KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

Political Cartoon: 'The Invisible Man?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'The Invisible Man?'" by Jimmy Margulies.

Here's today's health policy haiku:

CALORIES DON'T ALWAYS COUNT

Numbers are abstract
Eating is a primal need
I'll have a large, please

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Health Law Issues And Implementation

Health Chief Calls For 'Culture Of Increased Transparency'

Meanwhile, advocates praise new rules that will make it easier for consumers to figure out which drugs are covered in exchange plans while others parse rules about abortion coverages.

Poliltico: Burwell Soliciting Ideas For 'Increased Transparency' At HHS
Health and Human Services Secretary Sylvia Mathews Burwell is looking for ways to make her department more transparent after the House GOP discovered that officials had overstated Obamacare enrollment. Burwell emailed senior HHS leadership Sunday night asking them to work toward a “culture of increased transparency, ownership, and accountability.” ... When Burwell was nominated in April to be HHS secretary, she pledged to bring a greater openness and management structure to the agency. She’s generally made a good impression among lawmakers in her first six months on the job, but the flap over the enrollment numbers has created a new round of criticism. (Haberkorn, 11/24)

Bloomberg: U.S. Health Chief Calls Review After Obamacare Inflation
The health department acknowledged Nov. 20 that it had double-counted about 393,000 people in dental plans when it announced that 7.3 million Americans were enrolled in August. Enrollment was revised downward as a result, to 6.9 million in August and 6.7 million in October. ... Republicans have suggested the Obama administration intended to mislead the public by double-counting the dental plans, though so far there isn’t any evidence to support that claim. (Wayne, 11/24)

CQ Healthbeat: Advocates Praise Proposed Exchange Drug Access Provisions
Consumer advocates churning through the details of a 324-page rule proposed late Friday by the Centers for Medicare and Medicaid Services for 2016 exchange plans quickly spotted language they liked — provisions to make it easier to understand what drugs are covered by health plans offered in the new health law marketplaces. Carl Schmid, deputy executive director of the AIDS Institute, also praised language to prevent health plans from discriminating against patients with costly medical conditions, such as AIDS. (Reichard, 11/24)

Kaiser Health News: Obama Officials Seek To Clarify Abortion Coverage Rules
The Obama administration is seeking to clarify rules for the coverage of elective abortion in health insurance exchanges. ... A complicated compromise that got the final few anti-abortion Democrats to agree to vote for the [health law] in 2010 required every exchange to include health plans that do not cover abortions except in the cases of rape, incest or a threat to the life of the pregnant woman. Plans that do offer abortion other than in those cases are required to segregate funds and bill for that abortion coverage separately. But that did not happen. (Rovner, 11/24)

The added complications that some individuals and companies may face at tax time are also explored -

The New York Times: Answering The Hard Questions On The A.C.A.: Which Employees Must Be Covered?
If a business is subject to the mandate, to which employees must it offer insurance in order to avoid the penalty? On the surface, the rule seems straightforward: Every full-time employee — that is, anyone who puts in 30 hours of service a week, or 130 hours a month — is entitled to an offer of coverage from the company for that month (the monthly figure is 130 hours rather than 120 hours because most months are a few days longer than four weeks). ... But things become complicated when employee hours vary week to week or month to month. (Mandelbaum, 11/24)

Politico Pro: Proving Obamacare Coverage To The IRS: It's Complicated
When it comes to catching Obamacare insurance cheats, tax preparers are working without a net. For the first time, people will have to indicate on their 2014 tax forms whether they have health coverage. The IRS will have to figure out who is covered and who is fibbing to avoid the penalty under the Affordable Care Act individual mandate. (Dixon, 11/24)

The Fiscal Times: Obamacare Auto-Renewals Could Deliver Rate Shock
Returning Obamacare customers should take a close look at their coverage options for 2015 instead of just automatically re-enrolling in the same policy they had this year, health officials say. Otherwise, some policyholders could find themselves stuck with significantly higher rates. (Ehley, 11/24)

CNN Money: Obamacare Premiums: Going Up Unless You Shop
Obamacare premiums are going up for 2015. But your Obamacare premium doesn't have to. Multiple experts have sliced and diced the Obamacare health insurance offerings for 2015, and most, if not all, have found that premiums are rising, on average. ... all this doesn't mean that consumers will pay more for coverage through the exchanges next year. Many more insurers are offering plans for 2015 so most consumers will have a wider selection in terms of premiums, deductibles, doctor networks and coverage options, experts said. That's why it's crucial that people browse through all the Obamacare plans available. (Luhby, 11/24)

Other stories look at what's ahead for the lame duck session of Congress, including testimony by MIT economist Jonathan Gruber -

The Hill: 'Stupidity' Consultant Agrees To Testify
Jonathan Gruber, the former ObamaCare adviser in hot water for his comments about the “stupidity of the American voter,” has agreed to testify at a House panel next month, setting up a healthcare showdown in what could be the final week of this Congress. The House Oversight and Government Reform Committee will also hear from Obama administration official Marilyn Tavenner, who is under fire this week for using inflated enrollment figures for the healthcare law. (Ferris, 11/25)

CQ Healthbeat: Expiring Health Programs Stretch Lawmakers In Lame Duck
As Congress struggles to replace the formula that triggers Medicare fee cuts to doctors, lawmakers are also feeling pressure to prevent reductions to primary care doctors who treat low-income patients and to sort out funding for other programs that factor into the health law’s coverage expansion. The daunting "to-do" list stems from provisions that are all due to expire over the next 10 months and fund four separate federal health programs. Most pressing is language in the health law expiring at year's end that for the past two years has paid doctors who treat patients in Medicaid, the federal-state health program for the poor, at higher Medicare rates. Other high-priority programs include community health centers and loan repayment and training programs for health professionals. (Attias, 11/24)

What's That Meal Going To Mean For Your Waistline? Calorie Counts Coming

The federal government will soon mandate that restaurants and a host of other food-service establishments with at least 20 locations display the calorie counts for food they serve. The rules take effect a year from now.

The Washington Post: Calorie Counts: Coming To A Restaurant, Movie Theater, Vending Machine Near You
Chain restaurants, vending machines, grocery stores, coffee shops and pizza joints will soon have to display detailed calorie information on their menus under long-awaited rules to be issued Tuesday by the Food and Drug Administration. The calorie-posting requirements extend to an array of foods that Americans consume in their daily lives: popcorn at the movie theater, muffins at a bakery, a deli sandwich, a milkshake at an ice cream shop, a drive-through cheeseburger, a hot dog at Costco or Target. (Dennis, 11/24)

The New York Times: F.D.A. To Require Calorie Count, Even For Popcorn At The Movies
The rules will have broad implications for public health. As much as a third of the calories that Americans consume come from outside the home, and many health experts believe that increasingly large portion sizes and unhealthy ingredients have been significant contributors to obesity in the United States. ... Perhaps the most surprising element of the new rules was the inclusion of alcoholic beverages, which had not been part of an earlier proposal. (Tavernise and Strom, 11/24)

The Wall Street Journal: Federal Government To Mandate More Calorie Counts
Caloric ignorance will no longer be bliss at many restaurants across the country starting next year. The Obama administration plans to unveil final labeling rules on Tuesday that require restaurants with at least 20 locations to display the calorie count of food items on their menus. The changes, part of the 2010 Affordable Care Act, will bring the type of calorie tallies on public view across New York City and Seattle to chain restaurants nationwide. The changes have been delayed for years, and drew intense pushback from food chains and retailers that argued they were being unfairly included in the mandate. (Tracy, 11/24)

Wall Street Criticizes Calif. Insurers For Overstating Doctor Networks

The two companies provided consumers misleading information about the number of doctors with whom they had contracts. News outlets also look at marketplace issues in Massachusetts, Colorado and Minnesota.

Los Angeles Times: Wall Street Chides Top California Insurers For Obamacare Network Errors
Two leading health insurers drew new fire from Wall Street for overstating their Obamacare doctor networks and trying to deflect the blame. Last week, California regulators found that Anthem Blue Cross, a unit of publicly traded WellPoint Inc., and nonprofit insurer Blue Shield of California violated state law by giving consumers misleading information about their provider networks. The two companies' error rates each topped 25%, according to the California Department of Managed Health Care. (Terhune, 11/24)

The Boston Globe: 1 In 10 Hit Snag On Mass. Health Connector Site
About 5,000 people applying for health insurance have been temporarily locked out of the Massachusetts Health Connector’s website because of difficulties proving their identities online — an issue that Connector officials call inevitable and similar to experiences in other states. (Freyer, 11/24)

The Associated Press: Health Care Website Working As Hoped
Nearly 52,000 individuals in Massachusetts have been found eligible for insurance plans that comply with the federal Affordable Care Act during the first seven days of the open enrollment period for 2015. Of those, about 24,000 were immediately enrolled in MassHealth, the state’s Medicaid program. (11/24)

The Denver Post: Renewals Fuel More Signups On Colorado Health Exchange Than Last Year
State health insurance exchange officials on Monday said 6,144 people have signed up in the first eight days of open enrollment for 2015, well ahead of last year's pace of 204. The 6,144 sign-ups were predominantly renewals — 4,400 people re-enrolling through Connect for Health Colorado, according to its interim chief executive, Gary Drews. (Draper, 11/24)

Meanwhile, the controversy over former White House adviser Jonathan Gruber continues to reverberate in states that also contracted with him to help set up their marketplaces.

California Health Report explores a program that helps states fight chronic health problems.

California Health Report: Health Grants Go To Small Communities With Innovative Approaches To Obesity, Smoking
Created in 2012 by the Affordable Care Act and administered through the federal Center for Disease Control and Prevention, the two-year grants are intended to prevent chronic diseases like cancer, diabetes and heart disease. In the first round of grants, which ran from October 2012 to September 2014, more than $70 million went to communities and counties with fewer than 500,000 people. Eight new grants, which have now been renamed Partnerships to Improve Community Health grants, were awarded in California in September for a total of $12.2 million. (Renner, 11/24)

Veterans' Health Care

VA Fires Director Of Troubled Phoenix Medical Center

Sharon Helman had been on administrative leave after reports that records were falsified to hide long wait lists for treatment.

The New York Times: Health Care Delays Lead To Ouster Of Veterans Hospital Director In Phoenix
Under pressure from Republicans in Congress, the Department of Veterans Affairs on Monday fired the director of its Phoenix medical center, Sharon Helman, six months after she was placed on administrative leave amid revelations that hospital employees had manipulated wait lists to cloak long delays many veterans faced to see doctors. The department said it had “formally removed” Ms. Helman because an investigation by its inspector general had found that “allegations of lack of oversight and other misconduct were substantiated.” In a statement, the new department secretary, Robert A. McDonald, said those shortcomings ran “counter to our mission of serving veterans, and V.A. will not tolerate it.” (Oppel, 11/24)

Arizona Republic: VA Fires Phoenix Hospital Director
Facing a withering barrage of criticism from lawmakers and veterans advocates, Phoenix VA Health Care System Director Sharon Helman was fired Monday, nearly seven months after her suspension for alleged mismanagement, dishonesty and delayed care for veterans in the system. ... A report by the VA Office of Inspector General found that Helman knew the Carl T. Hayden VA Medical Center in Phoenix was publishing phony statistics about patient care. It said she included that data in her performance evaluations as a means of collecting bonus pay. (Wagner, 11/24)

The Associated Press: VA Ousts Hospital Chief In Phoenix Scandal
The head of the troubled Phoenix veterans' hospital was fired Monday as the Veterans Affairs Department continued its crackdown on wrongdoing in the wake of a nationwide scandal over long wait times for veterans seeking medical care and falsified records covering up the delays. Sharon Helman, director of the Phoenix VA Health Care System, was ousted nearly seven months after she and two high-ranking officials were placed on administrative leave amid an investigation into allegations that 40 veterans died while awaiting treatment at the hospital. (Daly, 11/24)

The Washington Post: VA Removes Sharon Helman, Manager At Center Of Phoenix Health-Care Scandal
Department of Veterans Affairs officials on Monday said they had “formally removed,” Sharon Helman, the director of the Phoenix VA Health Care System, where the largest nationwide scandal in the agency’s history first came to light this summer. ... The action comes amid complaints from a growing chorus of Republicans who said the agency was not acting quickly enough to discipline officials responsible for the wrongdoing, despite legislation this summer to expedite the process for firing VA senior executives. (Wax-Thibodeaux, 11/24)

Public Health And Education

FDA Strengthens Warnings On Uterine Surgical Tool

The device, called a morcellator, should no longer be used in the "vast majority" of women, the FDA says, because it can spread cancerous tissue.

The New York Times: F.D.A. Issues Caution On Use Of Uterine Surgery Device That Can Spread Cancer
A power device used during uterine surgery in at least 50,000 women a year in the United States risks spreading cancerous tissue and should no longer be used in “the vast majority” of women, the Food and Drug Administration said on Monday. The tools, laparoscopic power morcellators, have been widely used in operations to remove fibroid tumors from the uterus, or to remove the entire uterus. Morcellators cut tissue into pieces that can be pulled out through the tiny incisions made during minimally invasive surgery. (Grady, 11/24)

The Wall Street Journal: Surgical Tool Gets Strongest Warning
The top U.S. health regulator warned Monday that a common surgical tool shouldn’t be used on most women during hysterectomies, a decision that caps nearly a year of debate and is expected to sharply curtail a procedure that the agency said can spread hidden cancer. The Food and Drug Administration used its authority to call for an immediate “black box” warning for laparoscopic power morcellators, the strongest caution the agency issues. Typically, such warnings on product labels undergo a lengthy comment period before being completed, lawyers for device makers said. (Kamp and Levitz, 11/24)

The Washington Post: FDA Toughens Warning That Uterine Procedure Can Spread Cancer
The Food and Drug Administration strengthened its warnings Monday against the use of a controversial uterine surgical technique, recommending that doctors avoid using laparoscopic power morcellators to remove uterine growths in the vast majority of women because of the risk of spreading hidden cancers. ... The warnings, which come seven months after the FDA first recommended against the widespread use of the procedure, would inform patients that using power morcellators to remove uterine growths could unwittingly spread cancer inside their bodies and decrease the odds of long-term survival. (Dennis, 11/24)

USA Today: FDA Warns Gynecologic Device Has Spread Cancer
The US Food and Drug Administration Monday warned against a gynecologic device that has spread cancer in women who thought they had harmless fibroids. In the last year, two-dozen women have reported that their cancer was made worse by the device, called a power morcellator, which turned a treatable condition into a life-threatening disease. (Weintraub, 11/24)

Treating Rural Vets' PTSD From Afar

In other news, the number of prison inmates with severe mental health problems is overwhelming governments' ability to treat them.

Reuters: Telemedicine May Help Rural Vets With PTSD
For the many veterans with post-traumatic stress disorder (PTSD) who don’t have access to a trained mental health care team, connecting with such a team remotely by phone and video chats may help, a new study suggests. At least 500,000 veterans in the Veterans Health Administration (VHA) system, or nearly 10 percent of the VHA population, were diagnosed with PTSD in 2012, the researchers write in JAMA Psychiatry. (Doyle, 11/24)

The Philadelphia Daily News: Prison Inmates Have Long Waits For Psychiatric Care
Fred Avery Jr. is a convicted murderer with a long, violent rap sheet, so it's unlikely that many people were surprised when he allegedly stabbed three prison guards at a city jail last Monday as they tried to subdue him after he fought with his cellmate. But what did surprise some was that Avery was still in jail - and not in a mental institution in Norristown. Arrested 19 months ago, the 49-year-old Ogontz man remains in a legal limbo because of his mental status. (DiFilippo, 11/24)

The Denver Post: Treatment For Inmates Evolves
Colorado prisons treat more than four times as many people with mental illness each day as all of the psychiatric hospitals in the state. The Department of Corrections, by default, is the largest mental health treatment center in Colorado. A third of inmates, 5,760 prisoners, have mental problems. ... The state corrections budget for mental health treatment, excluding medications, has climbed 48 percent in just five years, from $8.1 million in 2007 to $12 million last year. (Brown, 11/24)

Marketplace

Congress Weighs Efforts To Cut Generic Drug Costs

The prices of about half of generic medicines went up since last summer, and about 10 percent of them more than doubled in cost in that time, with some common medicines rising by more than 500 percent, The New York Times reports.

The New York Times: Lawmakers Look For Ways To Provide Relief For Rising Cost Of Generic Drugs
With the prices for some common generic medicines soaring over the past 18 months, state and federal lawmakers are trying to find relief for patients struggling to pay. On Thursday, a Senate panel convened to investigate price increases for generic drugs. Separately, Senators Amy Klobuchar and John McCain will revive stalled legislation to allow some prescription imports from Canada. And Maine is testing out a hotly contested new law that allows its residents to buy drugs from overseas, flouting United States policy. One half of generic medicines went up in price between last summer and this summer; about 10 percent more than doubled in cost in that time, with some common medicines rising by over 500 percent, new data released in connection with a Congressional hearing found. (Rosenthal, 11/24)

The Wall Street Journal Pharmalot blog: Should Generic Drug Makers Pay Medicaid Rebates Tied To Inflation?
A pair of lawmakers has introduced identical bills in the House and Senate that would require generic drug makers to pay additional rebates to state Medicaid programs for any medicine that increases in price faster than the inflation rate. The move follows a hearing last week into recent spikes in prices for some generic drugs that was held by U.S. Sen. Bernie Sanders (I-Vt.). Along with U.S. Rep. Elijah Cummings (D-Md.), he is conducting an investigation into generic pricing and they introduced the bills. (Silverman, 11/24)

Meanwhile, Bloomberg looks at how some health plans are reacting to the increasing number of high-cost drugs.

Bloomberg: More Medicine Goes Off Limits In Drug-Price Showdown
Steve Miller is waging war on high-priced medicine, guiding decisions to ban drugs from the health plans of millions of Americans and sending companies reeling in a $270 billion market. He and his colleagues at Express Scripts Holding Co. (ESRX) say they are just getting started. Miller is chief medical officer for the company, which oversees prescription benefits for health plans and employers covering 85 million patients. Unless more is done about a wave of new and expensive drugs, some priced at as much as $50,000 a month, Miller says that health plans are going to be swamped as costs double to half a trillion dollars as soon as 2020. (Langreth, 11/25)

GAO Raises Concerns About Spending On New Medicare Programs

The government may be duplicating efforts under several programs and paying for the same services to test new payment and treatment delivery models, a study finds.

Medscape: CMS Duplicating Efforts To Test New Programs, GAO Study Says
The U.S. Centers for Medicare & Medicaid Services (CMS) may be duplicating efforts and paying for the same services under multiple programs to test new payment and treatment delivery models, the US Government Accountability Office (GAO) said in a recent report. Better coordination among the programs is needed to prevent the inefficient use of federal resources, GAO said. The CMS Innovation Center became operational in November 2010, 8 months after the Patient Protection and Affordable Care Act was signed into law. The agency received 10 times the federal funding ($10 billion through 2019) for research, demonstrations, and evaluations than had been appropriated in the previous decade. It also hired 184 new employees (Crane, 12/20.

Also in news on the health law, a federal court denied a request from a religious employer for an injunction to stop administration rules requiring contraception coverage --

The Hill: Hobby Lobby Denied Relief From Obama Birth Control Rules
A federal appeals court denied Hobby Lobby's request for a preliminary injunction against President Obama's birth control coverage rules. The Tenth Circuit Court of Appeals ruled Thursday that the Christian-run arts-and-crafts chain must comply with the policy as its case proceeds. The decision is the latest setback in Hobby Lobby's case against the Obama administration (Viebeck, 12/20)

Administration News

Peace Corps Inspector General Says Delayed Care Contributed To Volunteer's Death

The report calls for more thorough training for doctors and improved record-keeping.

The New York Times: Report Faults Care Of Peace Corps Volunteer
In a detailed examination of the death of Nick Castle, a 23-year-old volunteer who was the subject of an article in The New York Times in July, the Peace Corps inspector general cited “cascading delays and failures in the treatment” of Mr. Castle as a factor in the death .... More broadly, the report calls on the Peace Corps to make changes to its health care system, including giving its doctors more thorough training in gastrointestinal illnesses, the most common health complaint from volunteers. It also suggests the agency improve record-keeping. (Stolberg, 11/24)

Coverage And Access

Health Reporter Sets Up Crowdsourcing Site For Medical Care

KQED's Lisa Aliferis finds price differences within the same state, based on facility and insurance status. In other consumer news, the U.S. Preventive Services Task Force says that Vitamin D tests may not be necessary, even though they are growing in popularity.

The Washington Post: One Reporter Is Crowdsourcing The Price Of Health Care
Trying to shop around for the best deal on health care services can be maddening. So Lisa Aliferis, a health care reporter for KQED News in San Francisco, came up with a simple idea: ask people what charges they're actually seeing on their bills and try to make sense of the madness. ... insurers and patients rarely pay the listed price. Aliferis — in a partnership with KPCC, a public radio station in Los Angeles, and Clearhealthcosts.com, a health transparency startup — tried to capture information of actual prices that people, who reported the information anonymously, were seeing on their medical bills — breaking down what the insurers were charged and what people actually paid. She found big price differences within the same state, based on facility and insurance status. (Millman, 11/24)

NPR: Vitamin D Tests Aren't Needed For Everyone, Federal Panel Says
Should you get a blood test to see if you're deficient in vitamin D? It sounds like such a good idea, seeing as how most people don't get enough sunshine to make vitamin D themselves. And the tests are becoming increasingly popular. But there are problems with making vitamin D tests a standard part of preventive medicine, a federal panel said. The U.S. Preventive Services Task Force said Monday there's not enough evidence of benefits or harms to recommend vitamin D testing for all. (Shute, 11/24)

State Watch

State Highlights: Mich. Delays Dual-Eligible Program; Negotiations Stuck Between Big Ga. Hospital, Insurer

A selection of health policy stories from Michigan, Georgia, New York, Maryland, Kansas, Louisiana and California.

The Associated Press: Michigan Delays Dual Eligible Program
Michigan is delaying the implementation of its health care coordination program for people eligible for both Medicare and Medicaid. The Michigan Department of Community Health said Monday the start date for MI Health Link will move from Jan. 1, 2015 to March 1, 2015 to make sure it’s prepared to deliver services. (11/25)

Georgia Health News: Grady, Blue Cross At Impasse As Contract Expires
Contract standoffs between hospital systems and health insurers typically have a way of being resolved — often right before a deadline. But high-stakes negotiations between Grady Health System and Georgia’s biggest insurer failed to produce a new contract before the midnight deadline Sunday. That means Grady Memorial Hospital is now “out of network” for Blue Cross and Blue Shield of Georgia members. (Miller, 11/24)

NPR: Africa Inspires A Health Care Experiment In New York
There's a project in the neighborhood of Harlem in New York that has a through-the-looking-glass quality. An organization called City Health Works is trying to bring an African model of health care delivery to the United States. Usually it works the other way around. If City Health Works' approach is successful, it could help change the way chronic diseases are managed in poverty-stricken communities, where people suffer disproportionately from HIV/AIDS, obesity and diabetes. (Palca, 11/24)

The Baltimore Sun: Highly-Demanded Free Medical Equipment Loan Closet Closing
Bette Botzler Decker started with the "Z" file cards while her fellow volunteers started at "A" when it came time to call all those who have borrowed medical equipment from the Baltimore Ninth District Health Committee Loan Closet, located at the former Loch Raven Elementary School. ... The Loan Closet, which has operated since 1952, is the last remnant of a once-vibrant health center system. The county ran 15 health centers — with immunizations, baby clinics, X-ray clinics and the loan closets — from Arbutus to northern Baltimore County. If there were new volunteers to step in, Decker said, the Loan Closet wouldn't have to close. Equipment remains very much in demand. (Tilghman, 11/24)

Kansas Health Institute News Service: State Releases Plan To Keep Medicare Reimbursements At Osawatomie Hospital
State officials have a three-pronged plan to ensure Osawatomie State Hospital maintains its Medicare reimbursements after a federal agency announced last week they are in jeopardy. Meanwhile, mental health advocates say the situation at that hospital underscores the need for legislators who hold the state's purse strings to allow the executive branch to follow through on reforms that are still in their early stages. ... That plan includes a nursing assessment upon admission to determine if new patients are at risk for edema, rashes, pressure ulcers or other conditions. (Marso, 11/24)

Kansas Health Institute News Service: New Effort To Tighten Regulation Of Mental Health Drugs Concerns Advocates
A legislative committee’s recommendation could reignite a debate over whether the state should have the power to regulate Medicaid reimbursements for mental health medications, as it does for other types of drugs. Kansas law currently bars state officials from using regulatory tools — such as prior authorization and preferred drug lists — to manage the use and cost of mental health medication prescribed to Medicaid recipients. The Legislature’s KanCare Oversight Committee recommended repealing that law last week. (Marso, 11/24)

The Associated Press: Louisiana Elderly Office Needs Leadership, Audit Finds
Gov. Bobby Jindal's decision not to replace the fired head of his Office of Elderly Affairs for nearly three years has lessened the effectiveness of the agency's mission to help the elderly, according to an audit released Monday. Legislative Auditor Daryl Purpera's office said the agency's formula for sending state and federal money to local councils on aging doesn't determine where needs are greatest. The audit said the office doesn't consistently track the services it funds, and the shortfall could become more acute as the elderly population grows and the need for services intensifies. (DeSlatte, 11/24)

Editorials And Opinions

Viewpoints: As More People Covered, Fewer Doctors?; 'Shameful' GOP Lawsuit

A selection of opinions on health care from around the United States.

Los Angeles Times: The GOP's Shameful Lawsuit Against Obamacare
[T]he courts are likely to toss out the case because the dispute is political, not legal. ... Republicans have sought to undermine and destabilize the Affordable Care Act by attacking the benefits it provides to Americans on the lowest economic rungs. This lawsuit, which would affect millions who earn near-poverty-level wages, follows a case brought by conservative activists that seeks to end insurance subsidies for more than 13 million low- and moderate-income Americans in 37 states. We get that Republicans are intractably opposed to the healthcare law, but it is particularly shameful that they should take it out on the Americans most in need of the help. (11/24)

The Washington Post: When Health Coverage Expansion Means Longer Waits For A Doctor
One concern about the Affordable Care Act is that as more Americans get health insurance and start using it, those who already have coverage will have to wait longer for care. Recent research with a focus on Massachusetts suggests this may actually happen, but may not last long. Several years after the coverage expansion in that state, access to care for other, previously covered residents appears to be no worse than before the expansion. (Austin Frakt, 11/24)

Los Angeles Times: Ex-Health Net Member Learns To Deal With Medi-Cal
There are a lot of people who resent having to buy health insurance under Obamacare. Presumably their only weakness is Kryptonite. Then there are those who desire Obamacare coverage but have been forced out of the program and into plans for low-income people. They now face difficult choices because a growing number of doctors won't accept them as patients. ... It's one of the lesser-known aspects of the federal Affordable Care Act that anyone whose income drops below a certain level will be automatically shifted to Medicaid — or Medi-Cal in California. (David Lazarus, 11/24)

The Wall Street Journal: Poll: Ebola Was a Bigger Story Than the Midterms
If you have any doubts on how concerned Americans became about the small number of Ebola cases in the U.S., check out this chart. When the Kaiser Family Foundation surveyed the public for our Kaiser Health News Index, we found that the public followed Ebola in the U.S. more closely than any other story over the past month–and much more closely than the midterm elections. (Drew Altman, 11/24)

The Journal of the American Medical Association: Modern Drug Development: Which Patients Should Come First?
The goal of drug development is to expeditiously bring safe, effective medications to the patients who need them most. In parallel with the traditional phases of drug testing, drug manufacturers must choose the patient populations and the indications for which drugs will first be studied. Historically, novel agents ordinarily have been introduced in patients with advanced disease states. ... Recent trials in cardiovascular and cancer medicine, however, have challenged this approach; many novel drugs now seek to establish safety and efficacy in early disease settings. The shift in initial target population raises questions regarding optimal protocol. (Dr. Muthiah Vaduganathan and Dr. Vinay Prasad, 11/24)

The Philadelphia Daily News: Mental Health A Monumental Prison Problem
America just can't get it right when it comes to mental illness. Decades ago, we shut down most of the country's psychiatric hospitals because they had become locked, Dickensian wards of cruelty and neglect for those with acute depression, schizophrenia, bipolar disorder and other conditions. ... Instead, we declared, America would provide treatment in the community, rendered with the compassion, dignity and humanity that had been lacking in our psychiatric houses of horror. The intentions were good. The execution has been a travesty. (Ronnie Polaneczky, 11/24)