Viewpoints: Health Law ‘Checkup’; Reid’s Legacy; GOP’s ‘Useful’ Budget; Attempting To Fool Cancer

The Washington Post: A Checkup For Obamacare
Five years after the Affordable Care Act became law, the reality of reform remains hotly contested. ... Here’s my take, after talking to numerous health-care experts and examining the data: Notwithstanding its bumpy rollout, the law has accomplished its goal of expanding coverage — at a significantly lower cost than expected. (Ruth Marcus, 3/28)

The Wall Street Journal: The Achievement That Puts Harry Reid In The History Books
Sen. Harry Reid is the first to admit that he’s not the most eloquent speaker. In fact, he has a habit of speaking his mind, which can be deadly for a lesser politician. But Sen. Reid, who announced Friday that he would not seek re-election to the Senate seat he first won since 1986, did something that no other Senate majority leader could claim: He got comprehensive health-care legislation through the killing field that is the U.S. Senate to the president’s desk for his signature. (Jim Manley, 3/27)

The New York Times: Imaginary Health Care Horrors
There’s a lot of fuzzy math in American politics, but Representative Pete Sessions of Texas, the chairman of the House Rules Committee, recently set a new standard when he declared the cost of Obamacare “unconscionable.” If you do “simple multiplication,” he insisted, you find that the coverage expansion is costing $5 million per recipient. But his calculation was a bit off — namely, by a factor of more than a thousand. The actual cost per newly insured American is about $4,000. (Paul Krugman, 3/30)

Los Angeles Times: Ted Cruz's Ride On The Obamacare Train Wreck
When Sen. Ted Cruz, the conservative firebrand from Texas, launched his presidential campaign last week at the Rev. Jerry Falwell's Liberty University, he earned grudgingly glowing reviews from otherwise skeptical pundits. The very next day he drove straight into a pothole on his already-narrow road to the Republican nomination: Obamacare. ... When it comes to denouncing the evils of the president's health insurance plan, Cruz takes second place to no one. Obamacare is “unconstitutional,” he says. It's “a train wreck.” ... So, last week, when Cruz said he intended to sign his family up for health insurance coverage through Obamacare, the media had a field day. (Doyle McManus, 3/28)

The Wall Street Journal: Congress Does Something Useful
Lightning struck twice on Capitol Hill this week, as House Republicans united long enough to advance incremental conservative reforms. Maybe there’s hope for this GOP majority. Most important, Republicans in the House and Senate passed budget outlines that when reconciled will let them avoid a Senate Democratic filibuster on some reforms later in the year. ... Passing a budget means the GOP is more likely to be able to put a repeal of ObamaCare on Mr. Obama’s desk, framing the issue for 2016. ... The other House victory was a 392-37 vote to put doctor payments under Medicare on a more honest budget path. (3/27)

Los Angeles Times: The GOP's Budget Gimmickry Won't Fix The Deficit
[T]he aging population and rising healthcare costs threaten to cause the deficit to grow again in a few years unless Congress makes fundamental changes to the largest federal health programs, Medicaid and Medicare. The Senate and House resolutions call for spending up to $3.8 trillion in the fiscal year that starts Oct. 1. ... Some of the biggest cuts in that spending come with no plan to achieve them, such as the $1 trillion in savings the House proposal envisions in unspecified entitlements. But the resolutions do call for major changes to Medicaid and, in the House's version, Medicare too, albeit years in the future. Sadly, the changes seek to save money in those programs mainly by shifting risk from the federal government to the states and to beneficiaries, rather than by attacking the core problem of rising healthcare costs and entrenched poverty. (3/27)

The Washington Post: Partners In Budget Posturing
First, we are an aging society. From 2010 to 2030, the 65-and-over population is projected to grow 85 percent, from 40 million to 74 million. Under current policies, spending on the elderly — mainly Social Security, Medicare and long-term care under Medicaid — inexorably rises as a share of national income and the budget. In 2014, these three programs already represented $1.7 trillion of the $3.5 trillion of annual federal spending. Second, paying for aging puts downward pressure on other spending — or upward pressure on deficits and taxes. The military (2014 spending: $596 billion) is being steadily shrunk. As a share of GDP, its spending is projected to drop 25 percent under current policies by 2025. Similar pressures also squeeze many domestic programs, from federal law enforcement to highways. (Robert J. Samuelson, 3/29)

The Wall Street Journal: New York Lessons For Chicago’s Fiscal Blues
I had the privilege of working with New York Gov. Hugh Carey in 1975 to avoid the bankruptcy of New York City, and I am currently assisting the Control Board overseeing the city of Detroit. Throughout these years, I have observed, researched and commented on the growing fiscal stress our cities and states have faced. In Chicago, Detroit and across the U.S., local and state governments have made promises in good faith to their 19 million employees to provide retirement benefits and, in many cases, health-care benefits as well. Many government officials didn’t realize that the cost of these promises would rise faster than the tax revenues that were being generated to cover their operations. (Richard Ravitch, 3/29)

The Kansas City Star: Kansas Ailing In Medicaid Study
Lawmakers in Kansas who have been blocking Medicaid expansion don’t realize it, but they’ve been participating in a medical study. Since 2013, researchers at Quest Diagnostics, the nation’s largest medical testing provider, have tracked patients newly identified with diabetes. Overall, they charted an increase of 1.6 percent in 2014 over 2013. But in states that had expanded Medicaid eligibility to the limits called for in the Affordable Care Act, a dramatic number emerged. New diagnoses of diabetes within the Medicaid population increased by 23 percent. (Barbara Shelly, 3/27)

Concord Monitor: Maintaining Medicaid Expansion Helps State’s Economy, Working Families
Among the more notable features of a state budget recommended by the House Finance Committee is a proposed and ill-advised decision to end New Hampshire’s unique version of Medicaid expansion, called the New Hampshire Health Protection Program. The NHHPP leverages available federal funds to offer private sector health coverage to lower-income, otherwise uninsured New Hampshire residents. ... More than 38,000 New Hampshire residents are already enrolled in the program. We know, and study after study confirms, that health insurance coverage has a beneficial impact on the lives, health, economic security, productivity and success of individuals and families. (Tom Bunnell, 3/29)

Fairbanks News-Miner: Medicaid Expansion, Reform Right For Alaska
Alaska’s hospitals face great risk if our state opts out and thousands of Alaskans may remain without basic coverage. As president of the Greater Fairbanks Community Hospital Foundation, I support the expansion of coverage in this legislative session because it is vital to Alaska hospitals’ collective mission of improving their communities’ health, as well as essential to ensuring the survival of safety net hospitals in our rural areas. Under the ACA, Alaska hospitals anticipated almost 42,000 Alaskans would gain health coverage through Medicaid or the Alaska KidCare program to offset planned federal assistance. These cuts have already begun. (Jeff Cook, 3/29)

The New York Times: Company Thinks It Has Answer For Lower Health Costs: Customer Service
Virginnia Schock seemed headed for a health crisis. She was 64 years old, had poorly controlled diabetes, a wound on her foot and a cast on her broken wrist. She didn’t drive, so getting to the people who could tend to her ailments was complicated and expensive. She had stopped taking her diabetes pills months before and was reluctant to use insulin .... And one day in October, in the offices of Iora Primary Care in Seattle, Dr. Carroll Haymon and Lisa Barrow, a “health coach,” huddled around a speakerphone, talking to her. Ms. Schock had recently become a patient of the practice, and the three discussed her problems — personal, financial, logistical — for nearly 45 minutes. ... That kind of small change can make a big difference in a patient’s health — what good is the perfect drug if the patient can’t swallow it? — but the extra-mile work it took to get there can be a challenge for the typical primary care practice in the United States. (Margot Sanger-Katz, 3/27)

The New York Times: Trying To Fool Cancer
When it airs on Monday, the Ken Burns-produced documentary “Cancer: The Emperor of All Maladies” will emphasize how much more we now know about the genetic basis for cancer. This year, according to President Obama, cancer research and funding will focus on so-called precision, personalized or targeted medicine — using cancer’s molecular underpinnings to develop drugs that attack the genes or gene products that make up cancer’s factory while sparing normal cells. What a beautiful concept. The problem is, cancer is rarely that simple, or that easily fooled. (Mikkael A. Sekeres, 3/28)

The New York Times: Cops With Hearing Aids?
Should police officers be allowed to wear hearing aids? In 2011, two New York City police officers, each with 20 years on the force, were forcibly retired for doing just that. The year before, the N.Y.P.D. had finalized a policy requiring recruits to pass the standard hearing test without hearing aids. Officers who requested hearing aids would also be given the test. If they couldn’t pass it without the aids, they were off the force. Before that, any existing policy (if there was one, which is unclear) was not enforced. When the issue is public safety, we understandably want the standards to be very high. But most people don’t understand hearing loss, and they don’t understand hearing aids. The N.Y.P.D. didn’t. (Katherine Bouton, 3/27)

The New York Times: Pregnant, Obese ... And In Danger
One recent night on my delivery shift, eight out of 10 of my laboring patients were too heavy, with two weighing over 300 pounds. Over two-thirds of adults and about one-third of children in America now are overweight or obese. An obese pregnant woman is more likely to have a very large baby, weighing roughly nine pounds or more. And babies of obese mothers are more likely to grow up to become overweight or obese themselves. Maternal obesity causes more immediate problems as well. (Claire A. Putnam, 3/28)

The Washington Post: A Visit That Makes A Difference
That memory [of a child being abused] from my early days in law enforcement would be bad enough if it had been a single occurrence. Unfortunately it has been replicated again and again. And it’s on my mind as I await details of a bill in Congress that could significantly reduce child abuse and neglect and crime in the coming years. Known as the Medicare “doc fix” bill, the legislation was overwhelmingly approved by the House and is expected to be taken up by the Senate when it returns in April. As written, it will extend funding for the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program. (J. Thomas Manger, 3/27)

Los Angeles Times: Supreme Court Ruling Puts State Regulatory Boards In Crosshairs
These are just two of countless ways that members of a business or occupation can close the doors to others by using their authority on a state regulatory board. This smacks of "restraint of trade," a fundamental no-no in antitrust law. Until a few weeks ago, such state regulatory boards thought they had an exemption from the law. The U.S. Supreme Court has now set them straight, ruling 6-3 on Feb. 25 that if a "controlling number" of a board's members are active participants in the business it regulates, they could be sued as antitrust violators. The case involved North Carolina's board of dental examiners, but its nationwide impact could be immense. ... Hanging in the balance is the state's ability to regulate not only barbers and pet groomers, but also doctors and surgeons, nurses, chiropractors, optometrists, accountants, architects, lawyers, pest exterminators and security alarm installers. (Michael Hiltzik, 3/27)