon it. That seems likely. To date, though, Congress has voted 15 times since 2002 to override the SGR with temporary "doc fixes" (Wasik, 7/31).

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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.