KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

First Edition: July 16, 2012

Today's headlines include a variety of reports from the past weekend's meeting of the National Governors Association in Williamsburg, Va., and how the nation's state executives continue to wrestle with what to do next after the Supreme Court's decision on the health law's Medicaid expansion.

Kaiser Health News: In Pennsylvania, Medicaid Cuts Reduce Options For Dental Care
Essential Public Radio's Erika Beras, working in collaboration with Kaiser Health News and NPR, reports: "Medicaid, a program funded jointly by the federal government and the states, covers the poor and disabled, and coverage varies by state.  Most states don't pay for any dental care. Now, in Pennsylvania, Republican Gov. Tom Corbett has reduced Pennsylvania's 2 million adult Medicaid patients to basic dental care – eliminating root canals, periodontal disease work and limiting the number of dentures a patient can receive. The plan now covers little more than cleanings, fillings -- and extractions" (Beras, 7/15). Read the story.

Kaiser Health News: Capsules: Study: PTSD Treatment For Soldiers Improving, But There's Still Work To Be Done
Now on Kaiser Health News' blog, Matthew Fleming writes: "When it comes to diagnosing and treating posttraumatic stress disorder among soldiers returning from service in Afghanistan, Iraq and other modern battle theaters, the Veterans Administration and the Department of Defense still have a long way to go to meet the needs of armed service members, according to a new Institute of Medicine study" (Fleming, 7/13). Check out what else is on the blog.

Los Angeles Times: Governors Divided Over Medicaid Expansion
But a greater number of governors on both sides approached the unexpected ruling with caution, largely out of concern for the long-term effect on state budgets that had been stretched to the brink by the economic downturn. ... The ruling also opened the door for states inclined to participate to seek further concessions from the federal government in how an expansion might be structured. Ultimately, said Gov. Dave Heineman of Nebraska, a Republican and the association's outgoing chairman, "there are going to be 50 different state solutions" (Memoli, 7/14).

Rueters/Chicago Tribune: Analysis: U.S. Governors Make Risky Political Decisions On Healthcare Funds
Republican governors bent on rejecting the healthcare law's expanded insurance coverage for millions of low-income Americans may see their gambit backfire if their party fails to sweep the November elections (Morgan, 7/15).

The Washington Post: Why Republican State Leaders Are Resisting Medicaid Expansion
The expansion of Medicaid called for in President Obama’s health-care law would seem an irresistible deal for states: Starting in 2014, in exchange for spending a percent or two more of their own funds, states will get nearly a trillion additional federal dollars during the next 10 years to extend health insurance to 17 million of their neediest residents. So why are so many Republican state leaders balking? Increasingly they speak of two experiences that, they charge, raise questions about whether the federal government can be counted on to hold up its end of the bargain: Congress's decision not to fund a mandated increase in Medicaid pay rates for doctors beyond two years and Obama’s recent willingness to consider cutting the federal contribution to Medicaid (Aizenman, 7/13).

The New York Times: Many Governors Are Still Unsure About Medicaid Expansion
How well the new health care law succeeds in covering millions of the poorest Americans will depend largely on undecided governors of both parties, who gathered here this weekend and spoke of the challenges of weighing the law's costs and benefits in a highly charged political atmosphere and a time of fiscal uncertainty. ... But as they gathered here this weekend at a meeting of the National Governors Association, most governors in both parties said that faced with a choice they did not expect to have, they needed to study how to proceed with this significant change in federal-state relations. Not all Democrats were leaping at the chance to expand their programs, and not all Republicans were ruling it out (Cooper, 7/14).

The Associated Press/Washington Post: Concerned About Costs, Governors Put Off Decisions On Health Care Law Until After Election Day
Millions of uninsured people may have to wait until after Election Day to find out if and how they can get coverage through President Barack Obama's health care law. More than two weeks after the Supreme Court gave the green light to Obama's signature legislative achievement, many governors from both parties said they haven't decided how their states will proceed on two parts under their control: an expansion of Medicaid, expected to extend coverage to roughly 15 million low-income people, and new insurance exchanges, projected to help an additional 15 million or so purchase private insurance (7/15).

Politico: GOP Governors Name Their Price On Health Care Law Expansion
Two dozen Republican governors fought all the way to the Supreme Court to win the right to reject President Barack Obama's expansion of Medicaid under the health care law. However, just a few weeks after the Supreme Court sided with them, some of these governors are leaving themselves an opening to expand Medicaid anyway — but on their own terms. Five Republican governors said Friday they would consider expanding the program if the feds gave them Medicaid dollars in block grants, which has been a goal of Republicans since the 1990s (Cheney, 7/14).

Politico: GOP Governors Say 'No' To Medicaid
Two Republican governors appear ready to turn down the Medicaid expansion now that the Supreme Court has given them a way out. Florida Gov. Rick Scott and Iowa Gov. Terry Branstad both attacked the Obama Medicaid requirements to cover millions of lower-income families, saying their states couldn't afford it. "I don't want to embark on something that is unaffordable," Branstad said on "Fox News Sunday" (Raju, 7/15).

NPR: Eyes On Election, Governors Hedge On Health Care
As governors from around the country meet this weekend in Williamsburg, Va., health care is near the top of their agenda. Specifically, what to do about the federal health law, now that the Supreme Court has given states new options. Republican governors in particular said they were genuinely surprised by the Supreme Court ruling. The justices declared the health law in general constitutional, but gave states the option of whether or not to dramatically expand their Medicaid programs (Rovner, 7/15).

The Washington Post: DGA Chairman O'Malley On Medicaid Expansion: 'Each Governor Has A Unique Set Of Challenges'
So what does the chairman of the Democratic Governors Association make of the fact that in more than half a dozen states, Democratic governors are waiting to make a decision on whether they’ll implement a key aspect of President Obama's signature health-care law? "Every governor has a unique set of challenges; some have greater political challenges to overcome than others," DGA chairman and Maryland Gov. Martin O'Malley told reporters Saturday at the National Governors Association annual meeting. While seven Democratic governors have yet to make up their minds on the Medicaid expansion, 22 Republican governors are undecided, as well (Sonmez, 7/14).

Politico: McDonnell Hammers Medicaid Expansion
Virginia Gov. Bob McDonnell denied on Sunday that his Republican peers were "playing politics" by rejecting the Affordable Care Act's Medicaid expansion, arguing the expansion was fiscally irresponsible. "Expanding Medicaid without fixing Medicaid is a terrible idea," McDonnell, a Republican, said on CNN's "State of the Union" (Reis, 7/15).

The Associated Press/Washington Post: For McDonnell, Va Govs' Meeting Provides A Final VP Audition For Romney As Decision Time Nears
Gov. Bob McDonnell had one last turn on the national stage as host of the weekend midsummer retreat of U.S. governors as a potential vice presidential running mate for Republican Mitt Romney. Then President Barack Obama upstaged him. For nearly a year, McDonnell's National Governors Association host team raised $1 million in private cash and organized a detailed itinerary of high-profile panels (7/15).

Politico: ACA Opponents Want To Kill Law Via Subsidies
The next shot in the legal war over the health reform law isn't another lawsuit but an academic paper that says federal exchanges can't give people subsidies to help pay for their coverage. The paper, authored by Case Western Reserve University's Jonathan Adler and the Cato Institute's Michael Cannon, puts intellectual heft behind an argument that has been percolating among the law's opponents (Feder, 7/16).

The Washington Post: Repealing Obama's Health Care Law Won’t Be Easy Even If GOP Wins It All In November.
Yes, if Mitt Romney wins the White House and his Republican allies retake the Senate, he could shred most of President Barack Obama's health care law without having to overpower a Democratic filibuster. But it won't be as easy as some Republicans portend, and it certainly won't be quick (7/16).

USA Today: Health Task Force Challenges Conventions, Faces Condemnation
And it seems nobody these days loves the U.S. Preventive Services Task Force. Few Americans had even heard of it until three years ago, when the advisory board with the 10-syllable name challenged convention by saying women under 50 might not benefit from mammograms, just as the debate over health care was coming to a boil (Szabo, 7/14).

The Wall Street Journal: Number Of The Week: Public Workers More Likely To Have Health Benefits
It's no secret that public employees tend to get better benefits than their private-sector counterparts. But a new report from the Labor Department this week is still striking in just how wide the gap is. ... The starkest contrast, though, is in health care. 73% of state and local government workers—including 83% of full-time workers—receive health benefits through their jobs. In the private sector, barely over half, 51%, of all workers get health benefits, and just under two-thirds, 64%, of full-time workers do. (The statistics only look at the percentage of workers who receive benefits through their employers, not at how many of them are without health insurance altogether.) Statistically speaking, there are two major reasons for the discrepancy. First, public employees are much more likely to be offered benefits than their private-sector counterparts: 99% vs. 86% for full-time employees. Second, public employees are much more likely to accept benefits when given the opportunity (Casselman, 7/14).

The Associated Press/Washington Post: Con Ed Reinstates Locked-Out Workers' Health Insurance, But No Progress In Talks
Consolidated Edison has reinstated health insurance for 8,500 locked-out New York utility workers. A Con Ed spokesman said Sunday that negotiations with the Utility Workers Union of America Local 1-2 will resume Monday as another heat wave is expected to hit New York City (7/15).

Los Angeles Times: Healthcare Law's Surtax Could Affect A Few Home Sellers In 2013
When the Supreme Court upheld the healthcare reform law on federal tax grounds, it re-stoked a housing issue that had been relatively quiet for the last year: The alleged 3.8% "real estate tax" on home sales beginning in 2013 that is buried in the legislation. ... In case you've heard rumors or received worrisome emails about any of this, here's a quick primer: Yes, there is a new 3.8% surtax that takes effect Jan. 1 on certain investment income of upper-income individuals — including some of their real estate transactions. But it's not a transfer tax and not likely to affect the vast majority of homeowners who sell their primary residences next year. In fact, unless you have an adjusted gross income of more than $200,000 as a single-filing taxpayer, or $250,000 for couples filing jointly ($125,000 if you're married filing singly), you probably won't be touched by the surtax at all (Harney, 7/14).

The Washington Post: Deltek: In Wake Of Court Ruling, Look To States For Health IT Opportunities
What the decision won't do, however, is trigger a new round of federal technology spending. Some of the major contracts associated with the legislation have already been awarded, and work has already begun. Instead, contractors seeking new health information technology work should look to the states (White and Jones, 7/15).

The New York Times: Troubled New York Hospitals Forgo Coverage For Malpractices
Several of the city's most troubled hospitals are partially or completely uninsured for malpractice, state records show, forgoing what is considered a standard safeguard across the country (Hartocollis, 7/15).

Los Angeles Times: Imperial County Leads State In Treatment Of Children With Asthma
For children with asthma in California, there is no place worse than Imperial County. They are far more likely than children in any other county to end up in the emergency room or hospitalized. Kids go the ER for asthma at a rate three times higher than the state's average, according to the Department of Public Health (Gorman, 7/16).

Los Angeles Times: UC Riverside Makes Rare Second Attempt To Add Medical School
UC Riverside's long-held dream to have a full medical school was badly battered last year when the state refused to pay for it and then national accreditors wouldn't allow it to open. Those denials were a blow to the UC system's proud tradition of adding campuses and programs to serve a growing state (Gordon, 7/15).

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