First Edition: November 13, 2017
Today's early morning highlights from the major news organizations.
Kaiser Health News:
Brokers Are Reluctant Players In A Most Challenging ACA Open-Enrollment Season
Lee Nathans, like insurance brokers in many states, expects to be crazy busy for the next several weeks, fielding calls from “people who are not going to be happy.” Open enrollment for Affordable Care Act coverage started Nov. 1, and the approximately 10 million people who buy their own health insurance are only now getting a look at what’s being offered. It’s daunting. “There will be a lot of people who will need to use a broker,” said Nathans, of Columbus, Ohio. (Appleby, 11/13)
Kaiser Health News:
Podcast: ‘What The Health?’ We Have Numbers!
Democrats won some unexpectedly large victories in Tuesday’s off-off-year elections, putting health care squarely back on the political map. Meanwhile, enrollment was unexpectedly high in the insurance exchanges’ opening days, according to the Department of Health and Human Services. (11/10)
California Healthline:
Wary Of Exchanges, Insurers Are Wooed By Expanded Medicaid Program
In California and much of the country, it’s a tale of two programs under the Affordable Care Act: state insurance exchanges and expanded Medicaid. Many health insurers, citing financial losses or the uncertainty of federal funding, have left the government exchanges where consumers buy subsidized coverage. The nation’s largest health insurer, UnitedHealth, exited the Covered California marketplace at the end of last year, and for 2018 Anthem will stop selling exchange policies in about half of California’s counties. (11/10)
The New York Times:
Trump Administration Guiding Health Shoppers To Agents Paid By Insurers
After cutting funds for nonprofit groups that help people obtain health insurance under the Affordable Care Act, the Trump administration is encouraging the use of insurance agents and brokers who are often paid by insurers when they help people sign up. The administration said in a recent bulletin that it was “increasing partnerships” with insurance agents and viewed them as “important stakeholders” in the federal marketplace, where consumers are now shopping for insurance. But some health policy experts warned that a shift from nonprofit groups, which are supposed to provide impartial information, to brokers and agents, who may receive commissions for the plans they recommend, carries risks for consumers. (Pear, 11/11)
The Hill:
ObamaCare Insurer Competition Declining: Study
Insurer competition in the ObamaCare marketplaces is declining, but three-quarters of enrollees still have a choice of two or more insurers, according to a new analysis. The analysis from the Kaiser Family Foundation finds that the average number of insurers per state declined to 3.5 for 2018, down from 4.3 this year and 5.6 the year before. (Sullivan, 11/10)
Politico:
Price Investigation Continues To Roil HHS
Tom Price left his job as Health and Human Services secretary in September, but the investigation into his use of private jets for official travel now threatens to enmesh others in the department. The department’s inspector-general’s probe will review who approved — or should have been approving — Price’s use of private jets on at least 26 trips from May to September, some of them quick jaunts on routes heavily traveled by commercial aircraft, according to three people with knowledge of the probe. (Pradhan and Diamond, 11/13)
The Associated Press Fact Check:
Trump Hails 'New' VA As Old Problems Persist
President Donald Trump speaks with pride about the progress of his overhaul of health care for veterans, declaring that the Department of Veterans Affairs already "is a whole new place." Old problems persist, though, and some of his steps are not as advanced as he advertises. For Veterans Day, the White House came out with a two-page statement to support the contention that "tremendous progress has been made in a short period of time." (Yen, 11/10)
The New York Times:
Trump Health Agency Challenges Consensus On Reducing Costs
For several decades, a consensus has grown that reining in the United States’ $3.2 trillion annual medical bill begins with changing the way doctors are paid: Instead of compensating them for every appointment, service and procedure, they should be paid based on the quality of their care. The Obama administration used the authority of the Affordable Care Act to aggressively advance this idea, but many doctors chafed at the scope and speed of its experiments to change the way Medicare pays for everything from primary care to cancer treatment. Now, the Trump administration is siding with doctors — making a series of regulatory changes that slow or shrink some of these initiatives and let many doctors delay adopting the new system. (Goodnough and Zernike, 11/12)
The Wall Street Journal:
Fewer Return Visits To The Hospital, But Higher Rates Of Death, Study Finds
The Affordable Care Act required Medicare to penalize hospitals with high numbers of heart failure patients who returned for treatment shortly after discharge. New research shows that penalty was associated with fewer readmissions, but also higher rates of death among that patient group. The researchers said the study results, being published in JAMA Cardiology, can’t show cause and effect, but “support the possibility that the [penalty] has had the unintended consequence of increased mortality in patients hospitalized with heart failure.” (Evans, 11/12)
The Hill:
Five States Ask Judge To Halt Trump's Rollback Of Birth-Control Mandate
Five states are asking a federal judge to halt the implementation of the Trump administration's recent rollback of ObamaCare's birth-control mandate. The attorneys general in California, New York, Maryland, Delaware and Virginia filed the motion for a preliminary injunction Thursday night with the U.S. District Court for the Northern District of California. (Hellmann, 11/10)
The Hill:
Maine Governor's Refusal To Expand Medicaid Sets Off New Battle
Maine Gov. Paul LePage’s (R) steadfast opposition to abide by overwhelming voter support of expanding Medicaid is likely to set off a funding battle when the state legislature meets early next year. Estimates over the expansion cost differ wildly, and the governor has said he won’t approve a plan if it involves raising taxes or raiding the state’s rainy day fund. (Weixel, 11/10)
NPR:
Medicaid Expansion Takes A Bite Out Of Medical Debt
As the administration and Republicans in Congress look to scale back Medicaid, many voters and state lawmakers across the country are moving to make it bigger. On Tuesday, Maine voters approved a ballot measure to expand Medicaid under the Affordable Care Act. Advocates are looking to follow suit with ballot measures in Utah, Missouri and Idaho in 2018. ... A study from the Urban Institute may shed some light on why Medicaid eligibility remains a pressing problem: medical debt. While personal debts related to health care are on the decline overall, they remain far higher in states that didn't expand Medicaid. (Smith, 11/10)
The Washington Post:
Danica Roem To Push For Transgender Health Care Along With Focus On Traffic
Del.-elect Danica Roem, the transgender woman who is perhaps the best known of the flood of Democrats who won seats this week in the Virginia state house, said Friday that she wants to make it easier for people to get health insurance coverage for treatment related to gender transitions. Roem (Prince William), who plans to focus mostly on easing traffic congestion in her district, said she also wants to work with the Democratic caucus in the House of Delegates to develop a bill that would require insurance companies to cover the costs of hormone medication, surgery and other treatments. (Olivo, 11/10)
Stat:
Sarepta Gets A Belated, But Helpful, Boost From Anthem For Its Pricey Drug
In a boost for Sarepta Therapeutics (SRPT), the last remaining large health insurer has agreed to cover its pricey treatment for a rare form of muscular dystrophy. In a policy bulletin issued on Thursday, Anthem (ANTM) declared Exondys 51 to be “medically necessary,” reversing a decision made a year ago not to reimburse the drug, which had just been approved to treat Duchenne muscular dystrophy amid controversy about underlying clinical data. (Silverman, 11/10)
Stat:
Targeted By An Addiction Treatment Center, Union Workers Feel Trapped As Their Benefits Are Drained
STAT and The Boston Globe interviewed 10 people treated at the institute over the last five years — teachers, mostly from New Jersey, as well as school custodians and social workers or their relatives. Most said they were allowed only limited contact with family. They complained about inadequate and cookie-cutter treatment, consisting mostly of group counseling and 12-step meetings, massages at a local chiropractor’s office, and plenty of free time. Several said the staff warned that their jobs would be at risk when they tried to leave before the treatment center deemed it appropriate. Although the patients were there voluntarily, many needed letters indicating they were fit to return to work. (Armstrong and Allen, 11/10)
NPR:
Brain Scientists Look Beyond Opioids To Conquer Pain
The goal is simple: a drug that can relieve chronic pain without causing addiction. But achieving that goal has proved difficult, says Edward Bilsky, a pharmacologist who serves as the provost and chief academic officer at Pacific Northwest University of Health Sciences in Yakima, Wash. "We know a lot more about pain and addiction than we used to," says Bilsky, "But it's been hard to get a practical drug." (Hamilton, 11/13)
NPR:
Is There A Way To Keep Using Opiod Painkillers And Reduce Risk?
Jon McHann, 56, got started on prescription opioids the way a lot of adults in the U.S. did: he was in pain following an accident. In his case, it was a fall. "I hit my tailbone just right, and created a severe bulging disc" that required surgery, McHann says. McHann, who lives in Smithville, Tenn., expected to make a full recovery and go back to work as a heavy haul truck driver. But 10 years after his accident, he's still at home. (Aubrey, 11/13)
The Associated Press:
NY State Lawmakers To Discuss Heroin, Opioid Epidemic
The New York state Senate is planning another meeting to hear from local law enforcement, mental health experts and the loved ones of those lost to heroin and opioids. Tuesday's meeting in Newburgh in the Hudson Valley will be hosted by Republican Sens. George Amedore, Fred Akshar and William Larkin. 11/11)
Stat:
6 Medical Innovations That Moved From The Battlefield To Mainstream Medicine
Wartime medicine is an incredibly challenging setting for the doctors, nurses, and paramedics who practice it: Not only are the injuries frequently serious ones, but the tools at hand are often more limited than in a traditional hospital. Over the centuries, that has meant that battlefield medical personnel have had to innovate. Those wartime practices, in turn, often served to refine medical practice beyond the military. (Samuel, 11/10)
The Wall Street Journal:
Falling Is Dangerous For The Elderly—And Often Preventable
One of the biggest health threats facing Americans age 65 and older is also one many of them don’t like to talk about: falling. At least half of senior Americans who fall don’t tell anyone, according to a report from the Centers for Disease Control and Prevention. Whether it’s a spouse declining to tell a partner, or an elderly parent hiding it from the children, many seniors keep quiet because they are embarrassed and fear losing their independence. (Sadick, 11/12)
The Washington Post:
The U.S. Postal Service Is Taking On Alzheimer’s With A New Stamp
For the 5 million Americans living with Alzheimer’s disease, help can seem far away. Scientists don’t fully understand the disease. The progressive dementia it brings can be scary and disorienting. And social isolation and loneliness are often part of the equation, further affecting brain function. Starting Nov. 30, a new stamp will lend a helping hand. (Blakemore, 11/11)
The Wall Street Journal:
Ankle Replacements Take Off As Devices Appear Durable
Ankle replacements, a new kid on the block compared with knee and hip replacements, used to be deemed a risky bet for patients under 65. But as doctors steadily gain confidence that the replacements will last, Carrie Kvitko, 60, from Columbus, Ohio, is one of a growing group of younger patients to sport a new ankle, made of metal and plastic and bending nearly as well as the original. In September, a year after her surgery, Mrs. Kvitko went on vacation to Magic Kingdom Park in Orlando and climbed 116 steps to the top of the Swiss Family Tree House. (Johannes, 11/12)
NPR:
Scientists Start To Tease Out The Subtler Ways Racism Hurts Health
The day Dr. Roberto Montenegro finished his Ph.D. was memorable. But not for the right reasons. "I still cringe when I think about it," says Montenegro. It had started well. His colleagues at UCLA had taken him and his girlfriend (now wife) out to a fancy restaurant to celebrate. "I was dressed up in the fanciest suit I had at the time and my wife looked beautiful, like always," he says. "We laughed and we ate and we were excited we didn't have to pay for this." (Bichell, 11/11)
The Associated Press:
‘There Was A Breakdown’: Inmate’s Suicide Leads To $7M Deal
The family of a mentally ill woman who killed herself inside a Pennsylvania detention center in 2015 will receive $7 million after a lawsuit against the private company running the prison was settled, according to a lawyer handling the case. The recent settlement capped a case that began with a descent into depression and paranoia in Janene Wallace’s late twenties and eventually resulted in imprisonment, a nearly three-month stint in solitary confinement and finally, a death by hanging, family attorney David Inscho said. (Izaguirre, 11/11)
Los Angeles Times:
Disneyland Shuts Down 2 Cooling Towers After Legionnaires' Disease Sickens Park Visitors
Disneyland has shut down two bacteria-contaminated cooling towers after Orange County health officials discovered several cases of Legionnaires’ disease in people who had visited the Anaheim theme park, authorities said. Twelve cases of the bacteria-caused illness were discovered about three weeks ago among people who had spent time in Anaheim and included nine people who had visited Disneyland in September before developing the illness, according to the Orange County Health Care Agency. (Barboza, 11/11)