KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: Mass. Abortion Debate Comes Down To 35 Feet; Tampa Mayor Leads Charge To Get Young People Signed Up For Health Care

The New York Times' Taking Note: On Abortion-Free Speech Case, Justices Pull Out Tape Measure
The First Amendment protects the speech of short, elderly women and large and intimidating men equally, but you would be forgiven for thinking otherwise after oral arguments before the Supreme Court Wednesday morning. The case was McCullen v. Coakley, a challenge to a Massachusetts law setting a 35-foot buffer zone around reproductive-health clinics where abortions are performed (Jesse Wegman, 1/15). 

USA Today: Uphold Abortion Clinic 'Buffer Zone': Our View
For years, authorities in Massachusetts were unable to stop harassment and violence outside clinics where abortions were performed. Injunctions, arrests and prosecutions didn't stop activists from screaming in patients' faces, physically impeding them from entering clinics or surrounding cars trying to enter parking lots (1/15). 

USA Today: Overturn 'Buffer Zone' Law: Opposing View
Free speech is perhaps our most cherished civil liberty. Without free speech — especially free speech on key cultural, political and religious issues — the United States is no longer the pluralistic republic envisioned by our Founders. Given free speech's primary constitutional importance, it should be restricted only to advance the most compelling government interests, in the least restrictive way possible (Jay Sekulow, 1/15). 

Bloomberg: Is Your Abortion My Free Speech?
To pro-life protesters, however, the [Massachusetts'] law is blatantly aimed to make their speech less effective by moving them 35 feet back from clinic entrances. From that distance, they say, their message of love and compassion -- often reinforced by graphic images of bloody fetuses -- will be harder to communicate to women entering the clinics. The truth is that the buffer zone will apply to both anti- and pro-abortion protesters, but pro-life protesters have a much stronger interest than do pro-choice advocates for being in close proximity to clinics. To some degree, at least, the law stacks the deck against them (Noah Feldman, 1/15).

Los Angeles Times: Pregnant And Dead In Texas: A Bad Law, Badly Interpreted
Marlise Munoz is dead. Yet her body is in a hospital intensive care unit, maintained on a ventilator. Why? The 33-year-old paramedic and mother of one from Fort Worth, Texas, apparently suffered a fatal pulmonary embolism in her home Nov. 26. ... doctors soon determined that Munoz had suffered brain death, "irreversible cessation of all spontaneous brain function." She was dead. Her husband, accordingly, asked that all the machines be stopped. ... The Texas Advance Directives Act, Section 166.049, provides that "a person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient." The Texas law, like similar laws in other states, is almost always applied when the woman is incapacitated and terminally or irreversibly ill. It does not, however, on any reading, apply to a pregnant patient who has died (Arthur L. Caplan and Thaddeus M. Pope, 1/16). 

Reuters: The Fierce Fight Over How To Die
There has been an ugly and sad pile-on by two people who ought to know better and a young woman fighting against cancer. It started — as these things can — in the blogosphere, where Lisa Bonchek Adams, mother of three and terminal cancer patient, has been chronicling her battles in sometimes raw detail. Her tweets are full of pain, literal and emotional. Apparently, her revelations have proved too much for journalists Emma Gilbey Keller and Bill Keller. In a post on theguardian.com, Ms. Keller suggested that Adams has gone over the line. "Should there be boundaries in this kind of experience?" Keller wrote. "Is there such a thing as TMI? Are her tweets a grim equivalent of deathbed selfies?" (Anne Taylor Fleming, 1/15).

The Washington Post: Exemptions From 'Contraception Mandate' Threaten Religious Liberty
Can my employer make me pay the cost of practicing his religion? In the coming months, the U.S. Supreme Court will decide two cases involving just this issue. The cases are about the Affordable Care Act’s "contraception mandate" — the law’s requirement that employer health plans cover Food and Drug Administration-approved contraceptives without out-of-pocket expense, including co-payments, co-insurance or deductibles. The employers in these two cases are among scores of profit-making businesses that are claiming a religious right under a federal statute to be excused from this requirement because the use of contraceptives violates their owners’ religious beliefs (Frederick Mark Gedicks, 1/15). 

Tampa Bay Times: Closing The Obamacare Youth Gap
Considering the antagonism to the Affordable Care Act among politicians in Republican-controlled states such as Florida, it is encouraging that the Obama administration has succeeded in getting millions of Americans signed up for new health insurance. But for health care reform to succeed more young people need to get coverage through the online marketplaces. This is where government can help with outreach and public information, and Tampa Mayor Bob Buckhorn is showing others how it can be done. ... The Tampa mayor announced Monday during a visit from Health and Human Services Secretary Kathleen Sebelius that navigators will be available at nine of the city's recreation departments to help people enroll through the online marketplaces. Also, the city's firefighters and rescue workers will be equipped with information on health coverage options when responding to emergency calls (1/15).

Bangor Daily News: Medicaid Expansion: A 'No Brainer' For Mainers
Some argue that covering more of Maine’s poor with MaineCare will result in unnecessary ER visits by the newly insured. While this may occur early in the process of expanding coverage, once people have access to a primary care medical home, the rates of ER use and avoidable hospitalizations should drop. That has been the experience in Massachusetts, where a similar law has been in place for several years. And we know from studies that people who get regular preventive care and proper management of chronic diseases have better health outcomes at lower costs (Robert Allen and Noah Nesin, 1/15).

WBUR: Want Better, Cheaper, More Seamless Health Care? Ask Me How
Now, as an adult and a doctor reflecting back on those times, I can say with certainty that my family’s primary care provider never spoke with our dentist and eye doctors about our health and wellness. My mother’s OB-GYN never communicated directly to our pediatrician about her care or anticipated my needs as a new infant. Fragmented, clunky and often disempowering, that was our health care system then in many ways. And it still is now (dR. Myechia Minter-Jordan, 1/15).

JAMA: Do Employee Wellness Programs Improve Health And Reduce Spending?
For some time, Wellness Programs have been growing in popularity across the United States. At this point, it appears that about half of employers with more than 50 employees offer them. But almost all really large employers, those with at least 50 000 employees, do so (Dr. Aaron Carrroll, 1/15).

The New England Journal Of Medicine: After the False Start — What Can We Expect from the New Health Insurance Marketplaces?
The huge share of the gross domestic product that is financed through health insurance and the extreme difficulty that consumers have in discerning value in health plans make last fall's disastrous rollout particularly unfortunate. Yet many ACA supporters seem almost blind to the need for better public management. The federal and state-based marketplaces have encountered multiple obstacles: delays in contracting for technical assistance, inadequate pay scales and cumbersome hiring processes, political opposition and court challenges, delays in issuing controversial federal guidance, a shortage of relevant expertise, tension between new exchanges and existing state agencies, and the inescapable challenge of implementing such complex legislation (Jon Kingsdale, 1/15).  

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