KHN ORIGINAL REPORTING & GUEST OPINION
- Building Ambitions: The Big Money World Of Kids' Care (A Three-Day Series)
- Parents Fear Health Law Could Derail Autism Coverage
- Health On The Hill: Religious Freedom, Individual Mandate And Anti-Injunction Act At Issue In D.C. Circuit Court
- Political Cartoon: 'But Wait, There's More?'
HEALTH REFORM
- Justice Dept. Action Could Impact Timing Of High Court Ruling
- GOP Lawmakers Show No Sign Of Backing Off Health Law Waivers Controversy
- Dem Lawmakers, Advocates Push To Save CLASS Act
CAPITOL HILL WATCH
HEALTH CARE MARKETPLACE
- GAO: Oversight Needed On Program That Gives Safety Net Providers Drug Discounts
- Insurers, Patients Wrestle With Payment, Care Issues And Strategies
- NPR: Bartering To Cover Health Care Costs
STATE WATCH
EDITORIALS AND OPINIONS
KHN ORIGINAL REPORTING & GUEST OPINION
Building Ambitions: The Big Money World Of Kids' Care (A Three-Day Series)
Reporting for Kaiser Health News, in collaboration with McClatchy, reporter Gilbert M. Gaul filed this story, the first in the three-part series: Growing Size And Wealth Of Children's Hospitals Fueling Questions About Spending. He writes: "Rising from a 60-acre field of old cypress swamp and cattle pasture near the Orlando airport, the 7-story Nemours Children's Hospital will be a monument to 'best-in-class' care, its leaders boast. That may be the case. But at a cost of about $400 million, the equivalent of $4.2-million for each of its 95 beds, Nemours will also rank among the more expensive children's hospitals ever built when it is completed next year. Some people believe construction never should have begun" (Gaul, 9/25).
For more information about this series, you can watch a related video in which Jackie Judd discusses more with Gaul, the reporter, and check out a sidebar exploring charity care at children's hospitals as well as two charts, one detailing charitable spending and one detailing the wealth of children's hospitals.
Look for the second part of the series on Sept. 27.
Parents Fear Health Law Could Derail Autism Coverage
Kaiser Health News staff writer Phil Galewitz, working in collaboration with The Washington Post, reports: "Autism treatment advocates have won one legislative battle after another since 2007, most recently in California, which sent a bill to the governor this month mandating that insurers cover the disorder. Now more than half the states have such requirements, but that success could be in jeopardy as federal officials set new national standards for health coverage" (Galewitz, 9/24). Read the story.Health On The Hill: Religious Freedom, Individual Mandate And Anti-Injunction Act At Issue In D.C. Circuit Court
Kaiser Health News staff writer Mary Agnes Carey and ABC News' Ariane de Vogue discuss Friday's oral arguments in the American Center for Law and Justice challenge to the health law (9/23). Both a transcript and audio for the discussion are available. Read the transcript or listen to the interview.
Political Cartoon: 'But Wait, There's More?'
Kaiser Health News provides a fresh take on health policy developments with "But Wait, there's More?" by Jen Sorensen.HEALTH REFORM
Justice Dept. Action Could Impact Timing Of High Court Ruling
The Obama administration must decide today whether to ask the full U.S. 11th Circuit Court of Appeals to reconsider a 2-1 August decision declaring unconstitutional the health law's individual mandate. If it does seek the full court's review, which could take weeks or months, it will likely push back a Supreme Court ruling until 2013.
Los Angeles Times: Obama Administration Must Make Risky Health Care Decision
Obama administration lawyers face a decision by Monday that carries a high political risk and will probably determine whether the Supreme Court decides on the constitutionality of the health care law before next year's presidential election (Savage, 9/25).
Meanwhile, late last week, the D.C. Circuit Court heard oral arguments in another challenge to the health law, this one brought by the American Center for Law and Justice.
Kaiser Health News: Health On The Hill: Religious Freedom, Individual Mandate And Anti-Injunction Act At Issue In D.C. Circuit Court
Kaiser Health News staff writer Mary Agnes Carey and ABC News' Ariane de Vogue discuss Friday's oral arguments in the American Center for Law and Justice challenge to the health law (9/23). Both a transcript and audio of the discussion are available.
The Associated Press/Washington Post: Conservative-Dominated Appeals Court Panel In D.C. Hears Challenge To Health Care Overhaul
A conservative-leaning panel of federal appellate judges raised concerns about President Barack Obama's health care overhaul Friday, but suggested the challenge to it may be premature. The arguments at the U.S. Court of Appeals in Washington over a lawsuit against Obama's signature domestic legislative achievement focused on whether Congress overstepped its authority in requiring people to buy health insurance or pay a penalty on their taxes, beginning in 2014 (9/23).
The Wall Street Journal: Judges Air Doubts On Challenge To Health Overhaul
Judges on a federal appellate court suggested Friday that last year's health care overhaul was an unprecedented assertion of power by the government, but they didn't clearly signal a readiness to strike down the law. The court at times questioned whether it even had jurisdiction to consider the case, an issue that could delay an ultimate resolution on the law's constitutionality (Kendall, 9/24).
CQ Health Beat: Judges Ponder 'Privatized Social Safety Net' In Health Care Law Arguments
Just down the street from the U.S. Capitol where the health care overhaul was written, three appeals court judges on Friday probed whether the landmark measure signals a new direction in social policy and if it's up to courts to "get in the middle" of that movement, as Judge Brett Kavanaugh, a Republican appointee, put it. "This could be the blueprint for a privatized social safety net," mused Kavanaugh, whose comments were somewhat surprising given that he is a former aide in the President George W. Bush administration and a member of the conservative Federalist Society. He placed the health care law in the context of a historical policy progression beginning with the New Deal era of the 1930s and continuing with the Great Society of the 1960s (Norman, 9/23).
National Journal: D.C. Circuit Hears Fourth Big Health Care Case
A conservative panel of appellate judges gave the Obama administration's signature health care reform law a mixed reception during oral arguments on the latest legal challenge to the law on Friday — and signaled that overturning the 2010 law could have repercussions beyond health care. The case before the D.C. Circuit Court is the fourth challenge to the 2010 law to be considered by a federal appellate court, and while the issue is considered likely to reach the Supreme Court, legal experts say the other cases are probably going to get there first. But the three-judge panel randomly selected to hear the D.C. case included two influential conservative judges with close ties to justices on the Supreme Court. If they vote to uphold the law, it could predict how the high court resolves the cases, court watchers said (Sanger-Katz, 9/23).
Bloomberg: Obama Health Care Law Gets Mixed Reaction From Appeals Court
President Barack Obama's health care law got a mixed reception in its fourth review by a federal appeals court as three judges grappled with questions about the law's constitutionality and their own authority to rule on it. In a two-hour argument yesterday in Washington, two judges of the U.S. Court of Appeals for the District of Columbia Circuit said a ruling upholding the law, which requires that most Americans buy insurance or face a tax penalty, could leave the government with unprecedented power over its citizens. "In 220 years there has been a whole lot of laws and a lot of crises, yet Congress has never once mandated a purchase," said Judge Brett Kavanaugh, adding that the "lurking next step" might be a law requiring investment in private retirement accounts (Schoenberg, 9/24).
GOP Lawmakers Show No Sign Of Backing Off Health Law Waivers Controversy
Even though the Obama administration decision to end health law exemptions for businesses and unions has now kicked in, Republicans say they will keep up their criticism. Politico Pro explores some of the questions that still surround this waiver program.
The Hill: Republicans Vow To Keep Controversy Over Health Reform Waivers Alive
GOP lawmakers want to make sure that health law waivers remain the gift that keeps on giving. Obama administration officials hope their decision to end controversial exemptions for businesses and unions this past week will mute the barrage of monthly criticism they've been getting for the past year. Don't hold your breath, Republicans say. "There is no end to the frustration and embarrassment that's going to come their way," said Rep. Michael Burgess (R-Texas). "I don't know that they've stopped the hemorrhaging from the waivers. I suspect that's going to continue to be litigated in legislation on the floor" (Pecquet, 9/25).
Politico Pro: Four Questions To Watch On Mini-Med Plans
Nearly 1,500 waivers later, the Obama administration's controversial effort to free some companies from the burdens of the new health care law is coming to an end. But the questions — and the controversy — are far from over. The waivers were supposed to help people who have "mini-med" health plans — bare-bones insurance plans that don't come anywhere close to the amount of coverage the health care reform law requires. The script seemed to be pretty much written: Those plans would end in 2014, and in the meantime, they'd get waivers so people wouldn't lose their coverage. Now, there are new questions being raised about these plans. Could they trip up young adults from getting the better health coverage they're supposed to get under the law? Who, exactly, is supposed to regulate them (Millman and Norman, 9/26).
In other health law implementation news, optimism exists on both sides of the aisle that a new initiative, the Independence at Home program, will lead to Medicare savings. Also, some parents and advocates fear that the health law could actually undermine health coverage for autism.
CQ HealthBeat: Some See Medicare Savings In Home Health Program, But Will CBO Agree?
Amid predictions that reducing the national debt will involve a grim exercise in cutting Medicare, there is hope — on both sides of the aisle — that a new initiative will actually save the program tens of billions of dollars a year. The optimism lies in the "Independence at Home" program to be launched Jan. 1. Created by the 2010 health care overhaul, the program could save money while also improving the lives of millions of frail elderly, say its advocates, which include Democrats Sen. Ron Wyden of Oregon and Rep. Edward J. Markey of Massachusetts and Republicans Sen. Richard M. Burr of North Carolina, and Reps. Christopher H. Smith of New Jersey and Michael C. Burgess of Texas. The program is designed to build on a model of care being used in some communities around the country in which small groups of doctors, nurse practitioners, and other support staff to come to the homes of very sick frail people and take care of them there (Reichard, 9/23).
Kaiser Health News: Parents Fear Health Law Could Derail Autism Coverage
Kaiser Health News staff writer Phil Galewitz, working in collaboration with The Washington Post, reports: "Autism treatment advocates have won one legislative battle after another since 2007, most recently in California, which sent a bill to the governor this month mandating that insurers cover the disorder. Now more than half the states have such requirements, but that success could be in jeopardy as federal officials set new national standards for health coverage" (Galewitz, 9/24).
Dem Lawmakers, Advocates Push To Save CLASS Act
The Hill reports that backers of this long-term care program, including congressional Democrats, say the administration can continue working on its developments using money from the health law.
The Hill: Dem Lawmakers To Fight For CLASS Health Program's Survival
Congressional champions of the health law's controversial CLASS Act said they'll do all they can to keep it alive after reports Thursday that the Obama administration is putting the long-term care program on ice. The Department of Health and Human Services recently asked Senate appropriators to strike $120 million that had been planned next fiscal year to implement the benefit for disabled Americans. And this past week, the administration was left scrambling to reassure advocates after the program's departing actuary said the CLASS Act office was closing down. … Advocates say that even without the $120 million appropriation next year, the administration can continue working on the program by using money from the health reform law. They said they expect the administration to still follow the timeline outlined by HHS in its initial funding request for FY 2012 (Pecquet, 9/25).
CAPITOL HILL WATCH
Congressional Mood, 'Super Committee' News Highlight Difficulties
The New York Times reports that expectations for the deficit-reduction panel continue to drop, as the Democrats' and Republicans' respective positions on trimming entitlements and raising taxes appear to be hardening. And, in the background, The Wall Street Journal notes that another government shutdown looms as lawmakers fail to make progress in striking a deal to fund the federal branch through Nov. 18.
The New York Times: As Sides Dig In, Panel On Deficit Has An Uphill Fight
As if expectations were not low enough for the special Congressional committee charged with writing a deficit-reduction deal, they seem to be falling by the day as the two parties harden their positions on spending and taxes. Last week began with contradictory markers from President Obama and Speaker John A. Boehner. Mr. Boehner reiterated that Republicans would oppose any tax increases, and then Mr. Obama, newly aggressive, warned that he would veto any measure that would trim Medicare benefits without also raising taxes on the wealthy (Calmes and Steinhauer, 9/25).
The Wall Street Journal: Congress Forced To Stay As A Shutdown Looms
Congress was scheduled to be off this week, but lawmakers must stay in Washington because they made no progress over the weekend in settling a dispute over spending that threatens a possible government shutdown. Despite promises to work together following a public backlash against the bickering that consumed much of the summer, Republicans and Democrats face the reality that disaster aid could run out Tuesday and the government could partially shut down beginning this weekend unless they strike a deal quickly (Bendavid, 9/26).
HEALTH CARE MARKETPLACE
GAO: Oversight Needed On Program That Gives Safety Net Providers Drug Discounts
Under this program, known as the 340 B program, drugmakers provide discounts to community health centers and other health care providers that treat vulnerable populations in exchange for having their drugs covered by Medicaid.
Modern Healthcare: GAO Urges Greater Oversight For Drug Discount Program
Additional oversight of the hospitals and clinics covered by the 340B drug discount program is needed even though participants' use of program is consistent with its purpose, according to a Government Accountability report. The Health Resources and Services Administration, the federal agency that administers and oversees the program, agreed with the GAO recommendations. The 340B program gives safety-net providers discounts on outpatient drugs (Lee, 9/24).
Politico Pro: GAO: 340B Program Needs Better Oversight
HHS is not providing adequate oversight of a program that grants discounted drugs to safety-net providers, the Government Accountability Office said in a report released Friday, a day after three top Republicans sounded alarm bells about the department's watchdog role. Under the 340B program, drugmakers agree to provide discounts to community health centers and other providers that take care of vulnerable populations, in exchange for having their drugs covered by Medicaid. The report finds that the office that oversees the program, the Health Resources and Services Administration, exercises "oversight of the 340B program [that] is inadequate to provide reasonable assurance that covered entities and drug manufacturers are in compliance with program requirements — such as, entities' transfer of drugs purchased at 340B prices only to eligible patients and manufacturers' sale of drugs to covered entities at or below the 340B price" (Feder, 9/23).
Insurers, Patients Wrestle With Payment, Care Issues And Strategies
News outlets report on a variety of issues reflecting the insurance hassles patients sometimes face and the efforts by insurance companies to find profits in better-coordinated care.
Health News Florida: Experts Split On Insurance Hassles
When Jack Gilliam walked into the emergency room at Florida Hospital, he had a tight chest, neck and jawline and a warning from his doctors that he would probably need a heart catheterization, an invasive chest X-ray that tests blood flow. ... His insurer, United Healthcare, wouldn't pay for the $25,000 procedure unless he failed a chemical stress-test. ... Some doctors and health advocates say such scenarios are increasingly common as insurance companies implement new tactics to limit payment and care. Yet opinions and data are so mixed, getting a clear picture of what's happening is tough, if not impossible (Davis, 9/23).
Bloomberg/BusinessWeek: Insurance Companies Seek Profits In-Network
Insurers have spent more than $5 billion in recent years buying up doctor practices and clinics to create networks that might help them woo new customers. The companies are betting they can cut spending by keeping patients healthier with better-coordinated treatment and by ensuring that physicians across the country use the most effective approach for any given condition (Weschler, 9/22).
In related news, WBUR's CommonHealth blog draws similarities between the health care challenges faced by the United States and China.
WBUR's CommonHealth blog: China And The U.S. Face Similar Health Care Challenges
The two countries are expanding insurance coverage and each is worried about rising costs. On costs, where patients go for care makes a big difference in China as it does in the US. A key challenge is how to persuade patients they don’t need to go to a hospital, especially high end hospitals, for routine care (Bebinger, 9/25).
NPR: Bartering To Cover Health Care Costs
NPR: Bartering For Health Care: Yardwork For Treatment
Deb Barth is raking leaves for Lesley Jones. But Barth isn't earning money for her yardwork, at least not in physical currency. She's earning "time dollars" — for every two hours she spends doing odd jobs, she'll earn a free visit with her doctor (Molinsky, 9/26).
Related, earlier KHN story: Bartering For Health Care Rises (Langton, 6/17/2009).
HEALTH POLICY RESEARCH
Research Roundup: Disparities In Heart Care, Hospital Deaths
Every week, Kaiser Health News reporter Shefali S. Kulkarni compiles a selection of recently-released health policy studies and briefs
National Bureau of Economic Research: Does Widowhood Explain Gender Differences in Out-of-Pocket Medical Spending Among The Elderly? -- The authors write: "We find that out-of-pocket medical spending is approximately 29 percent higher when an individual becomes widowed, a large portion of which is spending on nursing homes. Our results suggest a substantial role of living arrangements in out-of-pocket medical spending; however, our estimates combined with differences in rates of widowhood across gender suggest that marital status can explain only one third of the gender difference in total out-of-pocket medical spending, leaving a large portion unexplained. On the other hand, gender differences in widowhood more than explain the observed gender difference in out-of-pocket spending on nursing homes" (Goda, Shoven and Slavov, September 2011).
Commonwealth Fund: Variations In Amenable Mortality--Trends In 16 High-Income Nations -- This study compares 16 high-income nations that all showed an improving trend in "mortality amenable to health care." These are "deaths that are considered preventable with timely and effective health care." The U.S. had the least improvement among patients under 75 years old. Between 2006 to 2007, 24 percent of deaths in the 16 countries surveyed were due to amenable mortality, according to the research, which was based on data from the World Health Organization (Nolte and McKee, 9/23).
Robert Wood Johnson Foundation: Spillover Effects Of Community Uninsurance On Working-Age Adults And Seniors – This analysis focuses on areas with large numbers of uninsured residents and whether that condition has a "spillover," or indirect, effect on the health care available to the privately-insured population in the area. Researchers used data from the Medical Expenditure Panel Survey (MEPS) to assess the quality of health care insured patients were receiving while in a community of uninsured. "Privately insured, working-age persons who resided in areas with a high rate of uninsurance were less likely than their peers in areas with a low uninsurance rate to have a usual source of care, an office-based visit, and any medical care expenditures." They also found that Medicare beneficiaries report "difficulty getting needed care" and prescription drugs. Both groups were less satisfied with their care (Gresenz and Escarce, September 2011).
Journal Of The American College Of Cardiology: Payment Source, Quality Of Care, And Outcomes In Patients Hospitalized With Heart Failure -- Researchers looked at more than 99,000 hospital admissions between January 2005 and September 2009 and grouped patients based on their insurance or payer status—private, HMO, uninsured, Medicare or Medicaid. Their assessment showed that patients without insurance or on Medicaid were less likely to receive beta-blockers prescription drugs, implantable cardioverter-defibrillators or anticoagulation medication for atrial fibrillation." They also had a longer hospital stays. The researchers also found the Medicaid and Medicare groups were offered fewer treatment options than privately-insured patients (Kapoo, et. al., 9/27).
Archives Of Surgery: Association Between Hospitals Caring For A Disproportionately High Percentage Of Minority Trauma Patients And Increased Mortality – By looking at 434 hospitals in the National Trauma Data Bank, researchers were able to categorize facilities as majority hospitals - serving a majority of white patients - and minority hospitals - with more black and Hispanic patients - and mixed hospitals, with a proportionately number of black, Hispanic and white patients. They concluded: "Patients treated at hospitals with higher proportions of minority trauma patients have increased odds of dying, even after adjusting for potential confounders. Differencesin outcomes between trauma hospitals may partly explain racial disparities" (Haider et. al., 9/19).
STATE WATCH
State Roundup: Grocery Workers Ratify Contract That Had Partially Hinged On Health Care
News outlets report on a variety of state health policy issues.
San Francisco Chronicle: Patient's Death Heightens Tensions After Strike
Veteran nurses locked out of Alta Bates Summit Medical Center in Oakland said Sunday that the death of a patient due to a medical error by a replacement worker wouldn't have happened if they had been allowed to do their jobs. The hospital's management countered that it was a freak accident that could have happened at any time -- with or without the replacement nurses. At the center of the dispute is a cancer patient, a woman who has not been identified but whose tragic death on Saturday has inflamed an already tense labor dispute (Baker, 9/26).
Los Angeles Times: Grocery Workers Ratify Contract
Members of Southern California's grocery union voted to ratify a new contract with Ralphs, Vons and Albertsons on Saturday night. ... One key sticking point was healthcare funding: A key question, for the UFCW and the three employers, was how much each side would have to pay to ensure that a healthcare trust fund covering workers would be economically viable for the long term. Among the issues resolved in the complicated deal, according to sources familiar with the negotiations, is that grocery workers would pay $7 a week for individual coverage and $15 a week for a family starting next April (Huffstutter, 9/24).
Fox/Reuters: Southern California Grocery Workers Ratify Contract
"This package protects our members' access to affordable comprehensive health care for themselves and their families," the union said in a statement late on Saturday. The union has said the agreement increases wages and protects healthcare and pension benefits through the life of the contract. Southern California is one of the most competitive food retailing markets in the United States. Many analyst see the region as a trend-setter for the rest of the industry (9/25).
The Texas Tribune: New Texas Law On Student Fitness Data Faces Obstacles
Under [a] new law, researchers can access unidentified individual student data, which they say will help bolster aggregate analyses that already show correlations between physical fitness and academic performance, gang activity and absenteeism. But the new law's effects may be limited. To help ease the pain of the $4 billion reduction in state financing for public education, and in an attempt to reduce state mandates at the district level, lawmakers exempted school districts from having to collect and report the data on a significant number of students (Smith, 9/26).
Rochester Democrat And Chronicle: Health Care: The Everywhere Issue
For a thorough perspective of health care in the Rochester area, it's hard to beat what Patricia Larrabee provides. She sees the good, bad and promising — often on the same day. Larrabee, a registered nurse, is president and CEO of Rochester Clinical Research Inc., which conducts clinical trials for pharmaceutical and biotechnology companies around the country. She and her staff see the leading edge of medical innovation — the latest drugs and medications, the newest thinking, the smartest people, many of them trained at local universities. But Larrabee also sees the underside of modern medicine, characterized by poor families unable to afford health insurance, unable to pay for care on their own and yet plagued by the fear, common to all humans, that they or their children might harbor a disease that will kill them (Tobin, 9/25).
The Sacramento Bee: Bill Before Jerry Brown Brings HPV Vaccine Debate To California
Days before Republican candidates began sparring over a vaccine to help prevent cervical cancer, a bill aimed at expanding access to the shot for California minors made its way to Gov. Jerry Brown's desk with little fanfare. Assembly Bill 499, by Assemblywoman Toni Atkins, D-San Diego, would allow those 12 and older to seek medical care to prevent sexually transmitted infections without parental consent (Van Oot, 9/24).
California Healthline: Hernandez Attacked In TV Ad
A consumer advocacy group took on the chair of the (Calif.) Senate Health Committee at the end of last week, and it has stirred up Sacramento. The ad was in reaction to the legislative decision to delay a vote on AB 52 by Mike Feuer (D-Los Angeles) and Jared Huffman (D-San Rafael), the proposal to regulate health insurance rate increases (Gorn, 9/26).
California Watch: For Caregivers, Health, Well-Being And Finances Can Suffer
More than 6 million California adults provide care for a family member or friend with a long-term illness or disability. ... caregivers have higher levels of psychological distress and engage in more poor health-related behaviors than do their non-caregiving counterparts, according to a study released last week by the UCLA Center for Health Policy Research. Nearly 52 percent work full time in addition to providing an average of more than 21 hours of care each week. Few are compensated for their care; one in five spends more than $250 of their own money on caregiving each month (Lin, /26).
New Hampshire Public Radio: HHS To Soon Seek Managed Care Proposals
The Department of Health and Human Services is inching closer to soliciting a bid to transform ... New Hampshire's Medicaid program. The changes to the healthcare program for low-income citizens is expected to save the state money. ... The plan is to hire an outside contractor to provide services to the state's Medicaid population (Gorenstein, 9/23).
HealthyCal: Homeless for Years, Older Women In Los Angeles Find A Good Home
The Downtown Women's Center's beautiful new building, sitting in the middle of the mayhem, is a standout. The DWC's Day Center serves hundreds of homeless women in its facilities every day and 71 lucky ones live in permanent residences, or efficiency apartments. ... Women often become vulnerable to homelessness if they have lost a spouse who was primary source of income for the family (Portner, 9/26).
Associated Press/(Minneapolis-St. Paul, Minn.) Pioneer Press: Group Erecting Wisconsin Billboard Decrying Health Effects of Eating Cheese
A nonprofit group with a history of provocative takes on food is preparing a billboard in the heart of dairy country about the dangers of eating cheese. The Physicians Committee for Responsible Medicine is sponsoring a billboard showing the Grim Reaper wearing a cheesehead hat with the message: "Warning: Cheese Can Sack Your Health. Fat. Cholesterol. Sodium"…. The Washington-based group, which supports a vegetarian diet, said it's a way to educate people about the harmful effects of eating cheese.
Minneapolis Star Tribune: Elder-Care Hurdle Criticized
Thousands of frail Minnesotans who plan to move into assisted living facilities will have to talk with a telephone counselor first under a state law that takes effect Oct. 1. The counseling is designed to help older people and their families make better -- and less costly -- long-term care choices. It also is projected to save taxpayers $3.8 million in the next two years because public programs such as Medicaid pick up much of the bill for long-term care. But it has kicked up a fuss among the state's 1,701 assisted living operators, who could lose customers (Wolfe, 9/24).
Denver Post: Colorado Gets $3.8 Million For Substance Abuse Programs
Colorado is one of nine states in line to get millions of dollars in federal money for substance-abuse programs, the state Department of Human Services said Sunday. Colorado will receive $8.3 million over the next five years for screening, prevention, intervention and referrals to treatment programs. Colorado's share is part of a $137 million federal initiative announced by Health and Human Services Secretary Kathleen Sebelius in August. The grants are partly funded by the Affordable Care Act, which President Barack Obama signed into law in 2010 to reform health care costs and programs (9/26).
Kansas Health Institute News: Medicaid Drug Settlement Nets Kansas $1.4 Million
Kansas will get $1.4 million as its share of a settlement with drugmaker Boehringer Ingelheim. The company had been accused of using deceptive practices to gain Medicaid overpayments. ... [Attorney General Derek] Schmidt said a total of 38 lawsuits have been filed by the Kansas Attorney General's Office that allege artificial inflation of the average wholesale drug price, which is used to set the Medicaid reimbursement rates. To date, 12 of the cases have been settled, resulting in $15.8 million in recoveries for the Kansas Medicaid program (9/23).
EDITORIALS AND OPINIONS
Viewpoints: LA Times Wants Solutions From GOP Candidates; WSJ Finds Worrisome Census Numbers
Los Angeles Times: The GOP's Hard-Right Tilt
We've now seen three full-dress debates among the Republican politicians who want to be the next president of the United States, and here's what we've learned: They all believe taxes are too high, even though federal taxes are lower as a percentage of the U.S. economy than any time in the last 60 years. They all believe onerous environmental regulations are preventing economic recovery, though few economists would agree. They believe President Obama's healthcare law is getting in the way of recovery, though most of its provisions don't really take effect until 2014. And they believe, correctly, that Social Security and Medicare are heading into fiscal crises — but in most cases, they haven't offered specific solutions. In other words, on the issues Americans are most worried about — reviving the economy, creating jobs and reducing the federal deficit — there's not much of a debate inside the GOP (Doyle McManus, 9/25).
The Wall Street Journal: The Census, ObamaCare And The Uninsured
The U.S. Census Bureau has released its latest estimates on poverty, income and health-insurance coverage. Strikingly, the official poverty rate is the highest it's been in 50 years. As one might expect, the number of Americans without health insurance also rose—to 49.9 million, an increase of 919,000 since 2009. But that large number hides more than it reveals. And diving into it shows that the uninsured rate won't fall unless the economy starts humming again. Unfortunately, ObamaCare's billions of dollars in new taxes and regulations won't allow that to happen (Sally C. Pipes, 9/26).
Chicago Tribune: Bachmann's Silence Is Golden
Steven Miles and Arthur Caplan are my new heroes. They should be yours too — if you hold the radical opinion that facts matter. Miles, a University of Minnesota bioethicist, offered $1,000 to charity if Michele Bachmann can prove a link she suggested between vaccinations for human papillomavirus and intellectual disability. Caplan, director of the University of Pennsylvania's Center for Bioethics, upped the ante on Miles' offer, adding $10,000 of his own (Leonard Pitts, 9/26).
(New Hampshire) Union Leader: Medicaid Politics: NH Taxpayers Lost
Had former Health and Human Services Commissioner John Stephen been able to implement his Medicaid reforms six years ago, New Hampshire would be in much better shape today. When Stephen became commissioner in 2003, New Hampshire had already spent more than a decade skimming federal Medicaid money into the general fund. In 2004, Stephen and Gov. Craig Benson arranged with the federal Department of Health and Human Services to change the “mediscam” formula in place since 1997. The deal was that New Hampshire would not be penalized for mediscam taxes if it fixed the formula in the next budget. The state did, but HHS later decided that New Hampshire should pay back $35 million in mediscam taxes collected in 2004 before the changes took effect. How to find $35 million in savings in this already deeply cut state budget? One method the Lynch administration hopes to use is to switch Medicaid from a fee-for-service program to a managed care program, like an HMO. That’s great, but here’s the interesting bit: Stephen proposed this change soon after he became commissioner, and Democrats, including Lynch, blocked it for partisan political reasons (9/25).
Minneapolis Star Tribune: The Best Health Care Solutions Just Might Bubble Up
Take it from politician-cum-professor Dave Durenberger: "All health care is local." Don't get him wrong. The former Republican U.S. senator, founder of the National Institute of Health Policy and University of St. Thomas prof is a strong supporter of the 2010 Affordable Care Act, which politicians in his erstwhile party call "Obamacare." But the real work of improving America's health and controlling costs won't be done in Washington, no matter who wins the next election, Durenberger told a Minneapolis church audience last week. It will happen in those places where local political and civic leaders put better, more affordable health high on their own agendas (Lori Sturdevant, 9/24).
Chicago Tribune: Chicago Wellness: Shape Up, Save Money
Chicago's police union walked right into a barrage of doughnut jokes last week by declining to sign on to the city's new wellness program. The president of the Chicago Federation of Labor, who leads an umbrella organization representing local labor unions, stood beside Mayor Rahm Emanuel to announce the program, a win-win designed to save taxpayers money by getting city employees to take care of themselves. All of the city's unions are on board except for the Fraternal Order of Police (9/26).
Milwaukee Journal Sentinel: Oral Cancer Drugs Should Be Covered
As a practicing oncologist, I find that no amount of training could prepare me for some of the challenging facets of my job. While my training prepared me and my colleagues to handle emotional issues faced by patients with life-threatening cancers, it did not prepare me to tell a patient that the best treatment for their disease is financially out of reach - simply because it comes in pill form. Yet this is exactly the scenario that plays out every day because many health plans do not cover oral anti-cancer medications at the same level as intravenous or infused anti-cancer medications given in a doctor's office or hospital (Parameswaran Hari, 9/24).
Milwaukee Journal Sentinel: Finding Answers At Mental Health Complex
Milwaukee County needs to modify its approach to treating mental health patients. That much is clear. But that does not mean that more money is needed to fix the obvious problems at the Mental Health Complex. It's more a matter of how well the county spends the money it has….We need to recognize that compliance - a patient taking his or her medications on schedule - is a core problem. And we need to fix it (Bob Chernow, 9/24).
San Francisco Chronicle: City's Bill Overreaches On Pregnancy Center Ads
San Francisco's city officials pride themselves as nationwide trendsetters and leaders in enacting progressive legislation to further the equal protection and interests of all San Franciscans. Yet, in the midst of this election season, the Board of Supervisors seems set on imitating failed legislation in other parts of the country, infringing on women's protected rights and dangerously limiting First Amendment protections. Is this the San Francisco way? The so-called "False Advertising by Limited Services Pregnancy Centers" bill follows a floundering national campaign by a pro-choice political organization to pass "disclosure" laws against pregnancy care centers (Shari Plunkett, 9/23).
EDITOR:
Stephanie Stapleton
WRITERS:
Jennifer Evans
Jenny Gold
Jessica Marcy
Andrew Villegas
Christopher Weaver
The Kaiser Daily Health Policy Report is published by Kaiser Health News, an operating program of the Kaiser Family Foundation. (c) 2011 Kaiser Health News. All rights reserved.
This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.
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