KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

A Matter Of Faith And Trust: Why African-Americans Don't Use Hospice

Even as end-of-life planning gains favor with more Americans, African-Americans, research shows, remain very skeptical of options like hospice and advance directives. The result can mean more aggressive, painful care at the end of life that prolongs suffering. (Sarah Varney, 5/5)

Political Cartoon: ‘Hit List?’

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: ‘Hit List?’" by Chris Browne.

Here's today's health policy haiku:


How many tests til
we prove nothing has gone wrong
or health care breaks us?

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

Senate Gives Final OK To 10-Year, Cost-Cutting Budget Blueprint

The GOP-backed budget resolution, which includes procedural tools Republican leaders hope will aid their efforts to repeal parts of the health law, is the first joint congressional budget plan in six years.

The New York Times: Senate Passes Cost-Cutting Budget Plan
The Senate gave final approval Tuesday to the first joint congressional budget plan in six years, ratifying a 10-year blueprint that would cut spending by $5.3 trillion, overhaul programs for the poor, repeal President Obama’s health care law and ostensibly produce a balanced budget in less than a decade. (Weisman, 5/5)

The Wall Street Journal: Senate Passes Budget Agreement
The budget’s passage also unlocks an important procedural tool known as reconciliation, which allows legislation to pass both chambers with a simple majority vote. ... Republican lawmakers say they hope to use that tool to repeal parts of Mr. Obama’s health-care law. Congress could use reconciliation, for example, to respond to any fallout from a challenge before the Supreme Court over how the law was established. The court’s ruling, expected next month, could upend the health-care law if the justices side with the plaintiffs. Mr. Obama is almost certain to veto any such measure by Congress. (Timiraos, 5/5)

USA Today: Senate Passes GOP Budget
The ten-year plan achieves balance with steep cuts in domestic spending while protecting defense spending and raising no new taxes. ... Democrats said the Republican budget would give tax breaks to the wealthy while stripping millions of Americans of health insurance, cutting federal tuition grants for college students, and slashing Medicaid and food stamp programs for the poor. (Davis and Kelly, 5/5)

The Washington Post: Senate Passes Budget Even As Impasse On Spending Continues
Senate Republicans celebrated on Tuesday after passing the first joint budget resolution in more than five years, but that success is just the start of the much more difficult task of funding the government. ... Democrats vowed to block deep funding cuts for medical research, food stamps, housing programs for low-income workers and the federal Pell Grant program for students. (Snell, 5/5)

The Associated Press: Senate Adopts GOP Budget Targeting ‘Obamacare’
Republicans and many economists say balancing the budget helps the economy in the long run and say it’s better to tackle the long-term financial problems of programs like Medicare and Medicaid sooner rather than later. They also promise to relieve the burden of debt that’s being passed on to future generations. (Taylor, 5/5)

Bloomberg: Senate Budget Allows Republicans To Seek Obamacare Repeal
The budget resolution, S.Con.Res. 11, spells out the Republican Party’s priorities by calling for $5.3 trillion in spending cuts to reach balance in nine years. Most of the reductions, $4.1 trillion, would come from programs including entitlements like Medicare. (Przybyla, 5/5)

Reuters: Senate Republicans Pass Budget Plan, Eye Obamacare Repeal
The first combined House-Senate budget in six years passed 51-48 with all Senate Democrats and two Republicans voting against it, presidential candidates Ted Cruz and Rand Paul. Senator David Vitter, a Republican who is running for Louisiana governor this year, did not cast a vote. The non-binding resolution does not go to Obama's desk to be signed into law. Instead, it helps guide Congress' consideration of government agency spending bills and serves as a Republican fiscal policy manifesto that will influence 2016 election campaigns. (Lawder, 5/5)

Health Law Issues And Implementation

Health Law Critics Say States Are Not Rechecking Eligibility Of New Medicaid Recipients

Fox News examines concerns that states are not adequately monitoring people who qualified for the health care program for low-income residents when it expanded under the health law. Other outlets also look at addiction coverage under the law, concerns about birth control coverage and fears about a future cost-control measure.

Marketplace: Why Health Coverage Alone Won't Solve Addiction
Thanks to the Affordable Care Act, millions more Americans now have insurance that will cover addiction treatment, with spending on addiction treatment expected to almost double by 2020. But a new report in the journal Health Affairs finds that despite newfound access, many facilities lack the capacity to take on new clients. Even with expanded access, University of South Carolina’s Christina Andrews says that coverage alone isn't getting many new patients in the door. (Gorenstein, 5/5)

The Hill: Dems Call For Crackdown On Insurers Over Birth Control Mandate
Senate Democrats are urging the Department of Health and Human Services to take action against health insurance companies that are ignoring an ObamaCare provision that guarantees free or low-cost birth control, which they call a "troubling nationwide trend." A group of 38 Democrats sent a letter to HHS Secretary Sylvia Mathews Burwell on Tuesday raising alarms that some insurance companies and pharmacies are making it difficult for women to access contraception. (Ferris, 5/5)

The Hill: 500 Groups Urge Repeal Of ObamaCare Cost-Cutting Panel
Over 500 organizations are calling on Congress to repeal a Medicare cost-cutting board that is part of ObamaCare. At issue is the Independent Payment Advisory Board (IPAB), charged with coming up with ways to cut Medicare spending if it rises above a certain threshold. ... The 500 groups (which include multiple chapters of the same organization), are largely healthcare providers, and are worried about cuts in payments under the board. (Sullivan, 5/5)

And in state news -

Fla. Gov. In DC To Push For Hospital Funds To Cover Uninsured

Gov. Rick Scott planned to meet today with members of the Obama administration to seek the extension of federal Medicaid funds to cover hospital care of the uninsured but said he would not change his opposition to expanding Medicaid. Meanwhile, Politico reports that the administration made it clear to Florida officials more than a year ago that it would extend that funding for one year but not beyond that.

The Associated Press: Scott Headed To DC To Negotiate For Florida Hospital Funds
Gov. Rick Scott is heading to Washington to try to convince the Obama administration to release federal hospital funds, but he insists that he will not support expanding Medicaid insurance to more than 800,000 Floridians. The Republican governor wants an extension on the more than $1 billion in low income pool funds, set to expire June 30th, for hospitals that treat low-income and Medicaid patients. But the federal government wants states to expand Medicaid under the Affordable Care Act, arguing it's more efficient to give people money to help buy health insurance than to pay hospitals for caring for the uninsured retroactively. (Kennedy, 5/5)

Politico Pro: Losing LIP: Florida Hospitals Say It’s No Surprise
Bruce Rueben says the fate of the Florida Low-Income Pool, which provides billions of dollars to cover uncompensated care costs, was clear to him more than a year ago. The Florida Hospital Association president and two state hospital executives were in Washington to press for an extension of program funding. During their April 10, 2014, meeting at CMS, agency officials said the state would receive a one-year continuation of LIP money — but that was it. (Pradhan, 5/5)

Community Health Centers Get $100M To Boost Care For Low-Income Patients

The funding, through the Affordable Care Act, will be used to build 164 clinics nationwide, including several in Florida, North Carolina and Washington state.

The Miami Herald: Four South Florida Health Centers Awarded Thousands In Obamacare Funds
Ten community health-center systems in Florida — including four in South Florida — were awarded a total of $5 million in Affordable Care Act funds Tuesday to build new health-center sites to increase access for about 46,000 Floridians. Across the state, six other groups in Tampa, Saint Petersburg, Lake Worth, Avon Park, Dade City and Palatka also received awards to create new health centers, joining more than 550 centers that have opened in the four years since the passage of the ACA. Blake Hall, executive vice president of Community Health of South Florida (CHI), said the money his organization received will go into building a health center in West Kendall. The two-story facility will be completed by the end of the summer at 13540 SW 135th Ave. and feature primary care, gynecological, family medicine, pediatric, dental and behavioral health services. (Herrera, 5/5)

Public Health And Education

Fourteen Cancer Centers To Use IBM's Watson To Guide Treatment

Using the supercomputer to analyze the DNA of tumors could speed genetic profile results from weeks to minutes, officials said. Matching therapy to DNA has improved outcomes for some patients.

Reuters: IBM's Watson To Guide Cancer Therapies At 14 Centers
Fourteen U.S. and Canadian cancer institutes will use International Business Machines Corp's Watson computer system to choose therapies based on a tumor's genetic fingerprints, the company said on Tuesday, the latest step toward bringing personalized cancer treatments to more patients. Oncology is the first specialty where matching therapy to DNA has improved outcomes for some patients, inspiring the "precision medicine initiative" President Barack Obama announced in January. (Begley, 5/5)

The Seattle Times: UW Medical Center Gets Cancer-care Help From IBM Super Computer
Cancer patients at the University of Washington Medical Center could soon see faster DNA-based analysis of personalized, precision treatments thanks to a new collaboration with IBM’s Watson super computer. UWMC is among more than a dozen cancer centers nationwide to join a new effort that could speed up genetic profile results from weeks to minutes, organizers announced Tuesday. (Aleccia, 5/5)

The Kansas City Star: KU Turns To IBM's Watson To Help Cancer Patients
Researchers at the University of Kansas Cancer Center now have some of the same IBM Watson computer technology that famously beat the best human players of the game show “Jeopardy” a few years back. Instead of giving Watson answers to “Jeopardy” questions, doctors at KU and 12 other cancer centers in the United States and Canada will be feeding the computer system reams of data on patient genomes. Ultimately, Watson will use this genomic information — as well as data from medical journals, clinical studies and treatment guidelines — to come up with treatment options tailored to individual patients. (Bavley, 5/5)

CDC Releases First National Study Of Latino Health

It found that while the death rate among the nation's fastest-growing ethnic group is 24 percent lower than for non-Hispanic whites, the Latino community is hit hard by certain diseases and conditions and has less access to health care.

NBC News: CDC Releases 1st Natl Study On Latino Health Risks, Causes Of Death
The Centers for Disease Control and Prevention (CDC) released Tuesday its first-ever national study of the leading causes of death as well as risk factors, disease prevalence and access to health services among U.S. Hispanics. It found that while the death rate among the nation's fastest-growing ethnic group is 24 percent lower than non-Hispanic whites, the Latino community is hit hard by certain diseases and conditions. (Guadalupe, 5/5)

The Hill: CDC: Hispanics In US Living Longer Than Whites
Hispanics in the United States are living an average of two years longer than white people, despite having less access to healthcare, according to the first national survey of the population's health. Figures released by the Centers for Disease Control on Tuesday state Hispanics have a mortality rate than is 25 percent lower than for the white population, though Hispanics are three times less likely to have health insurance and twice as likely to be in poverty. (Ferris, 5/5)


Community Health Systems Back In The Black

The hospital operator, which is the largest one by actual hospital count, benefited from its acquisition of Health Management Associates Inc. and from changes in uninsured rates and admissions resulting from the health law. Meanwhile, HCA, the largest hospital chain by revenue, will increase its capital spending to make room for new patients thanks to its market share and the impact of the health reforms.

The Wall Street Journal: Community Health Swings To A Profit
Community Health Systems Inc. swung to a profit in the first quarter as the hospital operator continued to benefit from its acquisition of Health Management Associates Inc. and from higher admissions and lower uninsured rates after a federal health-care overhaul. More than 11 million people have signed up for health coverage in state and federal marketplaces under the Affordable Care Act. (Armental, 5/5)

Modern Healthcare: Community Health Systems Returns To The Black As Patients Come Back
Community Health Systems, the largest chain by hospital count, has struggled in recent years to maintain patient volume at its rural facilities. But patients have started to return and the company is also capitalizing on cost savings from its 2014 merger with Health Management Associates. Those factors allowed the Franklin, Tenn.-based chain to return to the black in the first quarter after posting a net loss in the same period last year. (Kutscher, 5/5)

Modern Healthcare: With Strong Volume And Financials, HCA Makes Plans To Spend
HCA, the largest hospital chain by revenue, will increase its capital spending over the next three years to make room for the additional patients it is seeing thanks to market share gains and healthcare reform. The Nashville-based company said Tuesday that it plans to spend $7.7 billion over the three-year period, or $500 million more than it has previously committed. (Kutscher, 5/5)

And in news from the insurance industry -

Study Examines Some Drugs' Higher Costs, Questionable Benefit After Exclusivity

Also, Bloomberg reports that diabetes drugs often rise in tandem. So-called "shadow pricing" by competitors is one reason drug prices continue to surge.

Bloomberg: Diabetes Drugs Compete With Prices That Rise In Lockstep
On May 30 last year, the price for a vial of the blockbuster diabetes medication Lantus went up by 16.1 percent. On the next day, Lantus’s direct competitor, Levemir, also registered a price increase -- of 16.1 percent. In 13 instances since 2009, prices of Lantus and Levemir -- which dominate the global market for long-acting injectable insulin with $11 billion in combined sales -- have gone up in tandem in the U.S., according to SSR Health, a market researcher in Montclair, New Jersey. (Langreth, 5/6)

In Wake Of Settlement, DaVita Plans Stepped-Up Oversight

The kidney-care company announced plans to spend more than $25 million a year on compliance efforts.

The Denver Post: After Whistle-Blower Settlements, DaVita Will Bolster Compliance Work
DaVita HealthCare Partners Inc. plans to spend more than $25 million annually on compliance efforts related to allegations the kidney-care company profited by billing the government for usable medications that were discarded. In discussing a whistle-blower lawsuit settlement that could cost the Denver-based firm up to $495 million, DaVita CEO Kent Thiry told investors Tuesday that he was frustrated, humbled and disappointed. (Wallace, 5/6)

Reuters: Behind DaVita $450M False Claims Deal, A Defense Gone Awry
The well-known libel and defamation lawyer Lin Wood left Bryan Cave four years ago because he wanted to represent two whistleblowers – a doctor and nurse – who claimed that the kidney dialysis company DaVita had rigged its drug delivery protocols to overcharge Medicare, Medicaid and other government health programs for unused medications. The False Claims Act whistleblowers had filed their case back in 2007 and already had lawyers, including Marlan Wilbanks of Wilbanks & Bridges. But in March 2011, the Justice Department made the decision not to intervene in the case, leaving the whistleblowers to litigate against DaVita without help from the government. ... So how did a case that failed to entice the government turn into a half-billion-dollar bonanza? ... there’s not much mystery if you look at the public docket in the case. (Frankel, 5/5)

Veterans' Health Care

Senators Want Independent VA Review To Determine If Claims Troubles Are Systemic

A bipartisan group of senators says efforts by the Department of Veterans Affairs to fix delays in handling veterans claims are insufficient and calls for the Government Accountability Office to investigate all 56 regional offices. Meanwhile, California lawmakers push for a new clinic to serve 87,000 veterans.

McClatchy: California Lawmakers Push For New VA Clinic
California lawmakers are still trying to breathe life into a French Camp medical clinic designed to serve veterans living in the Northern San Joaquin Valley and Sierra Nevada foothills. Now, the resuscitation effort is up to the [U.S.] Senate. (Doyle, 5/5)

Campaign 2016

Mike Huckabee Casts Himself As Protector Of Medicare, Social Security

In declaring his candidacy for the Republican presidential nomination, the preacher, TV host and former governor pledged to protect popular but increasingly costly programs for older Americans, putting him at odds with several of his rivals.

The New York Times: Huckabee Vows To Protect Programs For Older Americans
Mike Huckabee drew roaring cheers from supporters on Tuesday as the latest entrant in a sprawling field of Republican presidential candidates by declaring himself the guardian of so-called entitlement programs, warning, “Let them end their own congressional pensions, not your Social Security!” But his pledge to fend off any tinkering with the popular Social Security and Medicare programs put him at odds with his Republican opponents, exposing growing fault lines in the party over an issue that has long been considered a political third rail. (Haberman, 5/6)

State Watch

Abortion Coverage Would Be Banned Under Bill Approved By Texas Senate

Under the Texas law, private health insurance plans and those offered through the federal marketplace could only cover the procedure in medical emergencies. In Iowa, the governor wants to change an odd provision that requires his sign off for payments of the state's Medicaid-covered abortions.

The Texas Tribune: Senate OKs Bill Banning Insurers From Covering Abortion
Health insurers would be prohibited from covering abortion in all cases save for medical emergencies under a bill the Texas Senate gave preliminary approval to on Tuesday. Senate Bill 575 by Republican state Sen. Larry Taylor of Friendswood passed on a 21-10 vote. One Democrat joined the chamber's Republicans to approve the measure. (Ura, 5/5)

The Associated Press: Iowa Gov. Branstad Seeks To Change Unusual Abortion Policy
Gov. Terry Branstad wants to halt a policy adopted two years ago that threatened to put him in the unusual position of having to sign off on payments for every Medicaid-funded abortion in the state. A spokesman for the Republican governor said Tuesday that Branstad's proposed Health and Human Services budget doesn't include that provision, which was developed in a compromise health care deal by the Democratic-led Senate and Republican-controlled House. At the time, conservatives hoped the requirement would limit the public dollars spent on abortion by putting more scrutiny on the conservative anti-abortion governor. (Lucey, 5/5)

Nev. Auditors Blame Faulty Computer System For Medicaid Overpayments

Meanwhile, South Carolina will repay the federal government $1.6 million related to room-and-board costs for patients with intellectual disabilities under a special Medicaid program.

The Charleston Post and Courier: SC Agrees To Refund $1.6M It Owes Feds Under Medicaid
South Carolina has agreed to pay back the federal government $1.6 million related to room-and-board costs for patients with intellectual disabilities, a new federal report shows. More than 6,000 South Carolinians with intellectual disabilities receive services through a special Medicaid program called the Intellectual and Related Disabilities Waiver. (Sausser, 5/5)

State Highlights: Pence Signs Ind. Needle-Exchange Bill, Measure To Protect Health Professionals From Liability As Volunteers

News outlets examine health care issues in Indiana, California, Nevada, Colorado and New York,

The Ledger Enquirer: New Law Will Give Immunity To Volunteer Medical Workers
Doctors, nurses and other health care providers will have civil immunity for their volunteer work under a new Indiana law. Gov. Mike Pence on Tuesday signed the bill that gives immunity from lawsuits to licensed medical professionals when they are performing basic treatments for free after registering with the state. They also must notify patients of the legal protection. (5/5)

The Associated Press: Ex-Clinic Chief In Las Vegas Hepatitis Case Gets Prison Time
The former business chief of a Las Vegas medical clinic linked to a 2007 hepatitis C outbreak has been sentenced to a year and a day in federal prison after pleading guilty to conspiracy to commit health care fraud. Tonya Rushing apologized Monday to Senior U.S. District Judge Larry Hicks, who also sentenced her to two years of supervised release after prison and ordered her to perform 150 hours of community service. (Ritter, 5/5)

Health News Colorado: Health Chief Vows To Keep IUD Program Alive
Colorado’s top doctor is refusing to give up on a birth control program that is leading the nation in reducing teen pregnancies and cutting abortions. Last week, Republicans in the Colorado Senate killed a bill that would have allocated $5 million in taxpayer funds to provide IUDs and other long-acting removable contraceptive devices (known as LARC) for low-income teens and young women in Colorado. (Kerwin McCrimmon, 5/5)

The Associated Press: NYC Mayor Proposes Millions In New Mental Health Services
Over 80 schools would get mental health clinics, every police precinct would have a victims' advocate and social workers would arrange psychological care for thousands of families in homeless shelters under Mayor Bill de Blasio's plan to invest tens of millions of dollars in mental health, his wife's signature issue. The proposal, which first lady Chirlane McCray unveiled Tuesday, comes as New York seeks to become a national model for cities to address mental health needs and . She's spearheading an effort to draw a full-fledged plan, expected this fall. (Peltz, 5/5)

The New York Times: Air Ambulances Offer A Lifeline, And Then A Sky-High Bill
Clarence W. Kendall, a rancher in Pearce, Ariz., was moving bales on top of a haystack when he fell eight feet and struck his head on the corner of a truck below. His health insurance covered most of the cost of treating the head trauma caused by the accident. But there was one bill, for $47,182, that his insurance did not pay. (Eavis, 5/5)

NPR: Whooping Cough Vaccine's Protection Fades Quickly
Lately, Californians have been focused on a measles outbreak that got its start at Disneyland. But in the past five years, state health officials have declared epidemics of whooping cough twice — in 2010 and in 2014, when 11,000 people were sickened and three infants died. Now an analysis of a recent whooping cough epidemic in Washington state shows that the effectiveness of the Tdap vaccine used to fight the illness (also known as pertussis) waned significantly. For adolescents who received all their shots, effectiveness within one year of the final booster was 73 percent. The effectiveness rate plummeted to 34 percent within two to four years. (Aliferis, 5/5)

Editorials And Opinions

Viewpoints: Huckabee Wrong On Entitlements; Va.'s Shift On Abortion; Solving ER Crowding

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

The Wall Street Journal: Huckabee’s Revival Campaign
We believe in political redemption, but [Republican presidential candidate Mike] Huckabee is already back at the same old stand. He is accusing Republicans who support entitlement reform of “robbing” seniors and says that as President he wouldn’t sign Paul Ryan’s Medicare reform. He recently lambasted New Jersey Governor Chris Christie for proposing to gradually raise the Social Security retirement age and means-test benefits. Aside from repealing ObamaCare, Mr. Huckabee has no answer of his own on entitlements, though they are steadily consuming more of the federal budget and national GDP. Entitlements on autopilot inevitably mean tax increases. (5/5)

The Washington Post: An Abortion Rights Win In Virginia
No one was misled three years ago when Virginia’s then-attorney general, Ken Cuccinelli II, a Republican, twisted legal logic to the breaking point by trying to shutter abortion clinics that had operated legally and safely for years. Mr. Cuccinelli, a crusading culture warrior, advanced a rationale as flawed as it was novel: He argued that a 2011 law, applying stringent hospital construction standards to small, outpatient abortion clinics, should apply not only to new structures but also to existing ones — a departure from long-standing practice for health-care facilities in Virginia. ... In a watertight official opinion, Mr. Herring laid waste to Mr. Cuccinelli’s reasoning and gave the green light for state regulators to restore common-sense rule-making. (5/5)

The New York Times' The Upshot: Candidates Disagree On Abortion, But Public Is In Surprising Harmony
If you listen to party leaders, you might think that the nation is hopelessly divided on abortion. Recently, for example, three presidential candidates — Mike Huckabee, Rand Paul and Hillary Rodham Clinton — addressed the issue in very different ways. .... But unlike the opinions of party activists and pundits, public opinion about women’s choices during their pregnancies yields surprising points of agreement across party lines. If you ask them specifics, Americans agree on quite a bit about when and why abortions should be legal. (Lynn Vavreck, 5/6)

The New York Times: How To Solve The E.R. Problem
Back in 2009, a big selling point of health care reform was the idea that expanding insurance coverage would increase Americans’ access to preventive and primary care and decrease the unnecessary use of emergency rooms, saving billions. ... There is one big problem with this logic: data. A new survey by the American College of Emergency Physicians found that 75 percent of emergency room doctors reported increases in patient volume since the Affordable Care Act went into effect. ... Opponents of the Affordable Care Act point to these increases as confirmation that yet another promise of the law was false. But these failures do not mean that the emergency room problem is unsolvable, just that insurance coverage alone is insufficient. (Ezekiel J. Emanuel, 5/6)

JAMA: An Affordable Care Act At Year 5 Key Issues For Improvement
The Patient Protection and Affordable Care Act (ACA), signed into law in March 2010, has been in place for nearly half a decade and by many measures is succeeding. ... Nevertheless, millions of US residents remain uninsured and millions will remain uninsured even after the ACA is fully in effect. Additionally, individuals now insured under the ACA may find health care unaffordable because of high cost-sharing. The complexity of the ACA’s operation, and in particular its use of the tax system to accomplish many of its goals, perplexes many who benefit from the tax credits or who are subject to the ACA’s individual or employer mandates. The United States still has the world’s most costly health care system. Many US residents continue to disapprove of the ACA and it remains under continual siege from its political opponents. (Timothy Stoltzfus Jost, 5/5)

The Washington Post: Stop Routine Breast-Cancer Screenings. Science Has Shown They Don’t Save Lives.
A panel of medical experts stood firm against political backlash last month and insisted that biennial mammograms are unnecessary for women below age 50. The guidance from the U.S. Preventive Services Task Force affirms long-standing evidence debunking the belief that standard screening of women as young as 40 for breast cancer reduces deaths. It’s an idea founded more in politics and profit than in science. (Karuna Jaggar, 5/5)