First Edition: June 20, 2013

Today's headlines include a variety of reports about the health law's implementation as well as related developments from Capitol Hill.

Kaiser Health News: GAO Report Points To Challenges In Setting Up Federal Health Insurance Marketplaces
Kaiser Health News staff writers Mary Agnes Carey, Julie Appleby and Jenny Gold report: “Testing of computer systems and training of consumer assistance guides are behind schedule, but the Obama administration has met other deadlines in its efforts to open new marketplaces where millions of consumers might shop for insurance starting this fall, according to a Government Accountability Office report released Wednesday” (Carey, Appleby and Gold, 6/19). Read the story.

Kaiser Health News: Health Law Provisions To Expand Kids' Dental Coverage May Fall Short, Advocates Say
Kaiser Health News staff writer Mary Agnes Carey, in collaboration with The National Journal, reports: “Some lawmakers and children's health advocates who supported the 2010 health law now find themselves at odds with the Obama administration over an idea that initially seemed simple – expanding coverage for kids' dental care. They say that without major changes, the children they hoped would gain dental coverage -- families who don’t qualify for Medicaid or the Children’s Health Insurance Program -- may not be able to afford it” (Carey, 6/19). Read the story.

The Associated Press/Washington Post: 5 Key Points To Know About The Health Care Overhaul Before Major Provisions Of The Law Kick In
Still a little hazy about the health care overhaul? You have plenty of company. About half the people surveyed earlier this spring by the nonpartisan Kaiser Family Foundation felt they didn’t have enough information to understand how the law will affect their family. Among those with an annual household income of less than $30,000, some 30 percent thought the law had been repealed by Congress or the Supreme Court (6/19).

The Wall Street Journal: What To Expect Of The Small-Business Insurance Exchanges
Looking to buy a small group plan from your state's new health-insurance exchange? There's a risk it won't be ready to open on time in October. A report released Wednesday from U.S. Government Accountability Office said that officials still have big tasks to complete, including reviewing plans that will be sold in the exchanges and training and certifying consumer aides who can help small businesses and individuals find plans (Needleman, 6/19).

The Associated Press: New York Doctors: Health Care Overhaul Will Overwhelm Primary Care Physicians
New York's medical community worries that adding 1.1 million people to insurance rolls under the federal health care overhaul will overwhelm primary care physicians, many of whom are already swamped. Federal data showed nearly 18,000 physicians providing primary care at the start of 2011 in a state with 19.6 million residents. That was the 11th-best ratio among states (6/19).

The Wall Street Journal’s Washington Wire: Sen. Donnelly Backs Key Change In Health-Care Law
Sen. Joe Donnelly of Indiana today becomes the first Democrat who voted for the health-care law to back changes to its requirement that companies offer coverage to employees working 30 hours a week or more or pay a penalty. Mr. Donnelly’s staff said the senator plans to announce Wednesday afternoon that he is signing on as a co-author to a bill initially introduced by Republican Sen. Susan Collins of Maine in April that seeks to change the rule to apply only to workers clocking 40 hours a week or more. The rule kicks in next year (Radnofsky, 6/19).

The Hill: Bipartisan Bill Would Soften ObamaCare Mandate
A pair of centrist senators introduced a bill Wednesday to soften the employer mandate in President Obama's healthcare law. The healthcare law requires employers to offer coverage to employees who work more than 30 hours per week. Some employers have said they will reduce workers' hours to avoid the mandate (Baker, 6/19).

The Washington Post's Wonk Blog: Democrats Like Health Reform Better When It's Called 'Obamacare.' Republicans Not So Much.
It's no secret that the term "Obamacare" gets a reaction from people. But some new numbers from the Kaiser Family Foundation suggest it’s true not just for critics of the health law. According to the nonpartisan group’s June tracking poll, support for the health law among Democrats jumps dramatically when labeled "Obamacare," vs. the plain old “health reform law” language some of us old school media types prefer (Somashekhar, 6/19).

Politico: Planned Parenthood Promoting Obamacare
Planned Parenthood is diving into a new area of education, not without its own controversy: Obamacare. The group’s more than 750 health centers across the country will be promoting the health law and helping women find out about new coverage options for themselves and their families before — and after — enrollment begins Oct. 1. They’re creating everything from refrigerator magnets to online apps that help people enroll in a health plan. Some affiliates will be applying to become official government-funded “navigators” to give people more hands-on help through the signup process (Smith, 6/19).

ProPublica/The Washington Post: Report: 700 Doctors Wrote Possibly Harmful Medicare Prescriptions
More than 700 doctors nationwide wrote prescriptions for elderly and disabled patients in highly questionable and potentially harmful ways, according to a report of Medicare’s drug program released Thursday. The review by the inspector general of the Department of Health and Human Services flags those doctors as “very extreme” in their prescribing and says Medicare should do more to investigate or stop them (Weber, Ornstein and LaFleur, 6/20).

USA Today: Doctors Perform Thousands Of Unnecessary Surgeries
Tens of thousands of times each year, patients are wheeled into the nation's operating rooms for surgery that isn't necessary, a USA TODAY review of government records and medical databases finds. Some, such as Stelly, fall victim to predators who enrich themselves by bilking insurers for operations that are not medically justified. Even more turn to doctors who simply lack the competence or training to recognize when a surgical procedure can be avoided, either because the medical facts don't warrant it or because there are non-surgical treatments that would better serve the patient (Eisler and Hansen, 6/20).

The Washington Post: Chamber: Safety Net Spending Is A ‘Time Bomb’
The nation’s largest business lobbying group launched a renewed effort Wednesday to reduce projected federal spending on safety-net programs, labeling them a “ticking time bomb” that, left unchanged, “will bankrupt this nation.” The effort is aimed at convincing Americans — whom polls show still largely oppose benefit reductions and other changes in Social Security, Medicare and Medicaid — that the nation must rein in spending on these programs (Tankersley, 6/19).

Politico: PhRMA Talks Up Role In Policy And Research
In an interview with POLITICO nearly three years into his reign of the powerhouse drug industry lobby, Castellani was more interested in talking about policy than in flexing political muscle. And he says he wants the pharmaceutical industry to have a reputation for engaging with the big health policy questions of the day, not just for pursuing the narrow economic agenda of Big Pharma (Norman and Haberkorn, 6/20).

Reuters: Two-Fifths Of U.S. Adults Care For Sick, Elderly Relatives
Four in 10 U.S. adults are now caring for a sick or elderly family member as more people develop chronic illnesses and the population ages, a new study has found. ... Researchers, which found that the number of caregivers increased 10 percent between 2010 and 2013, surveyed 3,014 adults nationwide and found that most caregivers were between 30 and 64 years old (Abutaleb, 6/20).

Stateline: New End-Of-Life Measure Quietly Sweeps The Nation
The emergency call came in at 10:47 on a Saturday night: “Woman in Overland Park with difficulty breathing. Code one closest.” Angela Fera, a paramedic in Johnson County, Kan., and her partner raced to the house, sirens blaring. When they arrived, six minutes after the first dispatch, a man told them that his 62-year old wife had terminal cancer and was unconscious. The paramedics found her sitting upright in bed, ghostly pale with a weak pulse and shallow breathing. Death seemed imminent. ... A new end-of-life document, more explicit and binding than a DNR and advanced directives, is designed to clarify patients’ wishes—and spare caregivers such as Fera from facing such wrenching choices (Ollove, 6/20).

The Wall Street Journal: Unions Target Home Workers
As the population ages, more people are being paid by the government to care for the elderly in their homes. That has prompted unions to try to organize more such workers, who typically receive modest wages and few or no benefits. But others question whether these workers even qualify to join a union, noting that many are caring for their relatives and could be considered self-employed. Battles have broken out in many legislatures over moves to allow, or bar, these workers from organizing (Maher, 6/19).

USA Today: GOP House Campaign Chief Says Abortion Ban Is No Blunder
The chief of the GOP's congressional campaign committee dismissed the idea that House passage of an abortion ban this week was a political blunder opening the door to a fresh series of Democratic charges that the Republicans were waging a "war on women" (Page, 6/20).

Los Angeles Times: What Changes Now That Doctors Have Declared Obesity A ‘Disease’?
Does it really matter if the medical establishment calls obesity a “disease” instead of a chronic health condition or a disorder? …
“This will make a difference” in the treatment that obese patients get, said Dr. Rexford Ahima of University of Pennsylvania’s Institute for Diabetes, Obesity and Metabolism. “I would imagine it would cause the insurance companies to think again” about paying for weight-loss treatments, just as they do for smoking-cessation programs, Ahima said (Gorman and Healy, 6/19).

The New York Times: HPV Vaccine Is Credited In Fall Of Teenagers’ Infection Rate
The prevalence of dangerous strains of the human papillomavirus — the most common sexually transmitted infection in the United States and a principal cause of cervical cancer — has dropped by half among teenage girls in recent years, a striking measure of success for a vaccine against the virus that was introduced only in 2006, federal health officials said on Wednesday. … Earlier data from the C.D.C. showed that Hispanic girls were more likely to be vaccinated than white girls, even though they were less likely to come from families with health insurance or to get regular medical care. That is partly because a federal program that covers vaccines for the poor and underserved gave the H.P.V. vaccine to clinics, while many patients with private insurance had high co-pays or had to pay the full price, generally up to $500 for a complete cycle of the vaccine. But cost will be less of an issue after the full implementation of President Obama’s health care law, which Dr. Frieden said requires providers to cover the vaccine at no cost to patients (Tavernise, 6/19).

The Associated Press: Bill Seeks To Reduce Health Care Exchange Secrecy
A state legislative committee on Wednesday approved a bill that would require California's health insurance exchange to make more contract information publicly available, even as advocates for open government urged lawmakers to go further. The Senate Health Committee voted 9-0 to pass the legislation by Republican Sen. Bill Emmerson and Democratic Sen. Mark DeSaulnier. They introduced the bill, SB332, after a story by The Associated Press revealed the unique degree of privacy granted to Covered California, as the exchange is called (Olson, 6/19).

Los Angeles Times: CalPERS Health Premiums Will Rise An Average Of 3% In 2014
The California Public Employees' Retirement System, the country's third-largest purchaser of health benefits, said its health insurance premiums next year would increase 3%, on average, for nearly 1.3 million members. The giant pension fund said that would mark its smallest rate increase since 1998. Premiums at CalPERS rose 9.6% this year and 4.1% in 2012 (Terhune, 6/20).

The Associated Press/Washington Post: Virginia Attorney General Presses Treasury To Release State’s Entire $115M Share Of Settlement
Attorney General Kenneth Cuccinelli’s office is pressing the federal Treasury Department to release Virginia’s remaining $105 million share of a national Medicaid fraud settlement and rescind its demand for more details on how the money will be spent. The office received an initial disbursement of $10 million Wednesday, spokesman Brian Gottstein said (6/19).

Los Angeles Times: Judge Hears Claims Of Neglect In Prison Psych Wards
U.S. District Judge Lawrence Karlton heard that testimony as prison lawyers seek new sanctions against California over the treatment of inmates in the state's crowded prisons, an unintended consequence of Gov. Jerry Brown's failed bid earlier this year to end federal court oversight. In separate motions, prisoners' lawyers also sought orders against use of force and tear gas on mentally ill inmates, their housing in solitary confinement, alleged lack of treatment for inmates on death row, and the continued shipment of inmates at high risk of contracting valley fever to prisons infected with the deadly spores (St. John, 6/19).

Boston Globe: Panel To Assess Hospital Merger
Moving into uncharted territory Wednesday, the state’s new Health Policy Commission voted 10 to 0 to press forward with a full “cost and market impact” review of Partners HealthCare System’s agreement to acquire the 378-bed South Shore Hospital in Weymouth. The review could create a stumbling block for the first major hospital expansion bid in seven years by Boston-based Partners, the largest hospital and physicians group in Massachusetts, which seeks to take over one of the state’s last remaining independent hospitals (Weisman, 6/20).

Boston Globe: Mental Health Clinics Cited
Dozens of therapists who were unlicensed or improperly supervised routinely treated mentally ill patients at three clinics owned by a major provider of care to low-income people in Massachusetts, state records show. At an Arbour Health System clinic in Lawrence, state inspectors determined that all 23 therapists were not qualified to see patients on their own, yet were doing so without regular oversight by a licensed professional. Similar staffing violations were discovered at Arbour clinics in Malden and Fall River. ... Arbour operates five psychiatric hospitals and 11 mental health clinics in Massachusetts. Its for-profit parent, Universal Health Services, is a publicly traded company that earned more than $443 million last year and has staked its future largely on expanding in the behavioral health care market (Conaboy, 6/20). 

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