KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

Obamacare Cash Helps Pay Texas' Medicaid Bill

A provision of the Affordable Care Act that covers some Medicaid administrative costs will help close a $338 million gap in the state’s Medicaid budget, even though Texas has declined to expand the health program for the poor. (Edgar Walters, Texas Tribune, 3/26)

Political Cartoon: 'How Would You Feel?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'How Would You Feel?'" by Roy Delgado.

Here's today's health policy haiku:

THE 'Y' CHROMOSOME STRIKES AGAIN

Even nurses have
a salary gender gap.
What is up with that?

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.

Capitol Hill Watch

House Approves GOP Budget Plan; Senate To Take Up Its Version

The House GOP blueprint, which won by a 228-199 vote in spite of fiscal hawks' protests, would dramatically change Medicare and Medicaid and create a path to repeal Obamacare. Although there are differences between this and the Senate approach, both save trillions of dollars by undoing the health law and cutting Medicaid and other safety-net programs. The budget blueprints are largely symbolic and don't have the force of law.

The New York Times: Increased Military Spending Wins Out After Dueling Budget Votes In House
House Republicans beat back protests from fiscal hawks and narrowly passed a budget that increases war spending but slashes domestic programs and begins to privatize Medicare with a goal of balancing the federal books in nine years. ... That triumph for more military spending was an anomaly in the budget blueprint, which would cut spending $5.5 trillion over the next decade. It also includes parliamentary language, called reconciliation, that orders House committees to draft legislation repealing the Affordable Care Act. Under budget rules, that reconciliation repeal bill cannot be filibustered in the Senate and would need only a majority vote to pass. The budget would turn Medicaid into block grants to the states, cutting health care spending for the poor by $900 billion. (Weisman, 3/25)

Politico: House Approves GOP Budget Blueprint
After two weeks of backroom negotiations with fiscal conservatives and defense hawks, the House approved a spending blueprint that would balance the budget in a decade, transform Medicare and Medicaid, prevent tax increases and repeal Obamacare. ... With only 188 members, Minority Leader Nancy Pelosi of California and her fellow Democrats had little hope of derailing the GOP resolution once Boehner was able to pacify both defense and fiscal hawks. But it didn’t stop Democrats from trying. Pelosi was especially critical of Republican plans to hold another vote to repeal Obamacare, noting there is no way for such an effort to succeed while Obama sits in the Oval Office. (Bresnahan, Sherman and Bade, 3/25)

The Associated Press: GOP-Controlled House OKs Balanced Budget Plan
The vote in favor of the plan was 228-199. The blueprint itself is non-binding, but sets Republicans on a path to pass legislation that repeals the health care law, remakes Medicare and overhauls the tax code, in addition to other steps to implement their plan. The GOP-controlled Senate is at work on a slightly different budget plan, with a vote expected by week's end. (3/25)

Los Angeles Times: House GOP Approves Budget To Hike Defense, Slash Safety-Net Programs
House Republicans pushed past their internal divisions to approve a budget blueprint Wednesday, putting the new Congress on track to notch a significant achievement once Senate Republicans pass their version by the end of the week. The ambitious but largely symbolic spending proposals adhere to Republican ideas for slashing social safety-net programs and lowering tax rates. ... The House and Senate must reconcile their different versions, which could prove difficult. The House plan overhauls Medicare by creating a voucher-like option for seniors to purchase private health insurance. Senate Republicans have distanced themselves from that approach and did not include it in their budget. (Mascaro, 3/25)

The Washington Post: How Boehner Got A Much-Needed Win On The Budget
The Senate is working toward passing its own budget plan later in the week. It has begun voting on a heap of amendments, a process that could keep lawmakers at work late Thursday into Friday morning. Once both chambers pass a budget, they will have to hash out the differences in a conference. If they reach a compromise, it would pave the way for a simple majority vote in the Senate on repealing President Obama's signature health-care law under a process known as reconciliation. The Price budget calls for repealing the law. While Obama would be certain to veto such legislation if it ever made it to his desk, it would be a vehicle for conservatives to register their lingering frustration with the law without facing a filibuster. (Sullivan, 3/25)

The Wall Street Journal: House Passes $3.8 Trillion Fiscal 2016 GOP Budget
Passage of the House GOP budget overcomes the first—and likely the highest—hurdle in Republicans’ quest to clear a unified spending blueprint through both chambers of Congress. ... Hard-fought passage of the budget marked a moment of vindication for House Republican leaders, who have suffered a series of embarrassments this year when they were forced to pull GOP bills from the floor and pass legislation with the help of Democrats. (Peterson, 3/25)

Reuters: House Republican Budget Crosses Finish Line, Barely
Overcoming internal divisions on defense spending, Republicans in the U.S. House of Representatives on Wednesday narrowly approved a non-binding federal budget plan calling for $5.5 trillion in domestic spending cuts over 10 years. The vote meant that House Speaker John Boehner avoided what could have been another embarrassing rebuke from his party's right flank. Instead, a complex series of votes engineered by Boehner succeeded and moved the budget issue to the Senate. (Lawder, 3/25)

The Associated Press: Senate Up Next After House Passes Bold Conservative Budget
The Senate is up next after House Republicans pushed through a boldly conservative budget eliminating deficits over the next decade by cutting deeply into Medicaid, food stamps and welfare, and repealing the president’s health care law. ... Both plans squeezed trillions by undoing so-called Obamacare and cutting Medicaid and other programs, but there were differences. House Republicans would convert Medicare into a voucher-like program, while Senate Republicans, eyeing the 2016 campaign in which they must defend their newly won majority, omitted such an approach. (Werner and Espo, 3/26)

The Hill: Senators Split On Medicare Budget Amendments
Senators blocked a Democrat-led Medicare amendment Wednesday from being included in the budget, but passed a Republican amendment on the health plan. Senators voted 46-53 on procedural motion, after Democrats tried to override the decision of Budget Committee Chairman Mike Enzi (R-Wyo.) to block the Dems' amendment. (Carney, 3/25)

House Set To Vote Today On Plan To Scrap Medicare's Flawed Doctor Payment Formula

The proposal, hammered out by Speaker John Boehner and Democratic leader Nancy Pelosi along with others, is attracting growing support. But its fate in the Senate is still not clear.

The Wall Street Journal: Passage Of ‘Doc Fix’ Bill Edges Closer
Lawmakers on Wednesday closed in on passage of a measure to permanently replace an 18-year-old formula for reimbursing doctors for Medicare patients, as support in the House swelled ahead of a vote Thursday and resistance faded among Senate Democrats. The speed with which the package advanced marks a doubly rare moment for this Congress, as it involves a bipartisan agreement and the most contentious of subjects: a change to an entitlement program. ... The House package also would provide two years of funding for a program that provides health insurance to children from low-income families. (Hughes, 3/25)

NPR: Is Capitol Hill Ready To Rest Its Near-Annual 'Doc Fix' Exercise?
Doctors who treat Medicare patients will face a huge cut, 21 percent, if Congress doesn't act by the end of the month. This isn't a new problem. While Democrats and Republicans on Capitol Hill agree that the formula that pays doctors who treat Medicare patients has long been broken, over the years they've been unable to pass more than temporary patches. But the leaders of the House from both parties have come up with a plan that they think can fix a problem that has bedeviled Congress since 1997. On Thursday, it goes to the House floor for a vote. (Summers, 3/26)

Reuters: Obama Ready To Sign Bipartisan Fix For Medicare Doc Payments
President Barack Obama said on Wednesday he was ready to sign bipartisan legislation to change the formula for reimbursing Medicare physicians, while the U.S. Senate's top Democrat appeared open to allowing a vote on the measure. Both developments signified growing support for a bipartisan effort to address a persistent problem and make small adjustments in Medicare costs. (Cornwell, 3/25)

The Associated Press: Obama Ready To Sign Bill Revamping Medicare Doc Fees
Obama's remark, made a day before the House is expected to approve the measure, seemed to add political momentum to the package's prospects in the Senate, where Minority Leader Harry Reid and others had complained about abortion curbs and other provisions. The overall bill is a compromise worked out by House Speaker John Boehner, R-Ohio, and Minority Leader Nancy Pelosi, D-Calif. (Fram and Pickler, 3/25)

The New York Times: House Leaders Confident Of Passing Medicare Bill
Leaders of both parties in the House expressed confidence on Wednesday that their chamber would soon approve sweeping changes in Medicare, even though the Congressional Budget Office released figures showing that the bill could add more than $140 billion to federal budget deficits in the coming decade. ... The measure has drawn support from many diverse organizations, including the American Medical Association, the American Hospital Association and liberal groups like Families USA, the Center for American Progress and the Center on Budget and Policy Priorities. (Pear and Steinhauer, 3/25)

Politico: Senate Democratic Opposition To Medicare Pay Bill Softening
President Barack Obama put pressure on Democrats on Wednesday when he said he looks forward to signing a “good bipartisan bill” to change the Medicare formula and permanently put an end to the “doc fixes” that Congress has passed for years. ... Senate Democrats had two big objections. They wanted to double the House’s two-year extension of the Children’s Health Insurance Program, and they didn’t want to include Hyde Amendment abortion restrictions to the bill’s funding for community health centers. Also, the Senate was not involved in the negotiations, which has frustrated Democrats. Senate Republicans are much more supportive, but some have expressed concern that the package is not fully paid for. (Haberkorn, 3/26)

The Hill: Health Groups Endorse Medicare Deal Despite CHIP Concerns
The $200 billion House deal on Medicare is drawing support from family health advocates, despite concerns from Democrats who say the legislation deprives funding for a children's health program. Leaders of the infant health advocacy group March of Dimes endorsed the bill Wednesday, praising lawmakers for acting "well in advance of the scheduled expiration" of the program. Their letter, addressed to House leadership, called for the bill's passage despite “disappointment” that the Children's Health Insurance Program (CHIP) is only funded for two years. (Ferris, 3/25)

CQ Healthbeat: 'Doc Fix' Would Swell Deficit By $141 Billion, CBO Says
The House-negotiated package to scrap Medicare’s physician payment formula would increase the federal deficit by $141 billion over 11 years, $900 million less than it would cost to freeze doctors’ payment rates over that period, the Congressional Budget Office estimated on Wednesday. (Attias, 3/25)

VA Officials To Testify About Prescription Abuse At Tomah Facility

Rep. Ron Kind, a Wisconsin Democrat, proposes regional pain management boards through the VA to avoid such abuse and a Cherokee leader asks lawmakers for more funding for Indian Health Services.

The Associated Press: Bill Could Prevent Problems Like Those At Tomah
U.S. Rep. Ron Kind says he hopes to establish regional pain management boards through the Department of Veterans Affairs to help prevent problems like those that occurred at a Tomah medical center. Kind introduced the bipartisan bill Wednesday saying he hopes the accountability boards would deter overmedicating. The Tomah hospital is under investigation for allegations of overprescribing practices and retaliatory behavior. (3/25)

The Associated Press: VA Officials Testify At Senate About Prescription Policy
A VA medical center in Tomah accused of rampantly overprescribing painkillers was expected to be a focus of a U.S. Senate hearing Thursday, with several Department of Veterans Affairs officials scheduled to testify. In written testimony released in advance of the hearing in Washington, interim VA Undersecretary for Health Carolyn Clancy said she is deeply concerned about allegations of overprescribing practices and retaliatory behavior at the center in Wisconsin, where investigations are ongoing. She said if employee misconduct is found, those responsible will be held accountable. (Ferguson, 3/26)

The Associated Press: Cherokee Nation Principal Testifies On Health Funding
Cherokee Nation Principal Chief Bill John Baker has testified before a U.S. House subcommittee on the need for increased funding from Indian Health Services. Baker testified Wednesday before the U.S. House Interior Appropriations Subcommittee that the Cherokee Nation has committed $100 million to improve its health care facilities and said Indian Health Services should pay a share to help staff the facilities with doctors and nurses. (3/25)

Meanwhile, a bipartisan bill is introduced in the House to reduce the cost of specialty drugs for many patients -

CQ Healthbeat: Effort Would Change Cost-Sharing for Specialty Drugs
A bipartisan House plan introduced Wednesday would require insurers to charge patients who use expensive specialty drugs and biologics a fixed co-payment instead of a percentage of the cost. The bill by Reps. David B. McKinley, R-W. Va., and Lois Capps, D-Calif., is a version of legislation that was introduced in 2014 and 2013 and gained some steam last year with 142 bipartisan cosponsors. (Gustin, 3/25)

Administration News

Obama Mocks GOP Critics While Marking A Health Law Milestone

President Barack Obama celebrated the fifth anniversary of the health law by chiding its critics and saying they were wrong about their predictions of doom. He also used the occasion to focus on a plan to revamp the way providers and health systems are paid.

The New York Times: Obama Praises Affordable Care Act On Its 5th Birthday
President Obama marked the fifth anniversary of the Affordable Care Act by mocking the law’s longtime critics as wrong about their predictions that its passage would doom America’s health care system. In an event at the White House on Wednesday, Mr. Obama said the law had decreased the ranks of the uninsured by a third, having enabled 16 million people to sign up for health coverage through the government marketplaces. (Shear, 3/25)

The Washington Post: Obama Mocks GOP On Fifth Anniversary Of Affordable Care Act
President Obama delivered a staunch defense of the Affordable Care Act on the week of its fifth anniversary Wednesday as he continues his bid to frame the health care law as a success in the face of legal and political challenges from Republicans. ... More than 16 million people who were previously uninsured now have medical coverage under the law, which is generally viewed as the president's signature legislative achievement. But the law, passed by Congress in 2010, is facing a Supreme Court ruling this spring that could wipe out subsidies for millions of them. The administration has not announced a backup if the court rules portions of the law unconstitutional. (Nakamura, 3/25)

McClatchy: Obama: Health Care Law Working Better Than I Expected
President Barack Obama took a victory lap Wednesday, celebrating the fifth anniversary of his signature health care law and proclaiming that it’s succeeded despite persistent Republican efforts to “repeal, undermine, defund and defame” the law. (Clark, 3/25)

USA Today: Obama Touts, GOP Attacks 5-Year-Old Health Care Law
President Obama's health care law is 5 years old, and so is the political debate surrounding it. Obama again praised the law Wednesday for insuring more people, reducing costs and saving lives, while Republicans continued to cite rising insurance prices and canceled policies for many. "In a lot of ways, it's working better than many of us, including me, anticipated," Obama said during an event at the White House. (Jackson, 3/25)

The Wall Street Journal: Obama Promotes Health-Care Payments Based On Outcome, Not Volume
Paying doctors, hospitals and other providers for improved care rather than treatment volume will benefit patients and lower U.S. health-care spending, President Barack Obama said Wednesday. As the Affordable Care Act reaches milestones in expanding coverage—nearly 11.7 million people had signed up through late February—the Obama administration is turning its focus to revamping the way providers and health systems are paid. (Armour, 3/25)

Meanwhile, in other health law news, a spokesman for Sen. Ted Cruz, who is a noted Obamacare critic, said he hasn’t made a final decision on whether he will sign up for Obamacare -

Politico: Ted Cruz ‘Still Weighing Options’ On Obamacare
Sen. Ted Cruz hasn’t made a final decision on whether he will sign up for Obamacare but will make up his mind “in the coming days,” a spokesman said Wednesday. Rick Tyler, national spokesman for the Texas Republican’s newly-launched presidential campaign, also defended Cruz against charges of hypocrisy for suggesting that he might enroll in Affordable Care Act health exchanges. (Topaz, 3/25)

Health Law Issues And Implementation

Senate Panels In Florida, Tenn. Move Medicaid Expansion Bills

The efforts come in statehouses that have been previously opposed to the expansion. The Tennessee legislation now goes to another committee while the Florida bill will move to the full Senate.

Tampa Bay Times: Senate Alternative To Medicaid Expansion Heads To Floor
A third panel approved the Senate's proposed alternative to Medicaid expansion and now the measure is headed to a floor vote. But things got dicey Wednesday when the Senate Appropriations Committee discussed SB 7044. As Health Policy Chairman Aaron Bean, R-Fernandina Beach, walked his colleagues through the proposal, several senators became engaged in intense side conversations. The discussions grew so large that the committee went into an impromptu recess. Appropriations Chairman Tom Lee, R-Brandon, later explained that some members had expressed concerns because the plan would temporarily put some beneficiaries into Medicaid Managed Care plans until the state creates a new private health insurance marketplace. (McGrory, 3/25)

Meanwhile, Connecticut officials are seeking a change in federal reimbursement on the Medicaid expansion.

Connecticut Mirror: Medicaid Rules Prompt A $45 Million State-Federal Disagreement
A $45 million hole in this year’s budget is the result of a disagreement between state and federal officials over how much the federal government should reimburse Connecticut for Medicaid spending for clients who became eligible under Obamacare. ... Connecticut was the first state in the country to expand Medicaid as part of the health law, beginning the coverage expansion in 2010. The federal reimbursement rate for their care rose from 50 percent to 100 percent as of Jan. 1, 2014. But what if one of those clients went to the hospital in 2013, but the state didn’t pay the bill until 2014? (Levin Becker, 3/25)

Report: Most Doctors Not Flooded With New, Sicker Patients Under ACA

The notion that expanded coverage under the Affordable Care Act would overwhelm physicians has not been borne out, according to a report by athenahealth, the Watertown, Mass.-based electronic record provider.

Modern Healthcare: Patient Load Manageable Under ACA
Physician practices have largely not been overwhelmed since the Affordable Care Act's individual mandate went into effect last year, contrary to concerns raised by ACA critics about the potential flood of new patients the law would bring. (Rubenfire, 3/25)

Meanwhile, the future of an ACA-funded program to bolster the number of primary care physicians in underserved areas is in question -

The New York Times: Amid Affordable Care Act Fight, A Health Center Program Struggles To Stay Alive
Dr. Savita Gopal, a 27-year-old resident physician at the Family Health Center of Harlem, sat in front of a computer last Thursday, peppering Jacob Doble, a 10-year-old from Harlem, with questions for 20 minutes. ... Dr. Gopal’s residency is supposed to last three years, but its future is uncertain. Her training is paid for by a provision of the Affordable Care Act called the Teaching Health Center Graduate Medical Education program, which is up for renewal this year. The program has allocated $230 million nationwide over five years to try to tackle a worsening shortage of primary care physicians and draw eager young doctors to places where they are sorely needed. (Slotnik, 3/25)

Marketplace

Employers Offer Record $693 Annually In Wellness Incentives Per Worker

That figure is up from $430 per employee five years ago, according to a new report. Elsewhere, high-deductible plans are examined, and Cigna forms an alliance with SCAN Health Plan to provide Medicare Advantage benefits.

Reuters: Employer Incentives For U.S. Worker Wellness Programs Set Record
Employers have ratcheted up the financial incentives they offer workers to participate in wellness programs to a record $693 per employee, on average, this year from $594 in 2014 and $430 five years ago, found a report released on Thursday. And fewer employers are imposing penalties such as charging more for insurance if workers do not participate or achieve goals such as losing weight. (3/26)

Kaiser Health News: High-Deductible Plans Bring Lower Costs Now, But Will They Mean Pricey Consequences?
Got a high-deductible health plan? The kind that doesn’t pay most medical bills until they exceed several thousand dollars? You’re a foot soldier who’s been drafted in the war against high health costs. Companies that switch workers into high-deductible plans can reap enormous savings, consultants will tell you — and not just by making employees pay more. Total costs paid by everybody — employer, employee and insurance company — tend to fall in the first year or rise more slowly when consumers have more at stake at the health-care checkout counter whether or not they’re making medically wise choices. (Hancock, 3/26)

Modern Healthcare: Cigna Eyes Medicare Advantage Growth With Retiree Pact
Cigna Corp. and SCAN Health Plan agreed to an alliance Tuesday in which both health insurers will provide retiree Medicare Advantage benefits to California employers. Each company will remain independent. Insurers may view these types of loose partnerships more favorably as a way to get a piece of growing markets like Medicare without having to overpay in a full acquisition. (Herman, 3/25)

State Watch

Ariz. Lawmakers OK Abortion Restrictions

The measure approved by the Arizona legislature would block women from buying insurance that includes abortion coverage through the federal exchange. It also would require abortion providers to inform women they can reverse the effects of drug-induced abortions. In other state news, New York lawmakers are set to approve a bill to codify abortion rights set by the Supreme Court, and Kansas legislators approved a ban on a common second-trimester abortion procedure.

Reuters: Arizona Lawmakers Approve Abortion Bill, Send To Governor
Arizona lawmakers on Wednesday passed a controversial measure blocking women from buying insurance that includes abortion coverage through the federal health care exchange. The fiercely-debated bill also requires doctors to tell women they could possibly reverse the effects of a drug-induced abortion, a claim that critics called "junk science." (Schwartz, 3/25)

State Highlights: Calif. Immigration Policy Driving Boost In Medi-Cal Sign-ups; Indiana Confronts HIV Outbreak

A selection of health policy stories from California, Indiana, Florida, New York, Iowa, Maryland and Kansas.

Los Angeles Times: Medi-Cal Rolls Could Swell Under Obama's Deportation Relief Plan
President Obama's executive actions on immigration, which have sparked a fierce political backlash nationwide, could also provide an unlikely boost for another of his goals: increasing health insurance signups. Immigrants living in the U.S. without permission can't enroll in Obamacare, but an unusual policy in California allows those granted temporary relief from deportation to sign up for Medi-Cal. That means up to half a million more Californians could apply for the state's low-income health program, according to data released Wednesday by UC Berkeley and UCLA. (Karlamangla, 3/25)

The Washington Post: Indiana Is Battling The Worst HIV Outbreak In Its History
The HIV epidemic that now grips Austin, Ind., seemed to come out of nowhere. Since the first diagnosis in mid-December, the number of infected there and in the surrounding region has skyrocketed — 26 by the beginning of March, 72 as of this Wednesday. It’s the worst HIV outbreak in state history, and has local and federal officials scrambling to stem the spread of the disease. (Kaplan, 3/26)

Health News Florida: The Nurse Will See You Now: Expanded Authority Proposal Gets Moving In Legislature
After initially stalling last week, a bill that would let nurses see patients without having the oversight of doctors, finally got moving Tuesday. House Bill 547 was the final proposal heard by the Health Innovation Subcommittee, and even though lawmakers approved it on a 9-to-4 vote, unclear whether the bill is enough of a priority, or even if it has enough support—to get through the House. Still, Republican Rep. Cary Pigman says he wants fellow lawmakers to hear him out and, “to recognize it’s a work in progress. It’s likely a multi-year work in progress.” (Hatter, 3/26)

ProPublica: The Fallout Of Workers' Comp 'Reforms': 5 Tales Of Harm
In some states, the cuts have been so drastic that injured workers have plummeted into poverty, losing their cars and even their homes. In others, workers spend years battling insurance companies for the surgeries, prescriptions and basic help their doctors recommend. The five case studies below are emblematic of the bewildering labyrinths injured workers have to navigate as a result of these cutbacks. (Grabell, 3/25)

The Associated Press: Paid To Sleep: NY Cracks Down On Napping Workers
By day, Tanya Lemon was a 35-year-old single mother who took care of her four children. By night, she worked 12-hour shifts as a nurse at a state group home in suburban Syracuse, paid to watch over vulnerable residents as they slept. That's also when she got her own sleep, prosecutors say — a routine that led to felony charges when Dennis Dattalo, a 25-year-old disabled man who couldn't speak, ran low on oxygen while on her watch and later died. The case has brought renewed attention in New York to the problem of fatigue among health care workers — and in particular highlights the low-paid nurses, aides and others who care for vulnerable people at night, when sleeping can all too often become part of the job. (Virtanen, 3/26)

The Des Moines Register: Health Groups Urge Caution On Medicaid Privatization
Representatives of hospitals, doctors and nursing homes joined with patient advocates Wednesday to urge the Iowa House to pass a bill giving legislators some oversight of the state's shift to privately managed Medicaid. "If managed care is done right, it can do some important and innovative measures to improve quality and access, as well as reducing costs," said Mary Nelle Trefz, a lobbyist for the Child and Family Policy Center. "But that's an important caveat: If it's done right." (Leys, 3/25)

Reuters: California Bill That Would Allow Assisted Suicide Passes Senate Panel
Physician-assisted suicide would be legal for terminally ill patients in California under a bill passed on Wednesday by a committee of the state Senate. The bill, passed by the Senate Health Committee, would allow patients who are mentally competent and have fewer than six months to live to obtain prescriptions for medication to end their lives. (Bernstein, 3/25)

The Wall Street Journal: California Lawmakers View Right-To-Die Video Left By Brittany Maynard
California lawmakers pursuing right-to-die legislation on Wednesday aired a posthumous video of Brittany Maynard, a 29-year-old San Francisco Bay Area woman with brain cancer whose move to Oregon to legally end her life last year drew wide attention. In the video, Ms. Maynard, who ended her life on Nov. 1, appeals to state legislators, and lawmakers elsewhere, to pass laws that allow terminally ill patients to end their lives with the assistance of doctors. Ms. Maynard said in the video she was “heartbroken” to have to leave behind “my home, my community and my friends in California” to take advantage of Oregon’s Death with Dignity Act. (Lazo, 3/25)

The Kansas Health Institute News Service: Two Kansas Counties, Two Vastly Different Health Outcomes
When it comes to standard measures of health, Kansas is a laggard. Whether we’re talking about obesity rates, incidence of diabetes, acute or chronic diseases, or childhood mortality, the Sunflower State typically ranks in the bottom half of state health rankings – and in recent years it’s been sinking even lower. That’s bad enough. But there are vast disparities within the state itself. Averages only give a rough-and-ready sense of the state’s overall health picture; dig deeper – down to the county level – and you’ll find that some counties actually perform quite well while others perform poorly. Nowhere is that more apparent than in two counties that sit cheek by jowl, both in metropolitan Kansas City: Johnson and Wyandotte counties. (Margolies, 3/25)

news@JAMA: Using Health Care Data To Track And Improve Public Health
Each year, County Health Rankings releases a report and an interactive website with detailed health data for every county in the United States. Most of the data available, however, are several years old. For example, for the 2014 report, measures for risk behaviors were based on data from 2006 through 2012, premature death on data from 2008-2010, and preventable hospitalization on data from 2011. America’s Health Rankings publishes annual data for health in states. For the 2014 report, infant mortality rates were based on data from 2011 and 2012, premature death rates from 2012, and rates of insurance from 2012 and 2013. (Sharfstein, 3/25)

The Des Moines Register: Mentally Ill Seniors Shifted Out Of State Institution
Administrators at the state Mental Health Institute at Clarinda have started transferring mentally ill senior citizens from the institution to private nursing homes, a spokeswoman confirmed Wednesday. The transfers will affect only about a dozen patients in a geriatric mental health program, but they are considered some of the toughest cases among the residents of two mental institutions that the state plans to close by July 1. (Leys, 3/25)

The Des Moines Register: Private Unit Considered For Mentally Ill Seniors
The Iowa Health Care Association, which represents most of the state's nursing homes, has shown interest in helping set up a small private facility for senior citizens with mental illnesses that make them aggressive. Although no such program has been formally proposed, the association recently sent the Iowa Department of Human Services an estimate of what it might cost. (Leys, 3/25)

The Kansas Health Institute News Service: Some Farmers Warming To Affordable Care Act
Until the federal health insurance marketplace opened in late 2013, farmers and ranchers were more likely to be uninsured than many other occupational groups. The Affordable Care Act changed that by requiring them — and most other U.S. citizens — to buy insurance. But it also gave them coverage options they didn’t have before. Jon Bailey, of the Nebraska-based Center for Rural Affairs, said it’s hard to make sweeping generalizations about how the health care law is working for farmers and ranchers. (Thompson, 3/25)

Weekend Reading

Longer Looks: Abortion Clinic Protests; Sitting With Patients; The Health Law 5 Years Out

Each week, KHN's Shefali Luthra finds interesting reads from around the Web.

The Atlantic: Free Speech Outside The Abortion Clinic
It’s not clear how much has changed since the Supreme Court’s ruling in McCullen v. Coakley nine months ago. There’s no evidence that activists are succeeding in changing women’s minds. What is succeeding is the one thing the Supreme Court intended: People who believe abortion is murder are able to share that message with those who least want to hear it. (Diana Pearl, 3/19)

The New York Times: The Importance Of Sitting With Patients
For hospitals to run efficiently, it is widely thought that they must operate like companies. There’s a certain number of patients to be seen, doctors to see them, diseases to be managed, procedures to be performed, and hours in which all this must occur. For patients to feel cared for, we must treat them like family — with all the time, energy and compassion that entails. It’s a tension with which doctors at all levels of training struggle. (Dhruv Khullar, 3/19)

The New York Times' The Opinionator: Bearing Witness
As excruciating as it can be to bear witness when a loved one is at the end of life, I highly recommend it to everyone given the chance. The things I’ve learned from being in the room with souls whose journeys happen to be winding down are nothing less than sublime gifts given by the person on the bed, separated from me by a thin sheet and a trillion words, most unspoken. At this stage, sometimes there’s a suction tube. And sometimes there truly are no words. There are other ways to listen, though. (Jo McElroy Senecal, 3/25)

Pacific Standard: Is Medicine’s Gender Bias Killing Young Women?
Heart disease is the number one killer of both men and women in the United States, yet it’s long been considered a “man’s disease” in the popular imagination. This perception likely stems, in part, from the fact that coronary heart disease, the most common cause of heart attacks, is more prevalent among men—and tends to strike them at a younger age. When younger women do have heart attacks, though, studies have found that they are about twice as likely to die as their male counterparts—and more than 15,000 women under the age of 55 do every year. ... In reality, the themes that emerged from the interviews with 30 women in the Yale study, as well as previous research on women and heart attacks, paint a more complicated—and even more disturbing—picture of how gender bias plays out on multiple levels, both within and outside the medical system, to affect women’s ability to get life-saving care in a crisis. (Maya Dusenbery, 3/23)

The Daily Beast: GOP Will Never Stop Coming For Obamacare
King v. Burwell hinges on whether or not four words buried deep in the text of the law contain the seeds of Obamacare’s destruction by eliminating tax subsidies for people living in states that declined to set up their own insurance exchanges. But even if they lose again at the court, conservatives say that they will continue to try to undo the law through the courts. (David Freedlander, 3/23)

The Weekly Standard: Journalists And Justices
King v. Burwell has generated a lobbying blitz in the liberal media of seemingly unprecedented proportions. It began even before the King petitioners asked the Supreme Court last July 31 to review a ruling against them by the Fourth U.S. Circuit Court of Appeals and is unlikely to stop until the justices issue their own decision .... the bulk of the lobbying, in newspapers, magazine articles, websites, and blogs, has consisted of belittling the petitioners, ridiculing the legal theories that their lawyers have put forth, impugning the motives of conservative and libertarian activists involved in the litigation, engaging in [arguments] designed to make the High Court feel sorry for the 8 million people who might not be able to afford Obamacare-mandated health insurance should the King petitioners prevail. (Charlotte Allen, 3/25)

Vox: Obamacare Is 5 Years Old, And Americans Are Still Worried About Death Panels
If there's any area of consensus, it's in misperceptions of the law: 82 percent of Americans either say the price tag has gone up, or aren't sure (the law's price has actually decreased as compared with initial estimates), and only 13 percent know the law met its first-year enrollment goals. Taken overall, the poll paints a frustrating picture for Democrats: most Americans aren't changing their opinion; those who are have mostly become more negative; and some widely held beliefs about the Affordable Care Act are far from accurate. But it's not all good news for Republicans, either: though most Americans dislike Obamacare, more want to see it improved than repealed. Democrats have lost the battle — they haven't made the health law more popular — but in thwarting repeal, and keeping Obamacare in place, they're arguably winning the war. (Sarah Kliff, 3/23)

Editorials And Opinions

Viewpoints: The Cost Of Fixing Medicare's Doctor Pay; Insuring Candidate Cruz

A selection of opinions on health care from around the country.

The Washington Post: The House May Be About To Finally Fix The ‘Doc Fix’
The House of Representatives is on course to pass a major piece of Medicare legislation with strong support from the leadership and rank and file of both parties. Yes, you read that right: On Thursday, the House is scheduled to vote on a package that permanently eliminates the expensive annual budgetary charade known as the “doc fix,” while enacting tens of billions of dollars worth of structural reforms to the massive program for seniors — and providing a two-year, $5.6 billion dollop of funding to an important children’s health-care program to boot. ... There’s also this quibble: According to the Congressional Budget Office, the bill will add roughly $141 billion to the federal deficit over the next 10 years. (3/25)

The New York Times: When Nancy Met Johnny
It’s a bipartisan plan cooked up by John Boehner and Nancy Pelosi. (Question: What do you imagine when you think of those two cooking? Macbeth or Cupcake Wars?) The subject was another fiscal cliff. Next week, Medicare payments to doctors are scheduled to drop by 21 percent. The formula for reimbursement is all screwed up, and Congress is always having to put in a last-minute fix. But this bill does not just kick the can down the road. It actually solves the problem. It fixes the formula and pays for the solution by raising the cost of Medicare for the wealthiest recipients. Plus, it’s got money for community health clinics and the CHIP health care program for children. (Gail Collins, 3/26)

The Washington Post PostPartisan: Yes, Ted Cruz Is A Hypocrite For Going On Obamacare
Sen. Ted Cruz (R-Tex.), who announced his run for president on Monday, had a mixed bag of second-day campaigning. On the one hand, he raised $1 million. On the other hand, the right’s champion of “no compromise” assault on Obamacare and much of the rest of the federal government admitted that, yes, he would be going on Obamacare. (James Downie, 3/25)

The Wall Street Journal: Where’s The Bait?
The charge of hypocrisy is rather baffling. Normally such accusations are made against those who espouse rules they don’t apply to themselves—an adulterer who preaches chastity, say, or a wealthy school-choice opponent who sends his own children to an elite private school. Cruz’s position is more analogous to that of a nonwealthy school-choice supporter who sends his children to the local public school because the law gives him no alternative. If anything, the law that gives the Cruzes no alternative is evidence of Democratic hypocrisy. Before ObamaCare, members of Congress received traditional health benefits like other federal employees. But as the Register notes, Iowa’s Sen. Chuck Grassley, a Republican, “pushed through an amendment on the [Patient Protection and] Affordable Care Act . . . that requires members of Congress to obtain their coverage via health insurance exchanges.” (James Taranto, 3/25)

JAMA: Hospital Community Benefit Programs
Promising health care delivery and payment reforms are under way that may have contributed to the slower rates of growth in health care spending seen in recent years. Delivery reform alone, however, is unlikely to slow cost growth over the long run: it is important to address the social, economic, and environmental determinants that contribute to the increasing burden of poor health and chronic illness. ... we suggest that a modest reorientation of hospital community benefit programs could help accelerate the development of successful regional health improvement initiatives. (Janet Corrigan, Elliott Fisher and Scott Heiser, 3/24)

CommonWealth Magazine: Explaining Obamacare To Foreigners
On the fifth anniversary of the signing of the Affordable Care Act, I ponder how non-Americans view our momentous and controversial health reform law. ... have traveled to Brazil, Australia, and South Africa, and also addressed foreign audiences here in the US, to explain what they should they know about the law and why they might care. I offer them two conclusions, and believe Americans might benefit by knowing them. They are: we remain laggards in providing access to health care coverage, and we are now real leaders in global efforts to improve health care’s quality, efficiency, and effectiveness. (John E. McDonough, 3/23)