First Edition: January 29, 2013

Today's headlines include a series of examinations of health law implementation developments on the state level.  

Kaiser Health News: Kidney Donation Over Age 70? Desperate Patients Saying, 'Yes, Please'
Reporting for Kaiser Health News, in collaboration with The Washington Post, Judith Graham writes: "But physicians are conservative about living kidney donors: Nearly three-quarters of transplant centers have not accepted organs from people older than 70, according to Johns Hopkins research" (Graham, 1/28). Read the story and related sidebar.

Kaiser Health News: Insuring Your Health: Long Waits For Consumers When Medicare Is 'Secondary Payer'
In her latest Kaiser Health News consumer column, Michelle Andrews writes: "Anyone who sues for personal injury probably knows that the process may take time. But for Medicare beneficiaries, too often it's not only the legal system that grinds slowly. Lawyers and policy experts say bureaucratic inefficiency at the federal Centers for Medicare & Medicaid Services (CMS) can add months or even years to the process. During that period, a beneficiary often must wait until Medicare is reimbursed for its costs before he or she can receive any payment" (Andrews, 1/28). Read the column.

Kaiser Health News: Capsules: Patient Loads Often At Unsafe Levels, Hospitalist Survey Finds
Now on Kaiser Health News' blog, Alvin Tran reports: "Nearly forty percent of hospital-based general practitioners who are responsible for overseeing patients' care say they juggle unsafe patient workloads at least once a week, according to a study published Monday as a research letter in JAMA Internal Medicine" (Tran, 1/28). Check out what else is on the blog.

The Associated Press/Washington Post: Legislators Worry About Costs As They Weigh Expanding Medicaid To Cover Low-Income Adults
As state legislative sessions advance, lawmakers are debating whether to expand their Medicaid programs as provided by President Barack Obama's health care law. It could be one of the most important decisions this year. So far 17 states and the District of Columbia have signaled they will go ahead, while 11 states are refusing. The rest are weighing options (1/28).

Politico: States Rethink High-Risk Pools, Exchanges
When the health exchanges open next year, they will cover some of the sickest and costliest patients, people who cannot easily get insurance precisely because they are so likely to run up bills that no insurer would want to be on the hook for. The federal health law contains several measures designed to spread the risk and tamp down some of the expected turbulence in the market. But a recent change in how the Department of Health and Human Services plans to run a three-year, $20 billion fund — known as reinsurance — to cushion health plans that end up with lots of high-cost customers is forcing states to rethink their own timetable for shifting some of their highest-risk people into the exchanges (Norman, 1/29).

The Associated Press/Washington Post: Questions And Answers About DC's Health Insurance Exchange
This fall, new insurance markets called exchanges will open in each state and the District of Columbia. A major component of President Barack Obama's health care overhaul, exchanges are online markets where consumers can choose between private health plans similar to what workers at large corporations already get. The government will help many middle-class households pay their premiums. Here are some facts about the district's exchange (1/28).

The Associated Press/Wall Street Journal: NY Health Exchange Expects To Insure 1.1 Million
President Barack Obama's federal health care overhaul, known as the Affordable Care Act, requires every state to have a new health insurance marketplace called an exchange. The exchange will be an online shopping center for small business and for people who don't get health coverage from their employer. Users will be able to compare the costs and benefits of various insurance plans, and they'll be able to find out whether they qualify for federal subsidies to help pay their premiums (1/28).

The New York Times' Bucks Blog: Breast Pump Coverage Under New Law Varies In Practice
As part of its coverage of preventive health-care services for women, the Affordable Care Act requires many insurance plans to provide equipment and services to promote breast-feeding, like breast pumps and lactation counseling, at no extra cost. The requirement took effect last summer but kicked in for many plans on Jan. 1, the start of new insurance plan years for many employers (Carrns, 1/28).

The New York Times: Biotech Firms, Billions At Risk. Lobby States To Limit Generics
In statehouses around the country, some of the nation’s biggest biotechnology companies are lobbying intensively to limit generic competition to their blockbuster drugs, potentially cutting into the billions of dollars in savings on drug costs contemplated in the federal health care overhaul law (Pollack, 1/28).

The Wall Street Journal: Patriot Coal Seeks Trust To Limit Retiree Health Costs
Patriot Coal Corp., currently under Chapter 11 bankruptcy protection, is seeking to limit its obligation to provide retiree health benefits to 22,000 active miners, retirees and their spouses and set up an outside trust to fund future benefits, according to documents filed in federal court Monday (Maher, 1/28).

Los Angeles Times: Legislation Proposed To Help California Launch Healthcare Overhaul
The state Legislature gaveled in a special session on healthcare Monday, pushing forward with sweeping proposals to help California implement President Obama's healthcare overhaul. The measures, including a major expansion of Medi-Cal, the state's public insurance program for the poor, would cement the state's status as the nation's earliest and most aggressive adopter of the federal Affordable Care Act. Beginning in January 2014, the law requires most Americans to buy health insurance or pay a penalty (Mishak, 1/29).

The New York Times: Rescue Plan Is Emerging For Hospital In Manhattan
Manhattan’s only remaining hospital south of 14th Street, New York Downtown, has found a white knight willing to take over its debt and return it to good health, hospital officials said Monday (Hartocollis, 1/28).

Los Angeles Times: Healthcare Providers Appeal To Block Medi-Cal Cut
California healthcare providers are appealing a December court decision that would allow the state to cut spending on medical care for poor residents. The case revolves around the state’s 2011 attempt to reduce by 10% reimbursements to doctors, pharmacies and others who provide healthcare through the Medi-Cal program. The cut has been continuously blocked by judges worried about how it would affect access to medical care (Megerian, 1/28).

NPR: What’s Wrong With Calling Obesity A Medical Problem?
Americans have gotten heavier since 1980 — this we know. And most doctors would say that the extra weight has made us more prone to heart disease, diabetes, arthritis, hypertension and even cancer. It's become a source of major national anxiety. The Robert Wood Johnson Foundation predicts that every state in the nation will have an obesity rate greater than 44 percent by 2030, and will be sicker for it (Barclay, 1/28).

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This is part of Kaiser Health News' Daily Report - a summary of health policy coverage from more than 300 news organizations. The full summary of the day's news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.