Daily Health Policy Report

Thursday, August 1, 2013

Last updated: Thu, Aug 1

KHN Original Reporting & Guest Opinion

Capitol Hill Watch

Health Reform

Health Care Fraud & Abuse

State Watch

Weekend Reading

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Does My Insurance Have To Cover Pregnancy Benefits For My Dependents? (Video)

Kaiser Health News consumer columnist Michelle Andrews answers a question from a reader about if the health law requires employer-sponsored insurance to cover maternity benefits for an employee’s dependents (8/1). Watch the video.

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Political Cartoon: 'Data Off-Base?'

Kaiser Health News provides a fresh take on health policy developments with "Data Off-Base?" by Mike Luckovich.


A catchy jingle...
That's how health exchanges plan
to attract shoppers

Meanwhile, here is today's health policy haiku: 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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Capitol Hill Watch

Obama Seeks To Calm 'Jittery Democrats' On Health Law Rollout

Meanwhile, senior GOP leaders plan more votes to chip away at Obamacare, in part to dissuade their rank and file from demanding a government shutdown this fall unless the health law is defunded.

The Associated Press/Washington Post: 'Right Side Of History' – Obama Seeks To Calm Jittery Democrats On Health Care, Immigration
President Barack Obama sought to calm jittery Democrats Wednesday as they prepared to head home to face voters, assuring them they're "on the right side of history" despite problems with the launch of his massive health care overhaul and an immigration fight with Republicans. In back-to-back closed sessions with House and Senate Democrats, Obama delivered his broad message about economic prosperity and expanding the middle class. But in return he was confronted with questions from Democrats who are nervous about implementation of the health care law as they look ahead to town hall meetings during the August recess — and to midterm elections next year (7/31).

Politico: McDonough Calms House Freshmen On Obamacare Rollout
White House chief of staff Denis McDonough has tried to calm yet another group on congressional Democrats on the Obamacare rollout: House freshmen. McDonough continued his confidence-building tour of Capitol Hill by meeting Tuesday with several dozen first-term members at Minority Leader Nancy Pelosi's urging, according to a House Democratic aide (Budoff Brown and Bresnahan, 7/31).

The Washington Post: House Republicans Pull Spending Measure To Focus On Bills to Embarrass White House
The collapse of the transportation bill, meanwhile, diverted attention from the primary goal House GOP leaders hoped to accomplish before heading home for five weeks: embarrassing the Obama administration and scoring political points. Eager to call fresh attention to the troubled Internal Revenue Service and lingering doubts about Obama's health-care law, Republican leaders dubbed this "Stop Government Abuse Week" and had scheduled votes on a collection of partisan measures intended to curb the power of government (O'Keefe and Montgomery, 7/31).

Politico: John Boehner Outlines New House Obamacare Votes
Speaker John Boehner is planning for a number of votes to continue to chip away at Obamacare, an attempt to dissuade Republicans from urging a government shutdown if the law is funded. Over the next few months, the House will vote to require verification for health care subsidies, stop the Independent Payment Advisory Board and eliminate funding streams, according to a source in the closed House Republican Conference meeting where he announced the strategy (Sherman, 7/31).

CNN: Ending Obamacare, Avoiding Gov't Shutdown A Juggling Act For Boehner
While House Speaker John Boehner isn't overtly ruling out picking a fight with President Barack Obama over a spending bill, he is laying out an alternative strategy to avoid a government shutdown. During a closed door meeting on Wednesday with House Republicans, Boehner tried to "gently hold members' hands and walk them away from this," said one GOP source who was in the room. The debate is about whether Republicans should attach a measure to defund Obamacare to a must-pass spending bill. The government runs out of money on September 30, the end of the fiscal year (Walsh, 7/31).

Reuters: House Republicans Leery Of 'Obamacare' Defunding Idea
A Tea Party-inspired plan to kill President Barack Obama's healthcare law by forcing a government shutdown unless funds to implement the law are denied has not gained traction among senior Republicans in the U.S. House of Representatives, lawmakers said on Wednesday(Cowan and Bohan, 7/31).

CBS News: Can The GOP Ever Really Stop Obamacare?
The Republican-led House of Representatives Friday will vote for the 40th time to roll back the Affordable Care Act. While symbolically meaningful, this vote will be as futile as the last 39 votes to repeal the law. Obviously, the Democratic-led Senate would never pass a repeal bill, and President Obama would never sign it. The Republican Party remains as committed as ever to repealing or at least dismantling the mammoth health care law that Democrats pushed through Congress in 2010 with zero GOP support. But after years of railing against the law and dozens of votes against it, Republicans are now divided over the best way to attack it (Condon, 8/1).

Texas Tribune: Cruz Calls On Grass Roots In Bid To Defund ACA
Congress has 61 days remaining to pass a resolution to continue financing federal government operations when the 2014 fiscal year begins Sept 1. If the resolution isn't passed, mandatory spending — such as spending on Social Security and Medicare — would continue, while programs and agencies that rely on discretionary spending, such as defense and federal law enforcement, would be shut down until Congress passed a resolution to resume financing those operations. "My focus for the next 61 days is very directly targeted to one thing, and that is working to defund Obamacare," Cruz said Wednesday (Aaronson, 7/31).

Meanwhile, liberal groups plan efforts to defend the law and put the GOP on the defensive -

Politico: Liberal Groups Aim To Put GOP On Defense On Obamacare
Obamacare supporters are launching a new war room operation to stick up for the law, mobilizing liberal groups to talk up its benefits and pound Republicans for trying to cut off its funding. The new effort — to be headed by Americans United for Change, an all-purpose liberal advocacy group, and Protect Your Care, which focused on Obamacare — will include rapid-response messaging and town halls to try to change the conversation over the health care law, its organizers tell POLITICO. They'll start next week, during the August recess, but they're promising to stick around during the massive effort to sign people up for Obamacare this fall (Nather, 7/31).

Politico: DSCC Chair Michael Bennet: Obamacare Will Boost, Not Bite, Dems In 2014
The head of the Senate Democrats’ campaign committee says Republicans have miscalculated if they think Obamacare will be their ticket to a Senate takeover in 2014. Sen. Michael Bennet (D-Colo.) told reporters at the Democratic Senate Campaign Committee's headquarters Wednesday that a year from now the health law probably won't tip tight races — and is more likely to be a boon to Democrats on the November 2014 ballot (Cheney, 8/1).

In other news from Capitol Hill -

Los Angeles Times: White House, GOP Lawmakers Looking At 'Grand Bargain' On Spending
The president was eager to remind lawmakers, as they head out after this week for their August recess, that much work remains to improve the economy and repair the federal budget. When Congress returns to work, it will be in session just nine days before the Sept. 30 deadline to pass legislation to fund the government. … Republicans have proposed trimming Medicare for the next generation of seniors, as well as the cost-of-living adjustment for recipients of Social Security and other government programs. But Democrats and the White House are willing to consider such cuts only if Republicans also agree to new tax revenue, which could come from changing the corporate tax code and doing away from some individual tax deductions for wealthier households (Mascaro and Hennessey, 7/31).

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ACA Provision Regarding Hill Staffers' Health Insurance Triggers Debate, Action

Under the law, members of Congress and some of their aides may have to pay more for their health coverage and buy it from new online health insurance marketplaces -- a reality that is triggering strong reactions on Capitol Hill.

Des Moines Register: Congress May Have To Pay For Health Insurance
Members of Congress and many of their aides could soon have to pay thousands of more dollars for their health insurance because of an apparent oversight in the way the Obamacare law was written. The issue is related to language U.S. Sen. Chuck Grassley helped insert into the 2010 Affordable Care Act, but the Iowa Republican denied Wednesday that his amendment was the problem (Leys, 7/31).

Politico: President Obama On Hill's ACA Mess: I'm On It
President Barack Obama privately told Democratic senators Wednesday he is now personally involved in resolving a heated dispute over how Obamacare treats Capitol Hill aides and lawmakers, according to senators in the meeting. The president's commitment was delivered at the beginning of Obama's remarks to Senate Democrats during a closed-door session (Bresnahan and Sherman, 8/1).

The Washington Post: Health Care Issue Triggers Hold On OPM Nominee Katherine Archuleta
An issue involving coverage of Capitol Hill staff members under the Affordable Care Act resulted in the ranking Republican on a Senate oversight committee saying Wednesday that he would put a hold on the nominee for federal personnel dire (Yoder, 7/31).

The Hill: Coburn To Block OPM Nominee Over Obamacare Concerns
Sen. Tom Coburn (R-Okla.) is planning to block a top executive nomination over concerns about how ObamaCare will apply to Capitol Hill. Coburn reportedly announced Wednesday that he would place a hold on Katherine Archuleta, nominated to head the Office of Personnel Management, until the Obama administration clarifies whether the federal government will be permitted to contribute to Hill staffers' premiums (Viebeck, 7/31).

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SGR Repeal Measure Moves To Full House Consideration

Some medical societies, which support repealing Medicare's Sustainable Growth Rate formula, are expressing concern that a bill won't be signed into law before a scheduled 25 percent reduction in Medicare physician payment takes effect. Meanwhile, members of the Senate Finance Committee are working on their own plan.

Medpage Today: SGR Repeal Bill Moves To Full House Vote
Some national and state physician medical societies are voicing concern with one provision of a bill to replace Medicare's sustainable growth rate (SGR) formula -- a bill that now awaits a vote before the full House of Representatives. The groups say the Medicare Patient Access and Quality Improvement Act of 2013, which the full Energy and Commerce Committee approved in a 51-0 vote Wednesday morning, errs by not giving certain savings in Medicare back to undervalued services. But there will certainly be time for the physician groups to have their concerns addressed. Even optimistic supporters of an SGR repeal admit it'll be tough to have a bill signed into law by the end of the year and before the SGR's scheduled 25 percent pay cuts take effect (Pittman, 7/31).

CQ HealthBeat: Senate Finance Members Vow To Write Their Own Bipartisan 'Doc Fix'
The House Energy and Commerce Committee unanimously approved a bill to replace Medicare's physician payment system Wednesday, while at almost the same time Senate Finance Committee members huddled on crafting their own plan, expected this fall. Senators leaving their closed-door meeting said they discussed goals and ways to proceed on legislation that would improve how Medicare pays physicians (Ethridge, 7/31).

In other legislative news --

The Hill: Single-Payer Health Care System Would Save Billions
Expanding the nation's Medicare program to cover people of all ages would save the government billions of dollars, according to a new study released Wednesday. The study found that a single-payer health care system based on the principles of legislation by Rep. John Conyers, Jr. (D-Mich.), the Expanded and Improved Medicare for All Act, would save the federal government about $592 billion in one year (Seligman, 7/31).

Modern Healthcare: Congress Should Consider Clarifying FDA's Authority Over Compounding, GAO Says
Congress should think about clarifying the Food and Drug Administration's authority to oversee drug compounding, the Government Accountability Office concluded in a report released on Wednesday. A deadly outbreak of fungal meningitis linked to contaminated compounded drugs in 2012 led to a series of federal hearings on Capitol Hill last fall (Zigmond, 7/31).

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Health Reform

Targeting The Health Law's Enrollment Message

Though some view it as a difficult sell, new advertising from the 17 states that are setting up health insurance marketplaces tends to be upbeat and positive. First Lady Michelle Obama is also pitching in on efforts to reach very specific populations.

The New York Times: Songs And Sunscreen Spread The Health Insurance Message
The part of President Obama's Affordable Care Act that requires Americans to obtain health insurance has been a contentious issue politically, but new advertising from the 17 states setting up marketplaces where residents will buy insurance tends to be buoyant. New commercials for the Oregon exchange, called Cover Oregon, for example, resemble something from a tourism bureau. In one commercial, the singer Matt Sheehy performs an anthemic song, "Long Live Oregonians," that is reminiscent of "This Land Is Your Land" by Woody Guthrie (Newman, 7/31).

The Associated Press: First Lady Asks For Latinos' Help On Health Care
Michelle Obama urged Latino activists to help sign people up for her husband's health care overhaul, especially the millions of younger, healthier people the system will need to offset the cost of caring for older, sicker consumers. The first lady said that, starting July 31, consumers can create an account at www.healthcare.gov , or www.cuidadodesalud.gov , its Spanish-language equivalent, so they can get ready to sign up for health insurance in the fall, starting on Oct. 1 (Plaisance, 7/31).

Though some health law advocates view the back-to-school season as the perfect time to get the word out, Politico reports that no clear effort to reach parents has emerged.

Politico: Schools Keep Distance From Obamacare Enrollment
When children return to school a few weeks from now, don't expect to find Obamacare forms stuffed inside their backpacks. Supporters of the health law see back-to-school season as a natural time for Obamacare outreach, a chance to find young families who could benefit from new health coverage options. But weeks before the school bells start ringing in parts of the country, there's no concerted effort to reach parents at the schoolhouse door. It's yet another sign of how the undying controversy could overshadow attempts to get people enrolled (Cheney, 8/1).

And in other related news -

Kansas Health Institute: Feds Promote Obamacaare As Launch Date For Insurance Exchanges Approaches
Federal officials today released a report on the benefits of Obamacare, breaking them down state by state as part of a public relations push in anticipation of the October launch of the reform law's health insurance marketplace. According to the report, there are 326,885 currently uninsured Kansans who could receive coverage through the new insurance exchange, which is scheduled to begin processing applications Oct. 1 for coverage that begins Jan. 1 (7/31).

The Associated Press: Apple-Inspired Connecticut Stores Planned Health Law
Besides television and radio advertisements, billboards and signs on buses, Connecticut's new insurance marketplace is planning to open storefronts inspired by Apple to help get the word out about President Barack Obama's health care law and coming enrollment (Haigh, 7/31).

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For States, 'Churn' Is A Matter Of Concern

California Healthline reports on how life events can cause individuals' incomes to change enough that it will also impact whether they qualify for subsidies to shop for insurance on the state's health exchange, or whether they should apply for Medicaid. It's an issue on which states are beginning to focus. 

California Healthline: 'Churning': The Latest Watchword For States Working On Health Reform
Under the law, if a person's annual income is below 138% of the federal poverty level -- or about $15,850 -- he or she qualifies for coverage under the Medicaid expansion. If a person's income is between 138% and 400% of the federal poverty level, he or she qualifies for federal tax subsidies to purchase private coverage through the state insurance exchanges. However, normal life events -- such as getting married or divorced, having children or taking a second job -- can alter an individual's income and push him or her back and forth between the two coverage levels, according to experts. … What strategy has Covered California, the state's health insurance exchange, selected? "Currently there is no strategy," Dana Howard -- Covered California spokesperson -- told California Healthline (Wayt, 7/31).

Meanwhile, news outlets report on premium rates in Maine and Florida for plans purchased on the exchange and examine Maryland's rates more closely.  

Bangor Daily News: Regulators Approve Maine Health Plans Under Obamacare, But Impact Remains Unclear
The state's insurance bureau met a deadline Wednesday to report on how much some Maine consumers and businesses will pay for health coverage under the Affordable Care Act, often called Obamacare, but the impact of the new federal health law remains unclear. ... Maine's submission to the feds was expected to shed light on how much consumers and small businesses will pay for insurance through the exchange and what benefits the plans will include. The trove of documents included a framework for how the insurers will set rates, but not a summary or side-by-side comparison of the plans, making it difficult to determine what consumers actually will pay, said Joe Ditre, executive director of the Augusta-based Consumers for Affordable Health Care (Farwell, 8/1).

Miami Herald: Florida Says Health Insurance Prices Will Spike; Feds Disagree
Florida insurance regulators unveiled for the first time Wednesday the prices proposed by private insurers for individual health plans to be sold on the state’s federally-run exchange, which is scheduled to launch Oct. 1. But the proposed health plans and prices — and the state’s analysis that federal healthcare reform would cause premiums to rise — were hardly definitive of the actual costs that Floridians are likely to pay for health insurance next year. That’s because the U.S. Department of Health and Human Services has yet to approve the proposed health plans for Florida’s exchange, and those plans, including the prices, may change as they have in other states (Chang and Borns, 7/31).

CQ HealthBeat: Keeping Risk Pool Open A Factor In Lower Exchange Rates For Maryland
A number of the 35 states that set up high-risk pools to help uninsurable residents get health coverage are in the process of winding them down as the coverage expansion provisions of the health care law are set to take effect next year. But some of these pools will stay open, at least for a while (Reichard, 7/31).

Related KHN Coverage: Patient Advocates Seek A Gentle Transition From High Risk Pools To New Exchange Plans (Andrews, 7/23).

Also, two companies depart from Georgia's state exchange; Virginia is poised to approve 15 plans to participate on the marketplace the federal government will operate for its residents; and the latest on Michigan's Medicaid expansion.  

Georgia Health News: Aetna, Coventry Back Out Of State Exchange
Aetna and the company it recently acquired, Coventry, have dropped out of the Georgia health insurance exchange. The two companies’ departure Wednesday means there are just five insurers left to offer coverage in the Georgia exchange, also known as a marketplace, which starts enrollment Oct. 1. (Miller, 7/31).

Richmond Times Dispatch: Va. OKs Health Plans For New Exchange
Virginia is poised to approve 15 health plans to compete in a new insurance benefit exchange the federal government will begin operating in the state on Jan. 1. But the final rates that eligible Virginians will pay for insurance in the new electronic marketplace will remain unknown until the federal government decides which plans will compete on the exchange and what they can charge. … The SCC Bureau of Insurance had approved five of the nine proposed plans for individual insurance coverage and all six plans proposed for small businesses as the deadline approached for state action late Wednesday. The remaining four individual market plans were still under review at the close of business (Martz, 8/1).

Detroit Free Press: Three State Medicaid Expansion Plans Move Out Of Committee To Full Senate
A Michigan Senate committee has moved to the full Senate not one, but three different plans to expand Medicaid. The first bill, passed by a 4-0 vote, builds on an earlier plan passed by the state House and is supported by Gov. Rick Snyder, who, in a written statement, praised the committee's action to move the bill forward and urged quick action by the full Senate (Gray and Erb, 7/31).

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With The Weight Of The Employer Mandate Temporarily Gone, Small Businesses Are Eyeing Expansion

The Wall Street Journal: Pivoting From Insurance
Many small businesses are eyeing expansion—at least temporarily—now that penalties under the Affordable Care Act's employer mandate have been delayed for a year. Nearly a quarter, or 24.4%, of small-business owners affected by the delay said they will invest in equipment or facilities with money that would otherwise have gone into complying with the health-care law, according to July's Wall Street Journal/Vistage Small Business CEO Survey. An additional 16% of small companies plan to hire new employees, 15% expect to provide raises or other benefits for their workers and 3% are planning to lower prices to gain a competitive edge (Janofsky, 7/31).

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Health Care Fraud & Abuse

Lawsuit Alleges Hospital Operators Paid Kickbacks, Defrauded Medicaid

A whistleblower says two hospital operators paid clinics to direct to their hospitals pregnant mothers living in the U.S. illegally.

The Associated Press: Whistleblower Suit: Hospitals Defrauded Medicaid
Two large hospital operators paid kickbacks to clinics that directed expectant mothers living in the country illegally to their hospitals and filed fraudulent Medicaid claims on those patients, a federal whistleblower lawsuit unsealed Wednesday said (Brumback, 7/31).

In related news -

Center for Public Integrity: Advocates For Nursing Home Reform Push Back Against Proposed Health Watchdog Cuts
[Health and Human Services Inspector General Daniel] Levinson's investigative unit, citing major budget and staffing cuts, is scrapping a planned new audit to identify the problem nursing homes and the medicines being misused, an ongoing practice that violates federal rules requiring that patients "be free from unnecessary drugs." That scheduled audit is among several high-profile investigations the OIG is postponing or canceling, including a review of the state insurance exchanges that are set to open later this year as a key provision of the Affordable Care Act (Schulte, 8/1).

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State Watch

State Highlights: Brooklyn Hospital Files For Bankruptcy, Plans To Close

A selection of health policy stories from New York, North Dakota, Texas, Minnesota and California.

The New York Times: Interfaith Medical Center Plans To Close
Giving up the fight to stay open, Interfaith Medical Center, one of Brooklyn’s most financially troubled hospitals, asked a bankruptcy court on Tuesday to approve its closing and sent layoff warning notices to its 1,544 employees (Bernstein, 7/31).

The New York Times: Abortion Law Is Blocked In North Dakota
A state judge on Wednesday temporarily blocked enforcement of a law requiring doctors who perform abortions to have admitting privileges at nearby hospitals. The law is similar to measures promoted by anti-abortion groups and upheld by courts in other states including Mississippi and Alabama (Eckholm, 7/31).

Dallas Morning News: Women's Health Program Serving Thousands Fewer Texans Since State Takeover
Thousands of women have dropped out of a health care program since the state altered it seven months ago in a fight over Planned Parenthood, state statistics show. Since the state began operating its own Texas Women’s Health Program, claims have dropped 23 percent, or about 4,000 visits monthly. The state broke from a Medicaid-funded program because federal rules allowed Planned Parenthood to deliver health services. Some Texas leaders insisted no organization that was affiliated with abortion providers should be allowed in the program (Martin, 7/31).

MPR News: New Underage-Drinking Law Aims To Change Perception, Save Lives (Audio)
The most important benefit of a new law on underage drinking is its educational effect, says a student who helped write it. The law, which takes effect Thursday, provides a limited shield from prosecution for underage drinkers who call 911 seeking help for themselves or a friend. Police had already followed a practice of declining to prosecute young drinkers who called emergency services because they thought a friend's life was in danger, said Matt Forstie, a University of Minnesota student and chair of the Minnesota Student Legislative Coalition. The bigger problem, he said, was that a large number of students admitted they would hesitate to call 911 in such situations (7/31).

California Healthline: State Helps Providers Navigate New Immunization Web Exchange Portal
State health officials yesterday staged their first provider webinar for the new Immunization Messaging Portal, an effort by the California Department of Public Health to automate the submission of immunization data. The new web portal replaces the former manual process for registering, testing and submitting electronic immunization data. Medicare and Medi-Cal providers participating in an electronic health record incentive program are required to submit immunization data electronically to the immunization registry. The electronic immunization system helps providers meet the meaningful use requirements of the federal EHR incentive program (Gorn, 7/31).

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Weekend Reading

Longer Looks: Mayo's Demands; Posting Hospital Prices

Every week reporter Ankita Rao selects interesting reading from around the Web.

The New Republic: Held Hostage By A Hospital
When the billionaire owner of the Minnesota Vikings football team decided last year he wanted a new, $1 billion stadium, he did what sports franchise owners often do: threaten to relocate to another state—at least implicitly—and thereby wrung nearly $500 million dollars from taxpayers. ... this year, a different kind of local juggernaut threatened to take its business elsewhere unless Minnesotans helped pay for a multibillion-dollar new development: The Rochester-based Mayo Clinic. ... the state legislature in May approved $585 million in city, county and state funds for infrastructure upgrades to accommodate Mayo's 20-year, $5.6 billion expansion. (Mayo itself is covering $3.5 billion of the cost, while healthcare-related businesses are expected to contribute $2.1 billion.) Worried that Obamacare will hurt its bottom line, Mayo is betting its future on its ability to lure an greater percentage of the wealthiest and sickest patients to its dazzling high-tech hospitals (Ilan Greenberg, 7/24).

The New Yorker: Tweeting Death
In the week before her death, Simon began live-tweeting his mother’s final days to his almost 1.3 million followers from her hospital room. The tweets were poignant and haunting, and have brought Simon—already a mini-celebrity—a new level of renown. Total strangers read what he wrote and responded deeply. ... The tweets, which felt almost aphoristic (a mere hundred and forty characters each), underscored one of the strangest things about being with someone at the end of her life: the surreality of time, the way that time bends and distorts, becomes material. ... It’s our equivalent of the ringing of church bells in the town square, for better or for worse (Meghan O'Rourke, 7/31).

The New York Times: Status And Stress
Although professionals may bemoan their long work hours and high-pressure careers, really, there’s stress, and then there’s Stress with a capital “S.” The former can be considered a manageable if unpleasant part of life; in the right amount, it may even strengthen one’s mettle. The latter kills. What’s the difference? Scientists have settled on an oddly subjective explanation: the more helpless one feels when facing a given stressor, they argue, the more toxic that stressor’s effects (Moises Velasquez-Manoff, 7/27).

The New York Times: Revealing A Health Care Secret: The Price
The Surgery Center of Oklahoma is an ambulatory surgical center in Oklahoma City owned by its roughly 40 surgeons and anesthesiologists. What makes it different from every other such facility in America is this: If you need an anterior cruciate ligament reconstruction, you will know beforehand — because it's on their Web site — that it costs $6,990 if you self-pay in advance. … What's remarkable is that this is remarkable. Why should a business become the subject of news stories simply because it tells people the cost of its services? Because it's health care (Tina Rosenberg, 7/31).

Los Angeles Times: 'Critically Ill' Author Frederick Southwick On What Ails Our Healthcare System
Mary Southwick was 34 when she developed pain on the bottom of one foot. After seeing a neurologist who said she had a nerve injury caused by dancing, she developed thrombophlebitis and was admitted to the hospital. An intern underdosed her heparin (blood thinner), and she suffered a large blood clot in a lung. This was soon followed by a heart attack, then respiratory failure, renal failure and shock. … Frederick Southwick, chief of infectious diseases at the University of Florida in Gainesville, says his wife's trauma motivated him to write the book "Critically Ill: A 5-Point Plan to Cure Healthcare Delivery." Here he offers some guidance to negotiate the healthcare system (Judy Mandell, 7/26).

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Editorials and Opinions

Viewpoints: Health Law Rollout Needs A Better Salesman; The Overhaul Is Shifting The Economy To Part-Timers

The New Republic: Obama Is Still A Terrible Salesman For Obamacare
We need a serious and sustained presidential conversation with the country about the new health care reform laws—or progressives risk losing ownership of this once-in-generation liberal reform. If you listen to people in focus group discussions right now, they are clueless about the most basic policies in the reforms, even though parts of the law are already in place, the exchanges are to be launched in October, and the law’s requirements and benefits will become fully operative in January. ... And in the most recent national surveys, more people think their health insurance situation will be made worse by the impending changes (Stanley B. Greenberg, 7/30).

USA Today: Lift Health Care Reform's Deductible Cap
The Obama administration recently announced that it would delay until 2015 the Affordable Care Act's "employer mandate," which will require all companies with at least 50 full-time employees to offer health insurance or pay a fine. The delay represents a big help to large firms. Now it's time for the administration to throw a similar lifeline to small businesses -- by lifting the law's cap on annual deductibles (Janet Trautwein, 8/1). 

Fox News: Mr. President, ObamaCare Is Creating A Part Time Economy
The June unemployment rate remained unchanged from the previous month at 7.6 percent, but the June underemployment rate, which includes those who have stopped looking or settled for part-time work, rose sharply from 13.8 percent to 14.3 percent. This is partly due to the transition of employment from full-time to part-time, as the private and public sectors are forced into the perilous compliance standards of the president’s health care law (Rep. Sam Graves, R-Mo., 8/1). 

Chicago Tribune: The Part-Timing Of America
The Affordable Care Act will give companies -- and, surprisingly, their workers -- a big incentive to embrace more part-time employment. That isn't necessarily a problem, except when it comes to paying the health-insurance bills for all those part-timers. Looks like that job will fall to you, taxpayers. Some of the motives at play here will strike you as familiar; others are fresh insights on the part-timing of America (7/31).

New England Journal Of Medicine: The Unanticipated Consequences Of Postponing The Employer Mandate
The Obama administration's decision to postpone implementation of the employer mandate is the latest in a series of delays and alterations of the Affordable Care Act (ACA). But postponing the mandate — which requires larger employers to offer lower-income workers health insurance coverage similar to that available in the new insurance exchanges, on equal and affordable financial terms — may create large ripple effects. The good news is that as compared with instituting the mandate as planned, postponing it should barely increase the number of uninsured Americans after ACA implementation. But it affects other provisions, particularly the individual subsidies for purchasing insurance, and creates distorted incentives that may leave the government paying significantly more than planned (Mark Pauly and Adam Leive, 7/31).

Los Angeles Times: The Latest Misguided GOP Effort To Stop Obamacare
The House is expected to hold yet another symbolic vote this week on a bill to neuter the Patient Protection and Affordable Care Act, once again taking aim at the much-unloved "individual mandate" -- the requirement that virtually all adult Americans obtain coverage, starting in 2014. ... The problem with this approach -- beyond the fact that the bill would be dead on arrival in the Senate -- is that it would leave intact the requirement that insurers offer coverage to all applicants without regard to their medical histories. Insurers would also be barred from charging sicker or riskier customers higher premiums than healthy ones, and would be limited in the surcharges they could impose on older applicants and smokers (Jon Healey, 7/31).

WBUR: Cognoscenti: When Your Doctor Says 'Cancer': The Risks Of Fear Itself
Imagine your doctor saying, "You have cancer." How would you feel? The diagnosis would be more specific: "You have Ductal Carcinoma in Situ" (DCIS) rather than breast cancer, or "You have a Gleason score 4 prostate cancer" rather than prostate cancer. But you would no doubt hear only cancer. How would you react, even if the doctor went on to tell you that what you have is unlikely to ever grow into anything that could kill you, or even harm you, and that in the case of DCIS, it might even go away by itself? (David Ropeik, 8/1).

Sacramento Bee: A Cost Of Dismantling Mental Health Care
Kathy Gaither, the person in charge of daily operations at the California Department of State Hospitals, went on an unexplained administrative leave earlier this month, a week after the state Senate confirmed her appointment. ... Whatever the reason for Gaither's departure, the lack of permanent leadership raises questions of priorities. The California Department of State Hospitals has a $1.6 billion budget and more than 10,000 employees, and is responsible for the care of 6,560 severely mentally ill people in seven state hospitals. The department has been without stable leadership since the previous director retired in December 2010 (Dan Morain, 7/31).

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Stephanie Stapleton

Andrew Villegas

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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.