Viewpoints: Conservative Health Policy; GOP’s Budget Plan; Medicare Spending At End Of Life

National Review: Why Conservatives Should Help People Get Health Insurance
Just how important is it that everybody in the United States be able to get health insurance? Conservatives are ambivalent, at best, about that goal. Many of them think that it is more important to restrain the growth of health-care costs; many of them worry that putting insurance within reach for everyone would involve excessive government power. They are right to be concerned about costs and about big government. They should nevertheless overcome their ambivalence. There are good reasons to embrace a conservative health-care policy that enables coverage for all Americans who seek it — not the least being that in the present political context, that policy might be the best way to restrain both costs and government. (Ramesh Ponnuru, 6/15)

Huffington Post: Two-Thirds Of People Who Would Be Affected By Obamacare Ruling Live In Republican Districts
House Republicans have been cheering on the lawsuit currently before the Supreme Court that, if successful, would cut off Affordable Care Act tax credits to more than 6 million people. Now a new report suggests the impact would fall disproportionately on their own constituents, rather than those in Democratic districts -- by a margin of 2-to-1. The research comes from FamiliesUSA, an advocacy and consumer support organization that is among the Affordable Care Act's loudest champions. The report's subject is the potential geographic impact of King v. Burwell, the lawsuit that the court heard in March and on which it is likely to rule by the end of the month. (Jonathan Cohn, 6/18)

The Wall Street Journal: A GOP Budget That Is Truly An ‘Ideological Document’
The Republican budget takes credit for about a $2 trillion reduction in spending from repealing ObamaCare. But it ignores the roughly $1 trillion in additional revenue that ObamaCare is estimated to bring in from added taxes and fees by 2025. If you eliminate the program, you lose the revenue, too. Beyond repealing ObamaCare, the Republican budget seeks to save an additional $2 trillion-plus by imposing pretty severe cuts on other entitlement programs—mainly Medicare, Medicaid, SNAP (the name for food stamps), and other programs that benefit mostly low- and moderate-income Americans. (Alan S. Blinder, 6/18)

Casper (Wyo.) Star-Tribune: Don't Miss Chance To Talk Medicaid Expansion
We’ve said it again and again – it’s time to expand Medicaid in Wyoming. But lawmakers have recently said it’s unlikely that the issue will be considered again until the 2017 policy session of the Wyoming Legislature. No matter how you feel about it, they said, it would need a two-thirds majority vote to be introduced in next year’s budget session, and that’s very unlikely. This is a problem for many reasons. First, the 17,600 Wyomingites who would benefit from expansion will continue to go without. These are our working poor, people for whom insurance and regular care could stave off bankruptcy. They will never be able to improve their situations without Medicaid expansion. Second, it just doesn’t make financial sense. (6/18)

The Panama City News Herald: Lawmakers Kick Health Care Can Down Road
The special session of the Florida Legislature that concludes this week has been like a summer blockbuster movie that, rather than resolving all the plot points, merely sets the stage for a sequel. Unfortunately, it’s one that most Floridians probably would rather not see. Legislators were forced to go to overtime after failing to agree on a balanced budget during the regular session that ended May 1. The sticking point then was disagreement over how to fund health care for the uninsured. (6/18)

The Wall Street Journal: Medicaid Vs. Cash For The Poor
The study, from MIT’s Amy Finkelstein, Nathaniel Hendren, and Erzo F.P. Luttmer, used data from an Oregon health insurance experiment—in which some low-income citizens received access to Medicaid and some did not, based on the results of a random lottery—to estimate the utility of Medicaid coverage. They found that beneficiaries valued Medicaid at 20 cents to 40 cents on the dollar; in other words, for every $1,000 the states and federal government spent on health coverage, the average beneficiaries felt like they were receiving goods or services valued at $200 to $400. (Chris Jacobs, 6/18)

Bloomberg View: Another Reason To Dismiss So-Called Death Panels
I am often asked whether we could constrain health-care costs by trimming only end-of-life care. After all, the argument goes, so much money is spent on treating people in their last year of life. The problem with this perspective – leaving aside the complicated ethical issues involved – has always been the difficulty of predicting which year will be a person’s last. If you don’t know, what exactly do you change in practice? But now research has revealed something else: The share of health-care spending that goes to end-of-life care is not as large as we’ve thought. Using Medicare survey data, a team of researchers led by Mariacristina De Nardi of the Federal Reserve Bank of Chicago examined health-care spending on Medicare beneficiaries. (Peter R. Orszag, 6/18)

Los Angeles Times: Rules For Medical Pot, Finally?
California lawmakers are, again, getting close to adopting the state's first system to regulate medical marijuana. Even if they're 20 years late and it's difficult to craft laws for a largely lawless industry, legislators must not let another session end without passing a comprehensive bill to license and control medical marijuana. (6/18)

New England Journal of Medicine: No Place To Call Home — Policies To Reduce ED Use In Medicaid
ED waiting rooms impose a substantial time cost on people seeking care, yet more patients visit the ED every year. Burdening patients with a bill if the cause of their visit is retroactively deemed not to have been an emergency will probably prove neither equitable nor effective in directing patients to alternative settings and could lead to unintended consequences if patients avoid care out of fear of economic hardship. Given these ramifications and the ineffectiveness of past attempts to impose costs on Medicaid patients seeking ED care, the Obama administration's decision to approve demonstration projects involving high cost sharing and loss of transportation coverage is troubling. Instead, CMS might encourage state initiatives to develop robust ED alternatives. (Ari B. Friedman, Brendan Saloner and Renee Y. Hsia, 6/18)

JAMA: Sexual Health In America Improving Patient Care And Public Health
Reproductive and sexual health morbidity in the United States continues to far exceed that of other developed nations. ... This morbidity has substantial national economic implications: each year STIs, including HIV infection, cost nearly $16 billion; teen childbearing an estimated $11 billion; and rape and other sexual assaults an estimated $12 billion. ... In 2010, Swartzendruber and Zenilman highlighted the need for change and promoting a shift from the longstanding and stigmatizing focus on morbidity toward a national sexual health–oriented strategy focused on health rather than disease. Five years later there has been little change despite steady accumulation of evidence in favor of shifting from a categorical, stigmatizing morbidity focus to a broadly integrated, health-promoting approach to sexual health. (David Satcher, Edward W. Hook III and Eli Coleman, 6/18)