KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: Revamping Health Law Regs — Again; Arkansas Decision On Medicaid Reverberates Nationwide

Los Angeles Times: Obama Breathes Life Into Canceled Health Plans – Again
The Obama administration wrote a new chapter Wednesday in the "if you like your health plan, you can keep it" chronicles, decreeing that plans it once derided as "junk" or "substandard" can remain in effect until October 2017 -- long after the next presidential election. The point, administration officials say, is to help those in the market for individual or small-group plans make a smoother transition into Obamacare (Jon Healey, 3/5). 

The Wall Street Journal: The Endangered Senators Rule
Maybe the White House figures that if it rewrites Obamacare enough times, the media will stop paying attention. On Wednesday it ordered one more delay of the mandates for individuals and small business -- in time to give a political reprieve to Senators vulnerable in the midterm election (3/5).

The New York Times: Republicans Place The Wrong Bet
Republicans may have bet too heavily on the wrong issue going into the midterm elections. When the health care law's website wasn't working, the law itself was at its most unpopular and its most newsworthy, and the president's poll numbers were cratering, many Republicans made the calculation that they could ride the wave of woe to an overwhelming electoral victory in November. But betting on stasis is stupid. Things change (Charles M. Blow, 3/5).

Bloomberg: Arkansas Republicans Help Obamacare Dig In
It's one case, in one state, but the renewal of Medicaid expansion in Arkansas is a big deal. ... This is a big deal because it’s another indication that Medicaid expansion is almost certainly going to be a one-way street. Once states get in, they aren't going to drop out. ... That's because, over time, repeal would mean taking away people's insurance. I'm not making a prediction that Obamacare will become popular. Nor does it mean that the ACA is "working." My point is only that very few politicians want to take away benefits from a large number of voters. And, in the case of Medicaid expansion, those benefits accrue to important organized interest groups, including hospitals (Jonathan Bernstein, 3/5).

Boston Globe: Close Shave In Arkansas
Yesterday, the Arkansas House of Representatives gave approval to the state's annual budget and, after a long hard fight, included continuation of its unorthodox health insurance expansion for low-income residents under the Affordable Care Act, dubbed the "private option." Does this matter beyond Arkansas' borders? Yes. Reversal would have been the first case of a state reversing an ACA expansion, and would have emboldened opponents to seek similar reversals in other states (John McDonough, 3/5). 

The Washington Post: Virginia GOP Legislators Oppose Medicaid Expansion Despite Benefits To Their Districts
Virginia House Speaker Bill Howell (R-Stafford) is leading the campaign to block Medicaid expansion even though the largest hospital in his Fredericksburg district says it desperately needs the money to continue supporting health care for the city’s poor. Fred Rankin, chief executive of the nonprofit parent of Mary Washington Hospital, said rebuffing expansion would cost his institution $14 million a year available under the Affordable Care Act. That would threaten the hospital's support for a free clinic and community health centers that serve low-income people (Robert McCartney, 3/5).

Roanoke Times: Hazards Ahead For Hospitals Without Action
The Virginia General Assembly wasn't responsible for creating either the Affordable Care Act or the subsequent need to expand Medicaid; nonetheless, today we need the General Assembly to help us deal with the consequences of the ACA. There seems to be much discussion about who is to blame for the issues and much less discussion focused on possible solutions. The people of Virginia and our health systems in Virginia need solutions -- and soon. Today, the ACA is already draining money from Virginia. While we are sympathetic to calls for audits and improvements to the administration of Medicaid, we are hopeful that those reforms can move forward in parallel with Medicaid's expansion (Victor Iannello, 3/5).

Roanoke Times: Health Care Progress Within Virginia's Grasp
The challenges facing hospitals, physicians and the health care system are many. First and foremost are the various reductions in payments for services to beneficiaries of the federal Medicaid program that are contained in the Affordable Care Act. ... The financial stakes and the financial integrity of hospitals and health systems ... are clearly tied to the outcome of this debate. In our most recent fiscal year, our system provided more than $131 million in uncompensated and charitable care to our region. This is significant, and the reality that businesses are bearing some of this cost through their own health insurance policies by subsidizing the care for the uninsured is unsustainable. There must be a way of caring for the uninsured going forward (James A. Hartley, 3/5).

Roanoke Times: Two Challenges, One Solution
Two issues have dominated this year's General Assembly session. The debates over mental health and access to medical care have largely played out on parallel tracks at the state Capitol, but in reality they are intertwined. Budget negotiators must recognize that truth if they hope to make meaningful improvements in the commonwealth's behavioral health system (3/5).

Norfolk Virginian-Pilot: Special Session: Just Another Ploy
Virginia House Republicans opposed to extending health insurance coverage to lower-income residents reiterated their latest battle strategy at a press conference Tuesday. They want to remove the issue from state budget negotiations and, instead, take it up in a special legislative session. On the surface, this might appear reasonable. But as has been the case with House Republicans' previous tactics for opposing the return of Virginians' federal tax dollars to Virginia, upon closer inspection the rationale for their latest position unravels (3/5).

And on other health care issues --

The New York Times: Room For Debate: When The Doctor Is No Longer The Boss
The Affordable Care Act seems to have accelerated doctors' flight from private practice into large physician groups and hospital networks. Do those systems' economies of scale benefit all involved? Or are there downsides for patients, physicians or others? (3/5).

Los Angeles Times' Capitol Journal: Compromise Unlikely In Fight Over Medical Malpractice Cap
You'd think this would be a simple problem to fix: The unfair low limits on pain and suffering awards in California medical malpractice suits. But few things of genuine importance are simple in California's innately pugnacious Capitol. There's greed, ill will, stubbornness, hubris, vindictiveness, indifference (doesn't affect me), cowardice -- all the human traits that politicians bring to Sacramento from the citizenry they represent. And too often these characteristics aren't tempered with people's counter-attributes of fairness, compromise and common sense (George Skelton, 3/5).

JAMA: The Three-Fold Path To Health Savings And Better Care
With each passing month, evidence accumulates that health care spending growth has reset to a new, lower level. Preliminary data for 2013 show an increase in health care spending essentially equal to the growth of the economy -- a rate of increase not seen for some time. With each passing month, evidence accumulates that health care spending growth has reset to a new, lower level. Preliminary data for 2013 show an increase in health care spending essentially equal to the growth of the economy -- a rate of increase not seen for some time. Employment data show that December and January were the 2 slowest months in health care employment in over 25 years. As the troubles with the Affordable Care Act's (ACA's) website recede in importance, the slowing in medical spending becomes the single most important story in health care (David Cutler, 3/5).

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