Kaiser Health News - Health Costs

House GOP Plans Vote Today On Abortion Bill

Tue, 18 Jun 2013 13:15:05 GMT

The measure, which would ban abortions after 22 weeks of pregnancy, has drawn a White House veto threat. In other Capitol Hill news, health care issues continue to be part of the immigration reform debate and some lawmakers have asked for a review of federal grants and programs designed to assist the severely mentally ill.

The New York Times: G.O.P. Pushes New Abortion Limits To Appease Vocal Base
After Republicans lost the presidential election and seats in both the House and the Senate last year, many in the party offered a stern admonishment: If we want to broaden our appeal, steer clear of divisive social and cultural issues. Yet after the high-profile murder trial of an abortion doctor in Philadelphia this spring, many Republicans in Washington and in state capitals across the country seem eager to reopen the emotional fight over a woman's right to end a pregnancy. Their efforts will move to the forefront on Tuesday when House Republicans plan to bring to the floor a measure that would prohibit the procedure after 22 weeks of pregnancy — the most restrictive abortion bill to come to a vote in either chamber in a decade (Peters, 6/17).

The Hill: Obama Threatens To Veto GOP Abortion Ban
The White House threatened to veto a GOP ban on late-term abortions that is expected to pass the House on Tuesday. In a Statement of Administration Policy, President Obama said the bill from Rep. Trent Franks (R-Ariz.) is an "assault on a woman's right to choose" (Viebeck, 6/17).

Roll Call: Health Care And Immigration: Uncomfortable Bedfellows
The Congressional Hispanic Caucus was emphatic that illegal immigrants should be included when the landmark health care bill was being negotiated in 2009. But the White House and Democratic leaders said it was not the right time and health care would be taken care of when immigration was overhauled. Now, as both chambers get serious about approving legislation that could enable about 11 million illegal immigrants to become citizens, Hispanic lawmakers are again being told that now is not the time. Barring a dramatic change of course, neither the bipartisan Senate bill nor a bipartisan House measure that’s now being crafted would help millions of uninsured, illegal immigrants get health insurance (Bunis, 6/17).

The Hill: Lawmakers Request Review Of Mental Health Programs
House members probing U.S. mental healthcare in light of the Newtown, Conn., shooting have asked government investigators to review federal grants and programs designed to assist the severely mentally ill. Reps. Tim Murphy (R-Pa.) and Diana DeGette (D-Colo.), who lead the Energy and Commerce subcommittee on Oversight and Investigations, asked the Government Accountability Office (GAO) on Friday to report back with a special study on federal investments in mental health (Viebeck, 6/17).

High Court: Feds Can Sue Pharmaceutical Companies Over Deals To Delay Generic Drug Sales

Tue, 18 Jun 2013 13:15:00 GMT

The Supreme Court ruled Monday that the Federal Trade Commission can challenge name brand drug makers for potential antitrust violations.

The New York Times: Supreme Court Lets Regulators Sue Over Generic Drug Deals
Pharmaceutical companies that pay rivals to keep less-expensive generic versions of best-selling drugs off the market can expect greater federal scrutiny after a Supreme Court ruling on Monday. In a 5-to-3 vote, the justices effectively said that the Federal Trade Commission can sue pharmaceutical companies for potential antitrust violations, a decision that is likely to increase the number of generic drugs in the marketplace and benefit consumers (Wyatt, 6/17).

Reuters: Supreme Court Says FTC Can Sue Over Deals That Delay Generic Drug Sales
The Supreme Court ruled on Monday regulators can challenge deals between brand-name drug companies and generic rivals that delay cheaper medicines from going on sale, which regulators say increase costs to consumers by billions of dollars (Hurley and Bartz, 6/17).

Medpage Today: Supreme Court Split On Pharma 'Pay For Delay' Deals
So-called "pay-for-delay" arrangements between generic and brand-name drug companies are not inherently legal, and each instance must be considered on a case-by-case basis, the Supreme Court ruled Monday. In the 5-3 decision overruling the 11th Circuit Court of Appeals, Justice Stephen Breyer, writing for the majority, listed five reasons why the appellate court erred in giving blanket immunity to pay-for-delay agreements, in which brand-name drugmakers pay or compensate generic drug companies in exchange for a later entry date of the cheaper generic version of a drug (Frieden, 6/17).

Viewpoints: Controlling Costs; Health Law's Guarantee Of Coverage; ACO Liability

Tue, 18 Jun 2013 13:13:11 GMT

The Fiscal Times: How To Control America's Health Care Costs
In the impassioned debates over healthcare, one fact is often lost—Americans pay more but get less for their health care than residents of other high-income countries. I believe we can change that. We can improve the quality of care and reduce our expenses, saving a trillion dollars or more a year, by making our health care system more efficient (William A. Haseltine, 6/17).

The Washington Post: Diabetes Has Been A Part Of My Daughter's Life For A Quarter-Century
My daughter has been a Type 1 (insulin-dependent) diabetic since she was 10 months old. There were some scary moments when she was very young, and some rough times when she was a teenager. But she's doing quite well now. ... I bring this up now because last month she turned 26, an age that had absolutely no import for my generation but is a significant milestone for young adults today. Under the Affordable Care Act, she was able to remain on my family's health insurance until that age, but now must be taken off (Lenny Bernstein, 6/17).

The New York Times: Million-Anecdote Baby
A friend of mine has an adult child with cancer, a young man just old enough to be beyond the age of coverage under his parents' health care plan. After nearly killing him, the dreaded Hodgkin's lymphoma is in remission. But he's still a pariah in the eyes of the insurance industry, which means they can deny him a policy that might save his life. Not for long. In six months' time, the heartless practice of refusing to let sick people buy affordable health insurance — private-sector death panels, the most odious kind of American exceptionalism — will be illegal from shore to shore (Timothy Egan, 6/14).

National Review: Obamacare's Not-So-Safe-Harbor Plans
Obamacare was supposed to help out low-income workers. But some struggling hourly employees could soon face even higher health costs than before the law was implemented. These unlucky workers, who will likely be concentrated in the retail and hospitality industries, will have to choose either to enroll in a health plan that strains their finances or to pay a steadily increasing penalty to the federal government (Jillian Kay Melchior, 6/17).

JAMA: The Looming Threat Of Liability For Accountable Care Organizations And What To Do About It
The promotion of accountable care organizations (ACOs), a new health care delivery and payment model designed to curb rising medical costs while improving quality, is one of the most important elements of the Affordable Care Act. The ACO model is based on shared-risk contracts, in which ACOs agree to share the financial risk of health care overspending with third-party payers. Although they originate in Medicare, these shared-risk arrangements are quickly spreading to the private insurance markets, where they aim to dismantle the volume-driven fee-for-service revenue model. Hundreds of health systems across the country have already adopted the ACO model and in so doing have taken on a new role of cost containment. What may be less clear to them is that they are taking on new liability risks (Dr. H. Benjamin Harvey and I. Glenn Cohen, 6/17).

MLive: The Long Road To Medicaid Expansion In Michigan
Sometimes the impossible takes longer. The Michigan House gets high marks for finally coming to grips with a decision to fold 320,000 uninsured folks into the federal Medicaid system. It wasn't pretty and it probably could have been done faster, but then speed in the legislative process is sometimes a bad thing (Tim Skubick, 6/18).

Politico: Late-Term Abortions Must End
Life's amazing potential often surprises us and too often we underestimate it. And that sacred connection of witnessing life's potential compels us to stop turning a blind eye to the scourge of late-term abortions in our great country. That's why this week, House Republicans will lead the fight to pass the Pain-Capable Unborn Child Protection Act, to put reasonable limits on dangerous late-term abortions (Rep. Marsha Blackburn, R-Tenn., 6/18).

State Highlights: Texas Pharmacists Want Medicaid Price Transparency

Tue, 18 Jun 2013 13:13:00 GMT

A selection of health policy stories from Pennsylvania, Texas, North Carolina, Georgia and California.

The Associated Press: Corbett Signs Anti-Abortion Coverage Bill In Pa.
Pennsylvania is joining about 20 other states in limiting coverage of abortions under health care insurance policies offered in a federally-run insurance marketplace starting next year under a sweeping federal law. The office of Gov. Tom Corbett, a Republican who opposes abortion rights, said he signed the bill Monday, without offering any comment (6/17).

Texas Tribune: Pharmacists Push Transparency In Medicaid Pricing
As a business owner, would you sign a contract that requires you to purchase a product, give that product away and then request payment from a third party without knowing how much you'd receive? What if you also didn't know how much you'd be reimbursed before signing the contract, and that the other party could change that reimbursement rates without notice? That's the situation facing Texas pharmacists participating in Medicaid managed care (Aaronson, 6/18).

North Carolina Health News: N.C. Emergency Patients Twice As Likely To Have Mental Health Problems
Research published by the Centers for Disease Control and Prevention compared rates of people reporting to North Carolina's emergency departments complaining of mental health issues to EDs in the rest of the country (Hoban, 6/17).

Georgia Health News: New Firm To Tackle Shortfalls In Senior Care
Outcomes Health Information Solutions, based in Alpharetta in northern metro Atlanta, has launched a company that aims to address gaps in the medical care of seniors. SeniorCare will send nurse practitioners into people's homes to assess the health of individual seniors and send the information to the appropriate insurers and physicians' office. It will primarily be a service company, unlike its health IT parent company, Outcomes Health (Miller, 6/17).

HealthyCal: Acupuncturists Expect Surge In Patients Under Obamacare
Students at Five Branches University in Santa Cruz signed petitions and wrote letters to Sacramento last year in hopes that acupuncture, one of their areas of study, would be covered under new state and federal health care reform laws. They got their wish. Last fall, California listed acupuncture as a benefit that insurers must include in new plans when the Patient Protection and Affordable Care Act, known informally as Obamacare, takes effect Jan. 1 (Bookwalter, 6/18).

California Healthline: Plan For Autism Medi-Cal Benefit Rejected
The Legislature late last week voted to exclude one type of autism therapy from Medi-Cal by reversing a previous decision to link it with the state's essential health benefit package. Applied behavioral analysis -- known as ABA therapy -- was part of the language in two nearly identical special session bills. ... The bills had implicitly included ABA therapy as one of the state's essential health benefits -- meaning it would have been covered for those children enrolled in Medi-Cal. Friday the Legislature struck that language from the related bills (Gorn, 6/17).

California Healthline: California Budget Puts Some Health Care Issues On Hold
[T]his year's balancing act is kinder to health and social services than any spending plan over the past half decade, according to legislators and veteran Sacramento watchers. "I would take this budget over the last five eight days a week," said Darrell Steinberg, Senate President Pro Tempore and one of the budget's main architects. Steinberg, a Sacramento Democrat long considered a champion of health care in several camps, acknowledged the budget didn't include all the health care spending advocates hoped it would -- particularly for Medi-Cal provider reimbursement and a certain type of autism therapy (Lauer, 6/17).

PwC: Slowdown In Health Care Costs May Be Turning Into A Trend

Tue, 18 Jun 2013 04:00:00 GMT

The accounting and consulting company PricewaterhouseCoopers projects lower overall growth in costs for next year.

The Associated Press: Report: Slowdown In US Health Care To Continue
There's good news for most companies that provide health benefits for their employees: America's slowdown in medical costs may be turning into a trend, rather than a mere pause. A report Tuesday from accounting and consulting giant PwC projects lower overall growth in medical costs for next year, even as the economy gains strength and millions of uninsured people receive coverage under President Barack Obama's health care law (Alonso-Zaldivar, 6/17).

Bloomberg: Health Cost Growth Slows Further Even As Economy Rebounds
Provisions in the Affordable Care Act that penalize hospitals for excessive readmissions and encourage employers to offer wellness programs are slowing the growth of U.S. medical costs, even as the economy rebounds. Health-care costs for commercial insurers and employers are expected to rise about 4.5 percent next year after accounting for changes in benefits, ... The report supports President Barack Obama’s contentions that the 2010 law has contributed to historically slow cost growth. “It’s picking up speed and force,” said Ceci Connolly, managing director of PwC’s Health Research Institute (Wayne, 6/18).

Meanwhile, another study examines the future of Medicare savings --

Politico Pro: Study: More Medicare Savings Coming
Medicare savings could be $1.1 trillion more than the Medicare trustees estimated over the next 10 years if current trends continue, according to a study backed by the Federation of American Hospitals. The study, due to be released on Tuesday, also finds that the recent decline in health care spending growth is because of structural changes in health care more than economic factors (Haberkorn, 6/17).

First Edition: June 18, 2013

Tue, 18 Jun 2013 11:34:31 GMT

Today's headlines include reports about a new publicity push in support of the health law.

Kaiser Health News: Insuring Your Health: Finding Answers About Health Coverage
In her latest Kaiser Health News consumer column, Michelle Andrews writes: "About half of Americans say they don't know how the Affordable Care Act will affect them. Four in 10 think it has been repealed or overturned, or they are unsure where it stands. So chances are good that when the major provisions kick in next year, including online health insurance marketplaces and new standards for health plan costs and coverage, people are going to have questions. Lots of questions. When they do, the biggest one of all may be where to turn for answers" (Andrews, 6/18). Read the column.

Kaiser Health News: Capsules: Facebook Raises The Status Of Organ Donation, Study Shows; Feds Seek Broad Payment Options For Exchanges
Now on Kaiser Health News' blog, Ankita Rao reports on a study tracking how Facebook raised the status of organ donation: "In May 2012, Facebook introduced an option that lets users add 'Organ Donor" to their profiles. … It also provided users a quick link to sign up for the national registry of organ, eye and tissue donors through Donate Life. … The results, as chronicled in a report released on Tuesday, were immediate. On the first day alone, more than 57,000 people added the label to their profiles, and 13,054 people registered to be donors online. A year later, 30,818 people had registered to be donors, about five times more than pre-Facebook rates" (Rao, 6/18).

Also on Capsules, Sarah Varney reports on feds' ideas about payment options for Obamacare customers: "Federal health officials have proposed that all health plans selling insurance on the new online marketplaces must allow for easy payment options for households without bank accounts or credit cards. The government's decision to mandate a menu of payment options including cashier's checks, money orders and re-loadable pre-paid debit cards comes amid increasing pressure from consumer advocates and business groups that are concerned low-income working families would be required to purchase health coverage under the Affordable Care Act but would have no way to pay their monthly bill (Varney, 6/18). Check out what else is on the blog.

The Associated Press/Washington Post: Report: Slowdown In US Health Care Costs May Turn Into A Trend, Not A Pause
There's good news for most companies that provide health benefits for their employees: America's slowdown in medical costs may be turning into a trend, rather than a mere pause. A report Tuesday from accounting and consulting giant PwC projects lower overall growth in medical costs for next year, even as the economy gains strength and millions of uninsured people receive coverage under President Barack Obama’s health care law (6/17).

The Associated Press/Washington Post: Outside Group Backing Obama Airing Health Care Reform Ads This Summer
An outside group supporting President Barack Obama's agenda plans to air a series of ads this summer promoting Obama's health care overhaul. Organizing for Action intends to spend at least $1 million this summer on ads to draw attention to the implementation of the health care law, including its quality of care and coverage of uninsured Americans (6/17).

Politico: Launching The Obamacare Campaign
President Barack Obama brought a campaigner's mindset to the White House — but the roll-out of Obamacare marks the first time he's adapted his campaign's groundbreaking grassroots tactics to the task of turning policy into reality. A trio of Obama's most experienced campaign operatives — one in the West Wing, two others in outside groups closely allied with Obama — are overseeing an effort to ensure that the Affordable Care Act, the president's biggest legacy project, doesn't turn into the failure the GOP predicts it will be (Thrush and Nather, 6/18).

The Wall Street Journal’s Washington Wire: 'Obamacare' Backers Ready Publicity Push
Supporters of the health-care law are set this week to reveal long-awaited details of their campaign to persuade millions of Americans to sign up for coverage. … The first ad highlights provisions in the law that are currently in place such as preventive visits without out-of-pocket costs for seniors, tax credits for small businesses and rebates for consumers, telling viewers that "the truth is, Americans are already seeing the benefits." The ad finishes by promising: "Better coverage and lower costs, that’s what Obamacare means for them" (Radnofsky, 6/17).

Politico: OFA To Launch Obamacare Campaign
Organizing for Action is launching a seven-figure ad buy championing President Barack Obama's Affordable Care Act, as POLITICO's Playbook reported on Monday. "The truth is, Americans are already seeing the benefits" of Obamacare, says a spot posted on YouTube, citing benefits including rebates from health insurance companies and tax credits for small businesses (Glueck, 6/17).

The Associated Press/Washington Post: Va. Panel Established To Certify Medicaid Reforms And Approve Expansion Meets For First Time
How do you expand Medicaid under the federal health overhaul law without provoking the wrath of conservatives dead set against it under any circumstances? A Virginia panel attempting that high-wire act took its first good look at the daunting challenge of modernizing the federal-state program, making it more like a commercial service, simplifying it and cutting billions of dollars in the process Monday and learned from a noisy contingent of protesters that there’s no way to please both sides (6/17).

The Associated Press/Washington Post: Arizona Gov. Brewer Signs Medicaid Expansion Law After Bruising Fight With GOP Conservatives
Arizona Gov. Jan Brewer has signed a law expanding the state's Medicaid program following her victory over conservatives in her own party opposed to embracing a key part of President Barack Obama’s health care overhaul (6/17).

The Wall Street Journal's Washington Wire: Don Berwick Formally Enters Mass. Governor Race
Don Berwick, who has served as administrator of U.S. Medicare and Medicaid programs, formally announced his plans to run for governor of Massachusetts Monday. … A Harvard pediatrician and health policy expert, Mr. Berwick was temporarily appointed by President Barack Obama during congressional recess in 2010. He was never confirmed by the Senate, hindered by comments he made praising the British government-run health care system and some health spending cuts that proved overly controversial, and he left the position in late 2011. Mr. Berwick was administrator in the first stages of health-care reform, which has significantly impacted Medicare and Medicaid. He has been a firm supporter of federal coordination of patient care and of moving away from "fee for service" payment structures (Ballhaus, 6/17).

The Washington Post: Former Obama Administration Official Berwick Announces Run For Governor
Former Obama administration official Donald Berwick will run for governor of Massachusetts in 2014, he announced Monday. "As a doctor, an educator, an innovator and someone who has dedicated his professional career to making things work better and to helping people – I am ready to lead," said Berwick, the former administrator of the Centers for Medicare and Medicaid Services (Sullivan, 6/17).

USA Today: Obama's Ex-Medicare Chief Running For Mass. Governor
It's too early to tell, however, if Berwick's role in advocating for the health care law known as Obamacare will help or hurt him in predominantly blue Massachusetts. The Bay State has its own health care law that mandates insurance coverage — which Obama said during his 2012 campaign was a model for Obamacare (Camia, 6/17).

Politico: Don Berwick Announces Run For Massachusetts Governor
Berwick, who has spent his career practicing medicine and running a leading health care improvement organization, has never held or even sought elected office. But he told POLITICO earlier this year that his time in Washington had made him want to stay in the public arena and try to enact policy ideas statewide. Massachusetts, the first state in the nation to expand health coverage, is now trying to address its high health costs (Kenen, 6/17).

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Health Law's Impact On Premiums Still A Question

Mon, 17 Jun 2013 13:53:00 GMT

Meanwhile, news outlets report on the Obama administration's challenge to educate a largely uninformed public about the law's benefits.

McClatchy: Obamacare's Big Decision: What Is It Going To Cost Me?
The cost of health coverage under Obamacare remains one the biggest mysteries of the nation’s health care overhaul. But nagging cost questions will slowly be answered this summer as insurers and state officials set 2014 health plan rates for people who buy coverage outside of work or purchase it through small employers. Those two coverage areas – the individual and small group markets – face the biggest rule and cost changes next year, when the main provisions of the Affordable Care Act finally kick in (Pugh, 6/17).

NPR: To Find Out How The Health Law Affects You, Ask The President
Call it the Affordable Care Act, call it Obamacare, call it whatever you want — it's coming. And soon. In less than four months people without health insurance will be able to start signing up for coverage that begins Jan. 1. A lot has been said about the law, most of it not that understandable. So starting now, and continuing occasionally through the summer and fall, we're going to try to fix that (Rovner, 6/17).

Milwaukee Journal Sentinel: Enrolling Uninsured In Obamacare Will Be A Challenge
Ray Bochas had little reason to learn about the details of the Affordable Care Act before February. That's when the InnoWare paper napkin and plate factory in Menomonee Falls shut down, and he lost his job and his health insurance. … He has heard that he's supposed to get health insurance next year but doesn't know what he and his wife will need to do. The Affordable Care Act's main goal of increasing the number of people with health insurance could hinge on reaching people like Bochas who will be eligible next year for coverage through Medicaid or through subsidized health plans sold on marketplaces known as exchanges (Boulton, 6/15).

The Wall Street Journal’s Law Journal: Want A Law Job? Learn The Health-Care Act
Some companies are warning that President Barack Obama's health-care overhaul will cost jobs. It won't be in their legal departments. Health-care companies racing to comply with the Affordable Care Act and other rules are calling in the lawyers, sparking a mini-boom for specialist attorneys who can backstop overloaded internal teams and steer clients through an increasingly crowded regulatory minefield (Smith, 6/16).

And here's the latest on how accountable care organizations are shaping up --

Medpage Today: Distribution Of ACOs Varies Widely
More than 40 percent of accountable care organizations (ACOs) formed under Medicare exist in only five states, leaving many states with one or none, according to an analysis by industry experts. Medicare ACOs are concentrated in states like Florida (32), California (22), and Massachusetts (18) but rural states -- like North Dakota, South Dakota, Utah, Wyoming, Oklahoma, and Kansas -- are devoid of them, according to the analysis by consulting firm MedeAnalytics in Emeryville, Calif. Others like Montana, Idaho, Mississippi each only have one Medicare ACO (Pittman, 6/14).

Federal Officials Give Final OK For Florida's Medicaid Managed Care Plan

Mon, 17 Jun 2013 13:25:09 GMT

Approval by the Obama administration was expected after it gave its initial go-ahead just hours before Florida Gov. Rick Scott announced his support for the health law's Medicaid expansion.

Politico: Florida Gets OK For Medicaid Managed Care
Obama administration health officials have officially approved a plan expanding Medicaid managed care throughout Florida. The move was widely anticipated after the Centers for Medicare & Medicaid Services gave its initial approval Feb. 20, a few hours before Gov. Rick Scott announced his support for the Medicaid expansion (Millman, 6/17).

The Associated Press: Medicaid Managed Care Gets Final OK
Federal health officials have given final approval to a plan to overhaul Florida’s safety net health insurance program. Gov. Rick Scott announced the decision on Friday, saying it would allow the state's Medicaid program to "to provide Medicaid users with quality, value-based and patient-centered care" (6/14).

Some GOP Lawmakers See Health Law As Means To Stall Immigration Reform Efforts

Mon, 17 Jun 2013 13:24:41 GMT

On Capitol Hill, immigration reform, sequester cuts and abortion issues continue to grab headlines.

The Washington Post: Republicans Trying To Use Health-Care Law To Derail Obama's Immigration Reform Efforts
After spending years unsuccessfully trying to overturn "Obamacare," Republicans are now attempting to use President Obama's landmark health-care law to derail his top second-term initiative — a sweeping overhaul of the nation's immigration system. Conservatives in both chambers of Congress are insisting on measures that would expand the denial of public health benefits to the nation's 11 million illegal immigrants beyond limits set in a comprehensive bill pending in the Senate (Nakamura and Somashekhar, 6/16).

The Associated Press/Washington Post: From Cancer Patients To Head Start, Impact Of Sequester Cuts Slowly Ripples Across Nation
The first warnings about the spending cuts were dire. In March, as the sweeping $85 billion reductions known as sequestration kicked in, President Barack Obama called them "stupid" and "arbitrary" and said they could thwart economic progress. Opponents said the administration was using scare tactics, predicting doom even though the cuts amounted to a tiny slice of the federal budget (6/15).

The Hill: House Rules Changes Abortion Bill To Allow Rape, Incest Exceptions
The House Rules Committee on Friday altered a controversial bill banning abortions after 22 weeks of pregnancy, in cases of rape, incest or when the life of the mother is threatened. The bill, from Rep. Trent Franks (R-Ariz.), was approved by the Judiciary Committee without this language. But on Friday, House Majority Leader Eric Cantor (R-Va.) hinted that this may change (Kasperowicz, 6/15).

Viewpoints: Don't Change Course On Medicare Reforms On Medical Equipment Prices; Liberals' Agenda Depends On Cutting Entitlements; Making Hospital Prices Public

Mon, 17 Jun 2013 13:23:43 GMT

The Washington Post: Medicare Changes Must Be Implemented Now
Marilyn Tavenner has been administrator of Medicare and Medicaid officially for only about a month, but already she faces a policy challenge from Congress. A majority of the House, 145 Republicans and 82 Democrats, wrote to Ms. Tavenner on Wednesday, asking her to delay implementation of a Medicare cost-reduction initiative, scheduled to take full effect July 1, for six months. They complain that procedural irregularities threaten patient access to wheelchairs, oxygen tanks, beds and diabetes test strips -- known in Medicare parlance as "durable medical equipment, prosthetics, orthotics and supplies," or DMEPOS for short. In fact, these concerns are overblown. Ms. Tavenner should not postpone these overdue reforms to Medicare's DMEPOS program (6/15).

The Washington Post: Liberals Should Lead Entitlement Reform
Social Security, Medicare and the other major health care programs will account for more than half of all federal spending 10 years from now, CBO says. That takes into account the recent good news of slower-than-expected growth in health care costs, and it assumes Medicare cuts that are unlikely to be implemented. The guts of these programs have to be preserved, as liberals rightly argue. Social Security keeps the elderly out of poverty. Medicare ensures that they get health care, and Medicaid and Obamacare should come close to extending that promise to all Americans. But while federal programs aimed at the young and the poor -- and at investments in the future -- are slated to dwindle, the entitlement programs are on track to give ever richer benefits to a growing older generation, some of whom don't need all that much help (Fred Hiatt, 6/16).

Los Angeles Times: Human Gene Patenting Is A thing Most Of Us Aren't Ready For
In the course of our country's history, the U.S. Patent and Trademark Office has bestowed coveted protection on many strange and wondrous inventions: the three-legged pantyhose (in case one leg runs), the sealed, circular peanut butter-and-jelly sandwich, the motorized ice cream cone. And of course, the human gene (Robin Abcarian, 6/15).

The Wall Street Journal: Will Companies Stop Offering Health Insurance Because Of The Affordable Care Act?
We asked a panel to tackle the question: Will the Affordable Care Act, as the law is formally known, lead many employers to stop offering health insurance? Our panelists are Kevin Kuhlman, a manager of legislative affairs at the National Federation of Independent Business, a research and lobbying group for small business; Christine Eibner, an economist at RAND Corp. who has studied the possible effects of the law on health-insurance markets; and David Marini, managing director, strategic advisory services, at Automatic Data Processing Inc., who also has studied the law's effects (Thrum, 6/16).

The Wall Street Journal: Should Physician Pay Be Tied to Performance?
We need to rethink how we pay doctors. That's one thing almost everyone can agree on. The question is, how? Currently, most doctors get paid for every service they perform. But one of the big ideas behind President Obama's health-care overhaul is paying doctors based on how well they do their job. … The idea of paying providers for their performance has found plenty of backers -- and opponents -- throughout the medical community (6/16).

The Wall Street Journal: Should Hospital Residency Programs Be Expanded To Increase The Number of Doctors?
Bills have been introduced in Congress that would increase the number of spots. But some critics say that we have too many doctors already, and that this contributes to the current problems in health care. Arguing in favor of training more doctors is Atul Grover, director of legislative affairs for the Association of American Medical Colleges. His opponent, Elliott S. Fisher, endorses ways to make health care better while reducing the number of doctors. Dr. Fisher is a professor at the Geisel School of Medicine at Dartmouth, director of Dartmouth Institute for Health Policy and Clinical Practice, and co-director of the Dartmouth Atlas of Health Care (6/16).

Boston Globe: Hospital Prices Should Be Published
Steven Sonenreich, chief executive of Mount Sinai Medical Center in Miami Beach, has pledged a move virtually unheard of in the health care industry: to publish what his hospital charges insurers for procedures. "We will post our prices relative to Blue Cross and Aetna, our contractual prices," Sonenreich said during a local radio appearance in May. He went on to challenge other hospitals to follow his lead, and they should (6/17).

USA Today: Target Obesity With Health Care Reform
The Medicare Board of Trustees just released its latest report on the program's finances and the results are terrifying. Despite a decline in health care costs, the Medicare Trust Fund will be bankrupt in 2026. For the program to survive for future generations, innovation will be essential. The old medical paradigm of diagnosing and treating diseases must give way to a more holistic approach aimed at eliminating risk factors that lead to disease. The best place to start is by addressing the growing problem of adult obesity (Tommy Thompson and Kenneth Thorpe, 6/15).

JAMA: The Medicare Trustees Report: Time For Reflection, Not Celebration
As I and others have cautioned, there has been an excess of exuberance about the recent slowdown in health care spending. The jury on that is still out on the degree to which the encouraging numbers are due to profound and lasting changes in the system rather than the recession. Now there is another round of excitement -- in this case misplaced rather than just excessive -- thanks to the recent Medicare Trustees Report (Stuart Butler, 6/17).

Milwaukee Journal Sentinel: The Cost Of Ignoring Alzheimer’s
Alzheimer's is one of the most feared of all diseases of aging. It is one of the top 10 causes of death in the U.S. There is no cure, and there are no effective treatments. No one has ever survived. The fiscal and human costs of Alzheimer's are intergenerational and will change our society if we ignore them. The Alzheimer's Association estimates that 5 million Americans have Alzheimer's and that the number of persons and families affected by this disease will increase by more than 50 percent over the next 20 years (Mark A. Sager, 6/15).

Richmond Times-Dispatch: Malpractice
Officials in Maryland apparently have been so impressed with Obamacare's ability to take a bad health care system and make it worse that they want to see if they can do the same. Maybe that's why they are planning to switch from the state's long-running system of specific price controls to an even more onerous system of global price caps. Since the 1970s, Maryland has essentially dictated what its 46 hospitals can charge for various procedures. Doing so has enabled the state to boast the lowest average cost for hospital care in 2011 -- but only at a significant cost to everyone else. Years ago, Maryland worked a special deal with Washington that enables its hospitals to receive considerably higher payments from Medicare (6/17).

Political Battles Congeal Around IRS Scandals, Implementation Questions

Mon, 17 Jun 2013 13:23:19 GMT

The Associated Press reports that the funding sought by the Obama administration for the Internal Revenue Service's health law activities could be in jeopardy as a result of recent scandals. Meanwhile, The Hill reports that GOP lawmakers are developing plans for handling constituents' questions about the health law.

The Associated Press: IRS Scandals Threaten Funding For Health Care Law
Mounting scandals at the Internal Revenue Service are jeopardizing critical funding for the agency as it gears up to play a big role in President Barack Obama's health care law. Obama sought a significant budget increase for the IRS for next year, when the agency will start doling out subsidies to help people buy health insurance on state-based exchanges. Congressional Republicans, however, see management problems at the IRS as an opportunity to limit the agency's funding just as it is trying to put in place the massive new law (Ohlemacher, 6/15).

The Hill: GOP To Constituents: Questions On ObamaCare? Call Obama
Republican lawmakers say they anticipate a flood of questions in the coming months from constituents on the implementation of ObamaCare, which will pose a dilemma for the GOP. People regularly call their representatives for help with Medicare, Social Security and other government programs. ... Some Republicans indicated to The Hill they will not assist constituents in navigating the law and obtaining benefits. Others said they would tell people to call the Department of Health and Human Services (Viebeck, 6/17).

In other news, Senate Democrats in some "red" states are not stepping back from the overhaul -

The Associated Press: 2014 Senate Democrats Firm Up Health Care Support
Far from reversing course, Senate Democrats who backed President Barack Obama's health care law and now face re-election in GOP-leaning states are firming up their support for the overhaul even as Republican criticism intensifies. Mark Begich of Alaska, Mark Pryor of Arkansas, Mary Landrieu of Louisiana and Kay Hagan of North Carolina will face voters in 2014 for the first time since voting for the Affordable Care Act — also known as "Obamacare" — three years ago. They aren't apologizing for their vote, and several are pursuing an aggressive strategy: Embrace the law, help voters use it and fix what doesn't work (Barrow, 6/15).

State Highlights: States Urge Using Life Insurance For Long-Term Care

Mon, 17 Jun 2013 13:21:00 GMT

A selection of health policy stories from California, Minnesota, Illinois and Oregon.

The Wall Street Journal: States Ease Use Of Life Policies For Elder Care
State lawmakers are encouraging elderly residents to use life insurance as a way to pay for long-term care -- and lower the Medicaid tab in the process. The strategy marks a tacit endorsement of so-called life settlements, a practice in which policyholders sell their policies at a discount in the secondary market and the buyer takes over premiums and consequently collects the death benefit (Greene, 6/16).

Los Angeles Times: California Lawmakers Finalize $96.3 Billion Budget
California lawmakers wrapped up their work on the state budget on Saturday, approving bills detailing plans for university tuition assistance, energy efficiency projects and the expansion of health care programs. The Legislature also renewed a $500 million tax on managed care plans, which was allowed to lapse last year, and approved a framework for boosting welfare grants in the coming years (Megerian, 6/15).

Los Angeles Times: S.F. Grudgingly Backs Kaiser Rate Hike For Public Workers
Officials who oversee the health care plans that cover San Francisco public employees this week excoriated Kaiser executives for failing to adequately explain a proposed rate increase but ultimately voted to back it. The city's public workers have seen their health care costs spiral while they have accepted pay cuts and furlough days at the bargaining table. In an unusual move, labor unions teamed up with San Francisco's Health Service System earlier this year to demand greater transparency from Kaiser (Romney, 6/14).

MPR News: Mayo Med School Receives $1M Grant In AMA Training Initiative
Mayo Medical School is one of 11 medical schools across the country to each receive a $1 million grant from the American Medical Association to help transform the way medical students are trained. Mayo's proposal will create a curriculum to prepare students to practice within patient-centered, community-oriented, collaborative care teams. The 11 schools will form a learning consortium to address gaps in the way medical students are trained now and the needs of 21st century medicine, said AMA president Jeremy Lazarus (Baier, 6/15).

Bloomberg: Chicago Hospital Accused Of Cutting Throats For $160,000
A surgeon at Chicago’s Sacred Heart Hospital cut a hole in Earl Nattee’s throat on Jan. 3, the day before he died. It’s not clear why. The medical file contained no explanation of the need for the procedure, called a tracheotomy, according to a state and federal inspection report that quotes Sacred Heart’s chief nursing officer as saying it happened "out of the blue" (Babcock, 6/15).

Oregonian: Dozens Of Lobbyists Tie Up Bill To Let Consumers Sue Insurance Companies
More than 40 registered lobbyists are fighting a bill that would give Oregonians the right to sue insurance companies. House Bill 3160 would add insurance companies to the state's Unlawful Trade Practices Act, allowing Oregonians to sue companies for not paying claims promptly, denying coverage for losses or medical bills, and other reasons. Insurance companies are the only industry exempt from the 1971 law after banks were added in 2010 in the wake of the recession (Zheng, 6/14).

California Healthline: Bill Would Extend Private Plan Requirement To Cover Autism Therapy
The autism community got good news this week when the Assembly Committee on Health unanimously passed a bill extending what advocates described as critical behavioral health therapy for people with autism. SB 126 by Sen. Darrell Steinberg (D-Sacramento) would require California insurers to include applied behavior analysis -- known as ABA therapy -- as an essential benefit under the Affordable Care Act next year (Hart, 6/14).

First Edition: June 17, 2013

Mon, 17 Jun 2013 11:40:59 GMT

Today's headlines include reports about how states are tackling the implementation of specific provisions of the health law.

Kaiser Health News: Hospital CEO Bonuses Reward Volume And Growth
Kaiser Health News staff writer Jay Hancock, working in collaboration with ABC News, reports: "Like hospital leaders everywhere, the people running Valley Medical Center in Renton, Wash., talk frequently about the need to control soaring medical costs. … But even as Valley officials talk about change, they're paying hospital CEO Richard Roodman tens of thousands of dollars in bonuses for driving the kind of profits and expansion many say are no longer affordable for patients, employers and taxpayers" (Hancock, 6/16). Read the story and related components, including a chart tracking CEO compensation, a sidebar detailing what sometimes determines a CEO’s compensation, a look at some CEOs who shuns bonus pay and an FAQ about the story. You can also watch the video.

Kaiser Health News: Panel Tells Congress Medicare Is Unfairly Penalizing Hospitals Serving The Poor
Kaiser Health News staff writer Jordan Rau, working in collaboration with The Washington Post, reports: "The financial penalties that Medicare imposes on hospitals with high rates of patient readmissions are too harsh for hospitals serving the poor and should be changed, according to a congressional advisory agency" (Rau, 6/14). Read the story.

Kaiser Health News: Your Smartphone Might Hold Key To Your Medical Records
Minnesota Public Radio’s Elizabeth Stawicki, working in partnership with Kaiser Health News and NPR, reports: "How could a local doctor in Maryland access his dad's medical record in Boston? Through Medicare Blue Button, a computer program that allows patients to download their medical history into a simple text file on their smartphones and personal computers. Then third-party applications that you download help organize this information" (Stawicki, 6/17). Read the story.

The New York Times: Choice Of Health Plans To Vary Sharply From State To State
When a typical 40-year-old uninsured woman in Maine goes to the new state exchange to buy health insurance this fall, she may have just two companies to choose from: the one that already sells most individual policies in the state, and a complete unknown — a nonprofit start-up. Her counterpart in California, however, will have a much wider variety of choices: 13 insurers are likely to offer plans, including the state's largest and best-known carriers (Abelson, 6/16).

The Washington Post: States Running Out Of Time On Health Insurance Exchanges
With the deadline for states to implement Affordable Care Act-mandated health insurance exchanges less than four months away, state governments will need to move fast. States are having to reevaluate their existing health insurance infrastructures to meet the act's requirements. They have already received nearly $4 billion in funding for the effort thus far — and can access more dollars through 2014 (White, 6/16).

The Associated Press/Washington Post: IRS Scandals Jeopardize Agency Funding To Put In Place Obama's Massive New Health Care Law
Mounting scandals at the Internal Revenue Service are jeopardizing critical funding for the agency as it gears up to play a big role in President Barack Obama's health care law. Obama sought a significant budget increase for the IRS for next year, when the agency will start doling out subsidies to help people buy health insurance on state-based exchanges. Congressional Republicans, however, see management problems at the IRS as an opportunity to limit the agency's funding just as it is trying to put in place the massive new law (6/15).

The Associated Press/Washington Post: Senate Democrats Running In 2014 In GOP-Leaning States Firm Up Support Of Health Care Law
Far from reversing course, Senate Democrats who backed President Barack Obama's health care law and now face re-election in GOP-leaning states are firming up their support for the overhaul even as Republican criticism intensifies. Mark Begich of Alaska, Mark Pryor of Arkansas, Mary Landrieu of Louisiana and Kay Hagan of North Carolina will face voters in 2014 for the first time since voting for the Affordable Care Act — also known as "Obamacare" — three years ago. They aren't apologizing for their vote, and several are pursuing an aggressive strategy: Embrace the law, help voters use it and fix what doesn't work (6/15).

Politico: Michigan Moves Toward Medicaid Expansion
Another Republican-controlled state embrace of Medicaid expansion could be just around the corner. The Michigan Senate is expected to vote this week on a compromise reached in the lower chamber that would expand the program but limit how long beneficiaries can stay on it (Millman, 6/17).

The Associated Press/Washington Post: Va. Panel Established To Certify Medicaid Reforms And Approve Expansion Meets For First Time
The state panel responsible for verifying that a series of daunting reforms to Medicaid have been met as a condition for expanding access to the federal-state health care program meets for the first time (6/17).

The Wall Street Journal: Aetna To Leave California Individual Insurance Market
The pullout is likely to draw attention as California has become a focus of national debate over the law's impact. Supporters, including President Barack Obama, who highlighted the state in a recent speech, argue that it has shown the success of the health overhaul in encouraging competition and pushing down prices (Mathews, 6/14).

Politico: New Project Addresses Mental Health Care Gap
A new project seeks to bridge the U.S.'s mental health care gap by linking up primary-care doctors and mental health experts. Though it's not funded as part of Obamacare, the project fits in with several of the health care law's goals: coordinating physical and behavioral health care for better health outcomes, shoring up the primary-care workforce and lowering costs through preventive care. The initiative, which is starting in New Mexico but could eventually be scaled nationwide, is also being launched amid heightened concern about filling gaps in the mental health care system after a series of high-profile shootings like the one in Newtown, Conn (Smith, 6/17).

Los Angeles Times: Walk-In Clinics Gaining Popularity
Nontraditional healthcare sites such as urgent care centers and retail clinics are gaining popularity with consumers looking to avoid the long waits and high prices of the doctor's office or emergency department. These sites, however, are not meant to replace a relationship with a primary care physician, and they're never a substitute for appropriate use of hospital emergency rooms (Zamosky, 6/14).

Los Angeles Times: California Lawmakers Finalize $96.3-Billion Budget
California lawmakers wrapped up their work on the state budget on Saturday, approving bills detailing plans for university tuition assistance, energy efficiency projects and the expansion of healthcare programs. The Legislature also renewed a $500-million tax on managed care plans, which was allowed to lapse last year, and approved a framework for boosting welfare grants in the coming years (Megerian, 6/15).

Los Angeles Times: S.F. Grudgingly Backs Kaiser Rate Hike For Public Workers
Officials who oversee the healthcare plans that cover San Francisco public employees this week excoriated Kaiser executives for failing to adequately explain a proposed rate increase but ultimately voted to back it. The city's public workers have seen their healthcare costs spiral while they have accepted pay cuts and furlough days at the bargaining table. In an unusual move, labor unions teamed up with San Francisco's Health Service System earlier this year to demand greater transparency from Kaiser (Romney, 6/14).

The Wall Street Journal: States Ease Use Of Life Policies For Elder Care
State lawmakers are encouraging elderly residents to use life insurance as a way to pay for long-term care—and lower the Medicaid tab in the process. The strategy marks a tacit endorsement of so-called life settlements, a practice in which policyholders sell their policies at a discount in the secondary market and the buyer takes over premiums and consequently collects the death benefit (Greene, 6/16).

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Employers' Challenge: Offering 'Affordable' Coverage

Fri, 14 Jun 2013 13:46:00 GMT

The Associated Press reports on the health law's requirement that employers with more than 50 workers provide affordable health coverage or face fines. But what is affordable? And will workers be helped or hindered by the rule?

The Associated Press/Washington Post: Employers With 50 Or More Full-Time Workers Required To Offer 'Affordable' Coverage
Requirements that medium-sized and large employers offer insurance coverage or face fines are one of the most complicated parts of President Barack Obama's health care law. While most of the estimated 160 million Americans with job-based coverage will not see major changes when the law takes full effect next year, the so-called employer mandate will be important to millions of workers, particularly in low-wage industries (6/13).

The Associated Press/Washington Post: Affordability Glitch: Low-Wage Workers In Some Big Firms Could Get Left Out In Health Overhaul
It's called the Affordable Care Act, but President Barack Obama's health care law may turn out to be unaffordable for many low-wage workers, including employees at big chain restaurants, retail stores and hotels. That might seem strange since the law requires medium-sized and large employers to offer "affordable" coverage or face fines. But what's reasonable? Because of a wrinkle in the law, companies can meet their legal obligations by offering policies that would be too expensive for many low-wage workers. For the employee, it’s like a mirage — attractive but out of reach (6/13).

State Of Health/KQED: Will Proposed Obamacare Fines Help Or Hurt California Workers?
For many businesses Obamacare is downright intimidating. The requirement to provide coverage to full-time employees or potentially face thousands of dollars in fines is what’s really worrying some large companies. Most employees at large businesses already receive health insurance through their employer. But there are still some exceptions. Barbara Andridge is a sales associate at a Walmart near Sacramento. She’s not sure if she’s eligible for the company’s health insurance program because her hours are all over the map — from eight hours one week up to 36 hours the next (Weiss, 6/13).

Supreme Court DNA Ruling Leaves Questions Unanswered

Fri, 14 Jun 2013 13:24:00 GMT

Editorial boards weigh in on what Thursday's Supreme Court ruling means for medical research and for the medical industry.

Boston Globe: Ruling Against Gene Patents Is Victory For Open Research
In its unanimous ruling Thursday that human genes cannot be patented, the US Supreme Court removed a worrisome source of uncertainty hanging over the biotechnology industry. ... The landmark ruling frees up endless amounts of genetic material for the free use of science. It sets a significant precedent that will ultimately benefit researchers, business, consumers, and, most importantly, patients (6/14).

The Washington Post: After DNA Patent Ruling, Encouraging Genetic Research
No, a unanimous Supreme Court ruled Thursday, genes cannot be patented, no matter how much effort a company expends in finding them. It is the right call but can’t be the last word. ... Congress should examine whether government-funded research and persisting market opportunities are enough to motivate genetic research, or whether it should offer more narrowly drawn patents, prize money or other new incentives for companies to continue sorting through the genome (6/13).

The Wall Street Journal: Supreme Gene Splitting
"Groundbreaking, innovative, or even brilliant discovery does not by itself satisfy" the requirements of patent law, Justice Clarence Thomas wrote. Patenting the natural elements which are the "basic tools of scientific and technological work" could "'tie up' the use of such tools and thereby 'inhibit future innovation premised upon them.'" This kind of patent on the natural building block of life would have inhibited both research and investment (6/13).

The New York Times: Clarity On Patenting Nature
The price of Myriad’s stock went up 10 percent in early trading after the court’s decision, an indication that Myriad is benefiting from its investment even as the court, properly, has safeguarded the ability of other researchers to work with the genes (6/13).

State Highlights: Ga. Ponders Higher Health Plan Rates For Employees

Fri, 14 Jun 2013 13:15:00 GMT

A selection of health policy stories from Georgia, Virginia, California and Oregon.

Oregonian: Oregon's Home Health Care Industry Faces Major Federal Cuts; Access Cited
Home health care providers in Oregon and their allies say their industry is in a bind. The state's rural home health providers don't make as much as they should from serving Medicare patients, and the state's providers overall are slated for an even bigger hit next year, according to the industry's advocates and allies in Congress. Last week, Oregon's Congressional delegation signed a letter to Marilyn Tavenner, administrator of the Center for Medicare and Medicaid Services, asking her to adjust the 2013 reimbursement rates for the state's rural home health providers, saying unusually low wages at one rural hospital in Coos Bay had unfairly brought down the wage index used to set federal reimbursement the entire state's rural home health sector -- amounting to a six percent cut (Budnick, 6/13).

Richmond Times Dispatch: Northern Virginia Clinic Sues To Challenge Abortion Rules
A Northern Virginia health clinic has filed the first legal challenge to new state Board of Health regulations governing Virginia's first-trimester abortion facilities. The Falls Church Healthcare Center filed the lawsuit this week in Arlington County Circuit Court against the regulations -- passed by the Board of Health in April -- which reclassified Virginia’s 19 clinics as new hospitals and subjected them retroactively to building standards for new hospital construction (Nolan, 6/14).

Georgia Health News: Schools, Agencies To Pay Higher Health Plan Rates
Georgia officials are raising the employer contribution rates for school districts and state agencies to cover employees in the State Health Benefit Plan. Those employees also may face premium increases for 2014, though their rates won’t be announced until later this summer. This year, teachers, other school personnel, state employees and retirees in the state's benefit plan had an average increase in their health insurance premiums of 9.5 percent. In recent years, the SHBP has shrunk a deficit of more than $800 million. Part of the reduction has come from charging school systems more to cover their non-certificate personnel -- administrative assistants, custodians, bus drivers, cafeteria workers and the like (Miller, 6/13).

Lund Report: Billing, Provider Issues Top List Of Oregon Health Plan Complaints
Billing issues, provider rudeness and access to primary care -- particularly for people living with chronic pain -- top the list of complaints that Oregon Health Plan patients have with providers and the plan itself, said Ellen Pinney, patient ombudsperson for the Oregon Health Authority, at last week's meeting of Health Share of Oregon's community advisory council. During her discussion with the coordinated care organization's advisory body, Pinney stressed the importance of looking at all the feedback the plan gets from patients -- not just the formal complaints (McCurdy, 6/13).

San Francisco Chronicle: Home Care Worker Can Sue County For Pay
In a case that could affect many low-paid home-care workers in California, the state Supreme Court has left intact a ruling allowing a caretaker to sue Sonoma County after her disabled client failed to pay her. The county had appealed a lower court ruling in February that allows a jury to decide whether a county social services agency was the worker's "co-employer" and therefore responsible for unpaid wages. Statewide organizations of county governments and the state of California joined Sonoma in asking the court to review the case. The court unanimously denied review on Wednesday (Egelko, 6/13).

California Healthline: Yamada Takes A Lonely Stand On ADHC Bill
The Senate Committee on Health yesterday rejected a bill designed to perpetuate adult day health care services in one of the strangest votes in recent memory. The legislators on the committee voiced strong support for the bill and said they wanted to vote for it, but bill author Assembly member Mariko Yamada (D-Davis) adamantly refused to consider an amendment removing a restriction on for-profit adult day health businesses. After a long and awkward discussion of personal philosophy, the committee rejected the bill. It failed to garner a single vote. In fact, no actual vote was taken on AB 518 because no legislator would even move the bill (Gorn, 6/13).

Texas Scrambles To Find Money For Approved Health Care Projects

Fri, 14 Jun 2013 13:14:00 GMT

In Texas, revenue woes are hampering a series of health care experiments, including ones for its poor and uninsured. Federal approval for the projects came in May. In California, lawmakers get set to add some dental coverage for the state's poorest residents.

The Texas Tribune: Lack Of Revenue Limits Experimental Health Projects
Texas received federal approval in May to begin more than 1,100 experimental projects that could transform the way health care is delivered to the state's poor and uninsured. But there is a catch: To receive billions of dollars in federal financing, health care providers across 20 Texas regions must start the projects using local financing and meet some performance benchmarks (Aaronson, 6/14).

The Texas Tribune: Interactive: Financing Health Care Transformation Across Texas
This interactive shows the regional distribution of $3.2 billion for projects the federal government approved in May and the percent of each region that is uninsured. Underneath the map is a detailed description of the approved projects from the Health and Human Services Commission (Aaronson, 6/14).

California Healthline: Medi-Cal Dental Coverage Partially Restored
Legislative leaders and Gov. Jerry Brown (D) agreed on a budget plan this week that restores partial funding for dental services in Medi-Cal, California's Medicaid program. … Although not the complete restoration of $131 million sought, the state plans to spend about $16.9 million this fiscal year and $77 million next year on dental coverage. The money will provide preventive care, dental restorations and full dentures for adult beneficiaries of Medi-Cal (Edlin, 6/13).

But in North Carolina --

North Carolina Health News: Health Issues Absent From House Budget Debate
The House tentatively approved its biennial budget Wednesday afternoon after a marathon session. But health and human services were hardly mentioned throughout the seven-hour debate (Hoban, 6/13).

In Unanimous Decision, Supreme Court Justices Rule Genes Can't Be Patented

Fri, 14 Jun 2013 13:14:00 GMT

The decision was applauded by many researchers and drew speculation that it could likely boost patient care. Meanwhile, the stock of Myriad Genetics tumbled after the court's finding invalidated the company's hold on testing for two breast cancer genes.

The Wall Street Journal: Justices Strike Down Gene Patents
The Supreme Court unanimously held Thursday that human genes cannot be patented, even when isolated from the body, a ruling expected to quickly expand access to genetic testing while potentially allowing inventors to retain rights to artificially created DNA. The decision marked the latest step in the court's decade long march to toughen the requirements for patents. The justices repeatedly have declared that 21st-century innovation depends less on locking up intellectual-property rights than on expanding access to discoveries in order to spur further progress (Bravin and Kendall, 6/13).

The New York Times: Justices, 9-0, Bar Patenting Human Genes
The decision is likely to reduce the cost of genetic testing for some health risks, and it may discourage investment in some forms of genetic research (Liptak, 6/13).

Los Angeles Times: Supreme Court Rejects Gene Patents
The Supreme Court ruled that human genes are a product of nature and cannot be patented and held for profit, a decision that medical experts said will lead to more genetic testing for cancers and other diseases and to lower costs for patients. In a unanimous ruling Thursday, the nine justices declared that human genes are not an invention, so they cannot be claimed as a type of private property (Savage, 6 14).

Politico: Supreme Court Rules Genes Can't Be Patented
The court did uphold patents for a type of synthetic DNA called complementary or cDNA, which is widely used in commercial biotechnology. Francis Collins, director of the National Institutes of Health, praised the opinion (Norman, 6/13).

The New York Times: After Patent Ruling, Availability Of Gene Tests Could Broaden
Almost immediately after the Supreme Court ruled that human genes could not be patented, several laboratories announced they, too, would begin offering genetic testing for breast cancer risk, making it likely that that test and others could become more affordable and more widely available. The ruling in effect ends a nearly two-decade monopoly by Myriad Genetics, the company at the center of the case (Pollack, 6/13).

Reuters: U.S. Top Court Bars Patents On Human Genes Unless Synthetic
A unanimous U.S. Supreme Court on Thursday prohibited patents on naturally occurring human genes but allowed legal protections on synthetically produced genetic material in a compromise ruling hailed as a partial victory for patients and the biotechnology industry. The ruling by the nine justices, the first of its kind for the top U.S. court, buttressed important patent protections relied upon by biotechnology companies while making it clear that genes extracted from the human body cannot be patented (Hurley, 6/14).

Boston Globe: No Patenting Of Genes, Justices Rule
The U.S. Supreme Court unanimously ruled Thursday that human genes are "a product of nature" and cannot be patented, a landmark decision that scientists said could remove impediments to research and enhance patients' ability to learn the disease risks that lurk in their DNA (Johnson and Weisman, 6/13).

CBS News: Supreme Court's Gene Patent Ruling Could Boost Patient Care, Experts Say
The Supreme Court's ruling that human genes cannot be patented has been met with excitement from doctors over the implications for patient health. Other experts, however, questioned whether there will be a widespread impact (Jaslow, 6/13).

Los Angeles Times: Supreme Court Ruling A Game Changer For Patients? Doctors Weigh In
The court's 9-0 decision in the case involving the Utah-based Myriad Genetics was welcome news to Grody as well as other doctors and genetic counselors concerned about future research and genetic counselors who said they've had their hands tied by the company's high prices and tough patent enforcement. "I'm very happy," said Raluca Kurz, a certified genetic counselor with Cedars-Sinai Medical Center. "I think we've all been waiting for this to happen for a long time" (Khan, 6/13).

Baltimore Sun: Ban On Patenting DNA Cheers Researchers
Researchers hailed the Supreme Court ruling Wednesday that bans the patenting of human DNA, saying it would expand access to genetic testing for disease at lower cost to patients. In a unanimous decision, the justices said Myriad Genetics did not have exclusive rights to the BRCA 1 and BRCA 2 genes that are linked to significantly greater risk for breast cancer and thus should not be the only company allowed to test for it. "Myriad did not create anything," Justice Clarence Thomas wrote for his fellow justices. "To be sure, it found an important and useful gene, but separating that gene from its surrounding genetic material is not an act of invention" (Marbella, 6/13).

WBUR: Here & Now: Reactions From Both Sides On Gene Patent Ruling (Audio)
The high court's unanimous judgment reverses three decades of patent awards by government officials. It throws out patents held by Salt Lake City-based Myriad Genetics Inc. on an increasingly popular breast cancer test brought into the public eye recently by actress Angelina Jolie's revelation that she had a double mastectomy because of one of the genes involved in this case (6/13).

Modern Healthcare: Myriad Stock Falls As Competitors Offer Lower Prices For Gene Testing
Just hours after the U.S. Supreme Court invalidated Myriad Genetics' monopoly on testing for two breast cancer genes, the company's stock went tumbling as competitors announced plans to offer the same services at lower prices (Carlson, 6/13).