Tuesday, February 9, 2010

Kaiser Daily Health Policy Report:
Check back on Kaiser Health News for the latest headlines

KHN Original Reporting & Commentary

• 1. For Senior Care, Sometimes It Does Take A Village
• 2. Sebelius To GOP: 'Don't Get Wrong Impression' About Obama Health Summit
• 3. Political Cartoon: 'Saints' Haircut'

Health Reform

• 4. GOP Wary Of Talks While Both Sides Express Low Expectations For Health Care Summit
• 5. Faced With Stalled Overhaul, Dems Still Wonder Who To Blame

Capitol Hill Watch

• 6. Health Debate Travails Boost Lobbying Firms

Health Care Marketplace

• 7. Anthem Blue Cross 39 Percent Rate Hike Draws Ire Of Federal, Calif. Regulators
• 8. As Health Overhaul Stalls, Hospitals Face Rising Cost Of Uncompensated Care
• 9. Insurer To Take New Role In Assessing Cancer Treatments

Quality

• 10. Surgical 'Checklist' Saves Money, Lives

State Watch

• 11. Budget Issues: Kansas To Downsize Hospitals For Disabled; Nevada May Cut Enrollment In Programs For Mentally Ill And Seniors
• 12. States Push Ahead On Health Care Reforms And Policy Issues, Pre-Empting Some Provisions Of Congressional Efforts

Editorials and Opinions

• 13. Today's OpEds: Questioning Transparency, The Bipartisan Summit And Starting Anew

KHN Original Reporting & Commentary

1. For Senior Care, Sometimes It Does Take A Village

[Feb 09, 2010]

top

2. Sebelius To GOP: 'Don't Get Wrong Impression' About Obama Health Summit

[Feb 09, 2010]

top

3. Political Cartoon: 'Saints' Haircut'

[Feb 09, 2010]

top

Health Reform

4. GOP Wary Of Talks While Both Sides Express Low Expectations For Health Care Summit

[Feb 09, 2010]

News outlets are focusing on political reaction to President Obama's Feb. 25 bipartisan summit on health care reform.

Los Angeles Times: Democrats are unfolding "a strategy to force Republicans to put policy ideas on the table that Democrats believe they can exploit in the fall elections. After a year of suffering GOP attacks on the president's plans for healthcare and the economy, the White House and congressional Democrats are gambling that voters will find Republican ideas to be even more unpopular." One of the Republican ideas includes a proposal for a long-term budget fix from "Rep. Paul D. Ryan (R-Wis.) that would aim to eliminate the federal deficit by, among other things, partly privatizing Social Security and converting Medicare into a voucher program" (Oliphant and Levey, 2/8).

The Wall Street Journal reports that both sides face risks with the confab: "Republicans worry they will wind up as props in a White House show of bipartisanship and the summit will involve 'changing the message but not the reality,' as one House Republican aide put it. And it's still not clear how the summit would help Democrats rescue their legislation, which has been stuck since their defeat in a Senate race in Massachusetts last month" (Meckler, 2/8).

The Associated Press reports that serious ideological differences separate the parties: "Both sides want to bar insurance companies from turning down people with health problems, but only Democrats propose requiring most people to get coverage -- a necessary first step, according to most experts. To illustrate the gap, the House GOP bill would cover 3 million uninsured people, the House Democratic version 36 million." Republicans say that the problem is in the Democrats' "big government" approach to the problem, said Rep. Dave Camp, R-Mich., who wrote the House GOP health reform bill (Alonso-Zaldivar, 2/8).

The New York Times: "When Republicans take President Obama up on his invitation to hash out their differences over health care this month, they will carry with them a fairly well-developed set of ideas intended to make health insurance more widely available and affordable, by emphasizing tax incentives and state innovations, with no new federal mandates and only a modest expansion of the federal safety net." The GOP plan also focuses on providing money to establish state-based high-risk insurance pools and looks at reining back medical malpractice costs with caps on pain and suffering. "They oppose the Democrats' call for a big expansion of Medicaid, which Republicans say would burden states with huge long-term liabilities. ... While the Congressional Budget Office has not analyzed all the Republican proposals, it is clear that they would not provide coverage to anything like the number of people -- more than 30 million -- who would gain insurance under the Democrats' proposals" (Pear and Herszenhorn, 2/8).

NPR: "Supporters of the president" say the summit may "also give cover to moderate Democrats who have pushed back at growing pressure to use the legislative procedural maneuver known as reconciliation to advance the legislation with simple majority votes in the Senate and House" (Halloran, 2/8).

Politico: "Obama hopes to walk into the Feb. 25 summit with an agreement in hand between House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid on a final Democratic bill, so they can move ahead with a reform package after the sit-down." But GOP leaders from the House asked, in a letter to the White House, "pointed questions that they would like answered before the meeting at Blair House." Among them -- would President Obama be willing to give up on using reconciliation to pass health reform (Budoff Brown and O'Connor, 2/9).

The Washington Times reports that in the letter, "sent late Monday to the White House, House Minority Leader John A. Boehner of Ohio and Minority Whip Eric Cantor of Virginia said that if President Obama will not start over, they 'would rightly be reluctant to participate' in the Feb. 25 summit he proposed" (Rowland, 2/9).

Kaiser Health News reports that Health and Human Services Secretary Kathleen Sebelius said Monday that the process is not starting over. "'A lot of people ask if this is starting over (on a health overhaul), the answer is absolutely not,' she said Monday in a talk at the AcademyHealth policy conference in Washington. Instead, she said the Feb. 25 televised event is to 'get Republicans to re-engage in the process. It is not acceptable that half the legislative body pushed away from the table months ago and said "we do not want to participate"' ... Sebelius said she hopes Republicans will put forward 'a real plan, not just criticisms'" (Galewitz, 2/8).

Roll Call: The GOP letter's included questions "about the upcoming meeting, such as whether health care experts and state lawmakers would be invited and whether Obama planned on introducing a legislative proposal at this discussion. 'Your answers to these critical questions will help determine whether this will be a truly open, bipartisan discussion or merely an intramural exercise before Democrats attempt to jam through a job-killing health care bill that the American people can't afford and don't support,' the letter said" (Kucinich, 2/8).

The Washington Post reports that the Republicans wrote that bipartisanship "'is not writing proposals of your own behind closed doors, then unveiling them and demanding Republican support,' Boehner and Cantor wrote. 'Bipartisan ends require bipartisan means.'" White House Press Secretary Robert Gibbs said that Obama remains open to any good ideas that "stand up to objective scrutiny." The text of the letter is also included (Shear, 2/8).

USA Today: In the meantime, other "Republicans such as (Rep. Tom) Price pointed to a House GOP health care bill, unveiled last year, as a starting point for negotiations with the White House. The $61 billion proposal, which the House rejected in November, would have let consumers purchase health insurance across state lines -- which, Price said, would foster competition" (Fritze, 2/9).

Related KHN story: The Debate Over Selling Insurance Across State Lines (Galewitz, 2/3)

top

5. Faced With Stalled Overhaul, Dems Still Wonder Who To Blame

[Feb 09, 2010]

top

Capitol Hill Watch

6. Health Debate Travails Boost Lobbying Firms

[Feb 09, 2010]

top

Health Care Marketplace

7. Anthem Blue Cross 39 Percent Rate Hike Draws Ire Of Federal, Calif. Regulators

[Feb 09, 2010]

Los Angeles Times: "California insurance regulators asked Anthem Blue Cross to delay controversial rate increases of as much as 39% for individual policies, hikes that have triggered widespread criticism from subscribers and brokers -- and now from the federal government. In a rare step, the Obama administration called on California's largest for-profit insurer to justify its rate hikes, saying the increases were alarming at a time when subscribers face skyrocketing healthcare costs."

"In a letter to Anthem's president, Health and Human Services Secretary Kathleen Sebelius voiced serious concern over the higher premiums, which go into effect March 1 for many of the insurer's estimated 800,000 individual policyholders" (Helfand, 2/9).

Reuters: "Sebelius called for Anthem to offer the public a detailed explanation of the rate hike as well as other information about how much of consumers' premium dollars go toward medical care rather than other expenditures. ... While it was unclear what, if any, steps the U.S. health department could take, Sebelius said she was 'very disturbed' and was 'closely monitoring' the Anthem situation" (Heavey, 2/8).

The Associated Press: Sebelius "said the company should also make public what percentage of customers' premiums go to medical care versus administrative costs. ... Sebelius said Anthem Blue Cross' parent company, WellPoint Inc., 'has seen its profits soar.' ... WellPoint earned $536 million in the final three months of last year."

"President Barack Obama cited the Anthem rate hikes in an interview with CBS' Katie Couric on Sunday as a reason to move forward with his health overhaul legislation, which is stalled in Congress" (Mohajer, 2/8).

The Washington Post: "The unusual salvo offers a reminder that, even as health-care legislation lies in limbo in Washington, the battle over surging health care costs continues in other venues."

"'We regret the impact this has on our members,' the company said in a statement. 'It highlights why we need sustainable health care reform to manage the steadily rising costs of hospitals, drugs and doctors. As such, it is important to go back to the beginning and get health care reform done right'" (Macgillis, 2/8).

top

8. As Health Overhaul Stalls, Hospitals Face Rising Cost Of Uncompensated Care

[Feb 09, 2010]

For American hospitals, "the cost of doing nothing in Washington translates into tens of billions of dollars each year in medical bills that go unpaid by patients with little or no insurance," The New York Times reports. "Nationwide, the cost of unpaid care for hospitals, which includes charity care as well as money that could not be collected from patients, was around $36 billion in 2008. It is expected to spiral higher." Some hospitals, such as Park Nicollet Health Services near Minneapolis, are already cutting back services and staff.

"Even for many patients who do have coverage under Medicaid or Medicare, some experts say, severe state and federal budget constraints mean hospitals will probably get squeezed by significant government payment cuts, whether or not the overhaul legislation moves forward" (Abelson, 2/8).

The Wall Street Journal: "Hospital stocks have dropped as much as 20% from their January peaks," in part because health overhaul would have reduced uncompensated care, which "amounts to more than 20% of revenue for hospital operators such as Health Management Associates and Community Health Systems, said John Ransom of Raymond James. Moreover, hospitals likely have missed their chance to negotiate a deal with lawmakers providing more certainty on government payments. Federally-run Medicare and state-administered Medicaid account for 40% to 45% of hospital revenue, Mr. Ransom said" (Jannarone, 2/9).

Reuters: "Last year, debate over broad health reform created uncertainty over the shape of the insurance market - making it difficult to make any strategic decisions -- while the companies also hoarded cash in the wake of the credit crisis and economic downturn. ... Analysts and company executives say the industry still has room for overall consolidation, as companies look to gain market share and leverage in local markets. Insurers that focus on Medicaid plans for low-income Americans - a potential growth area - also could be targets" (Krauskopf, 2/8).

top

9. Insurer To Take New Role In Assessing Cancer Treatments

[Feb 09, 2010]

top

Quality

10. Surgical 'Checklist' Saves Money, Lives

[Feb 09, 2010]

top

State Watch

11. Budget Issues: Kansas To Downsize Hospitals For Disabled; Nevada May Cut Enrollment In Programs For Mentally Ill And Seniors

[Feb 09, 2010]

Kansas Health Institute reports on downsizing at hospitals for the developmentally disabled: "Admissions to Kansas Neurological Institute will be halted this summer and restricted at Parsons State Hospital, the state's top welfare agency official said today. Don Jordan, secretary of the Kansas Department of Social and Rehabilitation Services, announced those decisions Monday before the House Social Services Budget Committee. Last year, the state's two hospitals for people with developmental disabilities recorded 20 admissions -- two at KNI; 18 at Parsons. ... Jordan said he expects the moves to take about three years. A committee made up of hospital officials and advocates for the developmentally disabled will spend the summer developing new admission standards for the hospitals." The move comes after Gov. Mark Parkinson ordered state officials to identify patients who could be moved safely into community settings. Meanwhile, family members worry "that many medically fragile residents would not survive in community settings" (Ranney, 2/8).

The Las Vegas Sun: "During Gov. Jim Gibbons' State of the State speech Monday, he told Nevadans to prepare for a smaller state government. Although the list of what he wants to jettison is not finalized, and some of these cuts need legislative approval, lawmakers privately have signaled that many will go through. The cuts would run from the dramatic -- allowing more mentally ill to become homeless -- to the mundane -- eliminating vacant positions." And, although the governor rejected proposed cuts, "such as eliminating a health insurance program that covers 22,000 children of the working poor, he proposed curtailing enrollment in programs that serve the mentally ill, mentally disabled and seniors" (Schwartz, 2/9).

The Concord Monitor: "State hospitals and health care providers are still calculating the impact of impending cuts to their funding. But, they warn, providers will not shoulder the cuts alone. Eventually, the cost of the services will be borne by average people through higher insurance premiums. ... On Friday, Health and Human Services Commissioner Nicholas Toumpas laid out a series of cost-cutting measures needed to fill an expected $43 million shortfall in the department's budget for fiscal year 2010. The shortfall was due mostly to higher-than-expected caseloads. Medicaid reimbursements for hospitals, child-care subsidies and nursing homes were among the areas hardest hit" (Schoenberg, 2/9)

Louisville Courier-Journal: With the worsening of the economy, "Kentucky's Medicaid rolls are rising faster than at any other time in the past decade, adding poor, disabled and low-income people at the rate of 3,400 a month. Kentucky's federal-state plan now covers about 790,000 people -- a record number for the state and roughly 20 percent of its 4 million residents. More than half are children. ... As a result, Medicaid spending in Kentucky has jumped from $3.4 billion 10 years ago to the current $5.4 billion program, a 58 percent increase. And officials don't see any relief in the next two years, even as the state faces one of its biggest budget shortfalls ever" (Yetter, 2/9).

top

12. States Push Ahead On Health Care Reforms And Policy Issues, Pre-Empting Some Provisions Of Congressional Efforts

[Feb 09, 2010]

Politico: "State lawmakers in at least three dozen states are pushing ahead with a series of measures aimed at pre-empting whatever might come out of Washington. On the left, Democrats in the California Senate recently approved a measure to establish a state-run, single-payer health care system favored by liberals on Capitol Hill. And on the right, conservatives in Virginia and other states are pushing legislation to stave off federal efforts to mandate that individuals secure insurance coverage or require businesses to provide it" (O'Connor, 2/9).

Columbia Missourian: "The Missouri Senate spent nearly all of its session time Monday on resolutions that would urge the state's attorney general to sue the federal government for legislation that may never see the light of day in the U.S. Congress." The legislation would urge the state attorney general to join with "other state attorneys general in threatening a lawsuit against the federal government if a version of the health care reform is passed into law. The attorneys general, led by Henry McMaster of South Carolina, have said they would sue over a provision inserted into the U.S. Senate version of health reform that was designed to win the support of conservative U.S. Sen. Ben Nelson, D-Neb." That language would have exempted Nebraska on a permanent basis "from funding the expansion of Medicaid that would be required under the proposed bill" (Bushnell, 2/8).

Modern Healthcare, on the rise of uninsured residents in Minnesota: "Less than 60% of Minnesotans had health insurance through an employer in 2009, which contributed to a notable increase in the number of residents without insurance in a state that typically has rates of coverage higher than national averages, a new study indicates. Authors of the Minnesota Health Access Survey said the results likely will serve as a preview of other state and national surveys because Minnesota is one of the first states to report academic findings on the rate of uninsured people for 2009." The survey "found that the number of Minnesotans without insurance increased by 106,000 between 2007 and 2009, leaving the state's uninsured rate at 9.1%, compared with 7.2% two years earlier" (Carlson, 2/8).

The Philadelphia Inquirer reports on efforts by the "Law Enforcement Health Benefits Inc., which oversees health-care benefits for Philadelphia police. LEHB and its administrator, Thomas Lamb, are roundly praised for aggressively reining in costs. ... Even so, LEHB's efforts cannot offset city health-care costs that are high relative to other employers', mostly because Philadelphia employees pay little out of their own pockets. That leaves taxpayers shouldering health-care costs that jumped 123 percent from 2001 to 2008, a period in which city revenue rose only 38 percent. ... Starting in July, Lamb will be at the forefront of a new effort to control medical costs known as self-insurance. Instead of paying a premium to its insurer, Independence Blue Cross, LEHB, using city funds, will now pay claims as they come in. The city hopes to save about $5 million in fiscal 2001 because of the switch to self-insurance" (Hill, 2/9).

St. Paul Pioneer Press: A legislative effort "to rescue a state-run health care program for the poor took its first hesitant step Monday toward becoming law." The measure, advanced by Sen. Linda Berglin, DFL-Minneapolis, is estimated to cost roughly $320 million and "would restore coverage, now set to expire at the end of March, for those earning less than $7,800 a year." A companion measure is moving through the House. "The bill is on a fast track as one of the big early tests of the 2010 session. It passed out of the Senate's Economic Development and Housing Budget Division on Monday, will be heard in the Senate's Finance Committee today and is headed toward a vote Thursday on the floor of the Senate" (Hoppin, 2/8).

Kansas Health Institute: "Kansas is going to need more doctors to meet the growing needs of an aging population, officials here say. Meanwhile, the University of Kansas School of Medicine in Wichita has been successful training doctors who choose to remain in the state. Almost half its graduates have stayed in Kansas; the national average for retaining medical school graduates is 29 percent. With the aim of turning out more graduates, university officials here have long wanted to convert the Wichita campus to a four-year school. It's a two-year program, now" (Ranney, 2/9).

top

Editorials and Opinions

13. Today's OpEds: Questioning Transparency, The Bipartisan Summit And Starting Anew

[Feb 09, 2010]

top

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2010 Kaiser Health News. All rights reserved.

To subscribe, unsubscribe, or manage your email subscription options, including your preference for Text or HTML formatted emails, click here.

If you need help or have questions, please send an email to subscriptions@kaiserhealthnews.org.

Please do not reply to this email as this address is not monitored.