Kaiser Health News - Aging

Calif. Gov. Brown's Revised Budget Includes Substantial Medi-Cal Cuts

Tue, 15 May 2012 13:34:44 GMT

The ballooning budget deficit in California might mean hospitals and nursing homes will get less state money.

Reuters: California Targets Health, Public Workers To Fix Budget Hole
California Governor Jerry Brown on Monday unveiled a revised state budget plan that calls for new cuts to healthcare for the poor and elderly and reduced work hours for state employees as part of an effort to close a $15.7 billion budget gap (Christie, 5/14).

The Associated Press: California Gov. Jerry Brown Urges Austere Cuts, Tax Hikes To Tackle Reemerging Deficit
Brown said California's sputtering economic recovery is putting a heavier-than-expected drag on state tax revenue. The state has been blocked from making cuts to Medi-Cal and In-Home Supportive Services in court and by federal requirements. The revised budget deficit is $6.5 billion more than the $9.2 billion gap Brown anticipated in January (5/15).

Sacramento Bee: Optimistic Projections Led To Dramatic Surge In California Budget Deficit
[T]he state budget deficit had grown by a remarkable 70 percent since January, but fiscal experts said the economy had little to do with it. They instead blamed a bad marriage of volatile capital gains and political intransigence that led state leaders last year to count on a huge upswing in revenues that never materialized. At the same time, corporate tax changes from 2009 appear to have cost California more than state officials ever realized (Yamamura, 5/15).

San Jose Mercury News: Gov. Jerry Brown Slashes Programs For The Poor, Threatens To Do The Same To Schools
Brown also proposed cuts to hospitals and nursing homes to reduce Medi-Cal costs ... reducing state workers' pay by 5 percent through contract renegotiations; and using assets that used to belong to local redevelopment agencies (Harmon, Richman, Noguchi and de Sa, 5/14).

KQED: Brown's New Budget Cuts Would Hit Health Programs
Many of Governor Brown’s previous attempts to cut back on health care spending in the Golden State have been stymied by lawsuits or federal agencies that deemed the cuts too severe (Varney, 5/14).

KQED's State of Health blog: Governor's New Budget Slices -- Again -- Into Health Care
In a conference call with reporters today, Secretary of Health and Human Services Diana Dooley said the cuts to her agency were inevitable. "The problem we have and always have in health and human services is this is where most of the spending is. The spending is in education and health and human services to a very large degree, and the only place you can cut back are the places where you are spending" (Aliferis, 5/14).

California Healthline: May Budget Revise Hits Health Care Hard
Those proposals include: Reducing supplemental payments to private hospitals, along with elimination of public hospital grants and stopping increases to managed care plans for some supplemental public hospital payments. Taking back the 2.4 percent rate increase to nursing homes (Gorn, 5/15).

California Watch: Advocates Fear Patient Care Will Suffer Under State Budget Cuts
The revised budget poses a new set of challenges to care providers and patient advocates. Last week, groups representing doctors, nurses and nursing home residents decried a comparatively minor budget change that would have cut the mandate for hospital and nursing home inspectors to perform unannounced inspections to monitor compliance with state laws (Jewett, 5/15).

HHS Announcing Finalized Alzheimer's Plan

Tue, 15 May 2012 13:28:00 GMT

The plan, which includes an emphasis on research, sets 2025 as the target date for finding effective treatments for this disease.

National Journal: HHS Announces New Alzheimer's Plan Tuesday
Health and Human Services Kathleen Sebelius releases the administration's plan for fighting Alzheimer's disease later on Tuesday at the National Institutes of Health. Aging experts have been warning that the U.S. faces an epidemic of Alzheimer's as the giant Baby Boom generation hits the senior years. A team led by Denis Evans at Rush-Presbyterian–St Luke's Medical in Chicago projected in 2003 that by 2050, more than 13 million Americans will have the incurable brain disease, compared to about 5 million now (Fox, 5/14).

The Associated Press: Clock Ticking With New Plan To Fight Alzheimer's
The Obama administration is adopting a landmark national strategy to fight Alzheimer's disease, with an ambitious goal of finding some effective treatments by 2025. For families suffering today, the first National Alzheimer's Plan offers some help too. Starting Tuesday, families can turn to a one-stop website, www.alzheimers.gov, for easy-to-understand information about where to get help. Doctors also will get a chance to receive training on how to better care for people with Alzheimer's (Neergaard, 5/15).

Reuters: U.S. Launches Ambitious Alzheimer's Plan With Research Push
The U.S. government launched an ambitious push to develop new treatments for Alzheimer's on Tuesday with a first prevention study of high-risk patients and tests on an insulin nasal spray that has shown promise in earlier studies. The trials, funded by grants of $16 million and $7.9 million respectively, are part of a national Alzheimer's plan, a sweeping effort to find an effective way to prevent or treat Alzheimer's by 2025 and improve the care of those already afflicted with the brain-wasting disease (Steenhuysen, 5/15).

CQ HealthBeat: Collins Sees Opening to Accelerate Progress Against Alzheimer's
National Institutes of Health Director Francis Collins kicked off a two-day scientific conference on Alzheimer's disease Monday by saying he sees great promise in recent efforts to counter the mind-destroying condition. "We might be able to accelerate progress in a way that offers real hope to those individuals who are affected," he told researchers at the NIH Bethesda campus for the meeting (Reichard, 5/14).

CBS (Video): Promising Alzheimer's Research Delayed By Shortage Of Volunteer Patients
In Bethesda, Md. Monday, the National Institutes of Health began hosting a two-day summit on the fight against Alzheimer's disease. More than 5 million Americans have the disease, a number expected to triple by 2050. And researchers trying to defeat the disease are facing an unexpected hurdle, as CBS News correspondent Wyatt Andrews reports. ... "The problem is finding volunteers to join the studies," Turner said. "Patients." This one study of 750 patients is 250 patients short. Nationally, the shortfall is in the thousands, with almost every clinical trial related to Alzheimer's needing more volunteers (Andrews, 5/14).

Health Coverage Changes Prompt Aging, Disabled Care Concerns

Mon, 14 May 2012 13:57:00 GMT

NPR examines a new way to combat Alzheimer's -- with storytelling. In the meantime, health care changes to programs and budgets have some worried about how they will affect the aging and those with disabilities.

NPR: Alzheimer's Patients Turn To Stories Instead Of Memories
Storytelling is one of the most ancient forms of communication -- it's how we learn about the world. It turns out that for people with dementia, storytelling can be therapeutic. It gives people who don't communicate well a chance to communicate. And you don't need any training to run a session (Silberner, 5/14).

HealthyCal: The Health Perils Of Aging: Lonely and Sick
Social isolation and its common offspring -- loneliness -- became a political hot potato when California recently cut back on its adult day health care program, disqualifying 20 percent of the state's older and disabled citizens from its attendance rolls. Families who depended on the centers for medical supervision and social interaction suddenly had to scramble to find new programs to care for these relatives. For seniors with or without families, this often meant more time home alone. ... Loneliness can increase ... blood pressure, limit the body's ability to fight off illness, and has been linked to higher death rates (Perry, 5/13).

North Carolina Health News: NC Creates A Dilemma For The Grahams
Nancy Graham is 37 and has a developmental disability, the result of a genetic disease called Tay-Sachs, that's slowly eating away at her nervous system. ... The Grahams say they worry about the changes coming to Smoky Mountain Center ... If the Graham's moved Nancy to a nursing home, the state would pay more for her care, and they believe she wouldn't get care that's as good as what they provide. But, the Grahams are being given fewer services to use for Nancy's care because she lives at home (Wilson, 5/11).

When To Retire? Health Costs Enter Into The Decision

Thu, 10 May 2012 13:49:47 GMT

The New York Times: Working Late, By Choice Or Not
With the value of many 401(k)'s and homes taking a beating during the recession and with energy and health care prices climbing, many who dreamed that retirement was just around the corner have reluctantly kicked their retirement plans down the road (Greenhouse, 5/9).

Longer Looks: More 20-30 Somethings Are Taking Care Of Elderly

Thu, 10 May 2012 13:49:00 GMT

Every week, Kaiser Health News reporter Shefali S. Kulkarni selects interesting reading from around the Web.

ABC News: Early Burdens: Eldercare Falls on Young Shoulders
At 30, Suzette Armijo cares for her widowed 86-year-old grandmother, a retired National Park Service ranger in the final stages of Alzheimer's disease, while holding down a fulltime job, a part-time job and raising a 4-year-old son. "This was nothing that I had planned for," says Armijo, who moved her grandmother Elizabeth Armijo into a nearby six-bed assisted living home because veterans' benefits "wouldn't pay for her to live with me." ... Armijo is among a generation of young adult caregivers, the majority of whom are women, navigating tough turf without a roadmap. ... As they try to tap into resources to help an ailing grandmother, Mom or Dad, these 20-somethings and 30-somethings are often on a lonely road (Jane E. Allen, 5/4).

The Atlantic: Can a Sense of Purpose Slow Alzheimer's?
Medical professionals have also found correlations between a person's sense of purpose and their physical health and survival. As far back as 1946, the Austrian psychiatrist Victor Frankl, who spent several years in concentration camps during WWII and lost his entire family in the Holocaust, found that the people who survived the concentration camps best were those who believed they had a reason, mission, or purpose that required their survival ... [But now] it appears that a sense that your life has purpose, and that what you do matters, may actually protect your brain from the clinical effects of Alzheimer's disease (Lane Wallace, 5/9).

Newsweek: Why The Campaign To Stop America's Obesity Crisis Keeps Failing
Most of my favorite factoids about obesity are historical ones, and they don’t make it into the new, four-part HBO documentary on the subject, The Weight of the Nation. ... the government efforts to curb obesity and diabetes avoid the all-too-apparent fact, as Hilde Bruch pointed out more than half a century ago, that exhorting obese people to eat less and exercise more doesn’t work, and that this shouldn’t be an indictment of their character but of the value of the advice (Gary Taubes, 5/7).

The Root: On Blacks And Fat: Will Allen
Obesity is more common in African Americans than in other ethnic groups. But when it comes to black people and weight, that's where the agreement seems to end. Is food the culprit? Is exercise the solution? Is there even a real problem to begin with, or should we be focusing on health -- or even self-acceptance -- rather than the number on the scale? Against the backdrop of the first lady's mission to slim down the nation's kids, black celebs getting endorsements after shedding inches and a booming weight-loss industry, The Root will publish a series of interviews with medical professionals, activists and fitness enthusiasts that reveal the complexity of this issue and the range of approaches to it. For the fifth in the series, The Root talked to Will Allen, author of the Good Food Revolution: Growing Healthy Food, People and Communities (Jenée Desmond-Harris, 5/9).

Charlotte Observer: Nonprofit Hospitals Thrive On Profits (5 part series/major investigation)
Hospitals in the Charlotte region have margins among the highest in the U.S. They also have billions in investments and real estate. Experts say they could do more to lower patients' costs. ...To understand what’s happening nationally, one need look no farther than Charlotte’s Dilworth neighborhood, where North Carolina’s largest hospital system got its start. Carolinas HealthCare System began in 1943 with a 325-bed hospital called Charlotte Memorial, which struggled financially for decades. Its leaders decided they needed to grow to survive. They built a system that could attract paying patients while continuing to care for the uninsured. It worked. Over the past 30 years, they have transformed it into a juggernaut (Ames Alexander, Karen Garloch and Joseph Neff, 4/21).

Medscape: New AMA Head on Membership, the ACA, and Medicine's Future
Dr. [James] Madara: We support coverage for the uninsured; health insurance reforms, which include allowing children to remain their parents' plans until age 26; and eliminating the lifetime cap on insurance policies. But, like any complex law, the Affordable Care Act is not perfect. For example, the Independent Payment Advisory Board, a nonelected board that could set Medicare pricing independently without accountability, is something we would not encourage (interviewed by Dr. John Reed, 5/9).

How Much Will A Retired Couple Spend On Health Care? $240,000

Wed, 09 May 2012 13:42:02 GMT

This estimate, released by Fidelity Investments, reflects a 4 percent increase over medical bill projections for a couple that retired a year earlier. The amount doesn't include long-term care costs or over-the-counter drug expenses, among other things.

The Associated Press: Retired Couples May Need $240,000 For Health Care
Couples retiring this year can expect their medical bills throughout retirement to cost 4 percent more than those who retired a year ago, according to an annual projection released Wednesday by Fidelity Investments. The estimated $240,000 that a newly retired couple will need to cover health care expenses reflects the typical pattern of projected annual increases. The Boston-based company cut the estimate for the first time last year, citing President Barack Obama's health care overhaul. Medicare changes resulting from that plan are expected to gradually reduce many seniors' out-of-pocket expenses for prescription drugs (Jewell, 5/9).

Market Watch: Your Retirement Health-Care Tab Will Run $240,000
Retirement health-care costs are enough to cause a severe anxiety attack. Even with Medicare benefits, a 65-year-old couple retiring in 2012 will spend at least $240,000 in retirement, according to the latest estimate from Fidelity Investments. That doesn't include long-term-care costs, over-the-counter medications and most dental costs (Coombes, 5/9).

Bloomberg: Health Law Repeal To Cost Seniors $20,000, Fidelity Says
Retirees may pay about $20,000 more for medical care if the U.S. Supreme Court overturns the 2010 health care overhaul, Fidelity Investments said. A 65-year-old couple retiring this year will spend $240,000 out-of-pocket for care before their deaths, after accounting for Medicare coverage, Fidelity said in an annual estimate released today. That's an increase of $10,000 from last year and includes premiums and co-payments under Medicare and supplementary coverage called Medigap, the Boston-based mutual-fund manager said (Wayne, 5/9).

Home Health And Long-Term Care Issues And Trends

Tue, 08 May 2012 13:43:49 GMT

USA Today reports on the profitability of home health care businesses while NPR examines long-term care insurance.

USA Today: Home Health Care Is One Of The Most Profitable Franchises
A new report lists home health care as one of the top five most profitable franchises in the U.S., even as the industry fights new Department of Labor rules calling for mandatory overtime and minimum wage requirements for home health employees (Kennedy, 5/7).

NPR: Long-Term-Care Insurance: Who Needs It?
Americans routinely buy all sorts of insurance — for cars, homes, health and even pets and boats. But when it comes to long-term-care insurance, relatively few sign up. Out of more than 313 million Americans, only about 8 million have any such protection, according to the American Association for Long-Term Care Insurance. The low participation rate largely reflects the high cost of long-term-care insurance (Geewax, 5/8).

State Roundup: Conn. Retiree Health Plan Expansion Could Endanger Protections

Mon, 07 May 2012 13:36:00 GMT

A selection of health policy stories from California, New York, Iowa, Connecticut, Florida, Minnesota, Alaska and North Carolina.

Los Angeles Times: Near Melrose, A National Health Care Predicament Plays Out
Neighbors were already concerned about the growing number of group homes for the elderly and recovering addicts in the area, many of them for profit. A Times analysis found 24 licensed facilities offering residential care for the elderly within a mile of the proposed project and three more waiting for state approval. It is one of several such clusters that have emerged in Los Angeles County -- including parts of the San Fernando Valley and South Bay -- where families can afford fees that run into thousands of dollars per month. Large swaths of the county's less affluent areas have no such facilities (Zavis, 5/7).

The New York Times: Cuomo Seeking New Agency To Police Care Of Disabled
Gov. Andrew M. Cuomo, seeking to strengthen the state's chronically weak response to abuse of disabled people who live in publicly financed homes, plans this week to propose creating an agency dedicated to investigating problems with the care of nearly one million vulnerable New Yorkers (Hakim, 5/6).

The Connecticut Mirror: Federal Opinon Undermines State's Health-Pool Concept
The U.S. Department of Labor has advised the Malloy administration that opening Connecticut's state employee and retiree health plan to nonprofits and small businesses could jeopardize the legal protections it now enjoys as a government plan. The advisory opinion sought by Gov. Dannel P. Malloy could undermine a health care pooling bill passed last year and an expansion proposed by House Speaker Christopher G. Donovan (Pazniokas, 5/4).

KQED's State of Health blog: High-Deductible Health Plans: Health Access or High Risk?
Health care costs are skyrocketing and premiums along with them forcing some employers -- especially small businesses -- to drop coverage altogether. But others are moving to "high-deductible health plans." Five times as many businesses offer high deductible health plans as in 2005, according to the UCLA Center for Health Policy Research. But how do these plans play out for employers -- and workers themselves? (Weiss, 5/4).

Related, earlier KHN story: Quick Facts About High-Deductible Health Plans (Kulkarni, 4/27).

Los Angeles Times: Hospital Violated Patient Confidentiality, State Says
State regulators determined that a Redding hospital owned by Prime Healthcare Services Inc. violated patient confidentiality by sharing a woman's medical files with journalists and sending an email about her treatment to 785 hospital workers (Terhune, 5/5).

Modern Healthcare: Cancer-Care ACO To Launch In Florida
Baptist Health South Florida and oncology practice Advanced Medical Specialties, both of Miami, are working with Florida Blue, a Jacksonville-based Blue Cross and Blue Shield company, to set up an accountable care organization specifically for cancer treatment. The program will use a value-based reimbursement model that aims to lower the cost of cancer care while also improving care quality, according to a Florida Blue news release. It will focus on the treatment of the most common types of cancer (Kutscher, 5/4).

Des Moines Register: Wellmark Selects 4 Cities For Health Campaign
Four northern Iowa cities have been chosen for the first "Blue Zone" demonstration projects as part of a campaign to make Iowa the healthiest state in the nation. The winning towns are Cedar Falls, Waterloo, Mason City and Spencer. They will receive expert assistance in encouraging residents to lead healthier, more fulfilling and longer lives. The announcement was made Friday at the Des Moines headquarters ofWellmark Blue Cross/Blue Shield, a health insurer that plans to spend more than $20 million on the five-year campaign (Leys, 5/4).

KQED/The California Report: Traditional Hmong Healers Learning to Partner With Valley Doctors
Thousands of Hmong refugees settled in the Central Valley in the 1970s. ... [T]he Hmong were more likely to see a shaman than a doctor when they got sick and that has presented something of a challenge for health care professionals here in California. A hospital in Merced is addressing that with a program called "Partners in Healing" (Kalantari, 5/4).

Minnesota Public Radio: Minn. Test Of Meds Delivery In Emergency Goes Well
The Minnesota Department of Health and U.S. postal workers responded to a fictional airborne anthrax attack in the Twin Cities this weekend. ... "Operation Medicine Delivery" was the first full-scale test of a strategy for distributing medicine in the event of an epidemic or large-scale anthrax attack. About 300 mail carriers on Sunday delivered empty pill bottles to thousands of homes ... Once she did start thinking about it, [Claire] Thompson realized she has lots of questions. "How would they know how much medication to deliver to a home? Where are you going to get this stockpile anyway? I assume if everybody is so sick they can't leave their house, how you going to count on your mail service?" (Shenoy, 5/7).

Sacramento Bee: Bill Seeks To Ban California Chiropractors From Offering Laser 'Cure' For Allergies
Claims that laser therapy can be used to cure allergy symptoms have been popping up across the country, touted by some chiropractors who say the treatment represents an innovative approach to an age-old problem. But critics question the science behind the claims, and now a far-reaching bill before California's Legislature would prohibit chiropractors from performing and advertising allergy treatments altogether (Van Oot, 5/5).

MSNBC: Alaska's Senators Welcome Agreement For Rural Health Care
Alaska's Senators are welcoming an agreement by the Veterans Administration that allows Rural Alaska veterans to receive health care benefits at Native health clinics. A release from Senator Mark Begich's office says the VA, 14 Alaska Native Tribal Health Programs and the Department of Veterans Affairs signed an agreement that allows Alaska Native veterans to get care at participating village clinics. The VA will then reimburse the clinics. Before the veterans had to travel to Anchorage or as far away as Seattle for health care (Ebert, 5/5).

Healthy Cal: Community Clinics Try To Fill Dental Care Gap
Roughly three million poor and disabled Californians had their coverage for dental services cut three years ago, and community dental clinics have struggled to cover preventative services ever since. ... Dental services aren't mandated under the federal Medicaid program and California, with a program called Denti-Cal, was once one of the few states to cover non-emergency services for adults. But with the state budget crisis, legislators cut the non-mandatory services (Shanafel, 5/4).

California Healthline: Newborn Test Takes Baby Step Forward
A bill to require hospitals to screen all newborns for congenital heart conditions recently was presented to the Assembly Committee on Appropriations -- where it was expected to get a rough reception. ... California hospitals' cost of administering the screening test to newborns, the Assembly analysis estimates additional cost to the Department of Health Care Services to launch and run the program -- up to $1 million annually, as well as start-up costs of $300,000. The legislative analysis of AB 1731 also saw potential cost savings of $350,000 a year by avoiding expensive emergency room visits and operations to treat congenital heart disease (Gorn, 5/7).

North Carolina Health News: To Save Money, Improve Health, NC Changes Mental Health System – Again
Last summer, the legislature decided to turn the agencies that oversee $2.5 billion worth of publicly-funded mental health services into small insurance companies. The plan is based on the experience of one agency that has been functioning as a pilot project for the past six years. ... But for all the good intentions and high-minded rhetoric, the changes have been fraught with controversy in the courts, anxiety, and 'misunderstandings' between the state’s model provider agency, mental health consumers, local officials and advocates (Wilson, 5/7).

The Dallas Morning News: Texas Regulators Launch New Investigation Of Parkland Memorial Hospital
Parkland Memorial Hospital fired a social worker for complaining about pressure to break safety rules, a new lawsuit alleges. Texas regulators said Friday that they’re investigating the matter, which comes to light at a particularly difficult time for the Dallas public hospital. It is struggling to carry out a huge do-or-die overhaul that federal regulators recently ordered because of widespread threats to patient safety(Egerton, 5/4).

Health Costs, Disability Issues Cause Concern Among People Nearing Retirement

Mon, 07 May 2012 13:32:34 GMT

USA Today reports on new poll findings that indicate health care costs are a prominent fear among older workers. Also, Reuters reports on what might be behind the recent rise in disability claims among people in that same age group.

USA Today: Health Care Costs Worry Workers Nearing Retirement
Health care costs are a top retirement fear, and that's even though many older workers vastly underestimate how much they'll have to pay. … Nearly half of affluent Americans, who have at least $250,000 in household assets, say they are scared that rising health care costs will deplete their retirement savings, according to a Harris Poll released today by Nationwide Financial (Dugas, 5/6).

Reuters: Job Disability A Headache For Recovery
The 47-year-old from Michigan is among the 8.7 million American workers on the U.S. disability rolls, an important part of the social safety net. Since the recession began in 2007, she has been joined by a record number of people seeking disability benefits, raising questions about the program's solvency and casting a pall over future prospects for U.S. economic growth... Economists say part of the rise in disability claims may be due to people nearing retirement who ignored a health problem when the job market was strong, but then seek benefits when they lose their job as a bridge until they qualify for Social Security pension plans (Ciancio, 5/6).

At-Home Caregiving Comes With Personal, Financial Costs

Tue, 01 May 2012 13:32:01 GMT

News outlets examine the costs of care-giving and a new initiative to help Medicaid enrollees stay at home rather than live in nursing homes.

NPR: Discovering The True Cost Of At-Home Caregiving
Few people want to turn over a loved one to institutional care. No matter how good the nursing home, it may seem cold and impersonal — and very expensive. But making the choice to provide care yourself is fraught with financial risks and personal sacrifices (Geewax, 5/1).

MedPage Today: HHS Announces Homecare Initiatives
The Department of Health and Human Services (HHS) has announced several Affordable Care Act initiatives aimed at keeping more chronically ill patients at home for care. HHS announced Thursday that it had issued a final rule for the Community First Choice program, which increases the federal Medicaid funding match by 6 percentage points for states that provide home attendants and other forms of support to Medicaid enrollees who would otherwise need to be in a nursing homes (Frieden, 4/30).

First Edition: May 1, 2012

Tue, 01 May 2012 11:33:00 GMT

Today's health policy headlines include reports from the presidential campaign trail and from states on issues ranging from Massachusetts' payment reform to Idaho's scope-of-practices issues.

Kaiser Health News: $18 For A Baby Aspirin? Hospitals Hike Costs For Everyday Drugs For Some Patients
Reporting for Kaiser Health News, in collaboration with USA Today, Susan Jaffe writes: "Sudden chest pains landed Diane Zachor in a Duluth, Minn., hospital overnight, but weeks later she had another shock – a $442 bill for the same everyday drugs she also takes at home, including more than a half dozen common medicines to control diabetes, heart problems and high cholesterol. … Even though her health plan covers medical and drug expenses, her policy did not pay the hospital drug bill because St. Luke's never formally admitted her. Instead, billed the visit as observation care, which is considered an outpatient service" (Jaffe, 4/30). Read the story.

Kaiser Health News: Insuring Your Health: Some Insurers Deny ER Coverage To People Who Have Been Drinking
In her latest Kaiser Health News consumer column, Michelle Andrews writes: “Up to half of the people who are treated at hospital emergency departments and trauma centers are under the influence of alcohol, experts say. That may be a sobering statistic, yet a recent study found that emergency departments can capitalize on this "teachable moment" to discourage problem drinking in the future. But laws in more than half the states permit insurers to deny payment for medical services related to alcohol or drug use and that can derail hospitals' best intentions, experts say” (Andrews, 4/30). Read the column.

The Associated Press/Washington Post: On Taxes, Health Care And Government’s Role, Obama And Romney Offer Distinct Choices To Voters
Those differences surely exist. Obama and his Republican challenger are offering voters a distinct choice on taxes, a sharp disagreement over health care and a classic ideological divide on social issues that neither candidate seems eager to talk about (5/1).

The Associated Press/Washington Post: Santorum Wants Assurances From Romney Before He Publicly Backs One-Time Bitter Rival
Both Santorum and Gingrich have fervent followings among conservatives who make up the base of the party and who generally view Romney skeptically because of his positions on a host of issues. Romney has changed his position on bedrock issues such as abortion and gay rights. He supported the 2008 Wall Street bailout that angered conservatives and paved the way for the rise of the tea party. And he signed a health care overhaul as governor that provided the groundwork for Democrats’ national law that requires all Americans to buy insurance or face a fine. Romney’s health care overhaul in Massachusetts required health care coverage (5/1).

Politico: GOPers Split Over How To Reform Health Care
Ask each of the 242 House Republicans what kind of health policy they’d like to enact instead of President Barack Obama’s health care reform law and you might get 242 different answers. Even after three years of railing against Obama’s plan, Republicans have coalesced around only a few basic tenets of health policy — let alone a full replacement plan (Haberkorn, 4/30).

Politico: House GOP Targets Nonprofit Health Co-Ops
The CO-OP faithful are vowing to plow ahead despite the friction they've been getting from the House lately, as Energy and Commerce Committee Republicans attack the initiative on two fronts — investigating its loans while trying to defund the entire program (Norman, 4/30).

The Washington Post: Massachusetts Payment-Reform Bill Would Overhaul How Health-Care Providers Are Paid
In the next few months, Massachusetts is expected to take up legislation that would overhaul how doctors, hospitals and other providers are paid. The forthcoming payment-reform bill is expected to include many incentives for hospitals to accept "global payments," or a flat fee for all the care delivered for a specific person or group of people (Kliff, 4/30).

Los Angeles Times: Insurance Rate-Hike Initiative Gains High-Profile Backers
Several high-profile business names, such as San Francisco hedge-fund manager Thomas Steyer and agribusiness magnate Stewart Resnick, have contributed to a proposed ballot measure seeking tighter regulation of health insurance rates, according to campaign finance records (Terhune, 5/1).

The New York Times: In Fight Over Obama Health Law, A Front In Minnesota
With zeal, excitement and a meticulous attention to detail, the administration of Gov. Mark Dayton is trying to expand health insurance coverage and remake Minnesota's insurance market along the lines envisioned by President Obama (Pear, 4/30).

Los Angeles Times: Federal Judge Blocks Texas Funding Cuts To Planned Parenthood
A federal judge on Monday stopped Texas from removing Planned Parenthood clinics from a state women's health program because the organization provides abortions. In his ruling, U.S. District Judge Lee Yeakel in Austin cited evidence that the state rule banning Planned Parenthood from the program was unconstitutional. He imposed an injunction against enforcing the law until he can hear arguments in the case. The state immediately appealed (Hennessy-Fiske, 4/30).

The New York Times: Texas: Judge Prevents Ban On Funds To Planned Parenthood
A federal judge in Austin on Monday prevented Texas from enforcing a rule that would have banned Planned Parenthood from participating in a health care program for low-income women (Fernandez, 5/1).

The Associated Press/Washington Post: Federal Judge Stops Texas From Banning Planned Parenthood From Receiving State Funds
The law passed last year by the Republican-controlled Legislature forbids state agencies from providing funds to an organization affiliated with abortion providers. Texas law already required that groups receiving federal or state funding be legally and financially separate from clinics that perform abortions (4/30).

Los Angeles Times: California Agency Ripped Over Disparities In Autism Spending
California lawmakers and advocates for children with autism assailed the state Department of Developmental Services during a hearing Monday over the deep racial and ethnic disparities in how it spends money on the disorder (Zarembo, 5/1).

Chicago Tribune: Wisconsin's Walker Raises $13 Million For Recall Election
Walker enraged Democrats and unions representing government workers such as teachers when he pushed through the legislature last spring a measure drastically reducing their powers. The law forced them to pay a portion of the cost of health insurance and pensions, capped wage increases, and required unions to be recertified every year. … The first-term governor, who faces the expensive special election in June, raised that amount between January 17 and April 23, according to a finance report filed with the state (O'Brien, 4/30).

The Associated Press/Washington Post: Case Of Suspended Idaho Midwives Show Ongoing Tension Between Home-Birth Industry, Hospitals
Midwives and doctors are longtime rivals in the politics governing where women should give birth: Home or hospital. But that tension, typically played out privately between pregnant women and their health care providers, was laid bare this month in the case of two Idaho midwives suspended by the state after three babies died during a 14-month period between 2010 and 2011 (5/1).

The New York Times: ER Doctors Face Quandary On Painkillers
Dental patients — mostly uninsured or indigent — are not unusual in emergency rooms. Poor patients may forgo preventive care and delay treatment until they face a medical crisis. In many states, adult dental benefits under Medicaid, the government insurance program for the poor, have been scaled back or eliminated. And dentists often don’t accept Medicaid patients. But emergency physicians like Dr. Lobitz cannot know whether someone who claims to be in agony from dental issues is telling the truth — or simply plans, he said, to “go to the next emergency room, next town over, and get another 30 Vicodin” (Saint Louis, 4/30).

NPR: Studies Reignite Mammography Debate For Middle-Aged Women
Should women in their 40s routinely get mammograms to detect breast cancer? Two studies released Monday aim to help resolve that question, which is one of the most intense debates in women's health. The studies identify which women in their 40s are most likely to benefit from routine mammograms (Stein, 4/30).

The Wall Street Journal: Eye Drugs Roughly Equal, Study Says
The results of a closely watched study funded by the U.S. government show that the drugs Avastin and Lucentis are roughly equal at preserving vision in elderly people with a common eye disease, a finding that could potentially save Medicare and other insurers millions of dollars a year because Avastin is far less expensive than Lucentis (Whalen, 4/30).

Check out all of Kaiser Health News' e-mail options including First Edition and Breaking News alerts on our Subscriptions page.

Report: Nursing Homes And Anti-Psychotic Drugs

Mon, 30 Apr 2012 14:05:00 GMT

A report by the Boston Globe based on government information finds many nursing homes use powerful sedatives on patients who should not be getting them.

Boston Globe: Over two months in early 2006, she visited 10 facilities, trying to make sure she picked the right one. Weingartner finally chose Ledgewood Rehabilitation and Skilled Nursing Center in Beverly because it had an Alzheimer’s special care unit and it was near her home. She could visit her mother often (Lazar and Carroll, 4/29).

USA Today: Report: Anti-Psychotics Wrongly Prescribed In Nursing Homes
Many nursing homes are typically using anti-psychotic drugs in residents who display agitation and combative behavior, but who should not be administered the powerful sedatives, a Boston Globe report based on government data has found (Eversley, 4/29).

Earlier, related KHN coverage: Off-Label Use Of Risky Antipsychotic Drugs Raises Concerns (Boodman, 3/12).

State Roundup: Mass. May Vote On Assisted Suicide; Colo. To Try Medical Homes

Mon, 30 Apr 2012 14:04:02 GMT

Health policy news from Masschusetts, California, Iowa, Kansas, Colorado and Connecticut.

Boston Globe: Dying Wishes Expected To Be Decided On November Ballot
Heather Clish has become a leading advocate for affording terminally ill patients in Massachusetts the same choice her father had. Clish and other supporters are pushing a ballot initiative to legalize the practice they call Death with Dignity, more commonly known as physician-assisted suicide. Voters will almost certainly decide at the polls this November whether it should be allowed here, as in Oregon and Washington, the only two states where voters have explicitly authorized it (Helman, 4/29).

KQED/The California Report: Hospice Homes Provide End-of-Life Care Alternative
According to a recent survey, the vast majority of Californians would prefer to die at home. But year after year, most people die in hospitals or nursing homes. It's expensive and not especially comfortable for patients or their families. Hospice homes offer an alternative for the terminally ill -- and they provide end-of-life care at a fraction of the cost (Goldberg, 4/27).

The Connecticut Mirror: As DSS Seeks Public Comment, Advocates Critique Proposal For "Dual Eligibles"
The Department of Social Services is seeking public comments on an application to run a federal demonstration program ... At issue is a proposal to create a new model for providing and coordinating care for state residents who receive health care coverage through both Medicaid and Medicare. ... Their care costs more than $3 billion a year, an average of $53,500 a person. And despite the price tag, it's often inadequate and poorly coordinated (Levin Becker, 4/27).

Reuters: Kansas Lawmakers To Debate Who Can Pull Baby Teeth
The problem is that rural areas in the United States have a shortage of dentists, and one proposed solution is to license "dental practitioners" who could do things such as fill cavities and pull baby teeth. But the lobbying group representing dentists in Kansas wants no part of non-dentists messing with people's mouths, saying that only a person with a four-year graduate degree and additional training should be allowed to extract teeth (Murphy, 4/28).

Related, earlier KHN story: In Kansas, No Consensus On How To End ‘Dental Deserts’ (Thompson, 4/8)

Des Moines Register: Addition To Spending Bill Would Benefit One C.R. Doctor
When it comes to state permission to run a surgery center alongside his medical practice in Cedar Rapids, Dr. Lee Birchansky won’t take no for an answer. ... Republican lawmakers in the Iowa House last week added an amendment to a state spending bill providing an exception to the authorization process that has tripped up Birchansky all these years. ... Birchansky has been a generous political donor in recent years, contributing more than $18,000 to gubernatorial and legislative candidates since 1997 (Noble, 4/27).

Denver Post: Partisan Debate Over 'War On Women' Legislative Proposal
Senate Memorial 3, by Sen. Tim Neville, a Littleton Republican, urged Congress to enact what is known as the "Blunt amendment," which allows a health plan to decline coverage or services that are contrary to its religious beliefs. ... Neville's measure died on a party-line vote, with all 20 Democrats opposed and all 15 Republicans in support (Bartels, 4/27).

California Healthline: Mixed Reviews At Basic Health Program Briefing
The state Legislature is considering a bill to create a Basic Health Program in California. If adopted, SB 703 by Ed Hernandez (D-West Covina) would create low-cost health care insurance for as many as one million low-income Californians. ... The BHP is an alternative to the exchange's coverage for two sets of Californians -- adults with income between 133% and 200% of the federal poverty level, and for legal immigrants with income below 133% of the poverty level (Gorn, 4/30).

HealthyCal: Mental Health Treatment Newly Available At Clinics
Federal funding is available to help community clinics transition towards what they will resemble in 2014. ... community clinics are moving towards becoming ‘medical homes,’ or centers of care. That means qualifying low-income patients have access to primary care, pharmacy services, or specialty care (by referral). And especially exciting to health specialists is the new availability of mental health and substance abuse services, which are being included at clinics for the first time (Flynn, 4/29).

Colorado Public Radio: Home Sweet Medical Home
Colorado's just been chosen to be part of a big federal initiative to encourage medical homes. Doctors will get paid more if they take on greater responsibility for their patients. Here to explain is Dr. Marjie Harbrecht with the non-profit health consulting group HealtTeamWorks in Lakewood, and Julie Schilz, with Anthem-Wellpoint Health Insurance in Denver (Whitney, 4/27).

Medscape: Providers to Test Power of Apology in Malpractice Claims
The Massachusetts Medical Society (MMS) wants to prove that clinicians and hospitals can keep medical malpractice out of the courtroom by owning up to their mistakes with apologies — and sometimes cash as well. ... In the Massachusetts pilot project, participating hospitals would inform patients about adverse events as soon as they become aware of them and begin conducting a root-cause analysis (Lowes, 4/27).

Boston Globe: Patrick Signs Law To Allow HIV Test With Verbal Consent
Governor Deval Patrick signed into law Friday a bill that supporters say will provide greater access to HIV tests and bring Massachusetts into compliance with federal recommendations ... But some physician groups said the law did not go far enough because the rules still require written informed consent from a patient each time information is released from a patient’s file pertaining to HIV (Lazar, 4/27).

Ryan Says His Budget Will Protect Seniors

Sat, 28 Apr 2012 18:17:57 GMT

USA Today: Ryan Touts GOP Budget
(Rep. Paul) Ryan, chairman of the House Budget Committee, said [in the Republican weekly address] the GOP budget will reform the tax code and protect such programs as education and Medicare (Jackson, 4/28).

The Hill: Ryan Touts Budget As Way 'To Save The American Dream'
He said the plan would also promote energy exploration in the U.S. to curb rising gas prices and would help senior citizens by repealing Obama's health care law. "Repealing the president's health care law would also protect America's seniors," said Ryan. "The law raids over $500 billion from Medicare and empowers a board of 15 unelected bureaucrats to cut Medicare in ways that would deny seniors access to the care they need." ... Ryan's budget would cut more than $5 trillion more than President Obama's proposal, reduce spending in 2013 and 2014 compared to 2012, and revive his proposal last year to turn Medicare into a health insurance supplement program for anyone younger than 55. Democrats say the Ryan budget would essentially end the Medicare guarantee (Yager, 4/28).

State News: Cuomo's Plan For Out-Of-Network Charges Runs Into Trouble

Fri, 27 Apr 2012 13:42:00 GMT

Today's news on local health policy issues comes from New York, Connecticut, Mississippi, Colorado, Iowa, Texas, North Carolina and Kansas.

The Wall Street Journal: Cuomo Aims To Salvage Health Pact
Amid an intense lobbying battle between physicians and health insurers, Gov. Andrew Cuomo is trying to salvage his landmark overhaul of out-of-network medical charges. The outcome of the policy battle has large implications for health-care consumers who have been hit with unexpected spikes in their medical bills despite assurances from the governor that he had brought "fairness to a broken consumer reimbursement system" (Gershman, 4/26).

The Connecticut Mirror: Caring, Long Term: A Way Of Life For 1 In 8 Connecticut Residents
[Mimi] Galusha is one of an estimated 42 million Americans who act as unpaid caregivers, forming what experts call the backbone of the long-term care system. They far outnumber the home care workforce, providing services that one report estimated would cost $450 billion if performed by paid workers. In Connecticut, 486,000 people -- more than one in eight state residents -- were providing care to an adult with limitations in his or her activities at any given point in 2009, according to the report by AARP Public Policy Institute (Levin Becker, 4/27).

Kaiser Health News: Wanted: Mavericks And Missionaries To Solve Mississippi's Doc Shortage
When Janie Guice looks at the Mississippi Delta she sees a vast, flat flood plain, home to cotton fields and catfish farms, but she also sees desperate rural health problems and a deep shortage of doctors to deliver primary care to the region's residents (Hess, 4/26).

Kaiser Health News: Poor, Sick And Expensive: Colorado's Scaled-Down Medicaid Expansion
Starting in mid-May, Colorado will begin offering Medicaid to adults like [Dale] Miller who make less than $1,080 per year (that's 10 percent of the federal poverty line, or $90 per month) – but there’s a catch. Though the state estimates that there are 50,000 people who meet the income bar, Colorado will only be able to offer the health coverage to 10,000 people. Those people will be chosen by a lottery method in each county, designed to distribute the benefits fairly across the state (Whitney, 4/26).

Modern Healthcare: Iowa Health, Wellmark Announce ACO Plans
Wellmark Blue Cross and Blue Shield of Iowa and Iowa Health System, both of Des Moines, announced they will form an accountable care organization. ... IHS includes more than 200 physician clinics and employ more than 24,000, the release said. Wellmark covers 1.8 million customers in Iowa and employs 1,707 in the state, according to the company's website (Selvam, 4/26).

Houston Chronicle: Feds Seize Mental Health Clinic Records In Medicare Fraud Probe
Federal agents with search warrants seized hundreds of patient records from a Houston psychiatric hospital and its two mental health clinics Thursday, part of an escalating Medicare fraud investigation into financial exploitation and care of the mentally ill as detailed last year by the Houston Chronicle. The files, belonging to patients who attend counseling sessions at Westbury Community Hospital and its clinics in southwest Houston and Baytown, were boxed up and loaded into trucks in a pre-dawn swoop by the FBI and investigators from the Texas Attorney General's office (Langford, 4/26).

North Carolina Health News: NC Lawmakers Punt On Drugmaker Liability Bill
A bill that would significantly raise the bar for people suing pharmaceutical companies when they're injured by a drug was sent back to the senate judiciary committee yesterday after several months of meetings and, at times, emotional testimony from opponents. Senators on the judiciary Subcommittee on Pharmaceutical Liability did not make any changes to the proposed legislation and said there were still 'questions' about the bill (Hoban, 4/26).

Kansas Health Institute News: Governor Proposes Additional $1.9 Million For Larned State Hosptial
The funding, administration officials said, was needed to address staffing shortages cited during a recent accreditation survey. ... About half of the $1.9 million, he said, would be used to increase nurses' wages; the other half would allow the hospital to hire 23 additional direct-care workers. ... Larned State Hospital is one of the state's three hospitals for the mentally ill (Ranney, 4/26).

KQED’s State of Health blog: Humboldt County – Amid Stunning Beauty, Sad Health Profile
[The] California Department of Public Health] recently released its County Health Status Profiles 2012 ... In its overall death rate from all causes, Humboldt ranked next to last, 57th, with 865 deaths per 100,000 people. ... Perhaps the mix of poverty and rural character is a factor, creating a physical and socio-cultural isolation that could be affecting health (Kipling, 4/26).

House GOP Eyes Prevention Trust Fund As Means To Pay For Student Loan Plan

Thu, 26 Apr 2012 14:38:00 GMT

House Speaker John Boehner, R-Ohio, has scheduled a Friday vote on the proposal, which some news outlets describe as a "bitter pill" for Democrats.

The New York Times: Two Parties Find A Way To Agree, And Disagree, On Student Loan Rates
Republicans were equally indignant at what they saw as game-playing, saying that they, too, want to forestall the rate increase. They quickly tried to outmaneuver the president. Late Wednesday afternoon, Mr. Boehner hastily called a news conference to announce that the House would vote Friday on a student loan bill that seemed to take shape just as suddenly. The proposal would extend the current interest rate for federal student loans for one year. The $6 billion cost would be offset by eliminating the remainder of the money from the Prevention and Public Health Fund, a portion of the health care law (Baker and Steinhauer, 4/25).

The Associated Press: Political Battle Over Student Loans Heating Up
Democrats and Republicans alike say they want to prevent the cost of federal loans from ballooning for millions of students. But the effort has evolved into an election-year battle each side is using to embarrass the other and spotlight its own priorities to voters. In the latest political chess move, Speaker John Boehner, R-Ohio, scheduled a House vote for Friday on legislation preventing the 3.4 percent interest rate on subsidized Stafford student loans from doubling as scheduled on July 1. In a bitter pill for Democrats, the measure's $5.9 billion cost would be paid for with cuts from President Barack Obama's health care overhaul bill (Fram, 4/26).

The Washington Post: Republicans Announce House Vote To Keep Student-Loan Rates Steady
Congressional Republicans on Wednesday announced their opposition to a Democratic proposal to pay for extending low rates for college loans by imposing new payroll taxes on some small businesses. Instead, House Speaker John A. Boehner (R-Ohio) said the House would vote Friday on a proposal to hold the interest rates steady — offsetting the $6 billion cost with a cut in a health prevention fund created under President Obama’s health-care law (Helderman and Kane, 4/25).

Los Angeles Times: Student Loans, Violence Against Women Act Spur Fights In Congress
The looming confrontations on both issues show how hard it is for Republicans — or Democrats, for that matter — to compromise in this highly contentious environment, even when doing so would arguably be in their political interest. Although Republicans say they support keeping student loan interest rates low, they oppose the tax hike on higher incomes proposed by Democrats to pay for it. Instead, they want to pull money from Obama's healthcare programs. Republicans also are unveiling an alternative to the Violence Against Women legislation (Mascaro, 4/25).

The Hill: Democrats Oppose Health Cuts In Boehner's Student Loan Bill
Democrats quickly panned House Speaker John Boehner's proposal to pay for a student loan bill by cutting into President Obama's healthcare law. Boehner (R-Ohio) said the House will vote Friday on a proposal that would block a major increase in student loan interest rates, which he plans to offset by cutting the healthcare law's prevention fund (Baker, 4/25).

Reuters: U.S. House To Vote On Student Loan Rate Extension
The Republican-led House of Representatives, in an election-year showdown with President Barack Obama, moved on Wednesday to avert a doubling of a low-federal student loan rate by taking money from Obama's healthcare overhaul. House Speaker John Boehner unveiled the proposal and announced that his chamber would vote on it on Friday - after Obama on a campaign-style tour pushed Congress to take action to preserve the low rate for millions of students (Ferraro, 4/25).

Meanwhile, on the Senate side, a plan is taking shape to restructure health benefits for future postal service retirees.

The New York Times: Senate Passes Plan To Give Postal Service Fiscal Relief
Perhaps most significant, the bill would restructure the payments the agency makes into a health benefits fund for future retirees. Under a 2006 law, the agency has to pay $5.5 billion annually into the fund, which the Postal Service said had added $20 billion in debt to its balance sheet since 2007 (Nixon, 4/25).

State News: Calif. 'Green Houses'; Minn. Looks At 'Accretive Secret Sauce'

Thu, 26 Apr 2012 14:01:00 GMT

A selection of state policy news from California, Connecticut, Florida, Georgia, Kentucky, Maryland, Minnesota, and Wisconsin.

California Healthline: Senate Committee Approves New Type Of Nursing Home
A new idea elbowed its way into the familiar pile of health care legislation in the Senate Committee on Health yesterday. A nursing home model -- the "Green House Project" -- bucks the cold, institutional feel of many long-term care facilities. ... The idea is to have a small facility laid out like a regular home, with living areas such as a dining room and kitchen, as well as a private room and bathroom for each patient (Gorn, 4/26).

Related KHN blog post: Maryland’s First Green House Project Nursing Home Aids Low-Income Seniors (Kulkarni, 4/20).

Minneapolis Star Tribune: Hospitals Tread Fine Line In Pressing Patients For Money
The consultants at Accretive Health readily admitted that a "typical hospital" doesn't do financial counseling in the emergency room. But, they boasted, they had found a way to get 15 percent of ER patients to pay upfront. They called it the "Accretive Secret Sauce." Accretive's secret was roundly attacked in a report this week by Minnesota Attorney General Lori Swanson. But in Minnesota hospitals, it's no longer unusual to approach patients in advance about paying their bills, according to hospital executives (Lerner, 4/25).

Stateline: Drug Database Dilemma
To deal with the growing problem of prescription drug abuse, Kentucky legislators enacted tougher regulations on doctors and pain management clinics. The law mandates that all physicians and pharmacists who prescribe schedule II and III drugs, such as oxycodone (OxyContin) and hydrocodone (Vicodin), check the patient’s prescription record before writing or filling a prescription. They also have to register prescriptions for those drugs in a state database within 24 hours of writing or filling the prescription (Clark, 4/26).

The Connecticut Mirror: House Votes To Legalize 'Medical Marijuana'
The House of Representatives overwhelmingly voted Wednesday night to legalize the production, distribution and use of marijuana as a palliative for the chronically ill, reviving Connecticut's role in a national debate. ... If passed by the Senate and signed by the governor as proponents expect, Connecticut will join the ranks of states with a softening attitude toward the dangers and beneficial uses of marijuana (Pazniokas, 4/25).

The Baltimore Sun: New Web Portal Provides County By County Health Data
A new state web portal was recently launched that provides this and other health data for every county in Maryland. The Maryland Department of Health and Mental Hygiene with the Hilltop Institute at the University of Maryland at Baltimore County to create the website that uses data about Medicaid recipients (Walker, 4/26).

Georgia Health News: County Rankings Show Link Between Economy, Health
A county-by-county ranking of health statistics, released earlier this month, showed a geographic divide in Georgia. Rural South and Middle Georgia counties were clustered at the bottom of the state's health rankings, and urban/suburban at the top. ... It's the second year that Partner Up for Public Health, an advocacy campaign, has generated this comparison. The top 10 and the bottom 10 show that counties tend to score well or poorly on both measures (Miller, 4/25).

Health News Florida: Suit Reveals Financial Incentives
A Clearwater doctor has filed a "whistleblower" suit against the medical practice that employed him, saying he was fired for complaining about how patients were treated. His contract offered financial incentives, such as a percent of the profits on ultrasound tests he ordered (Gentry and Clear, 4/25).

(Eau-Claire) Leader-Telegram/(St. Paul) Pioneer Press: Eau Claire OKs Health Plans For Same-Sex Couples
When Eau Claire city employees re-enroll in June for their health insurance, police Detective Clay Wanta plans to switch from single-person coverage to a limited family plan to include his partner, Pete Brandt. The 12-year Eau Claire Police Department veteran watched Tuesday, April 24, as the city council debated the cost versus the fairness of allowing domestic partnerships to qualify for the same health benefits married couples can receive. ... The council voted 10-1 in favor of extending benefits, after almost two hours of debate (Dowd, 4/25).

Mercury News / Bay Area News Group: Tobacco Industry Gearing Up To Take Down California Cigarette Tax Initiative
In what is quickly turning into another high-stakes policy battle to be decided by California voters, tobacco giants Philip Morris and R.J. Reynolds are forking over tens of millions of dollars to defeat a new tobacco tax on the June ballot. Proposition 29, which would boost taxes by $1 a pack of cigarettes to $1.87, would raise about $735 million annually, most of which would go toward cancer research (Harmon, 4/25).