KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

Public Easily Swayed On Attitudes About Health Law, Poll Finds

Sixty percent of people generally favor requiring large firms to provide insurance or pay a fine. But support falls when people are told businesses could cut back workers’ hours and it increases when they learn that most businesses already provide coverage. (Julie Rovner, 12/18)

Health Law Issues And Implementation

State Exchanges Tally Their Enrollments For The First Month Of The Sign-Up Period

California's number topped 144,000 while Colorado signed up 108,077 for private coverage. News outlets offer other specific tallies and exchange-related coverage from Connecticut, Minnesota and Washington.

Los Angeles Times: New Obamacare Enrollments In California Top 144,000
California's health insurance exchange said 144,178 people have newly enrolled in Obamacare coverage during the first month of sign ups. During the initial rollout of the federal health law, 1.2 million people purchased a private health plan through the Covered California exchange. State officials are trying to hold on to most of those existing policyholders during the renewal process now and add about 500,000 more to finish open enrollment Feb. 15 with 1.7 million consumers. (Terhune, 12/17)

The Sacramento Bee: Board Shake-Up In The Offing At Covered California?
California’s health insurance exchange signed up more than 144,000 people in the first month this year and determined that another 157,000 were eligible for coverage. Another 216,423 enrolled in the state’s healthcare program for low-income residents and 75,000 were determined likely eligible for Medi-Cal, officials said Wednesday. (Cadelago, 12/17)

The Connecticut Mirror: 86,000 In Connecticut Now Signed Up For Obamacare
About 86,000 people are slated to receive private insurance coverage through Connecticut’s health insurance exchange, Access Health CT, as of Jan. 1, acting CEO Jim Wadleigh said Wednesday. Of those, about 66,000 are people who currently have coverage through the exchange and had their policies automatically renewed. The other 19,402 are people signing up for plans through the exchange for the first time. (Levin Becker, 12/17)

The Denver Post: Colorado Health Insurance Exchange Signs Up 136,315 In First Month
Colorado's health insurance exchange reported Wednesday that in the first month of open enrollment for 2015, it signed up 108,077 people for private plans and 27,306 for Medicaid. Despite technical problems that slowed or stopped many would-be consumers, Connect for Health Colorado enrolled 12,600 people on Monday, a single-day record. It was the deadline for those who want their coverage to begin Jan. 1. The exchange reported on Dec. 11 that 24,811 people had signed up for private health plans, with about a third of those as new customers. (Draper, 12/17)

Minnesota Public Radio: MNsure: Nearly 50,000 Signed Up For Jan. 1 Health Coverage
Total enrollment in public and private health plans through MNsure jumped 32 percent between Dec. 13 and Dec. 16, the health plan exchange said Wednesday. The total enrollment figure through Dec. 16 is 49,366, MNsure reported. Of those, 23,797 signed up for commercial plans, 7,681 enrolled in MinnesotaCare, and 17,888 signed up for Medical Assistance through the exchange. (Zdechlik, 12/17)

The Seattle Times: State Health Exchange Withholds Money To Deloitte Over Repeated Problems
Washington state’s health-insurance exchange is withholding payments to its primary technology contractor, Deloitte, as a result of repeated problems with the Washington Healthplanfinder website and the exchange’s payment and accounts systems. While Healthplanfinder — at wahealthplanfinder.org — has been more stable during the current open enrollment period than in the first enrollment last year, glitches continue to plague the site. Officials of the Washington Health Benefit Exchange, which manages the exchange, say many of those problems resulted from errors made by Deloitte. (Marshall, 12/17)

And on the topic of the federal exchange -

Health Law's Extra Funding To Pay Medicaid Doctors Disappears In 2015

The money was part of an effort to get more primary care doctors to participate in the Medicaid program but it was designed as a temporary pay raise. Also in the news is a look at how Arkansas is wrestling with the decision about continuing its landmark Medicaid expansion program.

Stateline: Raise For Medicaid Primary Care Docs To Disappear
A temporary bump in Medicaid fees paid to primary care doctors, an Affordable Care Act provision intended to get more physicians to accept Medicaid patients, will expire at the end of this month. Congress did not extend the higher rates, so unless states take action themselves or the new Congress revisits the issue, primary care doctors in Medicaid will see their fees fall by an average of nearly 43 percent starting in January, according to a new report from the Urban Institute. Whether the expiration of the fee increase will make a difference in physician participation in Medicaid is unknown. That is because there hasn’t been enough time to analyze whether the hike actually convinced primary care doctors to take Medicaid patients. (Ollove, 12/17)

The Associated Press: Arkansas' Model Medicaid Experiment In Jeopardy
Arkansas became the first Southern state to expand its Medicaid program in a way that many Republicans found acceptable. The state bought private insurance for low-income people instead of adding them to the rolls of the Medicaid system, which GOP lawmakers considered bloated and inefficient. Now Arkansas could be on the brink of another distinction: becoming the first to abandon its Medicaid expansion after giving coverage to thousands of people. (DeMillo, 12/17)

Ohio To Test Billing Improvements For Lower Costs, Better Care

The state will receive $75 million over four years to test a medical care billing model. Colorado, in the meantime, has won a $65 million grant to better treat people with mental illnesses.

Northeast Ohio Media Group: Ohio Wins $17.5M To Test New Billing Model To Improve Health Care While Lowering Costs
The model, developed over 18 months of negotiation between the state, medical providers and the four largest health insurers in Ohio -- Anthem, Aetna, United Healthcare and Medical Mutual -- attempts to shift the focus from quantity of services to quality of care. If the model works, doctors will be rewarded for providing better, more efficient care to their patients while keeping overall costs down. (Higgs, 12/17)

Poll: 60 Percent Of Americans Have Positive Views Of The Health Law's Employer Mandate

The latest tracking poll by the Kaiser Family Foundation found the majority of Americans like the requirement that large employers provide insurance for their workers. However, the poll also found that these opinions are easily swayed.

McClatchy: Six In Ten Support ACA Employer Mandate, Says New Kaiser Poll
The latest Kaiser Family Foundation tracking poll shows 60 percent of Americans have a favorable view of the Affordable Care Act’s “employer mandate,” while 38 percent view the provision negatively. The mandate requires large businesses with 100 or more workers to provide affordable health insurance for full-time workers or face a penalty of $2,000 per employee beginning in 2015. The rules allow these employers to cover only 70 percent of eligible employees in 2015 and 95 percent in 2016 and beyond. (Pugh, 12/17)

Kaiser Health News: Public Easily Swayed On Attitudes About Health Law, Poll Finds
Just days before the requirement for most large employers to provide health insurance takes effect, a new poll finds the public easily swayed over arguments for and against the policy. Six in 10 respondents to the monthly tracking poll from the Kaiser Family Foundation (Kaiser Health News is an editorially independent program of the foundation) said they generally favor the requirement that firms with more than 100 workers pay a fine if they do not offer workers coverage. But minimal follow-up information can have a major effect on their viewpoint, the poll found. (Rovner, 12/18)

Politico Pro: Poll: Support For ACA Still Depends On The Question
Americans like the Obamacare mandate that large employers offer workers health insurance a lot more than the law’s requirement that most people must buy insurance, according to a Kaiser Family Foundation poll released Thursday. The poll, which comes on the eve of the twice-delayed employer mandate taking effect next month for businesses with more than 100 full-time employees, found that 60 percent of people support the requirement. The individual mandate, by comparison, still drew support from just 35 percent. (Norman, 12/18)

Meanwhile, Politico also offers more detail on the mandate itself -

Politico: ACA Employer Mandate: Not As Bitter In Better Economy
Obamacare’s employer mandate looks a whole lot different during a job-growing economic recovery. The cost of compliance when the mandate takes effect Jan. 1 doesn’t seem quite as onerous when compared to the need to attract and retain workers. Alternative coverage strategies offer businesses a better chance to keep budgets in check without risking the law’s penalties. (Norman, 12/18)

Marketplace

CMS Database Will Add Industry Payments To Doctors For Medical Education Seminars

The payments will be reported on the new Open Payments database, which provides details about compensation to doctors from drugmakers and medical device companies.

The Wall Street Journal's Pharmalot: A Flip Flop? CME Payments To Doc Must Be Reported To Sunshine Database
In what appears to be an about face, the Centers for Medicare & Medicaid Services has revised a controversial provision of the Open Payments program and will now require companies to report payments to physicians who speak at, or attend, continuing medical education seminars. The change comes less than two months after the agency declared there are circumstances in which such payments would not have to be disclosed. In fact, this marks the fifth time that CMS has offered yet another interpretation of its final rule on disclosing CME payments. (Silverman, 12/17)

news@JAMA: Will A New Website Empower Patients To Ask Their Physicians About Financial Relationships With Industry?
The federal government recently unveiled a website called Open Payments that provides details about payments made by pharmaceutical and medical device companies to physicians. Initial news stories noted some interesting details. During the last 5 months of 2013, these companies paid physicians almost $3.5 billion in speaking and consulting fees, with some physicians earning more than half a million dollars in that period. The Open Payments site was immediately criticized for multiple problems, including the difficulty people have in navigating the site and the fact that there might be misattribution of some payments. Government officials said they plan to improve the site, and later introduced a search tool, making it easier for consumers to find their physician. Meanwhile, drug and device manufacturers and physician groups continue to complain that patients might misinterpret the data on the site. (Thacker, Kesselheim and Campbell,12/17)

UnitedHealth, Humana Remain Medicare Advantage's Major Players

The latest government data indicate that these insurers have more Medicare Advantage members than any others, and those numbers are likely to get even bigger when Medicare's current open enrollment period closes.

Modern Healthcare: UnitedHealth, Humana Continue To Dominate Medicare Advantage
UnitedHealth Group and Humana enroll more Medicare Advantage members than any other insurers, and it really isn't that close, according to the latest government data. More than 16.6 million people had a Medicare Advantage plan as of Dec. 1. Medicare's open-enrollment period ended Dec. 7, so that figure is likely to be even larger once the CMS releases its next monthly enrollment report. The private Medicare program has been a boon for insurers the past several years, offering sizable volumes and steady profit margins. Some companies have said the growth in Medicare Advantage, spurred in part by the aging baby boomer population, will be fundamentally important to earnings growth in 2015 and beyond. (Herman, 12/17)

In other marketplace news, reports about Genworth Investors' long-term care insurance policies, as well as forecasts for hospitals -

The Wall Street Journal's Moneybeat: Genworth Investors Seeing Red Again; Insurer Delays Results Of Reserve Review
Shares of Genworth Financial Inc. are taking another dive after the insurer delayed the completion of an annual review of its reserves for the long problematic line of long-term-care insurance. Some Wall Street analysts interpreted the delay as bad news, following the worse-than-expected third-quarter charge disclosed in November for the initial part of the annual review. (Scism, 12/ 17)

The Hill: Ratings Agencies Forecast Trouble For Hospitals
Credit ratings agencies are forecasting trouble for the U.S. hospital sector in 2015 as federal reimbursements decrease and Republicans float a variety of changes to ObamaCare. Standard & Poor's Ratings, Moody's Investors Services and Fitch Ratings all predicted that the healthcare world will face challenges in the form of rising costs and uncertainty surrounding the healthcare law. (Viebeck, 12/17)

State Watch

Vermont Gov. Drops Plan For Single-Payer Health System

After investing four years in the project, Gov. Peter Shumlin said the timing wasn't right for a universal, publicly funded health care system in Vermont because the current state of the economy would have made the required tax increases difficult for Vermont residents and businesses to handle.

WBUR: Vermont Gov. Won’t Pursue Single Payer Health Care This Year
Gov. Peter Shumlin of Vermont announced on Wednesday that his state would not pursue single payer health care in this coming legislative session. Shumlin blamed a sluggish economy for his decision. The taxes required for single payer would prove too burdensome for Vermont, a state that has downgraded its revenues twice this year. (Alpert, 12/17)

Politico: Vermont Bails On Single-Payer Health Care
Vermont Gov. Peter Shumlin on Wednesday dropped his plan to enact a single-payer health care system in his state — a plan that had won praise from liberals but never really got much past the framework stage. “This is not the right time” for enacting single payer, Shumlin said in a statement, citing the big tax increases that would be required to pay for it. (Wheaton, 12/17)

The Associated Press: Governor Abandons Single-payer Health Care Plan
Calling it the biggest disappointment of his career, Gov. Peter Shumlin said Wednesday he was abandoning plans to make Vermont the first state in the country with a universal, publicly funded health care system. Going forward with a project four years in the making would require tax increases too big for the state to absorb, Shumlin said. The measure had been the centerpiece of the Democratic governor's agenda and was watched and rooted for by single-payer health care supporters around the country. (Gram, 12/17)

Federal Grand Jury Indicts 14 People Linked To 2012 Meningitis Outbreak

The indictments were handed down against company officials, pharmacists and technicians who worked for the Massachusetts company responsible for tainted drugs that led to 64 deaths.

Bloomberg: Meningitis Outbreak That Killed 64 Spurs U.S. Indictment
Fourteen officials, pharmacists and technicians tied to the Massachusetts company involved in a 2012 meningitis outbreak that killed 64 people were indicted by a federal grand jury on charges including racketeering, conspiracy and second-degree murder. The New England Compounding Center's tainted drugs, including a steroid administered by spinal injection to treat pain, infected more than 700 people in 20 states, U.S. officials have said. The outbreak was caused by sloppy clean-room practices, including routine failure to properly sterilize drugs, according to the indictment unsealed Wednesday in Boston. (Larson and Lawrence, 12/17)

Los Angeles Times: 14 Indicted In Deadly 2012 Meningitis Outbreak
Fourteen people connected to a Massachusetts compounding pharmacy have been arrested on charges stemming from the 2012 meningitis outbreak that killed 64 people who received tainted drugs, officials said Wednesday. In the high-profile criminal case involving contaminated medicine, Barry Cadden, a co-founder of the New England Compounding Center of Framingham, Mass., and Glenn Adam Chin, a pharmacist who was in charge of the sterile room, face the most serious charges, according to the 131-count indictment. (Muskal, 12/17)

The Associated Press: 14 Arrested, Charged In Meningitis Outbreak
More than 750 people in 20 states were sickened and 64 died after they contracted fungal meningitis and other illnesses from tainted steroids made by the company. The steroids given were for medical purposes, not for body building; most received the injections for back pain. Cadden and Chin are charged with causing the deaths of patients in several states, including Michigan, Tennessee and Indiana. The others charged in an indictment unsealed Wednesday face charges ranging from mail fraud to the introduction of adulterated and misbranded drugs into interstate commerce. (12/17)

State Highlights: Patient Data Held For Ransom In Ill.; Senior Guardianship Law In Fla.

A selection of health policy highlights from Illinois, Florida, Michigan, Texas, Minnesota and New York.

Modern Healthcare: Patient Data Held For Ransom At Rural Illinois Hospital
Federal and local law enforcement officials are investigating a healthcare data-for-ransom security breach at 18-bed Clay County Hospital in Flora, Ill. The hospital received an e-mail ransom demand Nov. 2 containing patient names, addresses, Social Security numbers and dates of birth, but no clinical information, according to a release. The sender threatened to make the patient information public unless “a substantial payment from the hospital” was made, the hospital statement said. (Conn, 12/17)

Health News Florida: Elders Trapped By Guardianship Law
Florida's elder guardianship program is meant to help vulnerable elders. But Sarasota Herald-Tribune reporter Barbara Peters Smith recently published a series that shows the rapidly expanding system run in Florida’s probate court system ignores the rights of some. She spoke with Health News Florida Editor Mary Shedden about the year-long investigation. (Shedden, 12/17)

The Detroit Free Press: Macomb OK's Bond Issue For Unfunded Retiree Health Care
Macomb County commissioners today approved a resolution to issue up to $300 million in bonds to finance the county's unfunded retiree health care liability. The board, during a finance committee meeting, also approved sending a comprehensive financial plan to the state for approval. The state must review and approve the plan for the county to issue the bonds. (Hall, 12/17)

The Texas Tribune: Second HHSC Contract Scrapped Amid Bidding Questions
Nine months before Jack Stick resigned as the top lawyer for the Texas Health and Human Services Commission amid concerns over a $110 million no-bid contract awarded on his watch, he urged the same vendor to contact a sister agency — the Texas Department of Family and Protective Services — for related work. DFPS, which includes the mammoth Texas Child Protective Services agency, ultimately did sign a $452,000 no-bid contract with the company, 21 Century Technologies Inc., for a pilot program to help it better track families investigated for child abuse. That contract was abruptly canceled by DFPS's parent agency — HHSC — on Wednesday, one day after The Texas Tribune began asking about it. (Langford and Blanchard, 12/17)

The Miami Herald: Florida Silent On Children's Health Insurance Program Future
A bipartisan group of governors from 39 states is supporting extended federal funding of the Children's Health Insurance Program, or CHIP, which covers more than 8 million kids and their families nationwide, including about 400,000 children in Florida. But Gov. Rick Scott has not joined the chorus. Scott's office declined to explain why the governor has been silent on the issue after ranking members of the U.S. House Committee on Energy and Commerce and the U.S. Senate Finance Committee sent letters to governors of all 50 states in July asking for their input on the future of CHIP. (Chang, 12/17)

MinnPost: Minnesota's 2014 Mental Health Measures Cited As Models For Other States
In a year when many state legislatures reduced or cut spending for mental health care, a report by the National Alliance on Mental Illness (NAMI) found that Minnesota stands out as having remained strong in its commitment to supporting individuals and families in psychological distress. The report, titled "State Mental Health Legislation in 2014: Trends, Themes, and Effective Practices," showed that in comparison to 2013, when 36 states acted to restore funding to mental health budgets in reaction to the tragedy at Sandy Hook Elementary in Newtown, Connecticut, 2014 was marked by a reduction in such funding. Only 29 states and the District of Columbia increased funding for mental health services this year. (Steiner, 12/17)

The Associated Press: NY Medicaid Proposal For Covering Transgender Treatment
New York officials have proposed authorizing coverage for transgender treatment under the state's Medicaid program for low-income New Yorkers. Regulations proposed Wednesday would cover hormone therapy and gender reassignment surgery. For surgery, patients would need a medical referral and to have counseling and document a year of hormone therapy and living in the gender role consistent with his or her identity. (12/17)

The Associated Press: Texas Doctor Gets 10 Years For Health Care Fraud
A North Texas physician has been sentenced to 10 years in federal prison for his role in a $3 million Medicare billing scam. Dr. Joseph Megwa of Arlington was sentenced Wednesday in Dallas. The 60-year-old doctor in May was convicted of conspiracy to commit health care fraud and three counts of health care fraud. Megwa was also convicted of four counts of making false statements over Medicare claims in cases since 2006. (12/17)

Kaiser Health News: Too Little, Too Late For Many New Yorkers Seeking Hospice
WNYC's Fred Mogul, working in partnership with Kaiser Health News and NPR, reports: "But despite evidence that hospices can greatly relieve discomfort, extend life and save money, and despite a generous hospice benefit available through both Medicare and Medicaid, relatively few people in New York take advantage of it, compared to elsewhere in the country. The reasons for this local gap are complicated, but Jeanne Dennis, senior vice president of hospice and palliative care at the Visiting Nurse Service of New York, says one place to start is with patients’ fears." (Mogul, 12/17)

Weekend Reading

Longer Looks: Covering Mental Health; Doctors And Torture; Bogus Health Claims

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

CBS News/60 Minutes: Denied
When insurance companies deny the mentally ill the treatment their doctors prescribe, seriously ill people are often discharged, and can be a danger to themselves or others. (Video) (Scott Pelley, 12/14)

Arizona Republic: Mental-Health Funding: A Bitter Pill
Non-profit agencies that provide mental-health services in Maricopa County failed to tighten their belts on administrative costs in recent years, despite public funding declines that left some clients waiting months for services and others denied them entirely. A five-month Arizona Republic investigation, including a review of financial records for 28 non-profit mental-health agencies and their clients, found that: --Since the Great Recession began in fiscal 2007-08, average executive compensation at 19 non-profit charitable mental-health organizations has quadrupled the rate of inflation. --Some non-profit executives with six-figure salaries received annual bonus-and-incentive packages ranging from a few thousand dollars to nearly $100,000. One had a car allowance large enough to lease a Porsche. ... At the same time, underfunded agencies say families have been denied services or waited months for them because of diminished public funding that passes through the organizations in question. A three-part series. (Craig Harris, 12/15-12/16)

The Milwaukee Journal-Sentinel: Murray’s Problem
He might have chosen an easier path to contentment, this husband and father of three, a man who enjoys hiking and camping, fish fries and music in the park. But in the pursuit that dominates his life, the quest to cure spinal cord injuries, experiments fail. Under the microscope, a treated mouse shows no improvement. In the cage, it cannot grip a food pellet. And later, at dinner with his family, [Murray] Blackmore is quiet and distant. A four-part series. (Mark Johnson, 12/14-12/17)

Aeon: Final Independence: Nobody Wants A Protracted, Dehumanised Death: Why Is It Still So Easy For Doctors To Ignore A Dying Patient's Wishes?
In 1969, to protect the living and the brain-dead, the US attorney and human right advocate Luis Kutner, co-founder of Amnesty International, proposed the idea of living wills. These wills could protect people from futile end-of-life treatment, as long as medical professionals respected their wishes. But very few young people had documents drawn up, and those who wanted loved ones off ventilators, feeding tubes or both had to petition the courts, and found pushback at every turn. The first such case came in 1976, in the US. Karen Ann Quinlan was 21 when she collapsed at home after attending a party where she mixed alcohol and tranquilisers. (Jeanne Erdmann, 12/15)

The Atlantic: ‘Do No Harm’: When Doctors Torture
The Senate released its report on the CIA’s interrogation program on Tuesday, revealing horrendous details of the torture tactics used on prisoners, including waterboarding, sleep deprivation, and “rectal feeding.” Complicit in this treatment were several “medical officers” (it’s not explicitly stated whether they hold M.D.s), who enabled, oversaw, and designed many of the techniques. (Julie Beck, 12/12)

Vox: The Eight Most Bogus Health Claims Of 2014
Every day seems to turn up opportunities to abuse science in new and perverse ways, especially when it comes to health. You open a newspaper or news site, and you read about a health claim making the rounds: a diet that will give you the energy of a teenager, an exercise routine that will elongate your legs, a policy that will protect Americans from scary viruses. Many of these claims — even the ones that come from the lips of the most esteemed doctors and public officials — aren't backed by any good evidence. Some even run in the opposite direction of what the best-available evidence tells us. (Julia Belluz, 12/16)

Editorials And Opinions

Viewpoints: GOP Needs Subsidy Plan; Schumer Surprised By Reaction To His Health Law View

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

The Wall Street Journal: Time To Start Prepping Obamacare Reforms
The Supreme Court’s decision to hear arguments in King v. Burwell next year poses an enormous danger to Obamacare, but it also presents an urgent challenge to the law’s opponents. The outcome might result in many thousands of residents in more than half the states being unable to afford health insurance. The next Congress must be ready to respond with a consumer-oriented health reform. That means preparing now. (Yuval Levin and James C. Capretta, 12/17)

The Washington Post: The Schumer Prescription For 2016
The New York Democrat noted that the Affordable Care Act “was aimed at the 36 million Americans who are not covered” and asserted that “to aim a huge change in mandate at such a small percentage of the electorate made no political sense.” Schumer says he was surprised that nine paragraphs in a 6,600-word speech got all the attention. He shouldn’t have been. (E.J. Dionne Jr., 12/17)

The Washington Post: A High-Tech ‘Event Analysis’ Of The Affordable Care Act
About 10 million people have gained coverage in 2014, and notably, that’s not just the finding from this data source but from various other coverage surveys as well. Now, since trends in economic variables, including the share of those without health insurance coverage, by definition have some persistence, when you see a shift in a trend of this magnitude, your strong suspicion is that an “exogenous” change has occurred, i.e., something new entered the system that had a large impact on the variable in question. (Jared Bernstein, 12/17)

The Wall Street Journal: Medicaid Expansion In Red States
In the struggle between pragmatism and ideology over Medicaid expansion in red states, pragmatism may slowly be winning. Gov. Bill Haslam‘s announcement Monday of his plans to expand Medicaid under the Affordable Care Act makes Tennessee the 10th state with a Republican governor to expand the program (if the state legislature approves the plan). ... The governors of Indiana, Wyoming and Utah have also announced plans to expand. Many of these states are or will be negotiating with the Obama administration to expand Medicaid coverage for adults in ways that match their more conservative policy preferences and allow elected officials who opposed the health-care law to continue to distance themselves from Obamacare. (Drew Altman, 12/18)

The Washington Post: The Budget Stalemate Continues
Put differently, Democrats and Republicans have done precious little to resolve their basic differences over how large government should be, what it should do and who should pay for it. Both have benefited politically from outside events. They have claimed success while evading the hardest choices. In a letter with the report, outgoing Budget Committee Chairman Patty Murray (D-Wash.) urges Republicans to abandon their “partisan, cuts-only approach” and to accept tax increases. But the advice works both ways. Though Republicans have resisted new taxes (an exception: higher rates on the wealthy enacted in 2013), Democrats have been as adamant in resisting benefit cuts to Social Security and other “entitlements,” including Medicare. Not surprisingly, Murray’s letter does not mention benefit cuts. (Robert J. Samuelson, 12/17)

Boston Globe: Jonathan Gruber Is A Good Economist But Bad With PR
The Massachusetts Health Connector has 99 problems, but Jonathan Gruber isn’t one. The four GOP state senators who have called for the respected MIT economist to resign from the connector’s board are aiming at the wrong target. Last year’s bungled rollout of the state’s health website, which is intended to connect citizens with health insurance plans, cost taxpayers still-uncounted millions. Legislators would be better off demanding auditor Suzanne Bump and Governor-elect Charlie Baker get to the bottom of what happened, rather than joining a frivolous right-wing vendetta against Gruber. (12/17)

The Philadelphia Inquirer: SEPTA's Suit Against Gilead Raises Bigger Questions
Last week the regional transportation authority in this area, SEPTA, filed suit against pharmaceutical company Gilead for its “exorbitant pricing” of Sovaldi, a product to treat hepatitis C. SEPTA is a self-funded organization that covers the health benefits for its employees and their families, so Gilead's $84,000 per person price tag for a course of treatment represents a jolt to the agency's health care costs. SEPTA's lawsuit raises the question of why there has been no consortium of large, self-funded companies to act in unison and haul pharma to the woodshed for its pricing? (Daniel R. Hoffman, 12/17)

PLOS: Supporting Those Who Go To Fight Ebola
The Ebola epidemic is testing virtually every aspect of the public health and healthcare systems in the U.S., including healthcare institutions’ public service commitments. Although the number of cases in the U.S. remains very small, an extraordinary amount of public and hospital resources have been devoted to preparing for new cases domestically. In contrast, although US hospital and medical professional organizations have called for an “enhanced focus” on containing Ebola in West Africa, there is a striking absence of public commitments on the part of US healthcare institutions to contribute to the containment effort. (Michelle Mello, Maria Merritt and Scott Halpern, 12/17)