All Kaiser Health News

Calif. Unveils Tentative Price Tags For Health Plans On The Exchange

Fri, 24 May 2013 13:42:00 GMT

The monthly cost for policies sold on the state-run exchange came in lower than the 30 percent rate increases some had anticipated, though some consumers will still experience sharply higher premiums. Blue Shield of California estimated that current customers would see rate increases of about 13 percent.

Kaiser Health News: California Insurance Exchange Rates: Not Too High, Not Too Low
In the first disclosure of individual health insurance premiums by the nation's largest state, California announced on Thursday a wide array of choices for the 5.3 million people expected to qualify to purchase coverage through its online marketplace established by the Affordable Care Act (Varney, 5/24).

Los Angeles Times: New California Health Insurance Rates Unveiled
Amid anxiety over rising costs from the federal healthcare law, California received better-than-expected insurance rates for a new state-run marketplace, but many consumers still won't be spared from sharply higher premiums (Terhune, 5/23).

The New York Times: California Puts Tentative Price On Health Policies Under New Law
State officials said that rate increases for individuals who already had insurance would not be as high as some had feared. Blue Shield of California, for example, estimated its current customers would see rate increases of about 13 percent. Some estimates had suggested rate increases could be 30 percent. The increases are largely the result of higher prices and the need to cover people who now have no insurance and are likely to have expensive medical problems (Abelson, 5/23).

The Washington Post: California's Likely Health Insurance Rates Under New Law Are Lower Than Expected
California health officials on Thursday unveiled the likely rates that insurers will charge under President Obama’s health-care law — and they are lower than expected, rebutting warnings by critics that many people will experience "rate shock" once the law is fully implemented. On average, a person who chooses a mid-level plan can expect to pay around $321 a month, about $100 less than the amount projected by the Congressional Budget Office when the law was being debated in Washington (Somashekhar, 5/23).

The Wall Street Journal: California Outlines Health Premiums
Early results around the U.S. indicate prices for exchange plans will vary widely—both from state to state and among consumers—as will the effect of the law on premiums. In states such as Vermont and Rhode Island, with regulations somewhat similar to the federal law's rules, the legislation is having little effect on premiums. In other places, like Maryland and Kentucky, there have been signs of sometimes-large rate increases. In California, "we're getting the best-case scenarios" on rates, with some "far lower" than projected in an actuarial report commissioned by the agency, said Peter V. Lee, executive director of Covered California. He said costs would go up for some consumers, and down for others (Mathews and Radnofsky, 5/23).

Reuters: California Reveals Prices For Health Insurance Under Obamacare
California unveiled prices on Thursday that consumers will pay for a selection of health plans offered through the state under the Affordable Care Act, providing a glimpse into how health care reform may look as it is rolled out across the nation. Under the federal health care reform law, Californians who do not get or cannot afford health insurance through their jobs can buy coverage through an exchange, at a group rate negotiated by state regulators (Bernstein, 5/23).

HealthyCal: Covered California Rolls Out Health Plan Choices, Rates
Today was a big day for Covered California, the new state-run marketplace for health insurance created under the federal Affordable Care Act. The health exchange rolled out the 13 regional and statewide plans that will be available to more than 5 million Californians eligible to buy coverage through the new system beginning Oct. 1 (Weintraub, 5/23).

CQ HealthBeat: Exchange Bids Suggest Overhaul On Track In Pivotal State Of California
The Obama administration got a respite Thursday from the rising chorus of inside-the-Beltway doubts about the health care law with news from California that its insurance exchange will offer residents in the individual market 13 plans at what officials said are affordable rates. The plans available for small businesses will be announced in June (Reichard, 5/23).

The Hill: ObamaCare Plans Cheaper Than Expected In Key Rate Filing
New insurance policies under President Obama's healthcare law will cost significantly less than expected in California. The state released rate filings Thursday for the policies that will be sold through the health law's insurance exchange (Baker, 5/23).

Sacramento Bee: California Health Exchange Reveals Premium Costs, Insurers
California's newly created health exchange announced the bottom line on its insurance policies and rates Thursday, bringing sharper focus to family impacts of next year's health care overhaul. Thirteen companies were selected to sell policies for the individual market through Covered California, a state-owned marketplace for comparing prices of coverage with identical benefits but different networks of doctors (Sanders, 5/24).

CNN Money: Obamacare Premiums In California Lower Than Predicted
Health insurers in California will charge an average of $304 a month for the cheapest silver-level plan in state-based exchanges next year, according to rates released Thursday by Covered California, which is implementing the Affordable Care Act there. But many residents will pay a lot less than that for coverage. Rates will vary by region, age and level of coverage, and many lower-income Californians will qualify for federal subsidies that will greatly lower the premiums (Luhby, 5/23).

California Healthline: Exchange Premiums Closely Watched By Industry, Nation
California isn't the first state to announce premium rates and vendors in a new health benefit exchange, but the announcements this week from Covered California may carry more clout than those already announced -- and probably more than those yet to come. Covered California announced which health insurance plans will be offered and how much they'll cost when the new insurance marketplace opens for business this fall. It is another milestone in California's race to be ready for full implementation of the Affordable Care Act next year (Lauer, 5/23).

Tensions, Threats Emerge In Ariz. Medicaid Expansion Debate

Fri, 24 May 2013 13:41:00 GMT

In addition, the legislative debate continues in Texas while in Florida there's speculation about what's to become of the state's uninsured population now that the legislature didn't take action.

Arizona Republic: Threat, Vetoes Fly As Tensions Rise Over Medicaid Expansion
Gov. Jan Brewer sent five bills to the scrap heap Thursday in a pointed gesture intended to prod lawmakers into a deal on the budget and her plan to expand Medicaid. The five vetoes, follow-through on Brewer’s promise to block legislation until her top priorities move forward, capped a tense day that saw some lawmakers receive threats over their support for the plan to provide health care for more of the state’s poor (Pitzl, 5/23).

The Associated Press/Washington Post: Republican Arizona State Representative Says She got Threatening Message Over Medicaid Support
A Republican member of the Arizona House who supports GOP Gov. Jan Brewer's push to expand Medicaid received an obscene and threatening voicemail at her office, a sign that the rancorous debate over embracing a signature component of President Barack Obama's health care overhaul in the state is far from over (5/23).

The Texas Tribune: Amendment On Medicaid Expansion Unlikely To Stick
An amendment that blocks Texas from expanding Medicaid without legislative approval doesn’t seem likely to stick. The House on Thursday knocked down a nonbinding motion to instruct conferees to keep the "anti-Medicaid expansion" amendment when they meet with Senate members to work out the final language of Senate Bill 7 (Aaronson, 5/23).

Health News Florida: Left Out: FL's Poorest Uninsured
At 7 a.m. on a Monday morning, poor people who don't qualify for government health programs such as Medicaid are lined up outside a health department building on a busy street in St. Petersburg…These are some of the people who will not gain health insurance when the federal health law kicks into high gear on Jan. 1. They'll be left out because they are in Florida, one of the states that turned down federal funds to cover adults below the poverty level – people with incomes under about $11,500 (Gentry, 5/23).

Research Roundup: Getting A Critical Care Doc At Night; Poverty Among Seniors

Fri, 24 May 2013 13:16:00 GMT

Each week, KHN reporter Alvin Tran compiles a selection of recently released health policy studies and briefs.

JAMA Internal Medicine: Firearm Legislation And Firearm-Related Fatalities In The United States – Researchers analyzed 121,084 firearms deaths in the U.S., using 2007 to 2010 data from the Centers for Disease Control and Prevention: "The outcome measures were state-level firearm-related fatalities per 100 000 individuals per year overall, for suicide, and for homicide. In various models, we controlled for age, sex, race/ethnicity, poverty, unemployment, college education, population density, nonfirearm violence–related deaths, and household firearm ownership." They concluded that a "higher number of firearm laws in a state are associated with a lower rate of firearm fatalities in the state, overall and for suicides and homicides individually. As our study could not determine cause-and-effect relationships, further studies are necessary to define the nature of this association" (Fleegler et al., 5/13).

New England Journal Of Medicine: A Randomized Trial Of Nighttime Physician Staffing In An Intensive Care Unit – Previous studies suggest that the use of intensivists, doctors specifically trained in critical-care medicine, improve the outcomes of intensive care unit (ICU) patients. But studies analyzing the impact of nighttime staffing of intensivists in ICUs have shown mixed results. Researchers at the Hospital of the University of Pennsylvania compared nighttime staffing to the use of daytime intensivists who were available for phone-based consultation at night. More than 1,500 patients were included in their analyses. "We found no evidence that this staffing model, as compared with nighttime telephone availability of the daytime intensivist, had a significant effect on length of stay in the ICU or hospital, ICU or in-hospital mortality, readmission to the ICU, or the probability of discharge to home," the authors write. "In an academic medical ICU in the United States, nighttime in-hospital intensivist staffing did not improve patient outcomes" (Kerlin et al., 5/20).

Annals Of Family Medicine: Spreading A Medical Home Redesign: Effects On Emergency Department Use And Hospital Admissions – Patient centered medical homes (PCMH) emphasize long-term relationships between patients and providers as well as other attributes of primary care. This study analyzed how PCMHs in clinics owned by the Washington state insurance and health care system, Group Health Cooperative, affected health care use. The authors found that, one year after the implementation, Group Health patient visits to emergency departments significantly declined and there was a shift from face-to-face doctor/patient visits to greater use of secure messaging and telephone conversations. "Group Health's experience in spreading its PCMH model shows that achieving PCMH transformation across a diverse set of primary care clinics is possible with a clear change strategy … and sufficient resources and supports," they conclude (Reid et al., May 2013).

Health Care Cost Institute: Health Care Costs From Birth To Death -- Using commercial and Medicare health care data, the author of this report (sponsored by the Society of Actuaries) analyzed cost differences based on age, sex and health status. He reports that costs are generally high in the two years of life and then drop by age 5. They pick up again in the teen years and for women increase during the child-bearing years. Among other key findings: "An aging population is not an overwhelming driver of health care spending. ... Health costs are twice as high for people with cancer or other chronic conditions. Older men are more costly than older women" (Yamamoto, May 2013).

Kaiser Family Foundation: A State-By-State Snapshot Of Poverty Among Seniors: Findings From Analysis Of The Supplemental Poverty Measure – The authors write: "During recent deficit reduction discussions, policymakers have put forth a variety of proposals to reduce Federal spending that would affect people on Medicare, including options that would shift costs onto beneficiaries ... Based on the Census Bureau’s supplemental poverty measure, the poverty rate among people ages 65 and older is higher than is reflected in the official poverty measure, and is particularly high among seniors in some states. ... Under the supplemental poverty measure, which deducts health spending from income, poverty rates could increase if beneficiaries were required to pay higher cost sharing or premiums for Medicare. ... The supplemental measure suggests that a greater share of seniors may already be struggling financially than is conveyed by the official measure" (Levinson et al., 5/20).

Here is a selection of news coverage of other recent research:

San Francisco Chronicle: 56% Of Patients Don't Follow Prescription
It might take more than a spoonful of sugar to help the medicine go down for many Americans. In a survey of more than 1,000 adult patients who are on prescription medication for chronic illnesses, 40 percent say they haven't followed doctor's instructions or have skipped taking their meds at least once in the past year. More than a quarter said they've stopped taking medications altogether or never even filled a prescription. It's a problem known as medication nonadherence and is linked to 125,000 deaths in the United States each year (Roethel, 5/21).

Medpage Today: Medical Home Transition Long But Worth It
The path to becoming a patient-centered medical home is long, rough, and varies for each practice, but getting there is essential to providing high-quality, affordable healthcare to all Americans, researchers concluded. The Agency for Healthcare Research and Quality (AHRQ) came to that conclusion in summarizing the results of 14 grants it issued in the summer of 2010 to understand the processes and determinants of transforming primary care practices. ... The results were published Monday in a special supplement of the Annals of Family Medicine (Pittman, 5/20).

Reuters: Health Sites Too Complex, Full Of Cliches: Study
The importance of health literacy hit home for Lisa Gualtieri when a Cambodian refugee diagnosed with cancer asked her to act as a patient advocate. … A new study, published Monday in JAMA Internal Medicine, suggests one potential reason for the family's confusion: Despite good intentions, many experts may be creating educational materials that are too difficult for patients and their families to grasp (Oransky, 5/20).

Viewpoints: We Need More 'Socialism'; The IRS's 'Unwelcome Role'; 'Fog Of Obamacare'

Fri, 24 May 2013 13:11:20 GMT

Los Angeles Times: If This Health Plan Is 'Socialism,' We Need More Of It
So this is what socialism looks like: Private companies competing for people's business in an open marketplace. Californians got their first glimpse Thursday of what insurers plan to charge for coverage to be offered next year to about 5 million state residents who don't receive health insurance from employers (David Lazarus, 5/23).

The Washington Post: The Unwelcome Role Of The IRS In Obamacare
Thousands of new IRS agents will implement 40-odd provisions of the Patient Protection and Affordable Care Act — the exact number is a matter of dispute since the law itself is so confusing. The largest tax law and social policy change in a generation will be imposed on a skeptical public by a government agency whose credibility is in ruins. But the IRS is not merely implementing Obamacare. It engaged in a regulatory power grab to ensure that it could implement Obamacare (Michael Gerson, 5/23).

The Washington Post: The Fog Of Obamacare
You’ve heard of the "fog of war." Well, now we've got the fog of Obamacare. The controversial Affordable Care Act (ACA) has so many moving parts that it's hard to know how its implementation is proceeding. In 2014, many uninsured are supposed to get coverage either through insurance exchanges, where they can buy subsidized policies if their incomes are less than four times the federal poverty line, or through an expanded Medicaid. The trouble is that 20 or more states may reject the Medicaid expansion, and the exchanges aren’t yet finished. Much is unknown (Robert J. Sameulson, 5/23).

The New York Times' Economix: Debating Doctors' Compensation
Two themes run through the comments on previous blog posts that touched on the payment of the providers of health care. The first is that American doctors are paid too much. The second is that they are paid too little. Could both propositions be right? Let us explore the issue by looking at some numbers (Uwe E. Reinhardt, 5/24).

New England Journal Of Medicine: The Gross Domestic Product And Health Care Spending
How much will the United States spend on health care during the next decade or two? The answer matters greatly to physicians, federal and state governments, businesses, and the general public. The answer will determine the type and extent of care that physicians can provide to their patients, as well as the amount of physicians' take-home pay. It will also determine how much everyone else can consume or invest in other goods and services. Unfortunately, forecasting health care spending is extremely difficult. Future spending depends in part on developments within the health care sector and in part on developments in the economy as a whole (Victor Fuchs, 5/22).

Boston Globe: Do I Miss My Breasts?
I had voluptuous breasts. I miss them, when I think about them. But I rarely think about them because I’m busy not missing my family’s milestones and ordinary moments. The kind of moments that I suspect Angelina Jolie does not want to miss. Jolie and I have more in common than being mothers and having sexy husbands. I, too, carry the BRCA1 gene alteration, a mutation that raises a woman’s lifetime risk of ovarian cancer to 40-60 percent and breast cancer to 50-80 percent (Ellen Roth, 5/22).

WBUR: Cognoscenti: The Power Of Knowing: A Daughter Who Chose BRCA Gene Testing, Against Her Mother's Will
When Angelina Jolie explained in The New York Times her decision to take action after discovering she carried the BRCA-1 mutation, I saw on social media so many women asking each other, Would you undergo genetic testing? Many expressed anger at Myriad (the company that owns the patent), at insurance companies (several do not cover the cost of the test), and at doctors they believe hold assumptions about organ removal. While some cited how removing one's organs could shorten or alter their lives, as could cancer itself, others judged individual preferences as "right" or "wrong" (Tracy Strauss, 5/24).

The New York Times' Doctor And Patient: Disability And Discrimination At The Doctor's Office
It's been nearly 23 years since the Americans With Disabilities Act, a federal law prohibiting discrimination against people with disabilities, went into effect. Despite its unequivocal language, studies in recent years have revealed that disabled patients tend not only to be in poorer health, but also to receive inadequate preventive care and to experience worse outcomes (Pauline W. Chen, MD, 5/23).

USA Today: Mental Illness Manual No 'Bible': Column
Unlike many other physical ailments, there are no acceptable scientific tests that can pinpoint mental disorders. A blood test won't tell doctors which of my son's diagnoses, if any, are accurate. Instead, psychiatrists must rely on a patient or family members to describe symptoms of the illness to make a diagnosis. The doctor then consults psychiatry's "bible" — the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) — to determine which diagnosis best fits the patient's symptoms. This process can be ripe for error, especially if a patient doesn't believe there is anything wrong, a common reaction during a psychotic break (Pete Earley, 5/23).

The New York Times' Taking Note: Abortion After 20 Weeks
On the list of treasured Republican pastimes, trying to outlaw abortion and imposing a right-wing agenda on the District of Columbia (which is heavily Democratic and lacks any representation in Congress) both rank high. So it must have given Rep. Trent Franks of Arizona special pleasure to combine those hobbies by introducing a bill to ban abortion in D.C. after 20 weeks. But why stop there? (Andrew Rosenthal, 5/23).

New England Journal Of Medicine: Under The Medical Tent At The Boston Marathon
Bright sunlight filtered through the awnings of the medical tent pitched in Copley Square, where I joined the many medical professionals caring for people who'd fallen ill from their 26.2-mile run. Some volunteers had been staffing the medical tent for years — one nurse had worked at the Boston Marathon more than 25 times. Sickened and stressed runners poured into our makeshift hospital. A runner stumbled in and vomited into a bag. We helped him onto a cot, where he sat shivering. "You're OK," a nurse said gently, wiping his face. But his core temperature had dropped to 96 degrees, and he began having violent rigors. We brought him Mylar blankets and hot bouillon (Sushrut Jangi, 5/23).

State Highlights: La. Grand Jury To Examine $200M Medicaid Contract

Fri, 24 May 2013 13:11:00 GMT

A selection of health policy stories from Louisiana, Oregon, Connecticut, Kansas, North Carolina, California, and New York.

Modern Healthcare: States Delaying, Dropping Controversial Dual-Eligible Pilot Program
More than half of the states that applied to participate in a controversial CMS pilot for dual-eligible beneficiaries have either dropped out or delayed implementation of their programs, according to health policy experts. Among the 26 states that applied to participate in the CMS Financial Alignment Initiative, which stems from the Patient Protection and Affordable Care Act, six have dropped out or opted for different "customized" plans and nine have delayed their start dates (Daly, 5/23).

The Associated Press/Washington Post: Grand Jury To Look Into $200M Medicaid Contract Awarded By Jindal Administration
The Louisiana attorney general's office said a special grand jury was selected Thursday to look into possible criminal activity involving a $200 million Medicaid contract awarded by Gov. Bobby Jindal's administration. Assistant Attorney General Butch Wilson told a judge that the grand jury was being empaneled in Baton Rouge as part of an ongoing investigation into the now-canceled contract for Client Network Services Inc., or CNSI (5/23).

Lund Report: Regence Posts Strongest Profits In Oregon's Top Insurers
Regence BlueCross BlueShield of Oregon bolstered its position as the largest health insurance company in the state during the first three months of 2013. At the same, it also time delivered the strongest profits among large Oregon insurers. Regence BCBS total membership climbed by 18,800 lives during the first quarter of the year, to 491,702, and the insurer posted a $16.09 million profit, according to financial reports made available in the past week by the National Association of Insurance Commissioners (Sherwood, 5/23).

Oregonian: Nonprofit Health Insurers Often Beat For-Profits, But Not In Portland: Study
Nonprofit health insurers often beat the premiums of their for-profit competitors and usually provide better protections on out-of-pocket spending, according to a recent survey of six cities around the country, including Portland. Interestingly, in Portland the distinction between nonprofits and for-profits blurs, however. The survey, conducted by the free consumer information website, HealthPocket.com, analyzed more than 2,000 quotes, focused on individual female nonsmokers. It adds numerical context to the debate among health care insiders over the transformation of some nonprofit insurers (Budnick, 5/23).

CT Mirror: Senate Adopts Measure To Coordinate Care For Mentally Ill Children
The state Senate unanimously adopted a measure Thursday aimed at improving coordination between a wide array of caregivers and support services for children with mental illness. The bill, crafted in response to last December's tragic shooting at Sandy Hook Elementary School in Newtown, lays the groundwork for a more comprehensive, coordinated response by mental health agencies, schools and emergency mobile psychiatric services (Phaneuf and Becker, 5/23).

Kansas Health Institute: Network Execs Squabble Over Issue Of Exchange Connectivity
Following a heated exchange between two network chief executives, the board regulating digital health record exchange in Kansas voted Wednesday to prohibit the networks from charging each other connectivity fees until at least 2015. In Kansas, the exchange of digital patient information began last summer via two private networks licensed by the quasi-governmental Kansas Health Information Exchange, Inc. (KHIE) (Cauthon, 5/23).

North Carolina Health News: Bill Addresses Doctors & The Death Penalty
It’s been almost seven years now since the state of North Carolina carried out an execution, as the procedure has been subject to political pressure by anti-death penalty groups and caught up in court cases. One of the barriers to carrying out executions has been legal wrangling over the role of doctors in the procedure (Hoban, 4/24).

California Healthline: Task Force To Examine Developmental Centers
Diana Dooley, secretary of the state's Health and Human Services agency, yesterday announced formation of a task force to take a hard look at the viability of closing four developmental centers in California. "I don't know if the four developmental centers we operate can all close," Dooley said. … Developmental centers in California have come under fire recently -- with allegations of chronic abuse of patients, investigations by multiple government agencies and loss of federal certification. The state has taken a number of steps, particularly at Sonoma Developmental Center, to investigate possible abuses and improve safety of the centers' clients (Gorn, 5/23).

The New York World: No Restraint At Drug-Dosing New York Nursing Homes
A year after a federal health agency vowed to sharply reduce the use of powerful antipsychotic drugs in nursing homes, prescriptions have declined only modestly -- and dozens of New York City facilities have actually increased their use of the medications. In May 2012, the Centers for Medicare and Medicaid Services announced an initiative to reduce antipsychotic use in nursing homes nationally 15 percent by the end of 2012 (Skinner, 5/23).

House Panel Considers Measure That Would Ban Abortions After 20 Weeks

Fri, 24 May 2013 13:10:56 GMT

The bill, which is national in scope, is a response to the conviction of abortion provider Kermit Gosnell as well as a range of new state laws.

NPR: Abortion Opponents Try To Spin Murder Case Into Legislation
As predicted, abortion opponents on Capitol Hill are wasting no time in their efforts to turn publicity over the recent murder conviction of abortion provider Kermit Gosnell to their legislative advantage (Rovner, 5/23).

Politico: House Panel Considers Abortion Bill
A bill banning most abortions after 20 weeks nationwide received consideration from a House panel on Thursday -- and the Kermit Gosnell case and recent court rulings provided a fresh backdrop. But the same familiar arguments in the fight over abortion dominated the discussion (Smith, 5/24).

Health Law Politics Swirl Around Scandal Reports, Implementation Frustrations

Fri, 24 May 2013 13:10:00 GMT

Some of the political ebb and flow is exactly as expected, with news reports noting that Rep. Michele Bachmann, R-Minn., a staunch opponent of the overhaul, is focused on linking the Internal Revenue Scandal with the health law. However, in other coverage, The Associated Press reports that some labor unions, which were strong advocates, have become increasingly frustrated with some aspects of the law, and The Hill notes that some business groups are voicing concerns about the measure's wellness program.

The Associated Press/Washington Post: Health Care Overhaul Faces Backlash From Once Supportive Labor Unions
When President Barack Obama pushed his health care overhaul plan through Congress, he counted labor unions among his strongest supporters. But some union leaders have grown frustrated and angry about what they say are unexpected consequences of the new law — problems that they say could jeopardize the health benefits offered to millions of their members (Hananel, 5/24).

The Hill: Businesses Share ObamaCare Wellness Program Worries With White House
Business groups are weighing in on an ObamaCare proposal governing incentives for employees to stay healthy. The White House is currently reviewing a proposed rule for wellness programs that give workers incentives to take part in healthy habits such as joining a gym, signing up for a weight-loss plan or participating in a scheme to stop smoking (Hattem, 5/23).

The Washington Post's The Fact Checker: Bachmann's Absurd Claim Of A Vast IRS Health Database Of 'Sensitive, Intimate' Information
With the Internal Revenue Service in the news, Rep. Michele Bachmann (R-Minn.) has taken the opportunity to marry that scandal with her ongoing battle against the president’s health care law, a.k.a. "Obamacare." The picture she has sketched is pretty frightening — that the "most personal, sensitive, intimate, private health care information is in the hands of the IRS" via a vast database. Indeed, even though our colleagues at PolitiFact and FactCheck.Org have beaten us to the punch on this language, the issues she has raised have generated enough buzz on the blogosphere that we believe we should weigh in as well. What is Bachmann talking about? (Kessler, 5/24).

McClatchy: Scandal Draws Questions About IRS Role In Enforcing Obamacare
The blossoming IRS scandal over the targeting of conservative groups is provoking new scrutiny and terse questions about the agency’s role in shaping and implementing the controversial new national health care law, with the biggest changes set to begin next year. The Internal Revenue Service is an important cog in the implementation of the Patient Protection and Affordable Care Act of 2010, commonly shorthanded as Obamacare. The tax agency must act on 47 provisions of the new law, more than half of those already in effect, including the more controversial ones taking effect in 2014 such as the requirement that nearly all non-elderly adults have health care coverage (Hall and Lightman, 5/23).

Health Care Issues Become Hurdle For Immigration Reform Measure

Fri, 24 May 2013 13:10:00 GMT

The key question that seems to have stalled progress for House lawmakers is how to handle immigrants who do not have health insurance.

Los Angeles Times: Immigrant Health Care Bills Stump House Group
Differences over whether immigrants should be deported for failing to have health insurance or pay their health care bills have stalled a bipartisan group of House lawmakers, who blew past a self-imposed Thursday deadline as they pressed forward on a sweeping immigration overhaul (Mascaro, 5/23).

The Wall Street Journal: House Immigration Effort Hits Bump In The Road
Last week, a bipartisan group of House lawmakers thought they had a broad deal on how to overhaul the immigration system. This week, they don't. The eight House lawmakers were forced to backtrack from the "agreement in principle" reached last Thursday after House Democratic leaders objected to a provision dealing with health care coverage for illegal immigrants living in the U.S., according to aides from both parties. The group continued to meet this week, and its members remained hopeful they would be able to strike a deal that passes muster among all involved (Peterson, 5/23).

Modern Healthcare: Taxpayers Won't Pay Health Care Costs For Undocumented Immigrants
Two days after the Senate Judiciary Committee passed a comprehensive immigration reform bill, House Minority Leader Nancy Pelosi (D-Calif.) promised that U.S. taxpayers would not bear the cost of health care coverage for undocumented immigrants who are on the path to citizenship. Earlier reports had hinted that the coverage provisions under the Patient Protection and Affordable Care Act might be a sticking point as House members draft their own immigration-reform legislation (Zigmond, 5/23).

First Edition: May 24, 2013

Fri, 24 May 2013 11:11:54 GMT

Today's headlines include details on California's new health insurance exchange rates, whether consumers will experience "rate shock" and what these numbers say about the health law's implementation.

Kaiser Health News: California Insurance Exchange Rates: Not Too High, Not Too Low
Kaiser Health News staff writer Sarah Varney reports: "In the first disclosure of individual health insurance premiums by the nation's largest state, California announced on Thursday a wide array of choices for the 5.3 million people expected to qualify to purchase coverage through its online marketplace established by the Affordable Care Act" (Varney, 5/24). Read the story.

The Associated Press/Washington Post: Health Care Overhaul Faces Backlash From Once Supportive Labor Unions
When President Barack Obama pushed his health care overhaul plan through Congress, he counted labor unions among his strongest supporters. But some unions leaders have grown frustrated and angry about what they say are unexpected consequences of the new law — problems that they say could jeopardize the health benefits offered to millions of their members (5/24).

The Washington Post's The Fact Checker: Bachmann's Absurd Claim Of A Vast IRS Health Database Of 'Sensitive, Intimate' Information
With the Internal Revenue Service in the news, Rep. Michele Bachmann (R-Minn.) has taken the opportunity to marry that scandal with her ongoing battle against the president’s health-care law, a.k.a. "Obamacare." The picture she has sketched is pretty frightening — that the "most personal, sensitive, intimate, private health-care information is in the hands of the IRS" via a vast database. Indeed, even though our colleagues at PolitiFact and FactCheck.Org have beaten us to the punch on this language, the issues she has raised have generated enough buzz on the blogosphere that we believe we should weigh in as well. What is Bachmann talking about? (Kessler, 5/24).

The Associated Press/Washington Post: Hobby Lobby Appeal Tests Limits Of Federal Birth-Control Coverage Mandate
In the most prominent challenge of its kind, Hobby Lobby Stores Inc. asked a federal appeals court Thursday for an exemption from part of the federal health care law that requires it to offer employees health coverage that includes access to the morning-after pill. The Oklahoma City-based arts-and-crafts chain argued that businesses — not just the currently exempted religious groups — should be allowed to seek exception from that section of the health law if it violates their religious beliefs (5/23).

Los Angeles Times: Immigrant Healthcare Bills Stump House Group
Differences over whether immigrants should be deported for failing to have health insurance or pay their healthcare bills have stalled a bipartisan group of House lawmakers, who blew past a self-imposed Thursday deadline as they pressed forward on a sweeping immigration overhaul (Mascaro, 5/23).

The Wall Street Journal: House Immigration Effort Hits Bump In The Road
Last week, a bipartisan group of House lawmakers thought they had a broad deal on how to overhaul the immigration system. This week, they don't. The eight House lawmakers were forced to backtrack from the "agreement in principle" reached last Thursday after House Democratic leaders objected to a provision dealing with health-care coverage for illegal immigrants living in the U.S., according to aides from both parties. The group continued to meet this week, and its members remained hopeful they would be able to strike a deal that passes muster among all involved (Peterson, 5/23).

Politico: House Panel Considers Abortion Bill
A bill banning most abortions after 20 weeks nationwide received consideration from a House panel on Thursday — and the Kermit Gosnell case and recent court rulings provided a fresh backdrop. But the same familiar arguments in the fight over abortion dominated the discussion (Smith, 5/24).

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California Insurance Exchange Rates: Not Too High, Not Too Low

Sarah Varney — Fri, 24 May 2013 10:04:00 GMT

SACRAMENTO – In the first disclosure of individual health insurance premiums by the nation’s largest state, California announced on Thursday a wide array of choices for the 5.3 million people expected to qualify to purchase coverage through its online marketplace established by the Affordable Care Act.

The premiums, which aimed at a "just right" Goldilocks range, surprised many consumer advocates and analysts who had been anticipating much higher prices.

“We’ve hit a home run for consumers,” said Peter V. Lee, the executive director of the California exchange, known as Covered California.

The fear had been that shoppers in the individual insurance market would face severe "sticker shock" when the sweeping changes of the health law take effect beginning in January 2014. The law prohibits health plans from rejecting people with pre-existing conditions and doesn't allow insurers to charge women and sicker people higher premiums.

Nearly three dozen health plans submitted bids to sell their products in the competitive marketplace, and 13 were selected. But California exchange officials, authorized by state lawmakers to negotiate on behalf of consumers, rejected bids that were priced too high, they said, or failed to have robust networks of doctors and hospitals. “We held insurers’ feet to the fire,” said Lee of the negotiations.

From Bronze To Platinum

The companies approved to sell individual insurance on the exchange include the state’s dominant commercial players, such as Anthem Blue Cross, Kaiser Permanente, HealthNet and Blue Shield of California, as well as a number of regional and quasi-public health plans that largely rely on public and university hospitals and community health centers to deliver medical care to low-wage workers.

The proposed premiums still must be approved by state insurance regulators. Three of the nation's largest players in the employer-sponsored insurance market -- UnitedHealthCare, Cigna, and Aetna -- are not going to be selling on the California exchange.

The proposed premium prices vary depending on the geographic region of California, the consumer’s age and the richness of benefits, from catastrophic coverage for young adults to “Platinum” products. Under the premiums unveiled on Thursday, a 25-year-old in Los Angeles could choose a Health Net catastrophic plan for $117 a month or a more comprehensive “Bronze” plan for $147 a month from L.A. Care, the nation’s largest public health plan. And if that individual makes less than about $45,600 per year, she would qualify for a subsidy that would bring the cost of the premium down further.

Good Reviews

Predicting the impact of the federal health care law on premium prices has become a cottage industry among health policy researchers and consumer advocates, and California was expected to be a key test case. On Thursday, the reaction by those groups was largely positive.

“I’m impressed,” said Betsy Imholz, director of special projects for Consumers Union, a division of Consumer Reports. “I actually think they are good prices,” she said, especially for those who will receive federal insurance subsidies.

More than half of Californians shopping for insurance through the state-run marketplace will be eligible for federal income tax credits. Those credits will offset the price of private insurance: A 40-year-old individual in Los Angeles, for example, who earns $1,915 a month, or 200 percent of the federal poverty level, would pay a monthly premium of $90 for a Health Net HMO “Silver” plan in 2014, according to the rates released by Covered California.

At a press conference in Sacramento, which had a celebratory air, exchange officials said the restrained premiums largely reflected deft negotiating by the health plans with thousands of doctors and hospitals, including powerful hospital chains whose market clout has been blamed for rising health care costs in California.

“We made the pitch that we can’t sustain the current system with 7 million Californians not being insured,” said Paul Markovich, president of Blue Shield of California. “We felt there was a rate at which they could still be financially viable, but it would make rates much more affordable for this population.”

The rate for an individual plan offered by Blue Shield of California will increase an average of 13-percent for existing customers, said Markovich. But the benefits, he said, as mandated by federal and state regulators and uniform across all health insurance packages, will look more like the comprehensive insurance workers receive from employers.

For Some, 'Staggering Increases?'

Health care analysts said simply calculating how much an individual’s premium might increase next year was an incomplete – and faulty – assessment of the competitive marketplaces the federal health law was meant to unleash in each state.

Caroline Pearson, a vice president at Avalere Health, a consulting company in Washington, said she judged California’s performance by whether residents would have access to insurance products priced around $5,200 a year, the Congressional Budget Office’s estimate for an average individual market premium. Indeed, each region in California, based on her analysis, will offer plans below $4,000 a year. The offerings “strike me as very competitive,” said Pearson. “It speaks to the number of carriers that were attracted to the market, and that the exchange created competition to drive down prices.”

Still, some remained cautious about the sticker shock some middle-upper income families are likely to experience. Federal tax credits phase out at 400 percent of the federal poverty level, or about $94,000 a year for a family of four. “For that small number of people,” said Micah Weinberg, a senior policy adviser with the Bay Area Council, a business group representing large employers, “those premium increases are going to be staggering.”

States Embroiled In Medicaid Expansion Battles Are Running Out Of Time

Thu, 23 May 2013 14:09:00 GMT

Politico reports that this health law implementation issue remains an open question for about a dozen states. Some are on the brink of giving up for the first year but looking ahead to the next set of state legislature sessions. Meanwhile, news outlets report on related developments in Michigan, Texas, Ohio, California and Iowa.

Politico: Clock Ticking On Full Medicaid Expansion Funds
States still mired in the fight over the Obamacare Medicaid expansion are starting to give up on their first year of full funding — and it's unclear whether they would be able to tap into the money before 2015. Expansion remains an open question in about a dozen states after months of legislative fights. As more states continue to wrap up their budgets, some are already looking to next year's legislative sessions as their next shot at the expansion, even amid calls for state legislatures to return for special sessions (Millman, 5/23).

The Associated Press: Snyder: Mich. Could Still Get Medicaid Expansion
Republican Gov. Rick Snyder said Wednesday he is hopeful he can still broker an agreement with the Republican-led legislature to expand government health insurance for low-income adults, despite the state's tentative budget deal that leaves out the Medicaid expansion. Snyder told The Associated Press during an interview in Washington that while the budget deal he reached with GOP leaders in the legislature on Tuesday does not include the expansion, they could come up with a solution after the final budget is passed (Durkin, 5/22).

The Associated Press: After Steady Heckling, Perry Meets With Protesters
Hecklers demanding that Texas expand the Medicaid program under the White House-backed health care law repeatedly interrupted a speech by Gov. Rick Perry on Wednesday, then descended on his office for a meeting to keep pressing their case…Texas has the highest rate of uninsured in the nation, with about 6.2 million of its residents lacking health care coverage. Advocates say extending Medicaid as directed by federal health care reform could provide up to 1 million Texans with some coverage. But because Medicaid is a jointly funded federal-state program, Perry says embracing expansion could bankrupt Texas (Weissert, 5/22).

The Texas Tribune: Health Care Hecklers Meet With Perry
Gov. Rick Perry met with three health care activists who helped organize a protest of his speech before Austin business leaders Wednesday. Perry invited the activists to his office after a dozen or more protesters infiltrated a ballroom at the downtown Hilton Austin Hotel, where Perry was speaking before a gathering of the “2013 Global Business Summit” being put on by his office (Aaronson and Root, 5/22).

Des Moines Register: Expansion Includes State-Paid Premiums
After arguing for months over how to provide health care to poor Iowa adults, the Iowa Senate approved a compromise plan late Wednesday and sent it to the House. The proposal was expected to be considered today by the House, whose Republican leaders have endorsed it. Gov. Terry Branstad also supports it. The new Iowa Health and Wellness Plan would cover the same Iowans who would have been covered by Medicaid under President Barack Obama’s Affordable Care Act. But the approximately 150,000 people would have their health care covered in different ways. Poor adults making less than the federal poverty level, or about $11,500 per year for a single person, would qualify for medical benefits similar to what state employees receive. People making between that amount and about $16,000 could buy private insurance on the state’s new health insurance exchange. The government would pay premiums for at least the first year (Leys and Petroski, 5/23).

Columbus Dispatch: Bill In Ohio House Revives Medicaid Expansion
Rep. Barbara Sears, R-Sylvania, introduced legislation yesterday to provide coverage to an estimated 275,000 people with incomes under 138 percent of the federal poverty level. The cost would be paid entirely by the federal government for three years under the new health-care law. Sears said she hopes to win passage of the legislation by the end of June to give state Medicaid officials the six months they say they need to implement an expansion by Jan. 1. That’s when the federal aid becomes available, and it’s also when most Americans must have health coverage or face penalties. House Speaker William Batchelder, R-Medina, said lawmakers will be studying the proposal over the next month, and it was “possible” it could be approved by June 30 (Candisky, 5/23).

California Healthline: How Obamacare Could Change Medi-Cal For The Better (And Worse)
As many as 1.5 million Californians are expected to gain Medi-Cal coverage over the next six years, thanks to provisions in the Affordable Care Act. That might be the easy part. What's tricky: Making sure that the already-strapped Medicaid program -- which is facing a controversial 10 percent provider rate cut -- has enough dollars to go around. "Expansion of Medicaid in California is a step in the right direction," Paul Phinney, president of the California Medical Association, said in a statement last week (Diamond, 5/22).

Idaho, New Mexico Ask Feds To Run Health Exchanges

Thu, 23 May 2013 14:08:00 GMT

In addition, media outlets report that the nation's largest for-profit insurers will not participate in California's online marketplace. Eleven insurers have applied to operate plans in Colorado.

The Wall Street Journal: Two States Seek Help With Health Exchanges
Two states that had planned to run their own health-insurance exchanges this fall are asking the federal government for help in the first year, a sign of the obstacles states face in carrying out a centerpiece of the health-care overhaul. Idaho and New Mexico had been among a few Republican-led states that had agreed to operate their own health exchanges, which will offer a variety of insurance plans for people who don't have coverage otherwise (Dooren, 5/22).

Kaiser Health News: Capsules: 11 Insurers Want To Play Ball In Colorado's Marketplace
Colorado became the latest state Wednesday to post proposed health insurance plans for its new online marketplace, which is slated to begin enrolling people in coverage Oct. 1. What stands out is the number of plans being proposed. A total of 11 insurers are seeking approval to market about 250 health plans to individuals and small groups in the state's online marketplace (Galewitz, 5/22).

Los Angeles Times: UnitedHealth, Aetna And Cigna Opt Out Of California Exchange
Some prominent health insurers, including industry giant UnitedHealth Group Inc., are not participating in California's new state-run health insurance market, possibly limiting the number of choices for millions of consumers. UnitedHealth, the nation's largest private insurer, Aetna Inc. and Cigna Corp. are sitting out the first year of Covered California, the state's insurance exchange and a key testing ground nationally for a massive coverage expansion under the federal healthcare law (Terhune, 5/22).

And, in Washington state -

The Associated Press: 2 Insurers Left Abortion Coverage Out Of Washington State Health Exchange Proposals
Two insurance companies who filed to compete in Washington state's health care exchange initially proposed not to provide abortion coverage, officials said Wednesday. All current Washington health plans provide abortion insurance. Stephanie Marquis, a spokeswoman with the Washington state Office of the Insurance Commissioner, said the plans without such coverage in the health exchange were recently filed by Kaiser Foundation Health Plan of The Northwest and BridgeSpan Health Company (5/22).

Political Cartoon: 'Pennsylvania Railroaded?'

Thu, 23 May 2013 13:40:38 GMT

Kaiser Health News provides a fresh take on health policy developments with "Pennsylvania Railroaded?" by John Cole.

Meanwhile, here is today's health policy haiku:

HHS CONTRA?

Is Sebelius
equal to Oliver North?
That's what Lamar wrote.
-Anonymous

And, as a bonus:

EVEN JACKIE CHAN COULDN'T SAVE THIS RUSH HOUR

The evening commute
for KHN staff gives me
a "sinking" feeling.
-Anonymous

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Senate Immigration Bill Would Ease Restrictions On Foreign Health Workers

Thu, 23 May 2013 13:33:00 GMT

On Capitol Hill, several legislative efforts are moving forward on health issues. Among them is an effort by the Massachusetts delegation to keep bonus Medicare payments for the state's hospitals, while House Republicans are looking for another way to deal with a bill to fund high-risk insurance pools. In addition, a Senate measure is advancing that would increase scrutiny On compounding pharmacies.

Modern Healthcare: Immigration Bill Seeks To Ease Rules For Foreign Health Workers
After 30 hours of debate over a three-week period, the Senate Judiciary Committee has passed a bipartisan immigration bill that would seek to strengthen the country's healthcare workforce by making it easier for foreign health professionals to work in the U.S. The panel voted 13-5 on Tuesday to approve the sweeping Border Security, Economic Opportunity and Immigration Modernization Act (PDF) that Sen. Charles Schumer (D-N.Y.) introduced last month. In all, the committee considered 212 amendments in the bill that Senate Majority Leader Harry Reid has said he would like to bring to the floor for debate in June, "sometime soon" after Congress returns from a weeklong Memorial Day work period (Zigmond, 5/22).

Boston Globe: Mass. Tries To Retain $250 Million For Hospitals
The Massachusetts congressional delegation, after holding a rare emergency meeting Wednesday, launched what could be a final effort to preserve more than $250 million in bonus Medicare payments to the state's hospitals that critics call the "Bay State boondoggle." But the prospect of holding on to the windfall is dimming. The Democrat-controlled Senate voted earlier this year to end the payments, enacted under President Obama's health care overhaul law and which come at the expense of most other states. A similar bill was introduced in the Republican-led House this week (Jan, 5/23).

Reuters: Senate Committee Advances Drug Compounding Bill
A U.S. Senate committee on Wednesday unanimously approved legislation that would increase federal oversight for companies that compound and sell sterile drugs across state lines. The proposed legislation was introduced in response to a meningitis outbreak last fall that killed more than 50 people and sickened more than 700. The outbreak was traced to contamination found in steroid injections made by the New England Compounding Center (Dye, 5/22).

Kansas City Star: With Roberts' Backing, Bill To Reform Pharmacy Compounding Heads To Senate
A U.S. Senate committee on Wednesday passed bipartisan legislation that would fundamentally change how large-scale pharmacy compounding is practiced in this country. Also Wednesday, the Senate's Health, Education, Labor and Pensions Committee issued a report showing that poor compounding practices have persisted even since last fall, when a meningitis outbreak linked to contaminated steroid injections killed 55 people and sickened about 700 (Morris, 5/22).

CQ HealthBeat: Rejected High-Risk-Pool Bill To Get Another Chance
A month after House Republican leaders were forced to pull an unpopular health care law revision from the House floor, bill sponsor Rep. Joe Pitts said he expects to see a modified version under consideration again in "a couple of weeks." The reworked measure appears designed to mollify critics in the GOP rank and file who argued that the bill, as introduced, would have, in effect, just bolstered the president's signature health care law rather than repealed its provisions (Dumain and Ethridge, 5/22).

And, during a recent hearing -

McClatchy: Medical Company Declines To Answer Senate Questions On Medicare Billing
The president and chief executive officer of a medical equipment company invoked the Fifth Amendment at Senate hearing Wednesday, declining to answer questions about aggressive marketing tactics used to sell scooters, sleep apnea machines and other home medical supplies to Medicare recipients who may not need or want them. Jon Letko of U.S. Healthcare Supply LLC, based in Milford, N.J., exercised his constitutional right not to incriminate himself at the hearing before the Senate Subcommittee on Financial and Contracting Oversight (Wise, 5/22).

HHS Report Finds Uptick In Doctors' Use Of Electronic Health Records

Thu, 23 May 2013 13:32:50 GMT

Also in the news, the Pentagon is in search of a new system for veterans' health care while San Francisco is "leading the way" in new health data applications.

USA Today: Incentives Push Doctors To Electronic Medical Records
More than half of doctors' offices and 80 percent of hospitals that provide Medicare or Medicaid will have electronic health records by the end of the year, the Department of Health and Human Services announced Wednesday (Kennedy, 5/22).

CQ HealthBeat: HHS Report Shows Strong Growth In Use Of Electronic Health Records
More than half of all doctors now get Medicare or Medicaid incentive payments for using electronic health records, according to a report federal officials released on Wednesday. But Republicans say medical professionals should not just use the records in their own offices but also should exchange them with other providers (Adams, 5/22).

The Associated Press: Pentagon To Seek New Records System For Vets Health Care, Says It Won’t Solve Claims Backlog
The Pentagon has decided to buy a new computerized health records system to be able to better share and merge its data with the Department of Veterans Affairs, but officials cautioned that it was part of a “long-term modernization” effort and would not help ease the backlog in VA disability claims (5/22).

California Healthline: San Francisco Leading The Way In Health Data Applications
The city of San Francisco is leading the way in using health data in innovative ways and it's paying off in a big way, according to several city officials who spoke yesterday at the Healthy Communities Data Summit. The summit was held in San Francisco and that meant a number of success stories were local, but the conference cast a wide net in its approach to innovation prompted by public release of health data (Gorn, 5/22).

State Highlights: Conn. Democrats Eye Shifting $400M In Medicaid Money

Thu, 23 May 2013 04:00:00 GMT

A selection of health policy stories from California, Connecticut, American Samoa, Georgia, Oregon and West Virginia.

Los Angeles Times: Geography Has A Role In Elective Surgery Decisions, Study Finds
Geography plays a role in whether patients in California have elective operations such as joint replacement, weight loss surgery and gallbladder removal, according to a new study. The California HealthCare Foundation study showed wide variations in patient surgeries across the state (Gorman, 5/22).

CT Mirror: Democrats May Sidestep Spending Cap
Struggling to secure the super-majority necessary to exceed the current spending cap by half-a-billion dollars, legislative leaders are weighing a plan to green-light the extra spending with a simple majority. According to sources close to budget negotiations, the Democratic majority has discussed effectively shifting more than $400 million in Medicaid spending off the books next fiscal year. The process is common in other states, but rarely used here and never involving that much money (Phaneuf and Becker, 5/22).

Modern Healthcare: HHS Finds $2.2M In Billing Errors At Cedars-Sinai
Administrators at Los Angeles' largest community hospital, Cedars-Sinai Medical Center, were well aware of the flaws in their inpatient admissions process before an audit report Wednesday from HHS' inspector general's office publicly pointed them out. The 892-bed hospital posted a case manager in its emergency department last year to review all decisions to admit so-called "short-stay" inpatients, and that person now has access to standardized admissions criteria software from InterQual to evaluate make those decisions, hospital administrators wrote to the OIG (Carlson, 5/22).

Los Angeles Times: Most Unionized UC Hospital Workers Go To Jobs Despite Strike
As University of California patient care workers returned to the picket lines Wednesday, hospital administrators said they were gratified that so many others chose to come to work. More than three-quarters of union members who had been scheduled to work Tuesday did so, said Dianne Klein, spokeswoman for the UC office of the president. Hospital officials said they expected a similar turnout Wednesday (Gorman, 5/22).

The Associated Press/Washington Post: American Samoa To Keep Frequent Flier Miles Of Government Travelers; Use For Sick, Students
American Samoa plans to take away frequent flier miles from government workers who travel on behalf of the U.S. territory and use the loyalty points to help medical patients and students travel off the islands when necessary (5/22).

Georgia Health News: State Psychiatric Hospital In Thomasville To Close
A state agency Wednesday announced that its psychiatric hospital in Thomasville will close by the end of the year. The state Department of Behavioral Health and Developmental Disabilities told GHN that Southwestern State Hospital currently has a patient census of 116, divided between people with mental illness and development disabilities, and those housed in the facility’s forensic unit. The closing of the hospital continues the revamping of the state’s services for people with mental illness and developmental disabilities in the wake of Georgia’s landmark 2010 agreement with U.S. Department of Justice, which aims to move people from mental hospitals into community living situations (Miller, 5/22).

The Lund Report: Cultural Competency In Health Care Heads To Governor
Sen. Jackie Winters said 40 or 50 years ago, when some black Americans had diabetes, they had a colloquial term for it -- "the sugars" -- which their doctors may not understand. Winters, a black Republican senator from Salem, told The Lund Report that ethnic and racial minorities often face increased health disparities, often for purely cultural reasons, since physicians and nurse practitioners are more likely to come from an ethnic group different than their own. That's what's led her to find a legislative route that would compel health professionals to become educated in cultural competency (Gray, 5/22).

The Associated Press: W. Va. Gov Picks New Health Secretary
Former hospital executive and nurse Karen Bowling will become West Virginia's Health and Human Resources secretary on July 1, Gov. Earl Ray Tomblin said Wednesday, taking over a sprawling department recently scrutinized by an audit and assigned the daunting task of expanding the state's Medicaid program (5/22).

San Jose Mercury News: California Bill Would Prevent Genetic-Testing Firms From Using Surreptitiously Obtained DNA
If you want to keep your DNA to yourself, be sure not to leave any stray hairs, Q-tips or underwear lying around. There are genetic testing companies out there willing to reveal your most intimate biological secrets to anybody -- without your knowledge or permission. And under California law, such genetic snooping is perfectly legal. Now, legislators in Sacramento are considering a bill to change that. Senate Bill 222, which faces a key hearing Thursday, would require a donor's consent to collect, analyze or share genetic information (Shugart, 5/22).

Viewpoints: Sen. Alexander Sees Reflections Of Oliver North In Sebelius' Quest To Raise Funds; Vaccine Scare's Legacy

Thu, 23 May 2013 04:00:00 GMT

The Wall Street Journal: Kathleen Sebelius, Meet Oliver North
Major news outlets in recent days have reported that U.S. Department of Health and Human Services Secretary Kathleen Sebelius is raising money from the private sector -- including from health care executives -- for use by a private entity that is helping to implement ObamaCare. ... Is Ms. Sebelius raising funds for a private entity and then coordinating with that entity to do something Congress has refused to authorize, or for which it has refused to appropriate funds? And is she raising money from organizations she regulates, in violation of ethics laws? (Sen. Lamar Alexander, R-Tenn., 5/22).

The New York Times: Aftermath Of An Unfounded Vaccine Scare
Britain is experiencing serious outbreaks of measles that look to be a delayed consequence of a failure to vaccinate infants and young children more than a decade ago. A prime cause of that failure was ill-founded fears among parents that a widely used vaccine to combat measles, mumps and rubella might cause autism. Because they shunned the vaccine, their children, now in their teens, are suffering the consequences (5/22).

Milwaukee Journal-Sentinel: Mandatory Vaccinations Deserve Vigorous Debate
The debate over the mandatory influenza vaccinations of employees is worthy of a vigorous public airing. Controversy has been growing nationwide over the plight of employees, particularly health care workers, being dismissed from jobs due to their refusal to accept this unwanted intrusion into their personal health care decisions. I fully recognize this argument pits two groups advocating against each other over a position based on rights. Employers demand flu vaccinations of employees, with extremely limited exceptions, as a fundamental right of an employer. Those who object stand on individual liberties to make their own personal health care decisions without the threat of dismissal (Jeremy Thiesfeldt, 5/22).

The New York Times: Kill Bill
According to statistics United Republic assembled, the prescription drug industry spent $116 million lobbying for legislation to prevent Medicare from bargaining down drug prices — legislation that enabled drug companies to make an additional $90 billion annually. That amounts to an extraordinary 77,500 percent return on investment. Oil companies, in turn, had a return on investment of 5,900 percent, and multinational companies, 22,000 percent (Thomas B. Edsall, 5/22).

The New England Journal of Medicine: The Gross Domestic Product And Health Care Spending
An examination of data from the past 60 years for the economy as a whole and for health care expenditures indicates that there has been a robust relationship between the two. ... Some observers place great emphasis on the particularly slow growth of national health care expenditures in 2010 and 2011. How useful is the experience of growth over a period of 2 years in predicting the growth rate over the next 20 years? The answer seems to be not at all. ... [T]he rate of growth of national health care expenditures in the past appears to have been substantially related to the growth of the GDP. There has been some slowing of the growth of health care spending relative to the GDP, but it began not just a few years ago, but in the 1990s (Victor R. Fuchs, 5/22).

Columbus Dispatch: Obamacare May Lead To 'Skinny' Policies
Would you like to have a "skinny" health-insurance policy? Probably not. But if you're employed by a large company, you may get one, thanks to Obamacare. That’s the conclusion of Wall Street Journal reporters Christopher Weaver and Anna Wilde Mathews. They report that insurance brokers are pitching and selling "low-benefit" policies across the country. You might be wondering what a "skinny" or "low-benefit" insurance plan is. The terms may vary, but the basic idea is that policies would cover preventive care, a limited number of doctor visits and perhaps generic drugs. They wouldn't cover things such as surgery, hospital stays or prenatal care (Michael Barrone, 5/23).

JAMA: Public Health Regulation As A Public Process
Media coverage of new public health regulations often seems to follow a template: The [regulatory agency]'s plan to implement [public health regulation] is causing controversy among [businesses affected] and [individuals who object]. … But there's another way to think about how policy is developed to improve health: as a dynamic process open to a range of policy alternatives (Dr. Joshua M. Sharfstein, 5/22).

JAMA: Encouraging Smokers to Talk With Their Physicians About Quitting
Over the next few months, physicians may see an increase in patients asking for help in quitting smoking. Why? The Office on Smoking and Health at the Centers for Disease Control and Prevention recently launched the second stage of its national media campaign, Tips from Former Smokers (Tips). Some of the ads include a new call to action with the message, "You can quit. Talk with your doctor for help." This "talk with your doctor" initiative provides physicians with a golden opportunity to help more patients quit smoking (Dr. Tim McAfee, 5/22).

The Lund Report: Physician, First Do No Harm -- To Yourself
Studies confirm most doctors are overworked, exhausted, or depressed. The tragedy: few seek help. I ask the group, "How many physicians have lost a colleague to suicide?" All hands are raised. "How many have considered suicide?" Except for one woman, all hands remain up -- including mine. "Physicians have the highest suicide rate of any profession," I explain. "In the United States we lose over 400 physicians per year to suicide. That's the equivalent of an entire medical school. Even that's an underestimate because many physician suicides are incorrectly identified as accidents" (Dr. Pamela Wible, 5/21).

MinnPost: Failed Virginia Bill On Miscarriages Reveals Ignorance About Women's Health
As I've written here before, the medical ignorance of some politicians -- particularly in regard to women's reproductive health -- is a continual source of astonishment. ... While searching through the legislative history of Virginia state Sen. Mark Obenshain, now running on the Republican ticket for his state's attorney general position, reporters found that he had authored a bill in 2009 that would have required all women in Virginia to report miscarriages to police or risk legal penalties, including as much as a year in jail (Susan Perry, 5/22).

Bloomberg: Better Death Records Can Lead To Longer Life
Here's a morbid thought atop a morbid thought: Two in three deaths worldwide -- some 35 million a year -- go unregistered. And in many cases when deaths are recorded, reliable information on what caused them is lacking. Why does this matter? Without such records, public-health authorities can't tell enough about what's killing people to minimize the dangers they face (5/22).

Oregonian: Portland And Its Aversion To Fluoride Reflects Oregon's Unusual Politics
In 2011, the board of the Santa Clara Valley Water District voted to begin fluoridating water for about 850,000 customers in and around San Jose. Anti-fluoride activists grumbled but realized they didn't have the resources to take their fight to the public. That's sure not what happened in Portland, which once again showed that this far northwest corner of the country is willing to go where other parts of the country rarely tread (Jeff Mapes, 5/22).