KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

Indiana Medicaid Expansion May Tempt Other GOP-Led States

A three-year agreement between Indiana and the federal government imposes cost-sharing on poor adults and uses a cigarette tax and a fee on hospitals to pay the state's costs of expanding Medicaid -- and could lead to other GOP-led states following suit. (Phil Galewitz, 1/28)

One South Florida ZIP Code Leads The Nation In Obamacare Enrollment

Saturation advertising in one Hispanic-heavy city in South Florida has led to unusually high rates of health plan sign-ups through the federal insurance exchange -- and they lead the nation in health law insurance enrollment. (Chabeli Herrera , Daniel Chang and Nicholas Nehamas , The Miami Herald, 1/27)

Political Cartoon: 'Gain-Full Employment?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Gain-Full Employment?'" by Steve Kelley, The Times-Picayune.

Here's today's health policy haiku:


HHS now says
Enough fee-for-service stuff!
Value, not volume!

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

9.5 Million Sign Up For Insurance Through Health Law Marketplaces

Of those, 7.1 million have signed up through, and more than 58 percent of people who are signing up are doing so for the second time.

The New York Times: Health Care Enrollment Appears To Be Near Goal
The Obama administration said Tuesday that 9.5 million people had signed up to receive health coverage through public marketplaces in 2015, with less than a month to go before the enrollment deadline. At first glance, the report suggests that the administration has achieved its goal of having 9.1 million people enrolled at the end of this year. But in 2014, more than 15 percent of people who selected health plans in the public marketplaces failed to pay their share of premiums and were therefore not on the rolls at the end of the year. Officials said they thought that similar attrition could occur this year. (Pear, 1/27)

The Associated Press: Obama Administration On Track To Surpass Health Care Goal
Some 9.5 million people have already signed up for 2015 coverage under President Barack Obama's health care law, and the administration is on track to surpass its nationwide enrollment target set last year. The Health and Human Services Department said Tuesday that, through the middle of January, more than 7.1 million people had signed up in 37 states where the federal government is running the insurance markets. At least another 2.4 million signed up in states running their own exchanges. (Alonso-Zaldivar, 1/27)

USA Today: Florida Tops Obamacare Sign-Ups; Texas Lags
State and federal health care exchanges have enrolled more than 9.5 million people, according to data out Tuesday, meeting their target a full month before the enrollment period closes. Success has varied widely across the country, according to a USA TODAY analysis of new ZIP code-level data. The data show that aggressive outreach in South Florida helped that state account for nearly a seventh of all people who have selected plans on the exchanges. In the areas of Texas with the largest share of uninsured adults, insurance enrollments have lagged. Within the 35 Texas ZIP codes where at least a quarter of adult residents are estimated to be uninsured, total enrollments are up just 8.9 percent from last year, while the five Florida ZIP codes with similar populations are up 23 percent, the analysis shows. (Hoyer and O'Donnell, 1/27)

Indiana To Expand Medicaid But Gets Federal Nod To Implement Some Conservative Ideas

The plan, announced by Gov. Mike Pence who has been a strict opponent of the federal health law, will require participants to contribute to the cost of their care. Other Republican-led states may also consider this plan.

The Washington Post: Indiana Latest Red State To Opt Into Medicaid Expansion
As newly empowered Republicans in Washington are contemplating ways to unwind the president’s health-care law, another Republican governor with conservative credentials announced Tuesday morning he reached a deal with the Obama administration to accept Medicaid expansion funding in his state. Indiana Gov. Mike Pence, a former member of House leadership who’s viewed as a possible 2016 presidential candidate, announced he and the feds after months of negotiations agreed to a plan that will cover an estimated 350,000 low-income adult Hoosiers earning under 138 percent of the poverty level, or about $16,105 for an individual. It makes Indiana the 28th state (plus the District of Columbia) to opt into the voluntary coverage expansion. (Millman, 1/27)

Kaiser Health News: Indiana Medicaid Expansion May Tempt Other GOP-Led States
The deal reached Tuesday between the Obama administration and Indiana Gov. Mike Pence to expand Medicaid under the president’s health law should help sway reluctant Republican officials in other states because it imposes new costs on poor adults, promotes healthy behaviors and relies on financing from smokers and hospitals instead of state taxpayers, health experts say. (Galewitz, 1/28)

Indianapolis Star: Gov. Pence Gets Federal OK For Medicaid Alternative
Pence said the Healthy Indiana Plan 2.0, a revamped version of a program started by then-Gov. Mitch Daniels, goes beyond standard Medicaid expansion by requiring that participants contribute to the cost of their care. "I believe Medicaid is not a program we should expand. It's a program that we should reform – and that's exactly what we're accomplishing," Pence said Tuesday at a speech at St. Vincent Health, announcing the plan's approval. "HIP 2.0 is not intended to be a long-term entitlement program. It's intended to be a safety net that aligns incentives with human aspirations." (Rudavsky and Groppe, 1/27)

Indianapolis Star: Who Will Benefit From Indiana's HIP 2.0?
Indiana will become the 28th state to expand Medicaid, Gov. Mike Pence announced Tuesday. The new program, which Pence has named HIP 2.0, will be run differently than the state's traditional Medicaid program. Here's a look at the details. (Groppe, 1/27)

Los Angeles Times: Indiana Becomes Latest State To Expand Medicaid Through Obamacare
Indiana on Tuesday became the latest state to expand its Medicaid program through the Affordable Care Act, as another Republican governor agreed to accept federal dollars to extend government health coverage to low-income state residents. ... Indiana’s move, which had been closely watched nationally, marks a significant victory for the Obama administration. It has been working to persuade Republican state leaders to back coverage expansions made possible through the 2010 health law often called Obamacare. (Levey, 1/27)

The Wall Street Journal: Indiana Governor To Expand Medicaid Coverage
Indiana on Tuesday announced plans to expand Medicaid under the Affordable Care Act after securing concessions from the Obama administration that could pave the way for other Republican-led states to widen health coverage for low-income residents. Gov. Mike Pence is the latest Republican to opt into the health law’s expansion of Medicaid despite his party’s opposition to the legislation. His move could prompt up to a half-dozen other GOP-led states to follow suit, including Florida, Tennessee and Alabama, by giving them a model to follow. Under Indiana’s agreement, the state can require some Medicaid enrollees to contribute toward their care. (Radnofsky and Campo-Flores, 1/27)

The Associated Press: Indiana Wins Federal OK For State-Run Medicaid Alternative
Indiana has received federal approval to expand health coverage to about 350,000 uninsured residents through a state-run program Gov. Mike Pence said Tuesday will help the state's working poor families. Surrounded by state officials and staffers at an Indianapolis hospital, Pence announced that the Centers for Medicare and Medicaid Services had approved Indiana's waiver request for the plan his administration calls HIP 2.0. (Callahan, 1/27)

CNN: Indiana Gov. Mike Pence Spotlights Conservative Embrace Of Medicaid
Indiana Gov. Mike Pence is expanding Medicaid -- with a few conservative changes he's touting as big reforms to the program. The potential Republican 2016 presidential candidate announced his decision to embrace the Medicaid expansion included in President Barack Obama's health care law in a speech Tuesday morning. It'll make health coverage available to 350,000 more Hoosiers starting Feb. 1, he said. (Bradner, 1/27)

Politico: Mike Pence’s Perils On Obamacare
It’s a policy advocates say will ensure hundreds of thousands of Indiana residents get access to health care but that conservatives argue will blow a hole in federal and state budgets. And it’s just the kind of ammunition opposing candidates are likely to deploy in a crowded presidential primary as they try to distinguish themselves. (Cheney, 1/27)

Efforts To Expand Medicaid Gaining Ground Slowly In Southern, Western States

Following the announcement that Indiana will expand its Medicaid program, Stateline looks at attitudes in other states that initially were opposed to the health law provision. Also in Medicaid news, Oregon officials report on a glitch that has kept some enrollees from getting coverage.

Stateline: More States Lean Toward Medicaid Expansion
In the weeks after the election, governors in Alaska, Idaho, Montana, Tennessee, Utah and Wyoming asked lawmakers to approve detailed proposals for expanding the federal-state health plan for low-income adults, in some cases restarting previous efforts to seek approval for expansion. In a smaller group of states in the South – Alabama, North Carolina and Texas – governors said for the first time they were open to the idea of expanding Medicaid. Other than Arkansas, no Southern state has expanded Medicaid. If all six states now considering expansion plans win federal approval, more than 600,000 additional people could be eligible for Medicaid coverage. (Vestal, 1/28)

The Associated Press: Lawmakers Push Mead Administration's Medicaid Expansion Bill
Some Wyoming lawmakers are pushing an alternative to a pending Medicaid expansion bill that critics say would risk rejection by federal regulators. State Sen. Michael Von Flatern, R-Casper, and three other Republican lawmakers on Monday introduced a bill that would expand the federal Medicaid program in Wyoming by following a plan endorsed by the administration of Gov. Matt Mead. (Neary, 1/27)

The Associated Press: 43,000 Oregonians Waiting In Medicaid Application Backlog
About 43,000 low-income Oregonians are waiting for their Medicaid applications to be fully processed, state health officials say. The Oregon Health Authority says some of the applications came through the federal government's portal and have been determined eligible for benefits but have not been entered in the state's system; others are still incomplete and stuck in limbo. (1/27)

New Health Law Pitch To Young Adults: Coffee Shop Fliers, College Outreach

The same share of young people are seeking health insurance coverage through the health law as last year, worrying some officials. Elsewhere, Latino and African-American families find cultural and economic barriers to getting coverage.

Politico: Obamacare Advocates Refine Their Pitch To Millennials
Gone are the splashy tweets about health coverage from Katy Perry and the “brosurance” ads featuring guys doing keg stands. Fliers in coffee shops and bars are in, as are partnerships with community colleges and job training centers. Millennials are still a critical demographic for Obamacare, but young adults are being wooed very differently in Year Two of enrollment. They showed last year that they’re not slackers when it comes to the health care law — disproving fears that they’d feel too invincible to want insurance — so the approach now is quieter, better targeted, more local, according to advocates. And the data so far suggest it’s on track, they say. (Villacorta, 1/28)

CQ Healthbeat: Health Law Not Attracting More Young Adults, Figures Show
The share of young adults signing up health law coverage is about the same as last year, a sobering development for insurers seeking younger, healthier people to add to their risk pools. Individuals who are 18 to 34 years old comprise 26 percent of the newly-insured population, compared to 25 percent enrolled through Feb. 1, 2014, according to data the Department of Health and Human Services released Tuesday. (Adams, 1/26)

Stateline: Many African-Americans Fall Into Health 'Coverage Gap'
Thanks to the Affordable Care Act, the percentage of people of color who do not have health insurance is projected to fall dramatically by 2016, greatly narrowing the historic disparities in coverage between whites and nonwhites. But one minority group is likely to benefit less than others: African-Americans. (Wiltz, 1/27)

Ruling Could Send More Retirees Seeking Coverage To Exchanges

The Supreme Court's recent decision on retiree health care benefits could mean more of them seek health coverage on exchanges, some experts say. Elsewhere, drug costs in marketplace plans are examined, and Minnesota's governor proposes using taxpayer money to compensate for lower-than-expected enrollment in that state's insurance exchange, MNSure.

Modern Healthcare: Fallout From Retiree Health Plan Ruling Could Send More To Exchanges
A U.S. Supreme Court decision in a case involving healthcare benefits for retirees could potentially have implications for insurers and beneficiaries, experts say. “The implications of this case may well be we are going to see more and more retirees turning to the exchanges for their healthcare coverage,” said Nancy Ross, a partner at the Mayer Brown law firm in Chicago. (Schencker, 1/27)

The Baltimore Sun: Drugs Expensive Under Plans Sold On Health Exchange, Survey Finds
The Affordable Care Act is not so affordable for many Marylanders, according to a new survey. The landmark law that was supposed to make insurance available to hundreds of thousands of people without coverage is costing Marylanders so much more in prescription drug costs that it may deter patients from taking their medicine, the survey by the Partnership to Fight Chronic Disease found. (McDaniels, 1/27)

Poll: If High Court Rules Against Health Law Subsidies, Most Say They Want Them Restored

More than 6 in 10 Americans said they would want Congress to restore federal financial aid for people buying health insurance through the health law's federal exchange if the Supreme Court invalidates some of those government subsidies, according to a new Kaiser Family Foundation tracking poll.

The Associated Press: Poll: Most Say Restore Health Aid If Court Kills Subsidies
More than 6 in 10 Americans would want Congress to restore federal financial assistance for millions buying health care coverage under President Barack Obama's health care law if the Supreme Court invalidates some of those government subsidies, a poll said Wednesday. The finding by the nonpartisan Kaiser Family Foundation suggests that a complicated political landscape might await Republicans, who want to repeal and replace the law, should the court annul a crucial part of it later this year. (Fram, 1/28)

Kaiser Health News: If Supreme Court Rules Against Insurance Subsidies, Most Want Them Restored
A new poll finds that most people think Congress or states should act to restore health insurance subsidies if the Supreme Court decides later this year they are not permitted in states where the federal government is running the marketplace. The court in March is set to hear King v. Burwell, a lawsuit arguing that the wording of the Affordable Care Act means that financial assistance with premiums is available only in the 13 states that created and are running their own online insurance exchanges. If the court sides with those challenging the law, millions of people in the 37 states that use the federal site would lose the help they have been getting. A decision in the case is expected in late June. (Rovner, 1/28)

The Washington Post's The Fix: The Supreme Court Could Gut Obamacare. Here’s Why That Might Not Matter.
The Supreme Court could soon move to void many Obamacare subsidies -- something Republicans are banking on to effectively gut the law. But even if that happens, the American people say they would like the GOP Congress to restore the subsidies. That’s according to a new poll. And though it might not be quite that simple, it demonstrates the real dilemma Republicans could find themselves in if the Supreme Court does what they hope it will. The poll, from the Kaiser Family Foundation, shows 64 percent of people say they would want Congress to re-expand the subsidies to all beneficiaries of the Affordable Care Act, if the Supreme Court voids some of them. (Blacke, 1/28)

The Wall Street Journal's Washington Wire: White House To Court: GOP Health-Care Lawsuit Is ‘Incoherent’
The White House said a Republican lawsuit challenging its implementation of the 2010 health-care law misunderstands the constitutional separation of powers and should be thrown out, according to court papers filed Monday night. “Simply put, Congress’s power to enact legislation does not give it the power (either on its own or with the assistance of the judiciary) to manage the implementation of federal law,” Justice Department lawyers said in papers that ask U.S. District Judge Rosemary Collyer to dismiss the lawsuit. House Republicans filed a complaint in November, alleging the Obama administration exceeded its powers in how it is paying for and enforcing certain parts of the Affordable Care Act. The lawsuit said the administration had no authority without permission from Congress to pay certain discounts to insurers or to delay implementation of an insurance-coverage mandate that applies to large employers. (Kendall, 1/27)

Capitol Hill Watch

House Schedules Health Law Repeal Vote For Next Week

The House will vote on an effort to repeal the overhaul fully. It has already voted three times this month on bills to chip away at the law, including a measure to establish a full-time workweek as 40 hours instead of 30.

The Hill: House To Vote Next Week On ObamaCare Repeal
The House will vote next week on a bill to undermine the 2010 healthcare overhaul in what will be close to the 60th time over the last four years. Next week's vote will be the first in this Congress to repeal ObamaCare in full, leadership aides said. The House has already voted three times to modify the healthcare law this month, including to establish a full-time workweek as 40 hours instead of 30. (Marcos, 1/27)

In related news, lawmakers pressed administration officials regarding the sharing of consumer data gathered by and the Obama administration steps up its rate of issuing veto threats -

The Hill: Lawmakers Grill Officials On Data
Lawmakers pressed officials about consumer data on being shared with outside companies during a Tuesday House hearing. The hearing comes after revelations last week that the federal ObamaCare exchange was giving sensitive information about enrollees — including age, income, smoking habits and computer IP address — to private companies for advertising and data analysis purposes. The discovery spurred a new round of privacy concerns about the much-maligned website. (Bennett, 1/27)

USA Today: Obama Veto Threats At Record Pace To Begin New Congress
The Obama White House has threatened to veto eight bills taken up by the Republican House in January — the most veto threats to begin a new Congress since the Reagan White House first started issuing formal veto threats in 1985. The spurt of veto threats has rankled congressional Republicans, who say that President Obama isn't giving bipartisanship a chance. But the White House blames Republicans, saying they're bringing up bills they already know he opposes. (Korte, 1/27)

Capitol Hill And The White House Eye NIH And Medical Research Funding Issues

Also in the news from Congress, Rep. Tim Murphy, R-Pa., plans to reintroduce legislation to reshape the nation's mental health system. In the Senate, Charles Schumer, D-N.Y., is talking up a proposal that would extend health care coverage for the children of disabled military veterans.

The Baltimore Sun: House GOP Proposes Changes For NIH, FDA
House Republicans are considering significant changes to the way billions of dollars in National Institutes of Health grants are awarded to research institutions under a proposal intended to speed medical breakthroughs. The proposal, which Republican lawmakers unveiled Tuesday, would require the Bethesda-based NIH to set aside more money for high-risk research and young, emerging scientists while also giving the director more power to shape the agency's direction. (Fritze, 1/27)

CQ Healthbeat: Democrats Revive Effort To Free NIH From Sequester
House Democrats are wagering that pleas for increased funding for the National Institutes of Health could gain traction in the 114th Congress thanks to biomedical research legislation unveiled Tuesday. Rosa DeLauro, ranking member of the House Appropriations Labor, HHS-Education Subcommittee, introduced a measure on Monday that would ease sequester caps on domestic discretionary spending to allow a series of annual budget increases for NIH through 2021. Supporters maintain that the bill would enable appropriators to restore the agency’s financial condition to what it would have been had Congress adjusted its budget for inflation annually since 2003. (Zanona, 1/27)

Reuters: Obama's 'Precision Medicine' Plan To Boost Research, But Faces Hurdles
President Barack Obama's plan to put the United States at the forefront of individually tailored medical treatment should give a much-needed boost to research in the field but experts say it won't work without reforms to healthcare, including drug testing and insurance. The administration is expected to give the first details this week on the "precision medicine" initiative that Obama announced in his Jan. 20 State of the Union address. Obama said he wanted the United States to "lead a new era of medicine, one that delivers the right treatment at the right time." (Begley and Clarke, 1/28)

The Hill: Republican Seeks To Revive Mental Health Bill
Rep. Tim Murphy (R-Pa.) is attempting to unite mental health advocates around his plan to reshape the nation’s treatment and prevention systems, vowing to work with those who “are mired in the old ways.” Murphy, who is trained as a child psychologist, said he plans to reintroduce his bill in the next few weeks “after we do some other polishing and tinkering on this.” Murphy’s bill had won support from Republican leadership in Congress, who painted the bill as the GOP’s solution to the nation’s intensifying mental health crisis. But the bill’s path forward came into question last session, after the House Energy and Commerce Committee decided to break it in pieces to improve its chances of passage. (Ferris, 1/27)

The Associated Press: Schumer Eyes Health Coverage For Disabled Vets' Children
Sen. Charles Schumer plans to discuss a proposal for legislation that would extend health care coverage for the children of disabled military veterans. According to the New York Democrat, more than 13,000 state residents are enrolled in the Civilian Health and Medical Program of the Department of Veterans Affairs — or CHAMPVA. It's available for spouses and children of severely disabled vets. (1/28)

Meanwhile, a House committee easily approved the Wounded Warriors Federal Leave Act -

The Washington Post: House Panel Easily Passes Veterans Sick Leave Bill But Can’t Shake Partisan Past
Despite the partisan tussle over rules, this first meeting managed a good bipartisan start for one group of feds in particular — newly hired disabled veterans. On a voice vote, the committee unanimously approved the Wounded Warriors Federal Leave Act. It would allow most new federal employees with at least a 30 percent disability rating related to military service 104 hours of paid sick leave. That’s 13 work days. Generally, employees initially have no sick leave and earn hours as they work. Additional legislation is planned for the 15 percent of employees not covered. (Davidson, 1/27)

Veterans' Health Care

VA Increasing Its Efforts To Provide Hospice Care

As millions of veterans who served in World War II and Korea reach old age, the Department of Veterans Affairs is seeking ways to help them live comfortably in their final months. Also, the government settles a lawsuit accusing the VA of misusing a West Los Angeles campus while veterans slept on the street.

NPR: VA Steps Up Programs As More Veterans Enter Hospice Care
Starting last year, more military veterans are passing away in hospice care than in all of VA trauma and ICU wards combined. That's because the millions of Americans who served in Korea and World War II are reaching their 80s and 90s; Vietnam veterans are reaching their 70s. That means the U.S. Department of Veterans Affairs is focusing on how to make veterans comfortable in their final weeks and months. (Lawrence, 1/28)

Los Angeles Times: U.S. Settles Suit Over Misuse Of West L.A. Veterans Campus
The federal government has agreed to settle a lawsuit accusing the Department of Veterans Affairs of misusing its sprawling West Los Angeles health campus while veterans with brain injuries and mental impairment slept in the streets, people familiar with the agreement said Tuesday. Under the settlement, the VA will develop a master land-use plan for the campus that identifies sites for housing homeless veterans. Further details were not available. (Holland, 1/27)


Coalition Of Health Care Systems, Insurers Vows To Change Payment Practices

The announcement promises to put more emphasis on improving quality and lowering costs. This comes as hospitals say they are seeing fewer admissions.

The New York Times: Industry Group to Back Results-Focused Care
A coalition of some of the nation’s largest health care systems and insurers vowed on Wednesday to change the way hospitals and doctors are paid — placing less emphasis on the sheer amount of care being delivered and more on improving quality and lowering costs. (Abelson, 1/28)

Modern Healthcare: Hospitals Say Fewer Admissions, More Outpatients In 2013
U.S. hospitals continued to see downward trends in hospital utilization in 2013, and many of them adopted new models of coordinated care that might accommodate the flow of patients to outpatient-care settings. The American Hospital Association's latest annual statistical compilation again shows fewer admissions and births and higher expenses but also more outpatient visits in 2013. (Robeznieks, 1/27)

Meanwhile, real estate experts say there is a boom in senior housing, medical-office buildings and other health-care-related properties.

The Wall Street Journal: Graying America, Health-Care Overhaul Boosts Medical Properties
Investors are pouring money into buying and developing senior housing, medical-office buildings and other health-care-related properties, a class of commercial real estate that has been outperforming almost all others since the recession. The country’s aging population and recovering economy, as well as major changes taking place in the economics of health care, are fueling demand for more space. (Grant and Whelan, 1/27)

State Watch

State Highlights: Texas Public Health Costs Rising; Missouri Medicaid Switches Hep C Drug

A selection of health policy stories from Texas, Missouri, North Carolina, California, Kansas, Florida and Vermont.

The Texas Tribune: The Texas Health Care Budget: Four Things To Know
Texas' Republican leadership has fought tooth and nail against federal health care reform, adamantly opposed to taking either money or direction from the Obama administration when it comes to providing health care for the poor. But putting politics aside, public health care costs in Texas are rising about $1.3 billion over the next two years, according to one legislative budget estimate. Medicaid enrollment is growing, whether or not the state decides to accept more federal funds to expand the program's coverage to poor adults. And fiscal conservatives are raising the possibility, for first time in recent memory, that state appropriators will this year allocate more money for health care than education. (Walters, 1/27)

The Associated Press: Missouri To Save $4.2M By Switching Hep C Drug
State officials say Missouri's Medicaid program will save an estimated $4.2 million in fiscal year 2016 by using a newer, cheaper drug to treat hepatitis C. The state joined a group of 25 other states to receive rebates on Viekira from drug maker AbbVie. The state in most cases will provide that drug instead of Gilead Science's Sovaldi in an agreement announced Monday. (1/27)

The Charlotte Observer: Carolinas HealthCare And UnitedHealthcare Contract Nears End
In the midst of negotiations over a new contract, UnitedHealthcare has notified its brokers that Carolinas HealthCare System “wants to be paid up to 150 percent more than other hospitals in the Charlotte area for providing the same services.” The multiyear contract between Charlotte-based Carolinas HealthCare and the insurance company will expire Feb. 28 if a deal isn’t reached. That would leave 12 Charlotte-area hospitals and many doctors offices in Carolinas HealthCare “out-of-network” for the nearly 80,000 Charlotte-area members covered by UnitedHealthcare. (Garloch, 1/27)

Charlotte Business Journal: UnitedHealthcare Contract With Carolinas HealthCare Set To Expire
UnitedHealthcare began notifying patients this week by mail that its contract with Carolinas HealthCare System is scheduled to expire Feb. 28. Unless a deal is reached, Carolinas HealthCare facilities — including its hospitals and physicians practices — will no longer be considered in-network for individuals covered by UnitedHealthcare. That could mean higher out-of-pocket costs for nearly 80,000 patients with insurance coverage through UnitedHealthcare's commercial plans or Medicare starting March 1. (Thomas, 1/27)

The Kansas Health Institute News Service: Legislators Skeptical Of AARP Caregiver Bill
Legislators expressed skepticism Tuesday about a bill that would require hospitals to provide discharge instructions to patients’ designated caregivers. Kansas AARP has made House Bill 2058 one of its priorities for the session, running ads for it on public television. But the group has not come to an agreement with the state hospital association on the bill, and members of the House Children and Seniors Committee questioned whether it’s necessary. (Marso, 1/27)

North Carolina Health News: Local Health Directors Eye Future Warily
At the annual meeting of North Carolina’s state health directors last week in Raleigh, small knots of people gathered in the halls and the backs of conference rooms, all discussing the same question: How will public health survive the coming changes in health care financing? One of the biggest concerns voiced by health directors both off and on the record centered around the future of North Carolina’s Medicaid program. Currently, legislators are discussing changing both how the program gets administered and how services get paid for. And for many local health departments, Medicaid payments – small as they are – are key to keeping budgets solvent. (Hoban, 1/27)

Health News Florida: GOP Lawmaker Files Medical Marijuana Bill In Florida
There's a new push to legalize medical marijuana in Florida, and a Republican lawmaker is leading the charge. Though a constitutional amendment to legalize medical marijuana failed in November, Republican lawmaker state Sen. Jeff Brandes has filed a bill to make medical marijuana legal for Florida residents. (Watts, 1/27)

Editorials And Opinions

Viewpoints: GOP Governors Falling Into Line On Medicaid; States Must Vaccinate More Kids

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

Bloomberg: Another 2016 Contender Takes Obamacare Money
Governor Mike Pence of Indiana has reached an agreement with the federal government to accept expanded Medicaid for the Affordable Care Act, even while radically changing the state's regular Medicaid system. ... It’s a huge deal because it's another sign that the U.S. Supreme Court has only delayed the Medicaid expansion required under the law rather than preventing it altogether. If even a conservative firebrand such as Pence can't hold out, it's increasingly clear that the federal incentives for state governments to sign on are just too strong to resist. (Jonathan Bernstein, 1/27)

Forbes: Mike Pence Won't Admit It -- But He's 10th Republican Governor To Approve Medicaid Expansion
It’s important to note that several of the states that have said yes — namely Arkansas, Iowa, Michigan, New Hampshire and now Indiana — got or are seeking waivers to modify the Medicaid expansion for their states. And with [Indiana Gov. Mike] Pence winning new concessions from the federal government, other Republican governors are expected to ask for similar provisions that may be more palatable to conservatives. (Dan Diamond, 1/27)

The New York Times: Continued Assaults On Health Reform
Having failed to repeal the Affordable Care Act outright, congressional Republicans are moving ahead with plans to dismantle it piece by piece. Earlier this month, the House passed a bill that would undermine the so-called employer mandate, which requires certain employers to provide insurance or pay a penalty. In all, 240 Republicans and 12 Democrats voted for the bill while 172 Democrats voted against it. In the Senate, two Democrats recently joined dozens of Republicans to sponsor a similar measure. Like other attempts to weaken health care reform, the bill, named the Save American Workers Act, is based on false premises and offers false promises. But its bipartisan patina makes it a threat, as do the catchy if misleading assertions of its supporters to win public support. (1/28)

Bloomberg: Medicare Reform Dodges The Bigger Question
Yesterday's announcement by the Department of Health and Human Services, setting firm targets for shifting Medicare away from fee-for-service payments, has for the most part generated positive reviews. That makes sense -- that payment structure provides incentives for excess care, and HHS is right to move past it. But that shouldn't mean the Medicare agency gets a pass on the details. There are a few reasons to wonder just how serious HHS is about these changes. (Christopher Flavelle, 1/27)

The Washington Post: The Debt: Mission Unaccomplished
In 2013, according to statistics compiled by Medicare actuaries, spending grew 0.5 percent less than the previous year, the result of lower costs in both private health insurance and Medicare. The CBO has concluded that “the slowdown in health care cost growth has been sufficiently broad and persistent” to reduce significantly its spending projections for federal health-care programs. Nonetheless, the future is not pretty. (Ruth Marcus, 1/27)

The Wall Street Journal: The Secret To Taming Health-Care Costs
Monday’s report from the Congressional Budget Office on the country’s long-term economic outlook underscores what budget experts have long known: The rising cost of health care is the single largest driver of the gloomy long-term fiscal outlook for the U.S. Yes, the pace of increase has moderated in recent years. But many of the factors reducing cost increases are likely to prove transient. ... There are grounds for hope, however. As often happens in the federal system, state experimentation may be blazing a trail for national policy. Oregon offers one of the most promising models. (William A. Galston, 1/27)

The Washington Post's The Fix: The CBO’s Deficit Projections Have Settled Into A Post-Obamacare New Normal
The new president (a gentleman named Barack Obama) shifted the CBO's projections by signing into law the Affordable Care Act. The CBO's new projections for the next 10 years of costs from Obamacare — the cost of subsidies and Medicaid expansion, less penalty payments and other income — are slightly lower than what it figured last year. ... By 2025, Obamacare will be losing the government $145 billion a year. That's only a measure of the economic costs of the program directly; it doesn't include economic and health benefits that the program will create. It also doesn't include the taxes outlined by our Post colleague Glenn Kessler which offset some of the costs above. (Philip Bump, 1/27)

Los Angeles Times: How To Immunize More Kids: California Needs To Ban Personal-Belief Exemption For Vaccinations
It's time to ensure that more Californians are vaccinated.The outbreak this winter has illustrated quickly and forcefully how a highly contagious disease can spread when the vaccination rate falls below the level needed for "herd immunity." Herd immunity means that so many people are immune that the chance of outbreak is low, which protects the few who are not immunized because they are too young to have been fully vaccinated or because they are among the few in whom the vaccine doesn't "take" or because they haven't been vaccinated for valid medical reasons. (1/27)

Los Angeles Times: Historian Elena Conis Takes A Look At Decades Of Vaccination Skepticism
Last year saw more U.S. measles cases than in any other year in nearly the last quarter century, and 2015 isn't looking a whole lot better, after someone at Disneyland infected people who infected other people in what has become a seven-state outbreak. Measles vaccines have been around for 50 years, but a vaccine is usually only as good as the percentage of the population that gets it. So how do some people in a country that rejoiced in vaccines for killers like polio wind up wary of them? Emory University historian Elena Conis goes sleuthing in her book, “Vaccine Nation: America's Changing Relationship with Immunization,” finding answers in science, politics and shifting cultural standards about how we vaccinate and what our doubts are. (Patt Morrison, 1/27)

USA Today: Let Parents Make Informed Choices: Opposing View
While vaccines are promoted as safe and effective, this is not true for everyone. Vaccine risks are different for each child because we are not all the same, and doctors cannot predict which child will be harmed. Inflexible vaccine mandates threaten the health of those children. The federally recommended childhood vaccine schedule has exploded to 69 doses of 16 vaccines with hundreds of new vaccines in development. A baby today receives more vaccines by six months old than her mother did by high school graduation. Yet, there is incomplete testing of the safety of the current child vaccine schedule. (Mary Jo Perry, 1/27)

USA Today: Jail 'Anti-Vax' Parents
The entirely preventable California measles outbreak has now sickened more than 70 people. With perhaps hundreds more exposed, the outbreak will likely continue. As the disease spreads, experts will debate how we respond and what to do about the anti-vaccine movement that's partly to blame for this mess. Likely, all we'll agree on is better outreach to parents. That's not enough. Parents who do not vaccinate their children should go to jail. (Alex Berezow, 1/27)