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Summaries of health policy coverage from major news organizations.

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Political Cartoon: 'Flea In The Ear?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Flea In The Ear?'" by Milt Priggee.

Here's today's health policy haiku:


Hospitals increase
Expensive renovations
Patients not impressed

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Health Law Issues And Implementation

High Court Arguments Set For Wednesday -- And The ACA's Fate Could Hang In The Balance

News outlets analyze key aspects of the health law provision being challenged and highlight how the arguments in the case, King v. Burwell, could shape up.

The Washington Post's Wonkblog: The Supreme Court Is Deciding A Case That Could Derail Obamacare. Here’s What You Need To Know.
The fate of the Affordable Care Act, the president's signature domestic policy achievement, is once again in the hands of the Supreme Court this coming Wednesday. The justices will hear oral arguments in King v. Burwell, a legal challenge to the financial assistance that millions of Americans are receiving to purchase health insurance. The case is considered the greatest threat to Obamacare's future since the court considered a challenge to the law's individual mandate three years ago. (MIllman, 2/26)

Kaiser Health News: 5 Things To Know About The Supreme Court Case Challenging The Health Law
The Affordable Care Act is once again before the Supreme Court. On March 4, the justices will hear oral arguments in King v. Burwell, a case challenging the validity of tax subsidies helping millions of Americans buy health insurance if they don’t get it through an employer or the government. If the court rules against the Obama administration, those subsidies could be cut off for everyone in the three dozen states using, the federal exchange website. A decision is expected by the end of June. (Rovner, 2/27)

Reuters: Supreme Court Protesters Say No Plans To Disrupt Obamacare Case
An activist group that has twice disrupted U.S. Supreme Court proceedings in the past year says it does not intend to stage similar protests when the justices hear a major case next week that could gut President Barack Obama's signature healthcare law. Kai Newkirk, a spokesman for the group 99Rise, said in an email that "we are not planning anything" in relation to the Obamacare case being argued next Wednesday or the court's other big case of the year on whether states can ban gay marriage, which will be heard in April. (2/26)

Study: Obamacare Premiums Could Triple If High Court Strikes Subsidies

The price of healthcare premiums on policies sold in the individual market could rise by an average 255 percent in the states that rely on the federal exchange if the Supreme Court decides in favor of the law's challengers in King v. Burwell.

The Hill: Study: Obamacare Premiums Could Triple If Court Tosses Subsidies
The cost of healthcare premiums could rise as much 779 percent if the Supreme Court erases ObamaCare subsidies in a majority of states this year, according to a new study. A victory for the plaintiffs in King v. Burwell would erase subsidies in 37 states using, causing premiums to spike an average of 255 percent, according to new research by the nonpartisan group Avalere Health. (Ferris, 2/26)

Utah Gov. Assails Legislature's Refusal To Take Up His Medicaid Expansion Plan

Gov. Gary Herbert, a Republican, says he will continue to press for his plan. Also in the news, efforts in Kansas to expand Medicaid and the controversy in Minnesota about the state marketplace.

The Associated Press: Gov. Herbert Criticizes House Decision On Medicaid Plan
Gov. Gary Herbert sternly criticized the Utah House on Thursday for circumventing what he considers the proper legislative process and deciding not to consider his plan for expanding Medicaid. While calm and composed, Herbert didn't hide his displeasure with the House decision. He vowed to continue negotiating during the final two weeks of session— but didn't rule out calling for a special session later or taking executive action. (McCombs, 2/26)

Kansas Health Institute News Service: Kansas House Leaders Reluctantly Agree To Medicaid Expansion Hearing
The odds that the Kansas Legislature will pass a Medicaid expansion bill this session remain long. But they improved Thursday, however slightly, when conservative Republican leaders agreed to allow a hearing on expansion to avoid an immediate vote on the House floor. Rep. Jim Ward, a Wichita Democrat, was attempting to amend his Medicaid expansion proposal into an unrelated bill. Uncertain as to how a vote might turn out, House leaders dropped their opposition to a hearing in exchange for Ward withdrawing his amendment. Rep. John Wilson, a Lawrence Democrat, said the tactical maneuver “disrupted the plan” that GOP leaders had to block any consideration of Medicaid expansion. (McLean, 2/26)

Minnesota Public Radio: Bill To Make MNsure A State Agency Sparks Criticism
A MNsure board member took state lawmakers to task on Thursday for a proposal that would turn the state's online insurance exchange into a state agency. ... State Sen. Tony Lourey, DFL-Kerrick, has introduced legislation to create a stage agency, placing it in the governor's administration, a plan Gov. Mark Dayton supports. In a report earlier this month, Minnesota Legislative Auditor Jim Nobles was highly critical of MNsure and its leadership for bungling the launch of the health care website. (Zdechlik, 2/26)

Capitol Hill Watch

Support Emerging Among GOP Lawmakers For Short-Term Tax Credits If High Court Strikes Down Health Law Subsidies

Meanwhile, a leading House Republicans says he's heard about a document detailing the Obama administration's contingency plans if the Supreme Court rules against federal exchange subsidies. Such plans were also the subject of GOP questions for Health and Human Services Secretary Sylvia Burwell during a House subcommittee hearing.

The Wall Street Journal: GOP Lawmakers Seek Short-Term Tax Credits Extension
Support is growing among Republican lawmakers to temporarily help consumers pay their insurance premiums if the Supreme Court strikes down the health law’s tax credits in much of the country. The court will hear a legal challenge next week that contends the health-law’s language restricts its credits to residents of a handful of states that set up their own insurance exchanges. (Radnofsky and Armour, 2/26)

The Hill: Republicans Confront Health Chief On Secret Obamacare Plan
A Republican House subcommittee chairman is accusing the Obama administration of secretly preparing a fallback strategy if the Supreme Court strikes down a major piece of its healthcare reform law later this year, even as officials publicly maintain that no plan exists. (Ferris, 2/26)

Kaiser Health News: Health On The Hill: HHS Sec. Burwell Faces Stiff Questioning Over Health Law Contingency Plans
Kaiser Health News staff writer Mary Agnes Carey speaks with Melissa Attias of CQ- Roll Call about Department of Health and Human Services Secretary Sylvia Burwell’s visit to Capitol Hill, where she faced a torrent of questions about the pending Supreme Court arguments concerning health law subsidies and the impact the ruling may have on the millions of people who now have coverage because of the subsidies. (2/26)

In related news, Louisiana Gov. Bobby Jindal steps up the push for repeal during this week's CPAC meeting in Washington while others offer congressional context -

Politico: Bobby Jindal Hits Hill Republicans On Obamacare, Common Core
[Louisiana Gov. Bobby] Jindal —who was once in with Republicans on the Hill enough to snag the role of delivering the State of the Union Republican response in 2009 — is now criticizing his party for going against campaign messages of repealing the Affordable Care Act and Common Core and, instead, “waving the white flag” on the issues. (Breitman, 2/26)

The Wall Street Journal's Washington Wire: Jindal To GOP: No Time To Quit Obamacare Fight
Louisiana Gov. Bobby Jindal, looking to carve a conservative policy niche in the crowded field of potential GOP presidential candidates, Thursday criticized fellow Republicans in Congress for backing away from the push to repeal of the health care law. “They are about to wave the white flag of surrender on Obamacare,” Mr. Jindal said at the annual Conservative Political Action Conference, referring to congressional efforts to revamp rather than repeal the law. “We won’t stand for that. (Hook, 2/26)

The Fiscal Times: CPAC Alert: Conservatives Predict SCOTUS Will Rule Against Obamacare
The Supreme Court will rule against the Obama administration in the King v. Burwell case later this year, gut the Affordable Care Act and open the door to a conservative alternative to President Obama’s domestic achievement: This appears to be taken as an article of faith by many of the speakers at this year’s Conservative Political Action Conference (CPAC), taking place today and tomorrow outside Washington. (Garver, 2/26)


UnitedHealthcare Tightens Controls On Coverage Of Hysterectomies

The nation's largest insurer will require doctors to get prior approval for a high-tech version of this surgical procedure, which is one of the most frequently performed in the U.S. The changes result from recommendations from key medical societies that followed a series of investigative stories by the Wall Street Journal.

The Wall Street Journal: Biggest U.S. Health Insurer Tightens Rules On Hysterectomy Coverage
The nation’s largest health insurer is imposing tighter controls on its coverage for hysterectomies after more than a year of debate over a medical device that was found to spread hidden cancer in some women undergoing the procedure. As of April, UnitedHealth Group Inc. will require doctors to obtain authorization from the insurer before performing most types of hysterectomies, according to a bulletin sent to physicians and hospitals. (Levitz, and Kamp, 2/26)

The Associated Press: UnitedHealth Tightens Rules Covering Hysterectomies
UnitedHealth Group Inc. says the changes are based on recommendations from the American Congress of Obstetricians and Gynecologists, which said vaginal hysterectomies are recommended over abdominal procedures and “keyhole” laparoscopic procedures. It quoted from recommendations ACOG issued in 2009 that said vaginal procedures are associated with better outcomes and fewer complications. (2/26)

Lawsuit Alleges HCA Hospitals Did Unnecessary Cardiac Procedures

The hospital company disclosed the lawsuit Thursday, which was filed in Florida in 2012 and singled out hospitals in that state for subjecting patients to high-risk procedures and submitting false medical claims. Meanwhile, Bloomberg reports that Gilead is avoiding billions in U.S. taxes on its costly new hepatitis C pill.

Wall Street Journal: HCA Discloses Suit Alleging Unnecessary Procedures, False Billing Claims
HCA Holdings Inc. on Thursday disclosed a lawsuit had been filed in Florida alleging the hospital operator subjected patients to medically unnecessary, invasive and high-risk cardiology procedures for years and then submitted false medical claims for federal reimbursement. The suit, made public Monday, was filed in February 2012 in U.S. District Court in Miami by Christopher Gentile, then professional liability claims director for a subsidiary of HCA in Tennessee, and singles out two HCA hospitals: Lawnwood Regional Medical Center & Heart Institute in Fort Pierce, Fla. and Regional Medical Center Bayonet Point in Hudson, Fla. (Armental, 2/26)

Bloomberg: Gilead Avoids Billions In U.S. Tax On Its $1,000-a-Pill Drug
Gilead Sciences Inc., whose $1,000-a-pill hepatitis C treatment is one of the world’s most expensive drugs, is avoiding billions of dollars in U.S. taxes by booking profits overseas. ... The data released in a securities filing Wednesday suggest that Gilead is shifting valuable intellectual property to low-tax countries and paying about 5 percent in taxes on its foreign income, said Robert Willens, an independent tax consultant based in New York. (Rubin, 2/26)

The Wall Street Journal: Catamaran To Buy Healthcare Solutions For $405 Million
Catamaran Corp. has agreed to buy Healthcare Solutions Inc. from Brazos Private Equity Partners LLC in a $405 million all-cash deal expected to boost the pharmacy-benefit manager’s presence in the workers’ compensation market. Meanwhile, Schaumburg, Ill.-based Catamaran posted stronger-than-expected revenue and earnings growth in its December quarter. Pharmacy-benefit managers, or PBMs, process prescriptions for the groups that pay for drugs, usually insurance companies or corporations, and use their size to negotiate with drug makers and pharmacies. They have put pressure on drugstores by negotiating for lower prices on behalf of their clients and via mail-order plans that compete for prescription business. (Dulaney, 2/26)

The Wall Street Journal: Generic Drug-Safety Rules Debated
Should generic drug makers update product labels on their medicines when they learn of safety risks? The question is being fiercely debated because federal law doesn’t allow generic drug makers to do so independently, unless a change has already been made to the corresponding brand-name medicine. The U.S. Supreme Court upheld this interpretation of the law in a controversial 2011 ruling and, as a result, consumers who claim they were injured by a generic drug cannot sue the manufacturer. (Silverman, 2/26)

Veterans' Health Care

Changes Proposed For Veterans' Health Care

The proposal, which came from a national veterans task force, would give veterans the choice to receive subsidized private care and convert the Veterans Health Administration into a nonprofit corporation, rather than a government agency.

USA Today: Veterans Propose Major Changes In VA Health Care
A national veterans task force is advocating radical changes in the medical system for America's former military personnel, including a choice to receive subsidized private care and conversion of the Veterans Health Administration into a non-profit corporation rather than a government agency. The reform measures, if enacted into law, would affect America's roughly 22 million veterans dramatically, especially the 8.5 million enrolled for care through the Department of Veterans Affairs. Repercussions would be even more profound for future veterans. (Wagner, 2/26)

Arizona Republic: Radical Changes In VA Health Care Proposed
A national veterans task force is advocating radical changes in the medical system for America's former military personnel, including a choice to receive subsidized private care and conversion of the Veterans Health Administration into a non-profit corporation rather than a government agency. (Wagner, 2/26)

CNN: Vets Not Impressed With VA Reforms
A group of lawmakers and policy activists called for an overhaul of the way the Department of Veterans Affairs delivers healthcare Thursday, arguing the VA should let veterans decide whether to get health care from the private sector. (Devine, 2/26)

State Watch

State Highlights: W.Va. Lawmakers OK 20-Week Abortion Ban; Federal Immigration Changes Don't Fix State Health Issues

A selection of health policy stories from West Virginia, Virginia, Missouri, California, North Carolina and Minnesota.

Los Angeles Times: West Virginia Lawmakers Pass 20-Week Abortion Ban
West Virginia's state Senate has approved an abortion ban at 20 weeks' pregnancy, as the state House of Delegates did earlier, and by hefty margins likely to withstand a possible veto. Gov. Earl Ray Tomblin, a Democrat, vetoed a similar measure last year, when his fellow Democrats controlled the state Senate and the House of Delegates. Lawmakers had adjourned and could not try to override it. (Pearce, 2/26)

Stateline: Immigration Changes Wouldn't Solve Health Issues
President Barack Obama’s controversial executive action on immigration has highlighted a thorny health care issue for states: Potentially millions of immigrants could legally stay here and work, but still lack health insurance. Unauthorized immigrants have limited access to health care coverage, and the president’s action likely will make them ineligible for most Medicaid services and bar them from purchasing insurance on the federal and state exchanges created under the Affordable Care Act. (Henderson, 2/26)

The Washington Post: With Time To Spare, Va. Lawmakers Finish Work On Proposed Budget
The proposed budget rejects McAuliffe’s call for Medicaid expansion, increasing certain business taxes by $11.7 million and closing tax loopholes for the coal industry. But it provides the millions the Democrat had sought to spur economic development and expand mental-health services and school breakfast programs. It includes raises for teachers and state employees and restores half of the $60 million in aid to localities cut during a special session late last year when revenue projections looked particularly bleak. (Vozzella, 2/26)

Los Angeles Times: Q&A: What's Next For Prime Healthcare, Daughters Of Charity Hospitals
Six struggling Catholics hospital in California are up for sale, and their future is in the hands of a fast-growing hospital chain based in the Inland Empire. Prime Healthcare Services Inc., a for-profit company with headquarters in Ontario, has offered to buy the financially struggling Daughters of Charity Health System for about $843 million. On Feb. 20, California Atty. Gen. Kamala D. Harris approved the sale -- with several key conditions. She said Prime Healthcare must keep all of the hospitals open for 10 years, while offering the same services and providing the same amount of charity care for indigent patients as Daughters of Charity has been offering. (Pfeifer, 2/26)

Charlotte Observer: Carolinas HealthCare To Extend Benefits If Contract Talks Fail
As the end of its contract with UnitedHealthcare approaches, Carolinas HealthCare System said Thursday that “an agreement may not be reached by the deadline” Saturday. If that happens, hospital officials say they’ll continue to provide care for UnitedHealthcare patients – at least for the next two or three months – as if they were not out-of-network. (Garloch, 2/26)

North Carolina Health News: The Health And Human Services Budgets Compared
Every year, we at N.C. Health News spend hours slogging through the text and the numbers to make the year’s budget more discernible to the lay reader. This spreadsheet details how parts of the Department of Health and Human Services budget changed between passage of the Senate budget at the end of May and the House budget on June 13 and the final bill passed on Aug 2. (Hoban, Singh and Namkoong, 2/26)

Editorials And Opinions

King v Burwell Views: GOP Unity Needed; Watching Roberts Again; Insurers' Risk

Many outlets offer opinions on the upcoming Supreme Court arguments over a key provision in the health law.

The Wall Street Journal: A GOP Exit Ramp From ObamaCare
Pure, unadulterated political gifts don’t come often to Washington, and even when they do their recipients are often too busy inspecting the horse’s mouth to make use of them. The miracle gift this season is King v. Burwell, and next week will show whether Republicans have the wit to unify around an effective strategy to dismantle ObamaCare. (Kimberley A. Strassel, 2/26)

The Washington Post: If You Want To Know Who Gets Health-Care Handouts, Look In The Mirror
Next week, the Supreme Court will hear a case that threatens to ax the subsidies millions of Americans receive for health insurance purchased on Obamacare’s federally run exchanges. And a sizable chunk of the population seems to be cheering for exactly that result. First, though, perhaps we should all look in the mirror and consider how much in health subsidies we’re milking from the government ourselves. (Catherine Rampell, 2/26)

The Washington Post: Five Myths About King V. Burwell
Once again, the future of the Affordable Care Act is in the Supreme Court’s hands. In King v. Burwell , which will be argued before the court Wednesday, opponents of Obamacare are claiming that under the law, subsidies for health insurance should be available only to people buying coverage on exchanges “established by the state,” i.e. state-run marketplaces. But 34 states don’t have their own exchanges, so their residents rely on the federally run marketplace. If the court rules in favor of King, the tax credits would end in those states. Let’s separate fact from fiction about this legal battle stemming from a mere four words. (Elizabeth B. Wydram 2/26)

Bloomberg: Is Washington Ready For The Death Of Obamacare?
If the plaintiffs prevail, millions of people in 34 states who bought insurance on federal exchanges would suddenly lose the subsidies that make it affordable. ... Entire segments of the health system redesigned their business models to take advantage of the ACA’s incentives. ... If subsidies vanish, [Stuart Butler says,] “suddenly the market is misaligned. If you’ve hired all these new doctors and health-care workers to cover all these new people walking in the door, and they don’t come, what do you do? You lay them off.” (Joshua Green, 2/26)

The Washington Post's Plum Line: Morning Plum: A Court Decision Gutting ACA Could Be A Lot Worse Than You Think
The potential impact of a Supreme Court decision gutting Obamacare subsidies in three dozen states is often discussed in terms of the millions who could lose health coverage, potentially destabilizing insurance markets across the country. But it turns out that the impact could be considerably more dramatic than that, radiating out to produce untold economic damage, too. (Greg Sargent, 2/26)

Los Angeles Times: Supreme Court Chief Justice Likely To Back Healthcare Law
When the Supreme Court hears oral arguments in King vs. Burwell next week, all eyes will be on Chief Justice John G. Roberts Jr., to try to figure out which way he's leaning. After all, this case is the latest challenge to the Affordable Care Act, and the last time the law was before the high court, Roberts was the deciding vote in favor of the government. There's one very good reason to think the chief justice will rule for the government again: He's too good a lawyer to do otherwise. (Brianne J. Gorod, 2/26)

Bloomberg: Insurers Left To Weigh Obamacare Risks
The problem for insurers is that they have already set their rates for 2015 -- and by the time the Supreme Court issues its ruling, many will also have submitted rates for 2016. If their insurance mix suddenly changes for the worse, they stand to lose a lot of money. So the American Academy of Actuaries has sent a letter to the administration, asking that insurance companies be allowed to resubmit more appropriate rates in the event of an adverse ruling. Obviously actuaries, who tend to work for insurers, are not exactly neutral parties on this question. Nonetheless, they're right: Insurers should be allowed to submit new rates if the government loses in King. (Megan McArdle, 2/26)

The Wall Street Journal: A Litmus Test For ObamaCare And The Rule Of Law
This spring will mark the 800th anniversary of the signing of the Magna Carta, the landmark agreement by King John of England at Runnymede ceding certain rights to rebel barons. Liberty will have another chance to shine on Wednesday when the Supreme Court hears a case with momentous implications about another sort of executive power. In this instance, though, it is the rebels who have the royal name: King v. Burwell raises questions about how President Obama has enforced the ObamaCare law—or, more precisely, modified, delayed and suspended it. (Ilya Shapiro and Josh Blackman, 2/26)

Politico: King v. Burwell Isn’t About Obamacare
The challengers maintain that the case is simply about reading plain language. (I have detailed elsewhere why their hyper-literal reading of four words out of context is anything but plain and is not how the Supreme Court usually reads statutes.) But King is about a lot more than this. The case is about federalism—the role of states in our national democracy. The reason the challengers don’t want anyone to realize that is because the very text-oriented justices to whom they are appealing are the exact same justices who have consistently interpreted federal laws to protect states’ rights. And the challengers would read the ACA in the opposite way—as having devastating implications for the states. (Abbe R. Gluck, 2/27)

Viewpoints: 'Blueprint' For A New VA Health Care System; The 'Food Cops'

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

The Washington Post: A Bold Blueprint For Transforming Veterans’ Health Care
Imagine how we would meet the service-related health-care needs of military veterans if we had a clean slate and were considering the question for the first time. The answer is obvious. Just as we do with veterans’ educational benefits, we would use the private sector. We would never create something like the Veterans Health Administration (VHA) that exists today. (Bill Frist and Jim Marshall, 2/26)

The Wall Street Journal: Government Food Cops Are Out To Lunch
The classic American sandwich is about to get a radical makeover. Forget about roast beef or cold cuts. Red meats and processed meats are out. A slice of cheese is permissible, provided it is low-fat and low-sodium. Skip the chips, even if they’re baked. Dinner needs an overhaul too: Less pizza, fewer cheeseburgers and casseroles, or change their recipes to make them healthier. At mealtime, water is the preferred beverage of choice—unless you are an adult, when moderate alcohol consumption is acceptable. (Cheryl Achterberg, 2/26)

The Washington Post: The Exquisite Hypocrisy Of GOP Medicaid Expansion Rhetoric
In the current fight over expanding health-care coverage to low-income people, Republican state leaders often deploy some version of this argument: States shouldn’t accept billions in federal money to expand their Medicaid programs because the debt-burdened federal government won’t keep its financial commitments. Responsible leaders shouldn’t structure their budgets on the fiction that the federal government will maintain the same level of support in the future, lest states be left with the expansion bill years down the road. (Stephen Stromberg, 2/27)

The New York Times' The Upshot: High Rate of Shopping and Switching in Obamacare Plans Is a Good Sign
For most customers returning to the Obamacare marketplaces this year, it really paid to shop around. New data shows that a large number of them did. That bodes well for those shoppers and the future offerings of the insurance marketplaces. More than half of people who bought insurance on last year explored their options before choosing a 2015 plan, according to a report from the Department of Health and Human Services. Of those 2.2 million who shopped, more than half switched to a new health plan. (Margot Sanger-Katz, 2/26)