KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

Health On The Hill: No Senate 'Doc Fix' Vote Before Recess. Will Break Hurt Chances?

After a decade of short term fixes, the House passed legislation to replace Medicare’s troubled Sustainable Growth Rate, or SGR, and replace it with an alternative doctor payment formula. Kaiser Health News' Mary Agnes Carey and Politico Pro's Jennifer Haberkorn discuss what's next for the bill when the Senate returns from recess next month. (Mary Agnes Carey and Jennifer Haberkorn, Politico Pro, 3/27)

Political Cartoon: 'A Pox On You?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'A Pox On You?'" by Steve Sack, Minneapolis Star Tribune.

Here's today's health policy haiku:

WHO'S PRACTICING MEDICINE?

Proposed Texas law
tells docs "don't ask about guns."
Patients first?  Really?

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

The Doc-Fix Back Story: How Boehner And Pelosi Made A Deal

The Medicare physician payment formula has long been a difficult issue on Capitol Hill. Action last week moved it close to resolution, but the Senate still has to act.

The Hill: How Boehner, Pelosi Surprised Everyone With A $200 Billion Deal
A few days after the chaos of a failed vote to fund the Department of Homeland Security, Speaker John Boehner asked for a meeting, alone, with House Democratic Leader Nancy Pelosi. Compromise was on his mind. With automatic cuts to doctors under Medicare set to take effect at the end of March, Boehner (R-Ohio) wanted to explore the possibility of a deal that would end the Sustainable Growth Rate (SGR), and with it a problem that has dogged Congress for nearly two decades. The March 4 meeting in Pelosi’s (D-Calif.) office on the second floor of the Capitol was brief, lasting only 11 minutes. But on the central question that has for years thwarted deal making between the parties — whether to raise taxes — Boehner got the answer he was looking for. Democrats would not insist on tax hikes in legislation ending the Medicare formula, Pelosi told Boehner. “That was, from our point of view, the breakthrough,” said Michael Steel, a Boehner spokesman. (Sullivan, 3/28)

Politico Pro: Long Road Of Frustration, Compromise Led To ‘Doc Fix’ Deal
The penultimate “doc fix” was what finally pushed John Boehner to say enough. It was last March, with big Medicare cuts to doctors again just a few days away and both Republican and Democratic opposition growing to the latest short-term remedy. House leaders stealthily put a bill up for a voice vote when no one was looking, a tactical move later decried by the rank and file. Shortly after that, the speaker decided that he was done with the increasingly messy and expensive Medicare payment fixes. (Haberkorn, 3/27)

Modern Healthcare: Hopes Run High For Passing Doc Fix When Senate Returns In April
The fix isn't in yet, but it's close. The Senate adjourned for its spring break Friday without taking action on legislation permanently repealing and replacing Medicare's sustainable growth-rate physician-payment formula. That failure to act was greeted with widespread disappointment from healthcare groups, which had hoped that the decade long headache of short-term fixes would finally end. (Demko, 3/28)

The New York Times: Boehner Reflects On Bipartisan Support For Medicare Bill
Lately, in the House of Representatives, all it takes to claim a major success is a bill passed with support from both Republicans and Democrats. On Thursday, when the House passed a bill amending various provisions of Medicare, it was hailed as one of the most significant bipartisan achievements in years. In an interview that aired Sunday, Speaker John A, Boehner, Republican of Ohio, reflected on the bill’s passage, and called it “an opportunity that presented itself.” (Siddons, 3/29)

News outlets also report on another set of challenges for congressional Republicans -- the budget proposals pending in the House and Senate -

The Associated Press: After A Few Stumbles, GOP Lawmakers Regain Footing On Budget
Republicans are looking like they’ve finally figured out how to govern. The GOP’s first months in control of both chambers of Congress were marked by high-profile stumbles and a near-shutdown of the Homeland Security Department. But this week, the party celebrated important successes. Republicans in both the House and the Senate came together to pass boldly conservative and balanced budgets, and House leaders struck a bipartisan deal on Medicare that passed on a huge vote and is expected to clear the Senate once lawmakers return from a two-week spring break. (Werner, 3/28)

The Associated Press: GOP-Guided Budget Sets Up Battles Between Congress And Obama
The Senate budget would cut $4.3 trillion from benefit programs over the next 10 years, including annulling Obama's health care law, a step the president would without doubt veto. Those savings would include $431 billion from Medicare, matching Obama's figure. The House budget would pare $148 billion from the health care program for the elderly and convert it into a voucher-like program for future beneficiaries, a step the Senate shunned. (Fram, 3/27)

Health Law Issues And Implementation

Feds Step Up Efforts To Raise Awareness About Health Law Tax Breaks

The Treasury Department on Friday released fact sheets about the most common exemptions to the health law's tax penalty. Meanwhile, the Associated Press reports on how the Affordable Care Act is leading some colleges to get out of the health insurance business.

The Hill: Feds Push To Inform Public About ObamaCare Tax Breaks
The federal government is taking extra steps to help the millions of people who qualify for ObamaCare tax breaks this year but may not know it. The Treasury Department released fact sheets Friday about five of the most common types of exemptions related to a person’s income level, job status, Medicaid eligibility and other scenarios. (Ferris, 3/27)

The Associated Press: Colleges Getting Out Of Health Insurance Business
The federal health care overhaul is leading some colleges and universities to get out of the health insurance business. Experts are divided on whether this change will be good or bad for students. Some call it an inevitable result of health care reform and a money-saver for students since insurance in the marketplace is usually cheaper than the college plans. Others worry that more students will go without health insurance since their premiums won’t be folded into the lump sum they pay for school, and they say college health plans offer more coverage for the money than other options. (Blankinship, 3/28)

Some news outlets also report on how the congressional repeal debate continues and how some consumers worry about what the high court will decide on state-run exchange subsidies -

NBC News: With 16 Million In Obamacare, Is The Repeal Debate Over?
With the Obama administration announcing this month that some 16 million people have obtained health insurance since the passage of the Affordable Care Act, the Republicans' intense focus on completely repealing the law is increasingly looking unrealistic. (Bacon Jr., 3/27)

The Philadelphia Inquirer: Now Insured, But Worried Over Pending Supreme Court Obamacare Ruling
Until she noticed the tiny blood spots on her sheets, Peg Fagan thought the itchy, raised area on her shoulder was a spider bite. So when her doctor asked during a routine checkup in April whether Fagan had any health concerns, she mentioned the bite. Fagan had melanoma, the most serious kind of skin cancer. The diagnosis was emotionally crushing. But if she had received it a month earlier, before the Independence Blue Cross silver tier Proactive plan she bought through healthcare.gov kicked in, it also would have been financially devastating. (Calandra, 3/29)

Maryland Misallocated $28M In Health Exchange Funds, Audit Says

An audit from the Department of Health and Human Services inspector general recommends that the state repay the money, which was miscalculated due to troubled enrollment projections.

The Associated Press: Audit: Maryland Misallocated $28.4M For Health Exchange
Maryland misallocated $28.4 million in federal money for its flawed health care exchange and should pay the money back, according to a federal audit released Friday. The audit marked the first time the inspector general of the Department of Health and Human Services recommended that a state repay misallocated federal grant funds involving a health care exchange. (Witte, 3/28)

The Washington Post: Md. Might Owe Federal Government Millions For Health-Care Exchange, Audit Finds
A federal audit of Maryland’s once-troubled health-insurance exchange found that the state waited too long to formally update its enrollment projections and numbers with federal grant providers, resulting in the misallocation of $28.4 million. The inspector general for the U.S. Department of Health and Human Services recommended Friday that Maryland repay that money and properly apply for reimbursement, which could be 50 to 90 percent of the original amount. (Johnson, 3/28)

Under Expansion Plan, Mich. Enrollment Soared, But Will The Program Continue?

Under Michigan law, the state must obtain a second waiver from the Obama administration by the end of the year or its Medicaid expansion will end next April. In other Medicaid news, the Montana Senate advances a bill that would expand the program and New Mexico lawmakers approved a bill that would help thousands of inmates enroll before they are released.

The Associated Press: Medicaid Expansion Enrollment Soars, Waiver Hurdle Remains
More than 600,000 low-income adults have signed up for Medicaid a year after Michigan expanded the insurance program under the federal health care law. Now Gov. Rick Snyder's administration is working to ensure the Healthy Michigan program continues. Michigan law requires the state to get a second waiver from the Obama administration by year's end or the Medicaid expansion will end next April. Under the waiver, adults who have been enrolled for four years would have to buy private insurance through a health exchange or pay more toward their care. (3/28)

Albuquerque Journal: Inmates Could Enroll In Medicaid Under Bill
[New Mexico] lawmakers approved a bill in the final days of the session that, if signed by Gov. Susana Martinez, would help thousands of inmates enroll in Medicaid and make them eligible for services upon release, officials said. The measure would allow inmates to apply for Medicaid coverage during their incarceration and directs the state Human Services Department to create a process to help inmates enroll. The agency currently does not accept Medicaid applications from inmates. (Uyttebrouck, 3/30)

Marketplace

A Push To Demystify Health Care Pricing

Marketplace details efforts to bring more pricing transparency to the health care industry. In addition, the Milwaukee Journal-Sentinel reports on a new website in Wisconsin that rates clinics on both cost and quality, while The New York Times reports on a New York pay-for-performance initiative.

Marketplace: A Push For Transparency In Healthcare Pricing
Usually when we shop, finding the price is the easy part. Cars, airplane tickets, burgers and beer; it’s all right there. But when it comes to health care, an industry we spend $3 trillion ... a year on, prices often remain a mystery. Some people say that genuine cost transparency would make some of the waste and price variations vanish. It's not easy breaking open a black box that, intentionally or not, richly rewards doctors, hospitals and insurers. (Gorenstein, 3/27)

The Milwaukee Journal-Sentinel: New Wisconsin Website Rates Medical Clinics For Quality
Paying for "value" — that prized mix of quality and cost — is widely cited nowadays as essential in slowing the rise in health care costs. The catch is that measuring quality and cost is proving to be much more difficult than often acknowledged. The inescapable and significant challenges are made clear in a website the Wisconsin Health Information Organization launched this month to rate physician clinics. (Boulton, 3/28)

The New York Times: Pay For Performance Extends To Health Care In Experiment In New York
For a generation, doctors in New York’s economically depressed neighborhoods have been the ugly ducklings of the medical hierarchy. Many are foreign born and foreign trained, serve mostly minority and immigrant patients, and often run high-volume practices to compensate for Medicaid’s low rate of payment. Now these doctors are in the vanguard of an experiment to transform New York’s health care services for the poor from a disorganized hodgepodge into coordinated networks of doctors, hospitals and other practitioners. (Hartocollis, 3/30)

Breakthrough Hep C Drugs Spike Medicare Costs By $4.5 Billion

Consumers also face the high cost of prescription drugs. Many will turn to discount programs that claim big savings, but some pharmacists tell buyers to beware.

ProPublica/The Washington Post: New Hepatitis C Drugs Are Costing Medicare Billions
Medicare spent $4.5 billion last year on new, pricey medications that cure the liver disease hepatitis C — more than 15 times what it spent the year before on older treatments for the disease, previously undisclosed federal data shows. The extraordinary outlays for these breakthrough drugs, which can cost $1,000 a day or more, will be borne largely by federal taxpayers, who pay for most of Medicare’s prescription drug program. But the expenditures will also mean higher deductibles and maximum out-of-pocket costs for many of the program’s 39 million seniors and disabled enrollees, who pay a smaller share of its cost, experts and federal officials said. (Ornstein, 3/29)

The Detroit Free Press: Can Free Discount Cards Really Offer Prescription Savings?
Many consumers are looking for a quick-fix to the high-cost of prescription drugs. But can you really expect all that much from paper discount cards that pop up in the mail? "Save up to 75 percent on your prescriptions instantly," reads the back of the free card from American Prescription Discounts. Really? Well, make sure you understand the small print and recognize that we're not talking about 75 percent off your co-pay. (Tompor, 3/27)

Meanwhile, the Food and Drug Administration is taking a light touch in overseeing health care monitoring devices like the Apple Watch -

Bloomberg: FDA 'Taking A Very Light Touch' On Regulating The Apple Watch
With Apple Inc. and fellow Silicon Valley companies edging further into health care, the U.S. agency in charge of oversight says it will give the technology industry leeway to develop new products without aggressive regulation. Bakul Patel, who oversees the new wave of consumer-focused health products at the Food and Drug Administration, said most wearable gadgets such as the soon-to-be-released Apple Watch and health-focused applications for smartphones have a way to go before warranting close scrutiny from the agency. (Satariano, 3/30)

Insurers Lower AIDS Drug Costs After Discrimination Charges

Aetna, and its subsidiary Coventry Health Care, will lower the cost of HIV and AIDS drugs, which can cost as much as $1,500 a month now, under insurance plans sold on the exchanges. Patient advocate groups had argued the high prices violated the health law's prohibition against insurers denying coverage to sick people or charging them more.

The Chicago Tribune: Insurer Lowers Cost Of HIV Treatments After Discrimination Complaints
Coventry Health Care is lowering the cost of HIV and AIDS drugs after the insurer's prices — more than $1,000 per month on some plans sold in Illinois — drew complaints of discrimination from patient advocates. Advocates have said Coventry and other insurance companies set the costs high to deter HIV and AIDS patients from signing up for their plans, skirting a federal requirement that insurers offer coverage to anyone no matter how sick he or she is. (Venteicher, 3/27)

Miami Herald: Coventry Slashes Co-Pays On All Oral HIV Drugs
On Friday, Aetna, which owns Coventry Health Care of Florida, announced it would become the second company to offer reduced co-pays on all oral HIV/AIDS medications, following a civil rights complaint filed last year that accused the company and several others of discrimination. ... Co-pays — the portion of the charge that consumers pay — will now range from $5 to $100, Poole said. Before the recent price cuts by Coventry and other insurance plans, co-pays on some plans could be as high as $1,500. (Herrera, 3/27)

Modern Healthcare: Aetna Revises HIV Drug Policy For All Exchange Plans
Aetna has changed how HIV drugs are listed within health plans sold on the exchanges after consumer groups criticized the health insurer's policy as discriminatory. Many plans on the Affordable Care Act exchanges have been found to engage in “adverse tiering.” Although the ACA prohibits health insurers from denying care to someone with a pre-existing medical condition, some companies have crafted health-benefit designs that would deter sicker people from choosing the plans by imposing higher out-of-pocket costs. (Herman, 3/27)

Quality

Making Choices About How We Die

A movement to encourage end-of-life conversations among family and friends is gaining traction through The Conversation Project, a Boston-based nonprofit. Meanwhile, Kaiser Health News profiles two doctors who are part of a California lawsuit asking the court to protect physicians from liability if they prescribe lethal medications to patients who are terminally ill and mentally competent to decide their fate.

Kaiser Health News: Hoping To Live, These Doctors Want A Choice In How They Die
The right-to-die movement has gained renewed momentum in California and around the nation following the highly publicized death of an East Bay woman with brain cancer. Brittany Maynard, 29, moved to Oregon to take advantage of its “Death with Dignity” law and died in November after taking a fatal dose of barbiturates prescribed by her doctor. ... Kathryn Tucker, an attorney on several of the court cases, is also spearheading the California lawsuit. This time, she and her legal team decided to include among the plaintiffs two doctors with life-threatening illnesses, Swangard and a retired San Francisco obstetrician. Physicians "have a very deep and broad understanding about what the journey to death can be like," said Tucker, executive director of the Disability Rights Legal Center. "The curtain is pulled back. For lay people, death is much more mysterious." (Gorman, 3/30)

Public Health And Education

Obama Administration Issues Plan To Fight Superbugs

President Barack Obama wants Congress to double funding to confront the challenge of antibiotic-resistant bacteria, a public health problem that sickens 2 million and kills 23,000 a year in the U.S.

The New York Times: Obama Seeks To Double Funding To Fight Antibiotic Resistance
President Obama on Friday urged Congress to double the funding to confront the danger of antibiotic-resistant bacteria, calling it a major public health issue that, if left unchecked, would “cause tens of thousands of deaths, millions of illnesses.” The administration also issued a new plan for attacking the problem, part of a national strategy that Mr. Obama laid out in an executive order in September. (Tavernise and Shear, 3/27)

The Washington Post: White House Announces Plan To Fight Antibiotic-Resistant Bacteria
The White House announced an aggressive plan Friday to combat antibiotic-resistant bacteria, a mounting problem that causes an estimated 2 million illnesses and 23,000 deaths every year in the United States. The plan lists specific goals to fight the spread of antibiotic-resistant microbes over the next five years. It outlines steps to prevent and contain antibiotic-resistant infections through better surveillance of "superbugs," to maintain the effectiveness of current and new drugs, and to develop next-generation therapeutics. (Sun, 3/27)

Los Angeles Times: Obama To Drug-Resistant Superbugs: We Are Coming After You
Each year, more than 2 million Americans are sickened by these superbugs and about 23,000 die as a result, according to the Centers for Disease Control and Prevention. The World Health Organization has warned that drug-resistant bacteria are on the rise in every part of the globe. The recent outbreak of carbapenem-resistant Enterobacteriaceae, or CRE, tied to contaminated duodenoscopes at Ronald Reagan UCLA Medical Center is just one example of the problem. As many as half of people infected with CRE may die. (Kaplan, 3/27)

The Associated Press: White House Unveils Plan To Fight Antibiotic-Resistant Germs
Critics said the White House needs to go further, particularly in terms of the antibiotics used in animals processed for meat. The Food and Drug Administration has already successfully encouraged many drug companies to phase out the use of antibiotics used for animal growth promotion. But advocacy groups have called on the agency to limit other uses of animal antibiotics as well, such as for disease prevention when holding animals in crowded conditions. (Pickler, 3/27)

The Wall Street Journal: White House Issues Plan To Fight Drug-Resistant Bacteria
The plan, formally known as the National Action Plan for Combating Antibiotic-Resistant Bacteria, sets goals to reduce by 50% to 60% illnesses caused by some of the most lethal microbes known to man by 2020. It seeks enhanced laboratory capacity across the U.S. to detect the worst pathogens, and it calls on federal agencies to set new rules aimed at curbing dangerous microbes. (Burton and Tracy, 3/27)

The Wall Street Journal: White House Plan For Limiting Antibiotic Resistance Is Criticized
The goal is to control the spread of these so-called ‘superbugs’ by 2020 and the plan outlines five goals to accomplish over the next five years. These include slowing the spread of resistant bacteria; strengthening surveillance efforts; speed development of diagnostic tests; hasten R&D for generating new drugs, and improve coordination among government agencies. (Silverman, 3/27)

Reuters: Battling Nightmare Infections: US CDC's Plan To Beat Superbugs
With painstaking effort, a group of Chicago hospitals has managed to cut by half the number of infections caused by an especially deadly type of superbug. Now U.S. health officials want that kind of campaign to go national. The White House on Friday told the U.S. Centers for Disease Control and Prevention to slash rates of infections from antibiotic-resistant bacteria by 2020 as part of a plan to prevent patient deaths and curb overuse of antibiotics administered to humans and animals. (Steenhuysen and Begley, 3/30)

Bloomberg: White House Plan To Fight Superbugs Promotes Drug Research
The Obama administration released a plan Friday to halt the spread of antibiotic-resistant bacteria in the wake of a deadly outbreak at a Los Angeles hospital in February. The plan seeks to reduce the rates of “superbug” infections in the next five years by limiting overuse of antibiotics in medicine and agriculture, according to a White House fact sheet. The federal government will invest in new antibiotic research and require hospitals to increase infection controls. (Sink and Edney, 3/27)

State Watch

In Ariz., Hospitals See New Financial Challenges Despite Medicaid Expansion

Elsewhere, a bill in North Carolina could mean nonprofits lose much of their state tax refunds. News outlets also report on various hospital-related news developments in California.

The Arizona Daily Star: Arizona Hospitals See Operating Losses
Operating margins at Arizona hospitals are declining despite a recent financial boost they got when the state expanded its Medicaid program, new data show. While uncompensated care in Arizona hospitals has dropped by one-third since the Medicaid expansion, other expenses are up, officials say. (Innes, 3/29)

The Winston-Salem Journal: Senate Bill Would Gut Annual Hospital Refund Costs
Large nonprofits, particularly health-care systems, are facing again a potential gutting of the state tax refund they receive on purchases. North Carolina Senate Bill 700 would reduce sharply the sales tax refund amount that a nonprofit or not-for-profit could receive in a fiscal year from $31.7 million to $70,370. (Craver, 3/29)

Los Angeles Times: South L.A.'s MLK Hospital Will Reopen With A New Healthcare Outlook
The new Martin Luther King, Jr. Community Hospital doesn't open until June, but that's hard to tell with all the people darting in and out of buildings at the South Los Angeles medical facility. ... "This place has a heartbeat," says Dr. Mark Ghaly, deputy director for community health and integrated programs for the Los Angeles County Department of Health Services. "The heartbeat is not the hospital." The focus of medical care, Ghaly argues, has shifted away from hospitals. And with its emphasis on preventive treatments, with its new urgent-care center and outpatient and public health clinics, the new MLK campus, he says, provides a state-of-the-art answer to the question: How do you build a hospital in 2015? (Karlamangla, 3/28)

Indiana HIV Outbreak Forces Needle Exchange Debate

Increased intravenous drug use is spreading HIV and hepatits C, prompting officials to reconsider syringe exchanges in states like Indiana where they are illegal.

NPR: Indiana's HIV Spike Prompts New Calls For Needle Exchanges Statewide
Scott County is one of the poorest and least healthy counties in Indiana. For years, it has struggled with injection drug abuse. Now the drug use in the area has spawned an epidemic of a different kind: HIV. ... The crisis led Indiana's governor, Mike Pence, to declare a public health emergency Thursday. It also reignited a debate in the state over the use of needle exchange programs to prevent HIV's spread among users of injected drugs. Such programs have been found to work elsewhere, but the strategy is illegal in Indiana — and in 22 other states. (Harper, 3/28)

The Wall Street Journal: Needle Exchanges Gain Currency
Evidence that HIV and hepatitis C are spreading among intravenous drug users is prompting more state and local officials to consider setting up needle exchanges—including some who had been resistant to such programs. The problem comes in tandem with rising intravenous use of heroin and prescription painkillers nationwide. (Campo-Flores and Whalen, 3/29)

State Highlights: More States Advance 'Right-To-Try' Laws; N.Y.'s Out-Of-Network Protections Start

A selection of health policy stories from Indiana, California, South Carolina, New York, Connecticut, Missouri and Washington.

Wall Street Journal's Pharmalot: More States Pass ‘Right To Try’ Laws, But Will These Make A Difference?
A divisive measure called “right to try” is getting a tryout in Indiana. ... Earlier in the week, [Indiana Gov. Mike Pence] signed a bill allowing people who are battling life-threatening conditions to gain access to experimental medicines. Known as a “right to try” law, the idea is to leapfrog a drug-development process that takes years before new treatments become available. The move reflects rising frustration with an FDA program called expanded access, in which people who are seriously ill can obtain a drug under development, even though they aren’t enrolled in a clinical trial. (Silverman, 3/27)

The Associated Press: NY Starts Out-Of-Network Health Coverage Protections
New protections against big surprise medical bills are starting in New York. They require insurance payments for out-of-network medical treatment in emergencies, when similar services or specialists are unavailable within the insurer's network or when care is provided without the patient's knowledge. (3/30)

Modern Healthcare: Network Squeeze: Controversies Continue Over Narrow Health Plans
Narrow-network plans have gained members because of their lower premiums, but experts say there is significant dissatisfaction with access, surprise bills and provider directory information. But there is significant consumer and provider dissatisfaction with how many of these plans are organized, including concern about inadequate access and information. Critics say insurers have made many missteps in building adequate networks and maintaining accurate, up-to-date provider directories. In some rural areas, there are too few in-network providers, forcing plan members to travel long distances to see one. Some patients find out that a hospital or doctor was out-of-network only after they receive a shockingly high bill. So far, federal and state regulations on narrow networks are vague and inconsistent, experts say. (Herman, 3/28)

Los Angeles Times: Blue Shield Of California Is Under New Pressure To Lower Rates
With billions of dollars in reserve, nonprofit insurer Blue Shield of California is facing new pressure to offer better prices for its policies. Despite its nonprofit status, the health insurance giant is usually on par or priced slightly above its for-profit rivals, according to a review of rates and interviews with insurance agents and industry officials. ... The San Francisco insurer's premiums are drawing renewed scrutiny since the California Franchise Tax Board stripped Blue Shield of its longtime exemption for state income taxes after an audit. (Terhune, 3/27)

The Island Packet: Beaufort County Retirees Can't Pay To Keep Health Insurance Plans
While some current and former Beaufort County employees may want to shell out more money to stay on their health insurance plans, they won't be allowed to, county officials said Thursday. The county had already researched that and other options before Beaufort County Council voted Monday to eliminate health coverage to 95 retirees and 590 current workers eligible to receive it upon their retirement, deputy county administrator Josh Gruber said. (Lurye, 3/27)

The New York Times: New York State’s Medical Marijuana Rules Shaping Up As Unusually Restrictive
When New York State’s lawmakers were mulling legalizing the medical use of marijuana last summer, some proponents feared that the proposed law was so restrictive that it would prevent many patients from receiving the drug. Now, with the state’s Health Department close to issuing final regulations about the new program, the law’s supporters say their fears may soon be realized. (McKinley and Saint Louis, 3/29)

NPR: New York City To Teens: TXT ME With Mental Health Worries
The majority of teenagers with mental health issues don't get help. But maybe if help were just a text message away — they wouldn't be so hesitant to reach out. That's the thinking behind NYC Teen Text, a pilot program at 10 New York public high schools that allows teens to get help with mental health issues by text. (Singh, 3/27)

St. Louis Public Radio: American Lung Association Wants To Help St. Louis Clinics Improve Asthma Outcomes For Children
St. Louis area pediatricians will soon have help managing asthma care for their patients. The American Lung Association is implementing a program here to improve the system that primary care clinics use to identify and treat the disease. The Enhancing Asthma Care for Children program has measurably reduced asthma symptoms for patients in other cities where it has been introduced, said Jill Heins, director of respiratory health for the American Lung Association of the Upper Midwest. (Phillips, 3/29)

The Milwaukee Journal-Sentinel: Police, Mental Health Teams Remain Limited In Milwaukee County
Mental health advocates say police and Milwaukee County officials still have a long way to go to catch up with the best practices from other cities. While the city is moving to train every officer in crisis intervention skills, that won't be completed until the end of 2017. In the meantime, advocates say police and county mental health administrators have not been aggressive enough in working together — despite early success in pairing police officers with mental health professionals. (Kissinger, 3/28)

The St. Louis Post-Dispatch: Insurer's Policy Change Could Leave Patients On The Hook For Bills
Some St. Louis area residents face the prospect of getting stuck with hefty medical bills because of a recent change by the nation’s largest health insurer. Minnetonka, Minn.-based UnitedHealthcare, which covers approximately one-fourth of Missourians, has changed the way it handles something known as “balance billing” — the difference between the provider’s charge and the amount allowed by the insurer. (Shapiro, 3/29)

Modern Healthcare: Premera Faces Class-action Suit Over Massive Data Breach
Premera Blue Cross failed to adequately protect its customers' personal information and notify them of a recent data breach in a timely manner, according to the latest class-action lawsuit filed Thursday against the insurer in federal court in Seattle. The suit is one of at least five class-action suits filed over the breach, said James Bilsborrow, an attorney representing the plaintiffs with law firm Weitz & Luxenberg. Premera announced earlier this month that a May 2014 cyberattack breached a system that contained records for 11 million of its customers. (Schencker, 3/27)

Editorials And Opinions

Viewpoints: Health Law 'Checkup'; Reid's Legacy; GOP's 'Useful' Budget; Attempting To Fool Cancer

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

The Washington Post: A Checkup For Obamacare
Five years after the Affordable Care Act became law, the reality of reform remains hotly contested. ... Here’s my take, after talking to numerous health-care experts and examining the data: Notwithstanding its bumpy rollout, the law has accomplished its goal of expanding coverage — at a significantly lower cost than expected. (Ruth Marcus, 3/28)

The Wall Street Journal: The Achievement That Puts Harry Reid In The History Books
Sen. Harry Reid is the first to admit that he’s not the most eloquent speaker. In fact, he has a habit of speaking his mind, which can be deadly for a lesser politician. But Sen. Reid, who announced Friday that he would not seek re-election to the Senate seat he first won since 1986, did something that no other Senate majority leader could claim: He got comprehensive health-care legislation through the killing field that is the U.S. Senate to the president’s desk for his signature. (Jim Manley, 3/27)

The New York Times: Imaginary Health Care Horrors
There’s a lot of fuzzy math in American politics, but Representative Pete Sessions of Texas, the chairman of the House Rules Committee, recently set a new standard when he declared the cost of Obamacare “unconscionable.” If you do “simple multiplication,” he insisted, you find that the coverage expansion is costing $5 million per recipient. But his calculation was a bit off — namely, by a factor of more than a thousand. The actual cost per newly insured American is about $4,000. (Paul Krugman, 3/30)

Los Angeles Times: Ted Cruz's Ride On The Obamacare Train Wreck
When Sen. Ted Cruz, the conservative firebrand from Texas, launched his presidential campaign last week at the Rev. Jerry Falwell's Liberty University, he earned grudgingly glowing reviews from otherwise skeptical pundits. The very next day he drove straight into a pothole on his already-narrow road to the Republican nomination: Obamacare. ... When it comes to denouncing the evils of the president's health insurance plan, Cruz takes second place to no one. Obamacare is “unconstitutional,” he says. It's “a train wreck.” ... So, last week, when Cruz said he intended to sign his family up for health insurance coverage through Obamacare, the media had a field day. (Doyle McManus, 3/28)

The Wall Street Journal: Congress Does Something Useful
Lightning struck twice on Capitol Hill this week, as House Republicans united long enough to advance incremental conservative reforms. Maybe there’s hope for this GOP majority. Most important, Republicans in the House and Senate passed budget outlines that when reconciled will let them avoid a Senate Democratic filibuster on some reforms later in the year. ... Passing a budget means the GOP is more likely to be able to put a repeal of ObamaCare on Mr. Obama’s desk, framing the issue for 2016. ... The other House victory was a 392-37 vote to put doctor payments under Medicare on a more honest budget path. (3/27)

Los Angeles Times: The GOP's Budget Gimmickry Won't Fix The Deficit
[T]he aging population and rising healthcare costs threaten to cause the deficit to grow again in a few years unless Congress makes fundamental changes to the largest federal health programs, Medicaid and Medicare. The Senate and House resolutions call for spending up to $3.8 trillion in the fiscal year that starts Oct. 1. ... Some of the biggest cuts in that spending come with no plan to achieve them, such as the $1 trillion in savings the House proposal envisions in unspecified entitlements. But the resolutions do call for major changes to Medicaid and, in the House's version, Medicare too, albeit years in the future. Sadly, the changes seek to save money in those programs mainly by shifting risk from the federal government to the states and to beneficiaries, rather than by attacking the core problem of rising healthcare costs and entrenched poverty. (3/27)

The Washington Post: Partners In Budget Posturing
First, we are an aging society. From 2010 to 2030, the 65-and-over population is projected to grow 85 percent, from 40 million to 74 million. Under current policies, spending on the elderly — mainly Social Security, Medicare and long-term care under Medicaid — inexorably rises as a share of national income and the budget. In 2014, these three programs already represented $1.7 trillion of the $3.5 trillion of annual federal spending. Second, paying for aging puts downward pressure on other spending — or upward pressure on deficits and taxes. The military (2014 spending: $596 billion) is being steadily shrunk. As a share of GDP, its spending is projected to drop 25 percent under current policies by 2025. Similar pressures also squeeze many domestic programs, from federal law enforcement to highways. (Robert J. Samuelson, 3/29)

The Wall Street Journal: New York Lessons For Chicago’s Fiscal Blues
I had the privilege of working with New York Gov. Hugh Carey in 1975 to avoid the bankruptcy of New York City, and I am currently assisting the Control Board overseeing the city of Detroit. Throughout these years, I have observed, researched and commented on the growing fiscal stress our cities and states have faced. In Chicago, Detroit and across the U.S., local and state governments have made promises in good faith to their 19 million employees to provide retirement benefits and, in many cases, health-care benefits as well. Many government officials didn’t realize that the cost of these promises would rise faster than the tax revenues that were being generated to cover their operations. (Richard Ravitch, 3/29)

The Kansas City Star: Kansas Ailing In Medicaid Study
Lawmakers in Kansas who have been blocking Medicaid expansion don’t realize it, but they’ve been participating in a medical study. Since 2013, researchers at Quest Diagnostics, the nation’s largest medical testing provider, have tracked patients newly identified with diabetes. Overall, they charted an increase of 1.6 percent in 2014 over 2013. But in states that had expanded Medicaid eligibility to the limits called for in the Affordable Care Act, a dramatic number emerged. New diagnoses of diabetes within the Medicaid population increased by 23 percent. (Barbara Shelly, 3/27)

Concord Monitor: Maintaining Medicaid Expansion Helps State’s Economy, Working Families
Among the more notable features of a state budget recommended by the House Finance Committee is a proposed and ill-advised decision to end New Hampshire’s unique version of Medicaid expansion, called the New Hampshire Health Protection Program. The NHHPP leverages available federal funds to offer private sector health coverage to lower-income, otherwise uninsured New Hampshire residents. ... More than 38,000 New Hampshire residents are already enrolled in the program. We know, and study after study confirms, that health insurance coverage has a beneficial impact on the lives, health, economic security, productivity and success of individuals and families. (Tom Bunnell, 3/29)

Fairbanks News-Miner: Medicaid Expansion, Reform Right For Alaska
Alaska’s hospitals face great risk if our state opts out and thousands of Alaskans may remain without basic coverage. As president of the Greater Fairbanks Community Hospital Foundation, I support the expansion of coverage in this legislative session because it is vital to Alaska hospitals’ collective mission of improving their communities’ health, as well as essential to ensuring the survival of safety net hospitals in our rural areas. Under the ACA, Alaska hospitals anticipated almost 42,000 Alaskans would gain health coverage through Medicaid or the Alaska KidCare program to offset planned federal assistance. These cuts have already begun. (Jeff Cook, 3/29)

The New York Times: Company Thinks It Has Answer For Lower Health Costs: Customer Service
Virginnia Schock seemed headed for a health crisis. She was 64 years old, had poorly controlled diabetes, a wound on her foot and a cast on her broken wrist. She didn’t drive, so getting to the people who could tend to her ailments was complicated and expensive. She had stopped taking her diabetes pills months before and was reluctant to use insulin .... And one day in October, in the offices of Iora Primary Care in Seattle, Dr. Carroll Haymon and Lisa Barrow, a “health coach,” huddled around a speakerphone, talking to her. Ms. Schock had recently become a patient of the practice, and the three discussed her problems — personal, financial, logistical — for nearly 45 minutes. ... That kind of small change can make a big difference in a patient’s health — what good is the perfect drug if the patient can’t swallow it? — but the extra-mile work it took to get there can be a challenge for the typical primary care practice in the United States. (Margot Sanger-Katz, 3/27)

The New York Times: Trying To Fool Cancer
When it airs on Monday, the Ken Burns-produced documentary “Cancer: The Emperor of All Maladies” will emphasize how much more we now know about the genetic basis for cancer. This year, according to President Obama, cancer research and funding will focus on so-called precision, personalized or targeted medicine — using cancer’s molecular underpinnings to develop drugs that attack the genes or gene products that make up cancer’s factory while sparing normal cells. What a beautiful concept. The problem is, cancer is rarely that simple, or that easily fooled. (Mikkael A. Sekeres, 3/28)

The New York Times: Cops With Hearing Aids?
Should police officers be allowed to wear hearing aids? In 2011, two New York City police officers, each with 20 years on the force, were forcibly retired for doing just that. The year before, the N.Y.P.D. had finalized a policy requiring recruits to pass the standard hearing test without hearing aids. Officers who requested hearing aids would also be given the test. If they couldn’t pass it without the aids, they were off the force. Before that, any existing policy (if there was one, which is unclear) was not enforced. When the issue is public safety, we understandably want the standards to be very high. But most people don’t understand hearing loss, and they don’t understand hearing aids. The N.Y.P.D. didn’t. (Katherine Bouton, 3/27)

The New York Times: Pregnant, Obese ... And In Danger
One recent night on my delivery shift, eight out of 10 of my laboring patients were too heavy, with two weighing over 300 pounds. Over two-thirds of adults and about one-third of children in America now are overweight or obese. An obese pregnant woman is more likely to have a very large baby, weighing roughly nine pounds or more. And babies of obese mothers are more likely to grow up to become overweight or obese themselves. Maternal obesity causes more immediate problems as well. (Claire A. Putnam, 3/28)

The Washington Post: A Visit That Makes A Difference
That memory [of a child being abused] from my early days in law enforcement would be bad enough if it had been a single occurrence. Unfortunately it has been replicated again and again. And it’s on my mind as I await details of a bill in Congress that could significantly reduce child abuse and neglect and crime in the coming years. Known as the Medicare “doc fix” bill, the legislation was overwhelmingly approved by the House and is expected to be taken up by the Senate when it returns in April. As written, it will extend funding for the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program. (J. Thomas Manger, 3/27)

Los Angeles Times: Supreme Court Ruling Puts State Regulatory Boards In Crosshairs
These are just two of countless ways that members of a business or occupation can close the doors to others by using their authority on a state regulatory board. This smacks of "restraint of trade," a fundamental no-no in antitrust law. Until a few weeks ago, such state regulatory boards thought they had an exemption from the law. The U.S. Supreme Court has now set them straight, ruling 6-3 on Feb. 25 that if a "controlling number" of a board's members are active participants in the business it regulates, they could be sued as antitrust violators. The case involved North Carolina's board of dental examiners, but its nationwide impact could be immense. ... Hanging in the balance is the state's ability to regulate not only barbers and pet groomers, but also doctors and surgeons, nurses, chiropractors, optometrists, accountants, architects, lawyers, pest exterminators and security alarm installers. (Michael Hiltzik, 3/27)