First Edition: February 13, 2012

Today's headlines include reports on how Medicare played into the President's State Of The Union address. 

Kaiser Health News: $2 Billion Medicaid Program Helps Mostly Illegal Immigrants
Kaiser Health News staff writer Phil Galewitz reports: "During the debate over the 2010 federal health care overhaul, Democrats promised that illegal immigrants wouldn't be among the 27 million people who'd gain coverage. President Barack Obama repeated that pledge last month when he outlined his immigration plan" (Galewitz, 2/12). Read the story.

Kaiser Health News: Higher Hospital Readmissions Aren't Linked To Fewer Deaths, Study Finds
Kaiser Health News staff writer Jordan Rau reports: "Some hospitals with high readmission rates say they're saving lives by bringing patients back at the first hint of trouble. The evidence for this is that a handful of hospitals with high readmission rates also have extremely low death rates among Medicare patients. But a study published Tuesday finds that there's no major link between hospitals with high readmissions and those with low mortality rates" (Rau, 2/12). Read the story.

Kaiser Health News: Capsules: Health Figures Big In State Of The Union Guest List
Now on Kaiser Health News' blog, Phil Galewitz reports: "Five of the 24 people invited to sit near First Lady Michelle Obama at tonight’s State of the Union have strong health care connections. They include a governor, a business owner and a beneficiary of the health law provision that prevents health plans from denying coverage because of pre-existing conditions" (Galewitz, 2/12). Check out what else is on the blog.

The New York Times' News Analysis: In An Age Of Spending Cuts, Making The Case For Government
In setting out how government could reach what he considers an acceptable level of fiscal stability through Medicare cuts and tax increases, Mr. Obama was doing more than trying to set the terms for the next, fast-approaching rounds in his fiscal cage match with Congressional Republicans (Stevenson, 2/13).

The Wall Street Journal: Obama Urges Action On Expansive Agenda
Mr. Obama repeated his earlier calls for reducing the budget deficit through a mix of tax increases and spending cuts. He also said he would support "modest reforms" in programs including Medicare, as long as wealthy Americans contribute as well (Nicholas and Nelson, 2/12).

The Washington Post: Obama: Limited Cost-Cutting For Medicare
When it came to Medicare, Obama reiterated his determination to accept only limited cost-cutting proposals. Among the ideas he appeared to reference was requiring pharmaceutical companies to charge Medicare the lower rates they currently receive from Medicaid, the federal-state health insurance program for the poor (Aizenman, 2/12).

The Washington Post: Fact Checker: Medicare Reform
Using Congressional Budget Office estimates of the president’s budget, we see that over 10 years, Obama's proposals would achieve $337 billion from 2013 to 2022, compared to $483 billion for Bowles-Simpson in the same time period. (Bowles-Simpson, or more accurately the National Commission on Fiscal Responsibility and Reform, is considered by many in Washington to be the model for a bipartisan approach for deficit reduction.) However, in 2022, both would achieve exactly the same amount of savings — $68 billion (Kessler, 2/12).

Los Angeles Times: Rubio Responds To President’s Speech with Familiar GOP Themes
Rubio, speaking from the Capitol, repeated GOP calls for a constitutional balanced-budget amendment and an overhaul of the Medicare and Social Security programs, though he provided no specifics. "Anyone who is in favor of leaving Medicare exactly the way it is right now is in favor of bankrupting it," Rubio said (Barabak, 2/12).

The Wall Street Journal: States Gear Up To Pitch Health Plans
Supporters of the 2010 health law are looking to draft sports teams, pharmacies and political ground operations for their biggest marketing campaign yet: persuading millions of uninsured, hard-to-reach and skeptical Americans to sign up for health plans this fall (Radnofsky and Dooren, 2/12).

The Associated Press/Washington Post: Brown to Testify On Measure To Expand Medicaid And Create Funding Stream For Exchange
Lt. Gov. Anthony Brown will be outlining the latest steps in Maryland to implement federal health care reform. Brown is scheduled to testify Wednesday on legislation before a House panel and a Senate committee (2/13).

The New York Times: Dispute Develops Over Discount Drug Program
The program, known as 340B, requires most drug companies to provide hefty discounts — typically 20 to 50 percent — to hospitals and clinics that treat low-income and uninsured patients. But despite the seemingly admirable goal, the program is now under siege, the focus of a fierce battle between powerful forces — the pharmaceutical industry, which wants to rein in the discounts, and the hospitals, which say they might have to cut services without them (Pollack, 2/12).

The New York Times: Big Insurer Hires  A Hospital Executive As Chief
Joseph R. Swedish, the 61-year-old chief executive of a major nonprofit Catholic-owned health system, Trinity Health, will become WellPoint's chief executive on March 25. He will be responsible for leading the company, which operates profit-making Blue Cross plans in 14 states, into a future in which health insurers will sell insurance through state and federal exchanges and to work in new ways with hospitals and doctors (Abelson, 2/12).

The Wall Street Journal: WellPoint Names New Chief Executive
WellPoint Inc. WLP 0.00%named Joseph R. Swedish as its new chief executive, unexpectedly turning to a hospital-industry veteran to lead the second-largest U.S. health insurer through the challenging implementation of the health-care overhaul (Mathews and Kamp, 2/12).

The Associated Press/Los Angeles Times: Health Insurer WellPoint Picks Joseph Swedish As Its New CEO
Swedish's resume includes work with HCA, the nation's largest hospital chain. He also has served as a director for another insurer, Coventry Health Care. In his new job, Swedish's tasks will include helping WellPoint prepare for coverage expansions that start next year under the federal healthcare overhaul (2/13).

The New York Times: College Health Plans Respond As Transgender Students Gain Visibility
Over the last decade, as activists started pushing colleges to accommodate transgender students, they first raised only basic issues, like recognizing a name change or deciding who could use which bathrooms. But the front lines have shifted fast, particularly at the nation’s elite colleges, and a growing number are now offering students health insurance plans with coverage for gender reassignment surgery (Perez-Pena, 2/12).

Politico: Broader Therapies Could Further Strain Medicare
A lawsuit may have lit the fuse on a budgetary time bomb in Medicare, even though it simply reaffirms what should be a routine payment policy for services like physical therapy that the massive federal health care program has always had. People on Medicare are entitled to various kinds of rehab and therapeutic services — occupational or speech therapy, for instance. But over the past 30 years or so, the coverage became spotty. Some people were able to get that care only if it could help them get better — not if it was aimed at keeping them stable or slowing a predictable decline. That became known as the “improvement standard.” The care was only for those who would improve (Norman, 2/13).

The Associated Press/Wall Street Journal: Study Questions Kidney Cancer Treatment In Elderly
In a stunning example of when treatment might be worse than the disease, a large review of Medicare records finds that older people with small kidney tumors were much less likely to die over the next five years if doctors monitored them instead of operating right away (2/12).

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